The Incidence of Stroke by Socioeconomic Status, Age, Sex, and Stroke Subtype: A Nationwide Study in Korea / 예방의학회지

OBJECTIVES: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. METHODS: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. RESULTS: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. CONCLUSIONS: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.

A Study on the Relationship Between the Morphologic Change and Surfactant Protein (SP)-A and Surfactant Protein (SP)-D Levels in Intratracheal Bleomycin-Induced Pulmonary Fibrosis in White Rats / 대한주산의학회잡지

OBJECTIVE: Surfactant protein (SP)-A and SP-D are involved in host defense mechanism. The author was prompted to perform a study on morphologic change and SP-A, SP-D level of surfactant after pulmonary injury inflicted by intratracheal bleomycin injection. METHODS: Fifteen white adult rats each weighing 250 g (Sprague-Daw ley) were divided into study (receiving bleomycin, n=9) and control groups (n=6). Study group were given a intratracheal injection of belomycin (5 mg/kg). Two groups were grown for five weeks at twenty five degrees Celsius, after which lung tissue were examined for morphologic change and SP-A and SP-D levels were measured using Western blot assay with densitometer. RESULTS: Before the study, the average weight of the study group was 286.69+/-14.54 g, and control was 286.69+/-14.54 g. Five weeks later, the average weight of the study group was 347.31.31+/-60.53 g and control group 352.71+/-16.84 g. However, no statistical significance was noted. On light microscopy, the control group exhibited normal findings while widening of lung interstitium and fibrotic change coupled with more prominent inflammatory cell infiltration were noted in the study group. The SP-A level were 15.34+/-1.52 ODU/microgram in the study group and 7.70+/-2.81 ODU/microgram in the control. SP-D level were 3.53+/-1.46 ODU/microgram and 7.51+/-2.33 ODU/microgram in the study and control groups respectively, there was a statistical significance (p<0.05). CONCLUSION: The morphologic change after pulmonary fibrosis induced by intratracheal bleomycin injection in white rats can be summarized as chronic inflammatory cell infiltration, fibroblast proliferation, deposition of collagen tissues, and lowering of SP-D level were noted. The increase of SP-A level is subject to further study in the future.

A Case of Metabolic Syndrome in a Child with Normal Weight / 대한소아내분비학회지

The worldwide obesity epidemic is realized during the past few decades. The risk of developing metabolic syndrome increases steeply with increasing obesity. Increasing childhood obesity heralds a greater health burden in adult life. The metabolic syndrome associated with obesity includes insulin resistance, dyslipidemia, hypertension, fatty liver, coronary heart disease and stroke. Excessive fat is a well known risk factor of insulin resistance. Not only the amount of fat, also its pattern of regional distribution is important. Moreover in Asia, there is a demand for a more limited range for normal BMIs because of the high prevalence of obesity related diseases, particularly diabetes and hypertension. Asian populations have a greater percent body fat even at a low BMI and progression in the prevalence of diabetes with increasing BMI is seen. Anthropometric measurement such as height, weight and BMI is not enough to predict the disease risk, body composition analysis should be followed. Here we report a case of metabolic syndrome in a child with weight within normal range with the review of literatures to emphasize the importance body composition analysis.

Translation and Linguistic Validation of Korean Version of the King's Health Questionnaire Instrument / 대한비뇨기과학회지

PURPOSE: With the aim of objectively assessing the symptoms' severity and treatment outcomes of urinary incontinence in the Korean population, the King's Health Questionnaire (KHQ) instrument was translated into Korean, with subsequent linguistic validation. MATERIALS AND METHODS: Between May 2002 and December 2002, two bilinguists independently translated the original English version of the KHQ into written Korean. A panel consisting of the aforementioned translators and three authors (SJO, HGP and SHP) reviewed the translations to form a single reconciled forward translation of the Korean version. Another bilingual translator, who had never seen the original KHQ, translated the draft Korean version of the KHQ back into English and subsequently assessed for equivalence to the original. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients were performed to test the interpretation of the translation. A summary of the changes from the patient interviews were then reflected in the final Korean version. The document was finally proofread to check the spelling, grammar, layout and formatting. RESULTS: The multi-step process of forward translation, reconciliation, back-translation, cognitive debriefing and proofreading of the Korean version of the KHQ was completed. Conclusions: Translation and linguistic validation of the Korean version of the KHQ instrument were completed. Further tests for its psychometric performance will be required.

