PURPOSE: This study was to analyse the factors affecting youth smoking, especially self-efficacy and perceived social norm, based on the stage of change. METHODS: A self-reported survey was conducted during the period from the 21st of April to the 17th of May, 2008. Data were collected from 10,707 students of 12 middle schools in Seoul, Gyeonggi-do, and Incheon. The data were analysed with SPSS/WIN 15.0. RESULT: The smoking possibility was 2.18 times higher in the male students than in female students, and 1.76 times higher in 8th-grade students and 2.48 times higher in 9th-grade students than in 7th-grade ones. Smoking possibility increased when students had more experience in alcohol, more friends who smoke, or worse relationship with their parents. Also this study showed that high-level self-efficacy and perceived social norm were acting as inhibiting factors of smoking. CONCLUSION: To reduce the youth's smoking rate, smoking prevention programs should provide educational chances to learn knowledge and skills on how to reject smoking temptation. Also, someone significant like parents should make it clear to the youth that they do not want their children to smoke.
Adolescent* ; Child ; Female ; Friends ; Gyeonggi-do ; Humans ; Incheon ; Male ; Parents ; Seoul ; Smoke* ; Smoking*

Peripheral nerve sheath tumors (PNSTs) are heterogeneous tumor groups of peripheral nerves that originate from either Schwann cells or modified Schwann cells, fibroblasts, or perineural cells. In this study, signalment and clinical data such as tumor location and size were evaluated for 15 cases of PNSTs collected from local animal hospitals. The mean age of dogs with malignant PNST was higher than that of dogs with benign PNST. Additionally, the male to female ratio in dogs with PNST was 1 : 4. In dogs with PNST, the primary sites of involvement were the hindlimb, forelimb, around the mammary glands, the neck, and the abdomen. Histiopathologic examination revealed that eight PNSTs were benign and seven were malignant. The tumor cells were composed of loosely to densely arranged interlacing bundles and wavy spindle cells arranged in short bundles, palisading, and whirling. High mitotic figures, local invasion, multifocal necrosis and atypical multinucleated giant cells were observed in malignant PNST cases. All PNSTs showed immunoreactivity for vimentin and S-100. However, only 93.3% and 73.3% were immunoreactive for NSE and GFAP, respectively. Overall, these results indicated that immunohistochemical markers such as vimentin, S-100 and NSE could help confirm the diagnosis of canine PNSTs.
Abdomen ; Animals ; Diagnosis ; Dogs* ; Female ; Fibroblasts ; Forelimb ; Giant Cells ; Hindlimb ; Hospitals, Animal ; Humans ; Immunohistochemistry ; Male ; Mammary Glands, Human ; Neck ; Necrosis ; Nerve Sheath Neoplasms* ; Peripheral Nerves* ; Schwann Cells ; Vimentin

No abstract available.
Thyrotropin*

PURPOSE: Kabuki syndrome is a multiple congenital malformation syndrome, with characteristic facial features, mental retardation, and skeletal and congenital heart anomalies. However, the cardiac anomalies are not well described in the Korean population. We analyzed the cardiac anomalies and clinical features of Kabuki syndrome in a single tertiary center. METHODS: A retrospective analysis was conducted for a total of 13 patients with Kabuki syndrome. RESULTS: The median age at diagnosis of was 5.9 years (range, 9 days to 11 years and 8 months). All patients showed the characteristic facial dysmorphisms and congenital anomalies in multiple organs, and the diagnosis was delayed by 5.9 years (range, 9 days to 11 years and 5 months) after the first visit. Noncardiac anomalies were found in 84% of patients, and congenital heart diseases were found in 9 patients (69%). All 9 patients exhibited left-side heart anomalies, including hypoplastic left heart syndrome in 3, coarctation of the aorta in 4, aortic valve stenosis in 1, and mitral valve stenosis in 1. None had right-side heart disease or isolated septal defects. Genetic testing in 10 patients revealed 9 novel MLL2 mutations. All 11 patients who were available for follow-up exhibited developmental delays during the median 4 years (range, 9 days to 11 years 11 months) of follow-up. The leading cause of death was hypoplastic left heart syndrome. CONCLUSION: Pediatric cardiologist should recognize Kabuki syndrome and the high prevalence of left heart anomalies with Kabuki syndrome. Genetic testing can be helpful for early diagnosis and counseling.
Abnormalities, Multiple ; Aortic Coarctation ; Aortic Valve Stenosis ; Cause of Death ; Counseling ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Genetic Testing ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Hypoplastic Left Heart Syndrome ; Intellectual Disability ; Mitral Valve Stenosis ; Prevalence ; Retrospective Studies

This study investigated the effect of switching normal diet to vegetarian diet rich in vegetables and fruits for school foodservice and home meal on the nutritional status, bowel habit improvement and stress reduction of teachers and adolescents. A total of 40 research subjects (26 students, 14 teachers) from one middle school voluntarily participated in the research. Questionnaire surveys and blood analysis were conducted before and after a 12-week vegetarian diet period. The participants were asked on their dietary habit, bowel habit and stress measurement. After 12 weeks, reduction of BMI (kg/m2) in the students (p < 0.05) and reduction of TC (mg/dL) in both teachers and students (p < 0.05) were observed. Also reduction of LDL-C (mg/dL) was observed in the teachers (p < 0.05) whereas serum calcium and Vitamin B12 was increased in the students and teachers (p < 0.005). The teacher's stress level was reduced (p < 0.05) after the 12-week vegetarian diet. As for the changes in bowel habit, the number of the students and teachers classified as experiencing functional constipation was decreased respectively from 10 to 7, from 7 to 5. Based on the result, it is considered that the vegetarian diet rich in fruits and vegetables improved general health status of study subjects suggesting that such a dietary habit would substantially contribute to improving nutritional status and bowel habit.
Adolescent ; Calcium ; Constipation ; Diet ; Diet, Vegetarian* ; Food Habits ; Fruit ; Humans ; Meals ; Nutritional Status* ; Research Subjects ; Vegetables ; Vitamin B 12

