Recently, the proportion of extrapulmonary tuberculosis in patients has increased in Korea. Though intestinal tuberculosis in not infrequent, a duodenal fistula caused by tuberculosis is a rare condition. A 29-year-old man was admitted to the Department of Internal Medicine because of fever and weight loss. The patient was a doctor participating in a resident fellowship. The patient was diagnosed with intra-abdominal tuberculous lymphadenopathy and was given anti-tuberculous medication. One month after the administration of medication, the patient showed symptoms and signs of duodenal obstruction because of marked duodenal wall edema and a deep ulcer on the second portion of the duodenum. A computerized tomogram and duodenography revealed the formation of a fistula at the second portion of the duodenum and the presence of abscess-forming tuberculous lymphadenopathy. The use of continuous anti- tuberculous medication resulted in the improvement of the clinical symptoms, with complete healing of the duodenal fistula and tuberculous lymphadenitis. This case suggests that transient clinical worsening in intra-abdominal tuberculous lymphadenitis may occur during an early period of anti- tuberculous medication.
Adult ; Duodenal Obstruction ; Duodenum ; Edema ; Fellowships and Scholarships ; Fever ; Fistula ; Humans ; Internal Medicine ; Korea ; Lymphatic Diseases ; Tuberculosis ; Tuberculosis, Lymph Node ; Ulcer ; Weight Loss

PURPOSE: Few data exist regarding cardiopulmonary resuscitation (CPR) education status in relationship to characteristics of socio-economic status and health and medical conditions in Korea. The purpose of this study is to describe the characteristics associated with the CPR educated populationand to develop and analyze a simple predictive model of the CPR education status. METHODS: Based on a health survey of Incheon Metropolitan City adults (5,114), differences between a CPR-educated group (n=220) and a CPR non-educated group (n=4,894) were analyzed and a logistic regression analysis of the two groups was performed to evaluate socio-economic status-gender, age, marital status, education level, number of family members, and monthly household income-and health-medical conditions-disease, accidental history, EMS (emergency medical service) experience, and health status. RESULTS: The participation rate in CPR education in Korea is only 4.3% which is vastly lower than in other developed countries, and there are statistically significant differences between the CPR-educated and CPR not-educated in gender (0.000), age (0.000), marital status (0.000), education level (0.000), and diseases (0.003). Similarly, gender (OR: 0.247, 0.000), age (OR: 0.964, 0.000), marital status (OR: 0.463, 0.000), education level (OR: 1.797, 0.000), numbers of family members (OR: 1.231, 0.004), and health status (OR: 0.894, 0.009) are statistically significant predictors of participation in CPR education. CONCLUSION: Monthly household income, accident history, and EMS experience are not statistically significant factors for participation in CPR education in Korea. It may be necessary to determine the optimal fees of CPR education based on social characteristics and economic conditions, Certain subgroups of lay persons such as high-risk patients and family members need targeted outreach programs.
Adult ; Cardiopulmonary Resuscitation* ; Developed Countries ; Education* ; Emergency Medical Services ; Family Characteristics ; Fees and Charges ; Health Surveys ; Humans ; Incheon ; Korea ; Logistic Models ; Marital Status ; Sociology

PURPOSE: Oxidative stress has been implicated in the pathogenesis of various diseases. Catalase is one of the main defense mechanisms against oxidative stress. To examine the possible relationship between oxidative stress, and gastric and hepatocellular carcinomas, HinfI restriction length polymorphism (RFLP) in the human catalase gene was assessed. MATERIALS AND METHODS: The genotype and allele frequencies in the promoter region of the catalase gene were studied by PCR-RFLP in 108 Korean controls, 80 Korean gastric carcinoma (GC) and 106 Korean hepatocellular carcinoma (HCC) patients. RESULTS: No statistically significant differences were found in the genotypic distribution and allelic frequencies between the controls and both types of carcinoma patient. CONCLUSION: To address the possible contribution of oxidative stresses to the pathogenesis of gastric and hepatocellular carcinomas, the associations between the catalase gene polymorphism and GC and HCC susceptibilities were studied. As a result, the catalase gene polymorphism was found not to be determinant of GC and HCC susceptibilities. Further studies are required on various other oxidative stress related genes to elucidate the mechanisms of GC and HCC.
Carcinoma, Hepatocellular* ; Catalase* ; Defense Mechanisms ; Gene Frequency ; Genotype ; Humans ; Oxidative Stress ; Promoter Regions, Genetic