Translation and Linguistic Validation of Korean Version of the Bristol Female Lower Urinary Tract Symptom Instrument

PURPOSE: With the aim of utilization in objectively assessing the symptom's severity and the treatment outcomes of urinary incontinence in Korean population, we translated the Bristol Female Lower Urinary Tract Symptom (BFLUTS) instrument into Korean which subsequently was linguistically validated. MATERIALS, METHODS AND RESULTS: Between May 2002 and December 2002, two bilinguists independently translated the original English version of BFLUTS into written Korean. A panel consisting of aforementioned translators and three authors reviewed the translations to form a single reconciled forward translation of the Korean version. Another bilingual translator who had never seen the original BFLUTS back-translated the first Korean version into English. The back-translation was subsequently assessed for equivalence to the original. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients to test the interpretation of the translation were made. Summary of the changes from patient interviews were then reflected in the final Korean version. Finally, it was proofread to check spelling, grammar, layout and formatting. CONCLUSION: Translation and linguistic validation of Korean version of BFLUT instrument were completed. Further tests for psychometric performance are needed.

Translation and Linguistic Validation of Korean Version of the Incontinence Quality of Life(I-QoL) Instrument

PURPOSE: Patient-relevant outcomes are increasingly used as complementary evidence of effectiveness in the evaluation of treatment options. With the aim of utilization in objectively assessing the symptom's severity and the treatment outcomes of urinary incontinence in Korean population, we translated the Incontinence Quality of Life(I-QoL) instrument into Korean version which subsequently was linguistically validated. MATERIAL, METHODS AND RESULTS: Our study lasted for a period of about 8 months, between November 2001 and June 2002. Two native Koreans speakers, who were also fluent in English, translated the original U.S. English I-QoL into written Korean independently. A panel consisting of aforementioned translators and three bilingual authors reviewed the translations to form a single reconciled forward translation of the Korean I-QoL. Another translator, who had never seen the original I-QoL, back-translated this first draft to English. The back-translation was assessed for equivalence to the original by the Health Research Associates, Inc. (HRA). Discrepancies between the original U.S.-English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients to test the interpretation of the translation were made. Summary of the changes was set to the HRA and the comments from patient interviews were then reflected in the final Korean version. Comparison of the Korean version of I-QoL with the original I-QoL was made to ensure conceptual equivalence during a meeting with professional translators representing many counties involved. Finally, it was proofread to check spelling, grammar, layout and formatting. CONCLUSION: Linguistic validation of Korean version of incontinence measure I-QoL was completed and was internationally approved. It is now ready to use in Korea and further test for psychometric performance of the Korean I-QoL is need.

A Case of Successful Endoscopic Therapy in Delayed Diagnosed Perforation after Endoscopic Colon Polypectomy / 대한소화기내시경학회지

With the wide use of colonoscopy and development of technology, colon tumors and colon polyps are being found frequently and for the treatment of colon polyp, endoscopic polypectomy is used at present. The most common complications of endoscopic colon polypectomy are hemorrhage and perforation. Colon perforation is an abdominal emergency with high mortality. When colon perforation happens, surgical resection was being used at past. But when colon perforations are resulted from therapeutic colonoscopy, devoid of down stream obstacles with a perfectly prepared colon, and the patient's general condition is satisfactory, colon porforation is successfully treated by conservative measures. But, in delayed diagnosed perforation endoscopic treatment is controversial yet. We report here a case which sustained iatrogenic delayed diagnosed perforation of the sigmoid colon caused by polypectomy that was successfully treated by endoscopic clip therapy.

A Case of Gastric Lipomatosis / 대한소화기내시경학회지

Gastric lipomas are rare benign submucosal tumor, usually solitary, and comprise about 3% of gastric benign tumors. The occurrence of gastric lipomatosis is extremely rare. Although most gastric lipomas are usually detected incidentally, they can cause severe symptoms such as obstruction, invagination, and life-threatening hemorrhage. The diagnosis and differentation from malignant tumors and other submucosal tumors are difficult with conventional diagnostic modalities such as X-ray or endoscopic examination. But endoscopic ultrasonography allows us to visualize the structures underlying the gastrointestinal wall in a noninvasive maneuver, and can contribute to make differential diagnosis and decision of management. The treatment of lipoma is still controversial. We reported a 70-year-old male who had gastric lipomatosis in entire stomach, which could be diagnosed with endoscopic ultrasonography and was proven by endoscopic lumpectomy, pathologically.

Development of New Gene Therapy for Erectile Dysfunction Using Antisense cDNA for Type V Phosphodiesterase Gene / 대한남성과학회지