Infective endocarditis carries high risk of morbidity and mortality. Rapid diagnosis and effective treatment are essential to good patient outcome. However, nonspecific symptoms and various clinical manifestations make early diagnosis difficult. Here we report on an unusual case of infective endocarditis initially presenting as acute pyelonephritis (APN). A 44-year-old female with a history of heart surgery was admitted for fever and both flank pain. The patient had undergone dental extraction 3 weeks prior to admission. Her lab work and physical examination revealed pyuria, positive bacterial culture of both blood and urine, costovertebral knocking tenderness, and CT findings consistent with APN, leading to her initial diagnosis as APN. Despite treatment with antibiotics, her symptoms did not improve while further physical examination revealed newly developed Osler's nodes and Janeway lesions. Echocardiography showed vegetation of the aortic valve with severe aortic regurgitation. She was diagnosed as a case of infective endocarditis and was treated successfully.
Adult ; Anti-Bacterial Agents ; Aortic Valve ; Aortic Valve Insufficiency ; Diagnosis ; Early Diagnosis ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Female ; Fever ; Flank Pain ; Humans ; Mortality ; Physical Examination ; Pyelonephritis* ; Pyuria ; Staphylococcus aureus ; Thoracic Surgery

BACKGROUND: Death from uterine cervical cancer could be preventable by an active participation of women at risk in a screening program such as the Papanicolaou test. In order to examine the presence of socioeconomic disparity in preventable deaths, we evaluated the time trends of cervical cancer mortality by socioeconomic status in Korean women. METHODS: We selected level of educational attainment and marital status as surrogate indices of socioeconomic status. Using death certificate data and Korean Population and Housing Census data from Korea National Statistical office, we calculated age-standardized yearly mortality rates from cervical cancer between 1998 and 2009 according to the level of education as well as marital status. RESULTS: Cervical cancer mortality peaked in 2003 and then decreased gradually over time. Cervical cancer mortality was the highest in the group with the lowest level of educational attainment in all age groups and the gap between the lowest and the highest educational level has increased over time. Cervical cancer mortality was lower in married women than unmarried women in all age groups, and the degree of difference did not change over time. CONCLUSION: In the Korean population, socioeconomic differential in cervical cancer mortality has persisted over time.
Censuses ; Death Certificates ; Educational Status ; Female ; Housing ; Humans ; Korea ; Marital Status ; Mass Screening ; Single Person ; Social Class ; Uterine Cervical Neoplasms ; Vaginal Smears

Advanced hepatocellular carcinoma (HCC) with tumor thrombus extending through the hepatic veins, inferior vena cava, and right atrium (RA) is very rare. However, whether active treatments such as radiation, transcatheter arterial chemoembolization, and sorafenib in advanced HCC with RA involvement prolong survival is uncertain. We present a rare case of advanced HCC with tumor thrombus nearly occupying the entire RA that was treated with sorafenib. The patient received 400 mg sorafenib twice daily. However, her liver enzyme levels continued to increase and abdominal computed tomography showed an increase in the tumor size in the liver and RA. In the present case, active treatment with sorafenib was ineffective; thus, palliative care may be more beneficial in advanced HCC with extensive RA involvement.
Carcinoma, Hepatocellular ; Heart Atria ; Hepatic Veins ; Humans ; Liver ; Palliative Care ; Thrombosis ; Vena Cava, Inferior

Most cases of gas gangrene caused by Clostridium species begin with trauma-related injuries but in rare cases, spontaneous gas gangrene (SGG) can occur when patients have conditions such as advanced malignancy, diabetes, or immunosuppression. Clostridium perfringens, a rare cause of SGG, exists as normal flora of skin and intestines of human. Adequate antibiotics with surgical debridement of infected tissue is the only curative therapeutic management. Mortality rate among adults is reported range of 67-100% and majority of deaths are occurred within 24 hours of onset. We experienced a case of SGG on the trunk, buttock and thigh in a neutropenic patient with acute lymphoblastic leukemia. His clinical course was rapid and fatal during pre-engraftment neutropenic period of allogeneic stem cell transplantation.
Adult ; Anti-Bacterial Agents ; Buttocks ; Clostridium ; Clostridium perfringens* ; Debridement ; Gas Gangrene* ; Humans ; Immunosuppression ; Intestines ; Mortality ; Neutropenia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Skin ; Stem Cell Transplantation* ; Thigh

Invasive lobular carcinoma is the second most common breast malignancy. Mammographic finding of invasive lobular carcinoma is often subtle or negative due to its histological feature showing infiltration of tumor cells into surrounding tissue with scanty fibrotic reaction. Thus, ultrasound plays an important role in detection of invasive lobular carcinoma. We report here on our experience with a 70-year-old female who had invasive lobular carcinoma of the breast with unique ultrasound findings; a mixed hyper- and hypoechoic mass at the fatty layer mimicking fat necrosis.
Aged ; Breast* ; Carcinoma, Lobular* ; Fat Necrosis* ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Ultrasonography ; Ultrasonography, Mammary