BACKGROUND: With the rapid growth of the elderly population, osteoporosis has become a major health problem worldwide. Although health knowledge and self-efficacy are important assets to facilitate healthy behaviors and disease prevention, such information as it relates to individuals and their bone health is limited. The purpose of this study was to assess the levels of knowledge, self-efficacy, and health behaviors on promoting bone health in middle-aged Korean women. METHODS: This is a cross-sectional survey study. A convenience sampling of middle-aged women (> or =40 years) was done at a community health center in Korea. Bone mineral density was measured by dual energy X-ray absorptiometry with the DEXXUM T. The level of knowledge was measured with the Knowledge of Osteoporosis Scale, and self-efficacy with the Osteoporosis Self-efficacy Scale. A questionnaire for bone health behaviors was developed for this study. Collected data were analyzed through descriptive methods, independent t-test, analysis of variance, and Pearson's correlation analysis. RESULTS: A total of 150 middle-aged women whose mean age was 59.8+/-11.5 years participated in the study. Most (74%) were menopausal. Less than one-quarter of participants (22.7%) had osteoporosis and less than half (42%) had osteopenia based on the T-score at the left femur neck site. Level of knowledge (mean score, 10.35) and self-efficacy (mean score, 47.67) ranged from low to moderate. Intake of calcium and vitamin D-rich foods was insufficient in our subjects. Bone health behaviors had significant positive relationships with knowledge (r=0.22, P=0.008) and self-efficacy (r=0.29, P<0.001) on promoting bone health. CONCLUSIONS: These results indicate that educational interventions are needed to enhance knowledge and confidence and to encourage middle-aged women to engage in bone health behaviors.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Community Health Centers ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Behavior ; Humans ; Korea ; Middle Aged ; Osteoporosis ; Self Efficacy ; Vitamins

Slipped capital femoral epiphysis is a rare hip disorder that mainly occurs in pubertal children. Although the exact cause of this disorder is unknown, it is known to be associated with obesity, trauma, delayed sexual development, delayed bone maturation, chronic renal failure, genetic diseases, endocrine disorders (growth hormone deficiency, hypothyroidism, hypogonadism), growth hormone therapy, and gonadotropin releasing hormone agonist (GnRH agonist) therapy. We report 2 cases of slipped capital femoral epiphysis in adolescent females who were receiving growth hormone therapy. The first case is of a 16 year-old-girl with chronic renal failure and renal osteodystrophy. The second case is of an 11 year-old-girl with idiopathic precocious puberty who had received GnRH agonist and growth hormone therapy. Unilateral or bilateral slipped capital femoral epiphysis developed at 1 year 3 months after treatment in both the cases. The chief complaints were pain in the hip joint and lower extremities. Growth hormone and/or GnRH agonist therapy was stopped, and in situ screw fixations of the involved hip epiphyses were performed.
Adolescent ; Child ; Endocrine System Diseases ; Epiphyses ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Hip ; Hip Joint ; Humans ; Hypothyroidism ; Kidney Failure, Chronic ; Lower Extremity ; Obesity ; Puberty, Precocious ; Renal Osteodystrophy ; Sexual Development ; Slipped Capital Femoral Epiphyses

PURPOSE: The incidence of type 2 diabetes mellitus is increasing worldwide because of the increase in the incidence of obesity. We performed this study to determine the type of diabetes and the clinical characteristics and laboratory data of the children who were newly diagnosed with diabetes mellitus (DM). METHOD: We reviewed the medical data of 75 children (35 boys and 40 girls) who were diagnosed with DM at Kyungpook National University Hospital between January 2001 and June 2008. RESULTS: Sixty patients (80%) were diagnosed with type 1 DM and 15 (20%) with type 2 DM. Approximately 70% of the study subjects developed DM in spring and winter. Further, 38% and 60% of the patients had a family history of type 1 and type 2 DM, respectively. The average age of the patients with type 1 DM was 10.6+/-2.6 years. Diabetic ketoacidosis was the first symptom in 15% of these patients. The average body mass index of these patients was 18.2+/-4.5 kg/m2. At least one of autoantibodies against pancreas was positive in 69%. The average age of the patients with type 2 DM was 13.4+/-1.2 years. Fifty-three percent of these patients was diagnosed without any symptom. Fatty liver and hypertension were diagnosed in 20% of the patients. Fifty-three percent of these patients were obese or overweight. CONCLUSION: Twenty percent of the children who were newly diagnosed with diabetes at our institute had type 2 DM. Since the incidence of type 2 DM in children appears to be increasing with an increase in the occurrence of childhood obesity, special attention should be provided to obese children.
Autoantibodies ; Body Mass Index ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis ; Fatty Liver ; Humans ; Hypertension ; Incidence ; Obesity ; Pancreas

