OBJECTIVE: Acupotomy is a modern acupuncture method that includes modern surgical methods. Since acupotomy is relatively more invasive than filiform acupuncture treatment, it is important to establish the safety profile of this practice. To justify further large-scale prospective observational studies, this preliminary study was performed to assess the feasibility of the approach and investigate the safety profile and factors potentially associated with adverse events (AEs). METHODS: This was a prospective pilot study that assessed the feasibility of a large-scale forthcoming safety study on acupotomy treatment in a real-world setting. The feasibility (call response rate, drop-out rate, response rate for each variable and recruitment per month) and safety profile (incidence, type, severity and causality of AEs, and factors potentially associated with AEs) were measured. RESULTS: A total of 28 participants joined the study from January to May 2018. A follow-up assessment was achieved in 258 (1185 treatment points) out of 261 sessions (1214 treatment points). The response rate via telephone on the day after treatment was 87.3%. There were 8 systemic AEs in all the sessions (8/258; 3.11%) and 27 local AEs on the total points treated (27/1185; 2.28%). Severe AEs did not occur. Total AE and local AE occurrence were associated with blade width and the number of needle stimulations per treatment point. CONCLUSION: The findings suggest that it could be feasible to analyze the safety of acupotomy in a real-world setting. Moreover, the primary data on some relevant AEs could be determined. We are planning large-scale prospective studies based on these findings. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0002849 (https://cris.nih.go.kr/cris/search/detailSearch.do/11487).
Humans ; Feasibility Studies ; Prospective Studies ; Pilot Projects ; Acupuncture Therapy/methods* ; Research Design ; Treatment Outcome

OBJECTIVES: To survey the awareness of patient to scrub typhus to provide data for education and communication concerning scrub typhus. METHODS: Patients with scrub typhus (case group, n=299) and people without scrub typhus within the previous 2 years (control group, n=598) were matched for age (within 5 years), gender, and occupation (farmer or non-farmer). The participants were recruited from 15 study areas between October and December 2006. RESULTS: The awareness rate of scrub typhus was 75.1%, and was significantly higher than in the case group (79.4% vs. 66.6%, respectively; p<0.01). The major routes of awareness were from 'past history of scrub typhus in family members or neighbors' (54.9%), 'television' (28.3%), and their past history of scrub typhus (5.5%). The average correct rate of scrub typhus was 48.4%, and the correct response rate of cases was significantly higher than controls (p<0.01). Especially, the correct rate of etiology, incubation period, route of transmission, and acquired immunity was <40%. Through conditional logistic regression test, the factor significantly associated with awareness in case group was age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.98). And the factors associated with awareness in control group were female (OR, 1.56; 95% CI, 1.03-2.36) age (OR, 0.98; 95% CI, 0.96-0.99), family history of scrub typhus (OR, 10.18; 95% CI, 1.37-75.99), history of receiving prevention education (OR, 8.47; 95% CI, 1.14-63.00). CONCLUSIONS: The rate of awareness was relatively low in study population. Thus, effective working guidelines and educational program to prevent scrub typhus must be developed, and publicity activities about the prevention of scrub typhus are needed for high-risk groups.
Adaptive Immunity ; Female ; Humans ; Korea ; Logistic Models ; Occupations ; Scrub Typhus

PURPOSE: We determined the rate of an occult contralateral inguinal hernia by conducting only a physical examination for the unilateral inguinal hernia patients who visited our hospital. METHODS: One hundred thirty nine patients were prospectively evaluated between September 2009 and October 2010. We divided the patients into 3 groups according to a physical examination of the contralateral inguinal area: Group A (no abnormality), Group B (suspicious) and Group C (definite). We defined Group B and Group C as possible occult bilateral hernia. In Group B, selective diagnostic laparoscopy was performed after the totally extraperitoneal herniorrhaphy was finishedover. We analyzed the rate of detecting a contralateral hernia, the positive predictive value and the accordance rate. RESULTS: Of the 139 patients, the number of patients in Group A, B and C were 113 cases, 4 cases and 22 cases, respectively. The age of the patients ranged from 18~86 years (mean age: 57.1), with a male to female ratio was 7:1. Twenty-six patients (18.7%) had possible occult bilateral hernia. For the left inguinal hernia patients, the incidence of contralateral hernia was 18.2% (12/66). For the right inguinal hernia patients, this was 19.2% (14/73). The detection rate of contralateral hernia by physical examination was 14.1% (19/135) and the positive predictive value was 86.4% (19/22). The accordance rate of simultaneous bilateral hernia was 57.9% for the direct hernia patients and it was 26.3% for the indirect patients. There was no recurrence or metachronous contralateral inguinal hernia occurrence. CONCLUSION: We can discover occult contralateral inguinal hernia by conducting a careful physical examination of the contralateral inguinal area. Conducting a proper physical examination is very important for detecting inguinal hernia.
Female ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Incidence ; Laparoscopy ; Male ; Physical Examination ; Prospective Studies ; Recurrence

