PURPOSE: There has been a number of reports on elution of bisphenol-A, an endocrine disrupting chemical, from milk bottles, all concerning the potential health effect of the substance. In this study, we measured the elution of bisphenol-A from milk bottles during boiling-water sterilization, to suggest a safe sterilization method. METHOD: Through the survey of 200 mothers, 78.5% of them expressed their concern on the possible harmful effect of bisphenol-A, which might be eluted from the bottles. And it was found that most mothers use boiling-water to sterilize bottles; duration of boiling bottles could be divided into three groups of 3, 5, and 10 minutes. We measured the elution of bisphenol- A from three different brands of bottles, subject to various mode of sterilization found in the survey. RESULT: In all the measurements, the concentration of the eluted bisphenol-A was in the range of 0.3 - 0.7 ppb, far below 2.5ppm, the level set up by Korea Food & Drug Administration(KFDA) for a potential harmful effect. CONCLUSION: Although trace amount of bisphenol -A can be eluted from polycarbonate milk bottles during sterilization, and bottle feeding, the amount is found to be too small to cause any health related impact for infants.
Bottle Feeding ; Disinfection* ; Humans ; Infant ; Korea ; Milk ; Mothers ; Sterilization ; Child Health

PURPOSE: This study has a purpose to suggest research and intervention directions for health promoting behaviors (HPB) of the Korean middle-aged in the future. METHODS: Forty four articles on HPB of the Korean middle-aged were reviewed and analyzed. The articles analyzed are theses written for a doctoral or master's degree and published between 1995 and 2007. RESULTS: 1. As for the major characteristics of the subject groups, most of them were between 40 and 60 years old (61.4%), were females (79.5%), and resided in cities (84.1%). 2. The dependent variables adopted were physiological, psychological and cognitive factors (self-efficacy, knowledge of health management, etc.), HPB and factors related to Health Promoting Lifestyle Profile (HPLP). 3. The average scores of HPLP were 1.57~3.08 on a 4-point scale. The highest score was observed in self-actualization, and the lowest score in exercise. 4. Self-efficacy, perceived health status and income had significant correlations with HPB. 5. In regression analysis, self-efficacy, self-esteem and perceived health status were the most powerful predictors. CONCLUSION: It is necessary to develop intervention tools for more diverse HPB of the Korean middle-aged. The interventions are recommended to focus on increasing exercise and to use strategies for improving self-efficacy and self-esteem.
Female ; Health Promotion* ; Humans ; Life Style

A 41-year-old female was admitted to our hospital for self-audible wheezing sound and dyspnea. On past history, she has been suffered from chest discomfort, and treated recurrently by other hospitals. But, there was no symptomatic improvement. A stridor and mixed wheezing sound was auscultated on whole lung field. PFT revealed fixed type or variable intra- & extra-thoracic air way obstructive pattern. By bronchoscopy & bronchogram, we found web-like structure on the distal trachea. A bronchoplasty was performed and the post-operative PFT showed slight improvement & she had no more complaints.
Adult ; Bronchoscopy ; Dyspnea ; Female ; Humans ; Lung ; Respiratory Sounds ; Thorax ; Trachea ; Tracheal Stenosis*

Surgical resection is mainstay treatment of hepatocellular carcinoma (HCC). However, its prognosis is poor, because of the high incidence of HCC recurrence (cumulative 5-year HCC recurrence rate of 70-80%). The most common site of HCC recurrence is the remnant liver, and extrahepatic recurrence occurs in 6.7-13.5% of patients. Because the tumor characteristics in extrahepatic recurrence are usually multiple and aggressive, the optimal treatment modality has not yet been determined. We report a case of complete remission and long term survival over 60 months in patient with extrahepatic metastasis after curative resection of HCC by aggressive treatment, which include lung resection for lung metastasis, radiotherapy for mediastinal lymph node metastasis, and systemic chemotherapy.
Carcinoma, Hepatocellular* ; Drug Therapy* ; Humans ; Incidence ; Liver ; Lung* ; Lymph Nodes ; Metastasectomy ; Neoplasm Metastasis* ; Prognosis ; Radiotherapy* ; Recurrence