PURPOSE: This study described female college students' knowledge, self-efficacy and health behaviors related to bone health. METHODS: A descriptive cross-sectional survey design was used. A total of 214 students were conveniently recruited from a school of nursing in Korea. Participants (mean age=21.2, SD=1.9 years) bone mineral density (BMD) was measured using dual energy x-ray absorptionmetry. Participants also completed a questionnaire consisting of knowledge test, self-efficacy scale and health behaviors related to bone health. Data were analyzed using SPSS/WIN 17.0 program. RESULTS: The mean BMD at left femoral neck site was 0.86 g/cm2 and 6.1~12.6%. Results showed that participants were below the expected range of BMD. Level of knowledge (correct rate=54%) and self-efficacy were moderate (mean 54.8 out of 84). More than 84% of subjects drank alcohol more than once a month and 58.4% did participate in regular exercise. Only 7.9% participants took calcium and vitamin-D rich foods every day. There were significant positive correlations between knowledge and self-efficacy (r=.17), health behaviors (r=.14) and self-efficacy and health behaviors (r=.28, all p<.05). CONCLUSION: These results suggest that health care professionals need to provide effective interventions for young women in order to enhance knowledge, self-efficacy and health behaviors related to bone health.
Bone Density ; Calcium ; Cross-Sectional Studies ; Delivery of Health Care ; Female ; Femur Neck ; Health Behavior ; Humans ; Korea ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to compare differences in the time when bowel sounds were heard and gas was passed in women who had an abdominal hysterectomy and were treated for 5 minutes (experimental group A) or 10 minutes (experimental group B) with San-Yin-Jiao (SP-6) acupressure. METHOD: The design of this study was a nonequivalent control group non-synchronized post test only design. The participants included 142 women, 39 in experimental group A, 30 in experimental group B, and 73 in the control group. Data was collected using a structured questionnaire which included items on general characteristics and a self report of time when gas was passed. Differences for the three groups as to time when bowel sounds were heard and gas was passed were analyzed using ANOVA. RESULT: The time when bowel sounds were heard was statistically significantly shorter in both experimental groups compared to the control group(F=10.29, p=.000). The time when gas was passed was statistically significantly shorter in experimental group B(10 min) compared to the control group(F=4.68, p=.011). CONCLUSION: It could be concluded that SP-6 acupressure of 10 minutes was effective in shortening the time until bowel sounds were heard and gas was passed for women who had had an abdominal hysterectomy. Replication of the study with a larger number of participants is necessary in order to be able to generalize the results.
*Acupressure ; Adult ; *Auscultation ; Female ; *Flatulence ; *Gastrointestinal Motility ; Humans ; *Hysterectomy ; Middle Aged ; Postoperative Complications/*therapy