Gastrinoma is the most frequent functional pancreaticoduodenal endocrine tumor in patients with multiple endocrine neoplasia type 1 (MEN 1). Primary hepatic gastrinomas in MEN 1 are very rare, with no previous reports published in the literature. We reported the case of a 39 yr old female patient with a history of repeated peptic ulcers and a hypoglycemia episode. Abdominal CT indicated a well-defined liver mass and a pancreatic head mass. Somatostatin-receptor scintigraphy with [111In] DTPA octeotride demonstrated a strong uptake of the radiotracer in the left lateral segment at the site of the hepatic mass. After operation, immunohistochemical staining was consistent with pancreatic insulinoma and primary hepatic gastrinoma. As the liver is a common site of metastases from gastrinoma, primary liver gastrinoma has not yet been reported with MEN 1. We diagnosed this patient using immunohistochemical studies and treated this patient by hepatic segmentectomy.

OBJECTIVE: To investigate the expression of cytokines and growth factors in disc specimens obtained from small numbers of patients with herniated nucleus pulposus (HNP) and degenerated disc disease (DDD). METHOD: A total of ten human intervertebral disc samples consisted of five painful degenerative discs and five herniated intervertebal discs were obtained from surgery. MRI and Western blot analyses on these disc samples were performed to determine the levels of disc degeneration and the expression levels of cytokines and growth factors. RESULTS: The levels of IL-6 were significantly greater in the DDD patients than in the HNP patients, but no statistical differences were observed in the expression of IL-1beta, IL-8 and TNF-alpha between the HNP and DDD patients. In addition, the expression of TGF beta was significantly higher in the DDD patients than in the HNP patients. CONCLUSION: The higher levels of cytokine and growth factor expression in the DDD than in the HNP show why discogenic patients usually have more severe back pain than patients with herniated discs.
Back Pain ; Blotting, Western ; Cytokines ; Dichlorodiphenyldichloroethane ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-6 ; Interleukin-8 ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Tumor Necrosis Factor-alpha

OBJECTIVE: This study was conducted to investigate the hygienic state and awareness of drink vending machines in a city. METHODS: Twelve of the most frequently used vending machines in various areas were selected in October 2008. As soon as fresh samples of milk coffee and adlay tea were collected in sterile containers from each machine, the temperature was measured. The samples were carried on ice to the laboratory to test total plate counts and Escherichia coli contamination. College students were inquired about drink vending machine hygiene by implementing self-developed questionnaires. RESULTS: The temperature of 6 milk coffee samples (50.0%) and 8 adlay tea samples (66.7%) turned out to be inadequate. The total plate counts of milk coffee samples were all adequate, although 9 adlay tea samples (75.0%) were inadequate. All the beverage samples were negative for E. coli. In questionnaires obtained from 74 users of coffee vending machines, only 2 (2.7%) expected the hygienic state of vending machines to be good. There were 27 people (33.3%) that knew the existence of hygiene-related laws for vending machines. CONCLUSIONS: This study reveals that the hygienic state of drink vending machines insufficiently reaches the standard for the hot beverage and that most people are not aware of importance of vending machine hygiene. It is necessary to make improvement in the hygiene of vending machines and public awareness in this city.
Beverages ; Coffee ; Escherichia coli ; Humans ; Hygiene ; Ice ; Jurisprudence ; Milk ; Tea ; Surveys and Questionnaires

PURPOSE: In May 2008, a diarrhea outbreak occurred among students of in a girls' high school (S school) in Sangju-si, Korea. An epidemiological investigation was carried out to clarify the cause and transmission route of the outbreak. METHODS: S school has been providing meals directly since July 2007. We conducted a questionnaire survey among 591 persons, and examined 283 rectal swabs and 98 environmental specimens. The patient case was defined as a member of S school who had diarrhea more than one time in a day, accompanied with one or more symptoms among abdominal pain or tenesmus from May 19th to May 26th 2008. RESULTS: The attack rate was 24.0%. Bacillus cereus were cultured from three of the rectal swabs and five of the preserved foods. It was suspicious that contamination was possible in seasoning vegetables, and we found some foods were seasoned with spices after being cooled by moving cooler for about 20 minutes. Enterotoxin positive B. cereus were cultured from two foods cooled by moving cooler. Enterotoxin negative B. cereus were cultured from two environmental specimens of the moving cooler. CONCLUSIONS: We presumed the cause of the diarrhea outbreak in S school was food poisoning by B. cereus. Because enterotoxin positive B. cereus were cultured from rectal swabs and foods, and the symptoms were corresponded. We estimated the outbreak was occurred by this process that B. cereus in the moving cooler contaminated foods during cooling and then rapidly proliferated.
Abdominal Pain ; Bacillus ; Bacillus cereus ; Diarrhea ; Disease Outbreaks ; Enterotoxins ; Food, Preserved ; Foodborne Diseases ; Humans ; Korea ; Meals ; Seasons ; Spices ; Vegetables ; Surveys and Questionnaires