PURPOSE: We examined the feasibility of gene therapy for erectile dysfunction using cultured human corpus cavernosal smooth muscle cells. MATERIALS AND METHODS: The vector construct was designed to contain a fusion gene of enhanced green fluorescent protein (gfp) and beta-galactosidase (lacZ) which was under control of CMV promoter. Cells within the second passage were transfected with the vector DNA only and vector DNA containing a part of cDNA in an antisense orientation for human type V phosphodiesterase (PDE) gene using lipofection. Reporter gene expressions were investigated by fluorescence microscopy and X-gal staining at 24-hour interval. Effects of gene transfer of type V PDE antisense cDNA were investigated after 48 hours of gene transfection using the RT-PCR for type V PDE gene and measurement of intracellular cGMP level treated by sodium nitroprusside (SNP), NO-donor, of various concentrations. RESULTS: Expressions of gfp and lacZ were observed for upto 72 hours after gene transfection. Results from RT-PCR analysis also confirmed the gene expression at the transcriptional level. Type V PDE mRNA expression was significantly inhibited and magnitude of cGMP increase was significantly enhanced by gene transfer of antisense cDNA for type V PDE gene compared with non-transfectant control cells. CONCLUSIONS: Our results demonstrate that the liposome-mediated gene transfer was shown to be effective in corpus cavernosal smooth muscle cells. Gene transfer of antisense cDNA for type V PDE gene effectively inhibited the expression of type V PDE gene at the transcriptional and translational levels, suggesting that this newly developed gene transfer system may be a potential gene therapy in the treatment of erectile dysfunction.

Significance of Peanut Agglutinin in the Differentiation between Basal Cell Carcinoma and Trichoepithelioma / 대한피부과학회지

Great difficulty may be encountered in the differentiation of basal cell carcinoma from trichoepithelioma snd, in some cases, it may even be irnpossible. Immunohistochemical methods using peanut agglutinin(PNA) which is glycoprotein of non-immune origin selectively binding to galactose-N-acetyl-galactosa-mine are increasingly used in dermatopathology to improve the diagnosis and differential diagnosis. Using PNA, anti-PNA antibody, and peroxidase antiperoxi-dase(PAP) technique, normal skin specimens, basal cell carcinomas, trichoepitheliiomas, and a variety of different skin tumors were studied, and different PNA Ibinding sites between basal cell carcinomas and trichoepitheliomas were observed. The results were as follows : l. In normal skin, except the basement membrane, epidermis and hair follicle epithelium showed a cell membrane staining of PNA, which stained weakly in the Ibssal cell layer. Sebaceous glands revealed membranous and cytoplasmic staining of PNA, but sweat ducts and duct coi1s were mostly negative. 2. 34 of 36(94.4%) basal cell carcinoma sections demonstrated peritumorous PNA-positive bands, and none of 5 trichoepithelioma sections showed peritumorous PNA-binding. 3. Peritumorous PNA-positive bands were strongly positive in solid and keratotic basal cell carcinomas, but decreased or absent in the vicinity of the ulceration or the dense inflammatory infiltration. 4. None of the other skin tumors(squamous cell carcinoms, keratoscanthoma, Bowens disesse and actinic keratosis} showed a periturnorous PNA-positive band. Therefore, we believe that the PNA staining on paraffin-embedded sections using PAP technique can be a useful probe for the differentiation of basal cell carcinoma from trichoepithelioma.

A Case of Generalized Granuloma Annulare / 대한피부과학회지

We experienced a case of generalized granuloma annular e in a 68-year-old man. Many factors have been implicated in the genesis of this disease, but in this case no etiologic factors were identified. He was treated successfully with systemic corticosteroid for about l year.

A Case of Malignant Acanthosis Nigricans Associated with Gastric Adenocarcinoma / 대한피부과학회지

A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.

A Case of Familial Benign Chronic Pemphigus Improved with Oral Etretinate ( Tigason R ) / 대한피부과학회지

We report a case of familial benign chroinic pemphigus in a 47 year old man. We had tried various treatments but no effect had been noted with systemic steroids, tetracycline, cephalosporin, rifampin, dapsone, and local application with antibiotic ar..d eteroid ointment. Thus the patient was started on 50mg of etretinate(Tigason) daily and almost complete resolution of the skin lesions was noted two moths after treatment. He was maintained on 15mg of etretinate daily and follow up evaluations for six months revealed no recurrence and no exacerbation of the lesions.

Silver Sulfadiazineb Cream in the Treatment of Herpes Zoster / 대한피부과학회지

Silver sulfadiazine, an antibacterial agent, has been used successfully in the praphylaxis and treatment of burn infection. 42 volunteers with herpes zoster were enrolled in a clinical trial to evaluate the effectiveness of topical silver sulfadiazine cream. 1% silver sulfadiazine cream was applied 4 times daily until crust removal and epithelialization on 21 patients. As the control, wet compress with 1: 5,000-1: 10,000 KMnO4 solution was done 4 times daily on 21 patients. ln treated group with silver sulfadiazine cream, the durations needed for marked reduction of erythema and edema of lesions, striking control of pain and burning sensation, complete drying of vesicles and crust formation, and crust removal and epithelialization were significantly decreased as compared to the control group. The rate of postherpetic neuralgia was also decreased markedly. The sooner the treatment began after the onset of symptoms, the more dramatic the response was. Signs of local or systemic side effects were not observed.