The role of the kidney in combating metabolic acidosis has been a subject of considerable interest for many years. The present study was aimed to determine whether there is an altered regulation of renal acid base transporters in acute and chronic acid loading. Male Sprague-Dawley rats were used. Metabolic acidosis was induced by administration of NH4Cl for 2 days (acute) and for 7days (chronic). The serum and urinary pH and bicarbonate were measured. The protein expression of renal acid base transporters [type 3 Na+/H+ exchanger (NHE3), type 1 Na+/HCO3- cotransporter (NBC1), Na-K+ ATPase, H(+)-ATPase, anion exchanger-1 (AE-1)] was measured by semiquantitative immunoblotting. Serum bicarbonate and pH were decreased in acute acid loading rats compared with controls. Accordingly, urinary pH decreased. The protein expression of NHE3, H(+)-ATPase, AE-1 and NBC1 was not changed. In chronic acid loading rats, serum bicarbonate and pH were not changed, while urinary pH was decreased compared with controls. The protein expression of NHE3, H(+)-ATPase was increased in the renal cortex of chronic acid loading rats. These results suggest that unaltered expression of acid transporters combined with acute acid loading may contribute to the development of acidosis. The subsequent increased expression of NHE3, H(+)-ATPase in the kidney may play a role in promoting acid excretion in the later stage of acid loading, which counteract the development of metabolic acidosis.
Acidosis ; Adenosine Triphosphatases ; Ammonium Chloride ; Animals ; Humans ; Hydrogen-Ion Concentration ; Immunoblotting ; Kidney ; Male ; Proton-Translocating ATPases ; Quaternary Ammonium Compounds ; Rats ; Rats, Sprague-Dawley ; Sodium-Hydrogen Antiporter

Sunitinib as a multitarget tyrosine kinase inhibitor is one of the anti-tumor agents, approved by the United States Food and Drug Administration to use treat gastrointestinal stromal tumor and metastatic renal cell carcinoma. The agent is known to commonly induce adverse reactions such as fatigue, nausea, diarrhea, stomatitis, esophagitis, hypertension, skin toxicity, reduciton in cardiac output of left ventricle, and hypothyroidism. However, it has been reported to rarely induce adverse reactions such as nephrotic syndrome and irreversible reduction in renal functions, and cases of intestinal perforation or pneumatosis interstinalis as such reactions have been consistently reported. In this report, a 66-year old man showing abdominal pain had renal cell carcinoma and history of sunitinib at a dosage of 50 mg/day on a 4-weeks-on, 2-weeks-off schedule. Seven days after the third cycle he was referred to the hospital because of abdominal pain. Computed tomography showed pneumoperitoneum with linear pneumatosis intestinalis in his small bowel. The patient underwent surgical exploration that confirmed the pneumatosis intestinalis at 100 cm distal to Treitz's ligament. We report a rare case of intestinal perforation with pneumatosis intestinalis after administration of sunitinib to a patient with metastatic renal cell carcinoma.
Aged ; Antineoplastic Agents/adverse effects/*therapeutic use ; Carcinoma, Renal Cell/*drug therapy ; Drug Administration Schedule ; Humans ; Indoles/adverse effects/*therapeutic use ; Intestinal Perforation/*diagnosis/etiology/surgery ; Kidney Neoplasms/*drug therapy ; Lung/radiography ; Male ; Pneumatosis Cystoides Intestinalis/*diagnosis/etiology ; Positron-Emission Tomography ; Pyrroles/adverse effects/*therapeutic use ; Tomography, X-Ray Computed

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial lung biopsy confirmed primary lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother's brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with lung cancer.
Adenocarcinoma ; Adult ; Anoxia ; Biopsy ; Brain ; Chemoradiotherapy ; Child ; Cough ; Emergencies ; Fetal Distress ; Humans ; Lung ; Lung Neoplasms ; Mothers ; Neoplasm Metastasis ; Parturition ; Pregnancy ; Pulmonary Atelectasis ; Rare Diseases ; Smoke ; Smoking ; Thorax