PURPOSE: Malignant melanoma is a fatal tumor arising in the melanocytic systems of the skin. The incidence of malignant melanoma, formerly considered a rare tumor in Korea, is observed to increase. The aim of this study is to analyze the clinical and histopathological pattern of malignant melanoma in one institute. METHODS: Thirty patients with ages ranging from 33 to 80 years, diagnosed as malignant melanoma at our skin tumor department, were enrolled in a retrospective study over a 6 year period(2000. 9-2006. 7). The analyzed data included age, sex, location, duration before diagnosis, clinical type, level of invasion, and stage. RESULTS: The cases were identified and analyzed by clinical and histopathologic study. The male to female ratio was 1:1.7. Lower extremities(especially, feet) were favored sites. The majority of cases were acral lentiginous melanoma(40%), followed by nodular melanoma (36.7%), superficial spreading melanoma(20%) in this study. Clark level IV was predominant in histopathologic study. There was merely narrow gap among each stage by AJCC. CONCLUSION: The clinicopathological characteristic of melanoma in our patients is quite different with that in the West. In this retrospective study, primary lesions of the foot were predominant with melanoma, and a high percentage of these were classified pathologically as acral lentiginous melanomas. Patients had a more advanced stage of disease at first presentation and a more deeply invasive primary lesion than Western patients. These suggest that malignant melanoma has a worse prognosis in our patients than in the West. So, further organized prospective studies are needed to approach the prudent and accurate diagnosis and management of melanoma in Korea.
Diagnosis ; Female ; Foot ; Humans ; Incidence ; Korea ; Male ; Melanoma* ; Prognosis ; Retrospective Studies ; Skin

PURPOSE: Arteriovenous fistula is one of high flow vascular malformations. Recently, arteriovenous fistula has been regarded as one of the type of arteriovenous malformations. The patients were diagnosed as arteriovenous malformation Schobinger clinical stage II. Even though arteriovenous fistula rarely occurs on head and neck, treatment of that is difficult due to frequent recurrence. In treating the arteriovenous fistula, chemical embolization, surgical excision and other treatment modalities were used, but the results were not satisfactory. The authors experienced three cases of arteriovenous fistula and treated them with surgical excision. METHODS: In cases, warmth, enlargement, pulsation, thrill, and bruit were found. For the accurate evaluation before the operation, angiography and MRI were checked in advance. Incision was made on the site of pulsation. The artery and vein connected to the arteriovenous fistula were dissected widely, individually ligated, and divided. And then the entire mass was totally removed. RESULTS: All surgical sites were healed well without complications and there was no evidence of recurrence in all cases up to for 2 years of follow-up examination. CONCLUSION: The arteriovenous fistula on face is a very rare disease and has difficulties in treatment. The authors experienced three cases of arteriovenous fistula with complete surgical removal and no recurrence was found in all cases.
Angiography ; Arteries ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Follow-Up Studies ; Head ; Humans ; Magnetic Resonance Imaging ; Neck ; Rare Diseases ; Recurrence ; Vascular Malformations ; Veins

PURPOSE: To understand the pathogenesis of the disease that presents abnormally proliferated vascular endothelial cells, a model of DMH(1,2-dimethylhydrazine)-induced abnormal proliferation of HUVECs(Human Umbilical Vein Endothelial Cells) was made. We indirectly determined that Protein Kinase C(PKC) restricts the cellular proliferation and inhibits the manifestation of growth factor by using several inhibiting substances of the transmitter through our previous studies. Thereupon, we attempted to observe direct enzymatic activities of PKC and its correlation with the abnormal proliferation of vascular endothelial cells. METHODS: 10(5) HUVECs cells were applied to 6 individual well plates in three different groups; A control group cultured without treatment, a group concentrated with 0.75x10(-8)M DMH only, and a group treated with DMH & 5x10(-9)M Calphostin C, inhibitor of PKC. In analyzing the formation of intracellular PKC enzyme, protein separation was performed, and separated protein was quantitatively measured. PKC enzyme reaction was analyzed through Protein Kinase C Assay System (Promega, USA), and the results were analyzed according to Beer's law. RESULTS: Enzymatic activity of PKC presented the highest in all reaction time of a group concentrated only with DMH, and the lowest in the control group. The group treated with DMH and the inhibitor revealed statistically lower enzymatic activity than group only with DMH in all reaction time, although higher than the control group. CONCLUSION: From the enzymatic aspect, most active and immediate reaction of the PKC was observed in the group concentrated with DMH only. The group treated with DMH & PKC inhibitor showed meaningful decrease. Accordingly, PKC holds a significant role in DMH-induced abnormal proliferation of vascular endothelial cells.
Cell Proliferation ; Dimenhydrinate ; Endothelial Cells* ; Jurisprudence ; Protein Kinase C* ; Protein Kinases* ; Reaction Time ; Umbilical Veins