BACKGROUND: Although fever is one of the most common and challenging problem in intensive care medicine(ICU), it is difficult to distinguish between infectious and non-infectious causes. Procalcitonin(PCT) has recently been reported to be an indicator of various infectious diseases. This study examined whether or not measuring the serum PCT level in patients with fever in the ICU can help distinguish fevers with infectious causes from those with non-infectious causes. METHODS: ICU patients with fever at 38degrees C or over from March to August 2005 were prospectively enrolled. The cause of the fever was identified by the culture results and clinical course. The leukocytes, CRP, PCT, IL-6, and TNF-alpha in the fever patients with infectious and non-infectious causes were compared, and the PCT level in the patients with fever in the ICU were compared with those without fever. RESULTS: 1) 42 patients were enrolled and 46 cases of fever were analyzed. 26 cases were considered to be infectious, while 13 cases were considered to be non-infectious. 7 cases were found to have no clear causes. 2) There were no significant differences in the degree of fever, leukocytes count, CRP, IL-6, and TNF-alpha levels in the patiemts with infectious and non-infectious causes. 3) The serum PCT level was higher in those with infectious causes than in those with non-infectious causes (15.1+/-32.57ng/mL vs 2 .68+/-3.63ng/mL) but there was no statistical significance (p=0.06). 4) The serum PCT level of the ICU patients with fever was significantly higher than in those without fever (10.94+/- 27.15ng/mL vs 0.45+/-0.49ng/mL) (p=0.02). CONCLUSION: The serum PCT cannot be used to distinguish the fever in ICU patients with infectious causes from that with non-infectious causes.
Communicable Diseases ; Fever* ; Humans ; Critical Care ; Interleukin-6 ; Leukocytes ; Prospective Studies ; Tumor Necrosis Factor-alpha

BACKGROUND: This study is to evaluate the effect of systemic corticosteroid on the clinical outcomes and the occurrence of complications in mechanical ventilated patients with severe community-acquired pneumonia (CAP). METHODS: We retrospectively assessed the clinical outcomes and complications in patients with severe CAP admitted to ICU between March 1, 2003 and July 28, 2009. Outcomes were measured by hospital mortality after ICU admission, duration of mechanical ventilation (MV), ICU, and hospital stay. Complications such as ventilator associated pneumonia (VAP), catheter related-blood stream infection (CR-BSI), and upper gastrointestinal (UGI) bleeding during ICU stay were assessed. RESULTS: Of the 93 patients, 36 patients received corticosteroids over 7 days while 57 patients did not receive corticosteroids. Age, underlying disease, APACHE II, PSI score, and use of vasopressor were not different between two groups. In-hospital mortality was 30.5% in the steroid group and 36.8% in the non-steroid group (p>0.05). The major complications such as VAP, CR-BSI and UGI bleeding was significantly higher in the steroid group than in the non-steroid group (19.4% vs. 7%, p<0.05). The use of steroids and the duration of ICU stay were significantly associated with the development of major complications during ones ICU stay (p<0.05). CONCLUSION: Systemic corticosteroid in patients with severe CAP requiring mechanical ventilation may have no beneficial effect on clinical outcomes like duration of ICU stay and in-hospital mortality but may contribute to the development of ICU acquired complications.
Adrenal Cortex Hormones ; APACHE ; Catheters ; Hemorrhage ; Hospital Mortality ; Humans ; Length of Stay ; Pneumonia ; Pneumonia, Ventilator-Associated ; Respiration, Artificial ; Retrospective Studies ; Rivers ; Steroids

BACKGROUND: Osteopontin (Opn) is recognized as an important adhesive bone matrix protein and a key cytokine involved in immune cell recruitment and tissue repair and remolding. However, serum levels of osteopontin have not been evaluated in patients with chronic obstructive pulmonary disease (COPD). Thus, the aim of this study was to evaluate and compare the serum levels of osteopontin in patients experiencing COPD exacerbations and in patients with stable COPD. METHODS: Serum samples were obtained from 22 healthy control subjects, 18 stable COPD patients, and 15 COPD with exacerbation patients. Serum concentrations of osteopontin were measured by the ELISA method. RESULTS: Serum levels of osteopontin were higher in patients with acute exacerbation than with stable COPD and in healthy control subjects (62.4+/-51.9 ng/mL, 36.9+/-11.1 ng/mL, 30+/-11 ng/mL, test for trend p=0.003). In the patients with COPD exacerbation, the osteopontin levels when the patient was discharged from the hospital tended to decrease compared to those at admission (45+/-52.1 ng/mL, 62.4+/-51.9 ng/mL, p=0.160). Osteopontin levels significantly increased according to patient factors, including never-smoker, ex-smoker and current smoker (23+/-5.7 ng/mL, 35.5+/-17.6 ng/mL, 58.6+/-47.8 ng/mL, test for trend p=0.006). Also, osteopontin levels showed a significantly negative correlation with forced expiratory volume in one second (FEV1%) predicted in healthy controls and stable COPD patients (r=-0.389; p=0.013). C-reactive protein (CRP) was positively correlated with osteopontin levels in patients with COPD exacerbation (r=0.775; p=0.002). CONCLUSION: The serum levels of osteopontin increased in patients with COPD exacerbation and tended to decrease after clinical improvement. These results suggest the possible role of osteopontin as a biomarker of acute exacerbation of COPD.
Adhesives ; Biomarkers ; Bone Matrix ; C-Reactive Protein ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Forced Expiratory Volume ; Humans ; Osteopontin ; Pulmonary Disease, Chronic Obstructive