OBJECTIVE: The purpose of this study was to determine whether funisitis is associated with changes in the umbilical cord plasma concentration of interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8), microbial invasion of the amniotic cavity and neonatal outcome. METHODS: The relationship among the presence of funisitis, IL-6 and MMP-8 concentrations in umbilical cord plasma at birth, the results of amniotic fluid culture performed within 5 days of birth was examined in 83 consecutive singleton births (20-35 weeks' gestation). Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel wall or Wharton's jelly. The IL-6 and MMP-8 concentration was measured with a specific immunoassay. Amniocentesis was performed in 47 patients within 5 days of birth. RESULTS: (1) Funisitis was present in 21.7% of patients. (2) Patients with funisitis had a significant higher cord plasma IL-6 concentration, but had no significant difference in cord plasma MMP-8 concentration. (3) Clinical chorioamnionitis was more common in patients with funisitis than those without funisitis. (4) A cord plasma IL-6 > 6.34 pg/ml had a sensitivity of 77.8% and a specificity of 75.4% in the identification of funisitis. (5) No correlation between cord blood plasma IL-6 concentration and MMP-8 concentration was found. (6) There was no significant correlation between gestational age at birth and cord blood plasma MMP-8 concentrations, but there appeared to be a trend to increase of cord plasma MMP-8 concentrations as gestational ages at birth were increased. (7) Neonates with congenital sepsis had a significantly higher cord plasma IL-6 and MMP-8 concentration than those without congenital sepsis. CONCLUSION: In patient with funisitis, umbilical cord plasma IL-6 concentrations were higher than those without funisitis, but umbilical cord plasma MMP-8 concentrations had no significant difference in each group. The umbilical cord plasma IL-6 and MMP-8 can be useful as a predictor of the occurrence of congenital sepsis in preterm infant.
Amniocentesis ; Amniotic Fluid* ; Chorioamnionitis* ; Female ; Fetal Blood ; Gestational Age ; Humans ; Immunoassay ; Infant, Newborn ; Infant, Premature ; Interleukin-6* ; Matrix Metalloproteinase 8* ; Neutrophil Infiltration ; Parturition ; Plasma* ; Pregnancy ; Sensitivity and Specificity ; Sepsis ; Umbilical Cord* ; Wharton Jelly

PURPOSE: Several studies have reported the recent increase in the incidence of acute poststreptococcal glomerulonephritis(APSGN). The objective of this study is to see changes of clinical findings/manifwstation in children with APSGN. METHODS: Medical records of 63 children who were diagnosed with APSGN in the deparment of Pediatrics, Kyungpook National University Hospital, between January 1992 and December 2006 were reviewed retrospectively. We analyzed various clinical characteristics such as age, sex, degrees of proteinuria, degrees of hematuria, and presence or absence of histories of systemic antibiotic use in children with APSGN, and compared the children with APSGN who were diagnosed between 1992 and 2000 to those who were diagnosed between 2001 and 2006. RESULTS: Age of the patients ranged from 2-14 years(median 7.11 years) at the time of disease onset. Study patients consisted of 41 boys and 22 girls. APSGN followed infection of the throat in 87% of cases. Patient developed an acute nephritic syndrome 12 days after an antecedent streptococcal pharyngitis. Forty patients presented with gross hematuria. Fortyone patients had hypertension at the time of diagnosis. Hypertension disappeared within 7.8+/-8.2 days, gross hematuria within 11.3+/-17.2 days and microscopic hematuria within 3.5+/-3.9 months from the disease onset. Patients in 2001-2006 had significantly higher increase of antistreptolysin O(ASO) titer. However, no significant differences in clinical characteristics were observed. Age, sex, severity of proteinuria, gross or microscopic hematuria, antibiotic therapy did not affect the clinical manifestations of glomerulonephritis. In other words, hypertension, duration of hematuria, recovery of serum C3 level are not different between the two time periods. CONCLUSION: Our data indicates that patients in 2001-2006 had significantly higher level of ASO titer. However, they did not show significant clinical differences. To evaluate the causes of the resurgence of APSGN, a national epidemic is needed.
Antistreptolysin ; Child ; Glomerulonephritis ; Hematuria ; Humans ; Hypertension ; Incidence ; Infant ; Medical Records ; Pediatrics ; Pharyngitis ; Pharynx ; Proteinuria ; Retrospective Studies ; Urinary Tract Infections