Cancer has become a major cause of death in Korea since 1989. Despite the major advances in the treatment of cancer, prevention and early detection is the most effective strategy to decrease the mortality from cancer. The indicence of invasive cervical cancer has declined since the 1950s, and indirect evidence suggests that this decline is the result of the institution of screening with cervical smear. However, cervical cancer continues to be a major health problem in the developing world today, where screening is not universal. Among Korean women, the incidence of cervical cancer is still high and was the 3rd most common cancer following stomach and breast cancer in 2000. If preinvasive conditions would be included, the disease would be the most frequent. The first organized screening programmes were initiated in 1949 at British Columbia, Canada. Since then, cervical cancer screening programmes have been implemented in almost all developed countries. In Korea, opportunistic screening began in the late 1950s, and organized screening began in 1998 by Health Insurance without a consensus meeting. The guidelines for the screening of cervical cancer were developed by National Cancer Center and the Koean Society of Obstetrics and Gynecology in May, 2001 ; and the national screening programmes were developed by the Supporting Evaluation Board of National Cancer Screening Program in December, 2001. This article introduces these programmes.
Breast Neoplasms ; British Columbia ; Canada ; Cause of Death ; Consensus ; Developed Countries ; Early Detection of Cancer ; Female ; Gynecology ; Humans ; Incidence ; Insurance, Health ; Korea ; Mass Screening* ; Mortality ; Obstetrics ; Papanicolaou Test ; Stomach ; Uterine Cervical Neoplasms* ; Vaginal Smears

This study was aimed at evaluating the nutritional status of Korean lactating women, who were attending peripheral community clinics in low-income areas, by anthropometric measurement, estimating dietary intakes and analyzing the contents of breast milk components, serum lipid content and fatty acid composition. Regarding anghropometric measurements, maternal circumferences decreased significantly at the trunk but not at the limbs. The skinfold thickness on all regions had the tendency to decrease during lactation. It was found that intakes of energy, protein, lipid and carbohydrates were desirable while calcium, zinc, copper and vitamin A were low and sodium was excessive. The energy % of fat was 22.41% of the total energy which is higher than the RDA for adults but it is proper for lactating women, but energy % from each fatty acid was usually low and an intake ratio of omega6/omega3 fatty acids was desirable. Accordingly, it is thought that dietary fat intake was balanced in quality. Concentrations of the nutrients in matured human milk showed the same range as that reported form different regions with the exception of calcium and magnesium which were relatively low. Serum lipid contents were decreased with the time postpartum and the average serum lipid content of lactating women were similar to the normal range of adults. Serum polyunsaturated fatty acids. especially omega6 fatty acids have gradually increased with the time postpartum, but the composition were not greatly influenced by dietary intakes.
Adult ; Breast* ; Calcium ; Carbohydrates ; Copper ; Dietary Fats ; Extremities ; Fatty Acids ; Fatty Acids, Unsaturated ; Female ; Humans ; Lactation ; Magnesium ; Milk, Human* ; Nutritional Status ; Postpartum Period ; Reference Values ; Skinfold Thickness ; Sodium ; Vitamin A ; Zinc

We have experienced a case of neurofibromatosis with unusual giant pigmentation, which presents itself as a 28 cm x 40 cm sized, serrated bordered light brownish patch speckled with small dark hyperpigmented macules on his back. Histopathologic examinations of light brown patch and speckles showed only an increase in basal melanin pigmentation.
Melanins ; Neurofibromatoses* ; Pigmentation*

No abstract available.

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the first line treatment for insomnia. However, many patients remain with sleep disturbances even after undergoing CBT-I, and those with short sleep durations have shown fewer gains. Acceptance and commitment therapy (ACT) is one of the third wave of behavioral therapies, and it is useful in helping patients get flexibility of mind. Therefore, we incorporated its components into CBT-I, came up with an advanced CBT-I program that involves cognitive behavior therapy based on ACT, and examined its efficacy in comparison to that of CBT-I. Methods: Patients with chronic primary insomnia were recruited at the memory center of CHA University Hospital from June to August 2020. To examine the efficacy of advanced CBT-I compared to that of CBT-I, the patients (n=16) were assigned to two groups (CBT-I: n=6; advanced CBT-I: n=10). The patients in each group were treated for 4 weeks (8 sessions). The quality of sleep, severity of insomnia, sleepiness, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep were assessed with self-report questionnaires. Results: The severity of insomnia, quality of sleep, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep improved after both CBT-I and advanced CBT-I treatment. Conclusions This study examined the efficacy of advanced CBT-I in improving the severity of insomnia, sleep quality, and other symptoms related to sleep. The results suggest that components of ACT were useful for insomnia.

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the first line treatment for insomnia. However, many patients remain with sleep disturbances even after undergoing CBT-I, and those with short sleep durations have shown fewer gains. Acceptance and commitment therapy (ACT) is one of the third wave of behavioral therapies, and it is useful in helping patients get flexibility of mind. Therefore, we incorporated its components into CBT-I, came up with an advanced CBT-I program that involves cognitive behavior therapy based on ACT, and examined its efficacy in comparison to that of CBT-I. Methods: Patients with chronic primary insomnia were recruited at the memory center of CHA University Hospital from June to August 2020. To examine the efficacy of advanced CBT-I compared to that of CBT-I, the patients (n=16) were assigned to two groups (CBT-I: n=6; advanced CBT-I: n=10). The patients in each group were treated for 4 weeks (8 sessions). The quality of sleep, severity of insomnia, sleepiness, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep were assessed with self-report questionnaires. Results: The severity of insomnia, quality of sleep, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep improved after both CBT-I and advanced CBT-I treatment. Conclusions This study examined the efficacy of advanced CBT-I in improving the severity of insomnia, sleep quality, and other symptoms related to sleep. The results suggest that components of ACT were useful for insomnia.

The serum concentrations of the major minerals(calcium, phosphorus, magnesium, sodium, potassium) and trace elements(iron, Zinc, copper manganese)were datermined in 23 breast fed infants living in Eumsung, Choong-buk region. The results obtained are summarized as follows: 1)The mean levels of calcium, phosphorus, magnesium, sodium and potassium of the serum of total subjects were 8.15+/-0.33mg/dI, 11.06+/-0.16mg/dI, 2.00+/-0.14mg/dI, 3.4476+/-17.99mg/dI and 9.06+/-2.04mg/dI respectively. 2)The serum concentrations of iron, zinc, copper and manganese in total subjects averaged 95.83+/-0.33mg/dI, 93.79+/-7.06 microgram/dI and 98.57+/-7.06 microgram/dI and 4.93+/-0.62 microgram/dI respecitively. 3)Breast fed infants had significantly higher serum calcim, magnesium, sodium and iron concentrations than the formula fed groups. Otherwise, serum potassium, copper and manganese levels in breast milk fed infants were significantly lower than those in formula fed infants. 4) In formula fed infants, serum potassium and copper levels increased increased significantly with months after birth.
Breast ; Calcium ; Copper ; Humans ; Infant* ; Iron ; Magnesium ; Manganese ; Milk, Human ; Minerals* ; Parturition ; Phosphorus ; Potassium ; Sodium ; Trace Elements* ; Zinc