BACKGROUND: Right middle lobe syndrome (RMLS) is defined as transient or chronic and recurrent atelectasis of the right middle lobe. Although numerous conditions are associated with RMLS, there are very few recent reports in Korea. This study evaluated the causes of RMLS in a local tertiary hospitalover a period of 42 months. METHOD: Eighty-eight patients (M:F=64:22, mean age: 67.2+/-10.3 years), who had consistent chest radiography findings and underwent bronchoscopy in Gyeongsang University Hospital from January 2003 to July 2006, were enrolled in this study. The clinical characteristics and causes of RMLS in these patients were retrospectively reviewed. RESULTS: The most common symptoms fo RMLS were cough, dyspnea and sputum. Tuberculosis was the most common cause (endobronchial tuberculosis in 22 and pulmonary tuberculosis in 1) The other causes were bronchial stenosis by benign fibrotic changes in 22 cases (25%), anthracofibrosis in 13 cases (14.8%), pneumonia in 11 cases (12.5%), lung cancer in 10 cases (11.4%), mucus impaction in 3 cases (3.4%), bronchiectasis in 2 cases (2.3%) and no demonstrable causes in 7 cases (8%). The bronchoscopy findings were mucosal edema with hyperemic changes in 38 cases (43.2%), mucosal edema with anthracotic pigmentation in 16 cases (18.2%), mucus impaction in 13 cases (14.8%), fibrotic stenosis in 13 cases (14.8%), a mass like lesion in 8 cases (9.1%), exudative necrotic material in 4 cases (4.5%), narrowing as a result of extrinsic compression in 2 cases (2.3%) and no demonstrable abnormalities in 12 cases (13.6%). CONCLUSION: Right middle lobe syndrome was observed more frequently in patients over the age of 65. The causes were mainly benign diseases with endobronchial tuberculosis being the most common.
Bronchiectasis ; Bronchoscopy ; Constriction, Pathologic ; Cough ; Dyspnea ; Edema ; Humans ; Korea ; Lung Neoplasms ; Middle Lobe Syndrome* ; Mucus ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Radiography ; Retrospective Studies ; Sputum ; Tertiary Care Centers* ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

OBJECTIVE: To investigate the efficacy and safety of oral bovine type II collagen (C II) in the treatment of rheumatoid arthritis (RA). METHODS: Forty-five patients with active RA were enrolled and randomized to receive placebo or oral C II for 3 months. Efficacy parameters were assessed monthly. Cumulative response rates (percentages of patients meeting the criteria for response at anytime during the study) were analyzed utilizing 3 set of composite criteria : Paulus criteria, ACR criteria for improvement in RA, and a requirement for > or = 30% reduction in both swollen and tender joint counts. RESULTS: The C II-treated group (n=25) showed significant higher response rate by the Paulus criteria compared to placebo group (n=20, p=0.04), and MHAQ scores between baseline and 3 months of treatment were also significantly decreased in the C II-treated group (p<0.05). However, there were no significant differences in tender and swollen joint count, and physician and patient global scores between C II-treated and placebo groups. Only one patient treated with C II had a urticaria 1 week after administration, but no serious side effects were found in the two groups. Patients treated with C II (n=15) showed the decreased levels of circulating IgG antibodies to bovine C II 3 months after treatment (p=0.02), whereas significant changes of IgG antibodies to C II were not found in placebo group (n=12). CONCLUSION: Oral administration of C II was safe and effective for the treatment of rheumatoid arthritis. The finding that serum IgG antibodies to bovine C II was decreased in patients who treated with C II suggest that autoimmune response to C II could be decreased by repetitive administration of C II.
Administration, Oral ; Antibodies ; Arthritis, Rheumatoid* ; Autoimmunity ; Collagen Type II* ; Humans ; Immunoglobulin G ; Joints ; Urticaria

The recent increase in the number of cases of indigenous hepatitis E virus (HEV) infection highlights the importance of identifying the transmission routes for the prevention of such infections. Presented herein is the first case of acute HEV infection after ingesting wild roe deer meat in South Korea. A 43-year-old male presented with abdominal discomfort and jaundice. He had not recently traveled abroad, but had eaten raw roe-deer meat 6-8 weeks before the presentation. On the 7th day of hospitalization the patient was diagnosed with acute viral hepatitis E. Phylogenetic analysis of his serum revealed genotype-4 HEV. This case supports the possibility of zoonotic transmission of HEV because the patient appears to have been infected with genotype-4 HEV after ingesting raw deer meat.
Adult ; Alanine Transaminase/blood ; Animals ; Bilirubin/blood ; Deer/virology ; Genotype ; Hepatitis E/*diagnosis/transmission/virology ; Hepatitis E virus/classification/*genetics/isolation & purification ; Humans ; Male ; Phylogeny ; RNA, Viral/analysis ; Republic of Korea ; Travel