PURPOSE: This cross-sectional survey was undertaken to examine the differences of BSE (breast-self examination) performance and health beliefs between Korean and Korean-American women and to identify which factors influence the BSE based on the HBM variables. METHOD: The study subjects were recruited from both Korea(189 women) and Cleveland in Ohio, USA(146 women). The HBM variables were measured using a reliable and valid Health Belief Model Scale. The subjects were also asked whether or not they did a BSE in the last year. RESULT: The Korean-American women who performed the BSE was statistically higher than that of Korean women. Regarding to the BSE-related health belief, the scores of benefits, confidence, and health motivation was significantly higher in Korean-American. After controlling for living places, age, education, and job, barriers and confidence variables significantly explained the BSE performance of Korean and Korean-American women. CONCLUSION: There was a differences in BSE-related health belief and performance between Korean and Korean-American women. Among health belief variables, barriers and confidence were core variables predicting the BSE performance of Korean and Korean-American women together.
Adult ; Aged ; Asian Americans/*psychology ; Attitude to Health/*ethnology ; Breast Neoplasms/*psychology ; Breast Self-Examination/*psychology ; Female ; Humans ; Korea/ethnology ; Middle Aged

BACKGROUND: Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) is a disease entity defined by the presence of thrombocytopenia and microangiopathic hemolytic anemia with or without fever, neurologic and renal symptoms. Therapeutic plasma exchange (TPE) has proven to be an effective treatment for TTP/HUS and has decreased mortality. We evaluated the effectiveness of TPE for TTP/HUS at the Department of Clinical Pathology, Samsung Medical Center during the last 6 years. METHODS: We assessed retrospectively the chief complaints, the clinical course, the treatment and the outcome in 17 TTP/HUS patients treated with TPE from December 1994 to May 2001. Minimal diagnostic criteria for TTP/HUS were unexplained thrombocytopenia and microangiopathic hemolytic anemia, with or without fever, neurologic, and renal symptoms. The range of ages of the patients was 15 to 63 years and the female to male ratio was 2:1. RESULTS: The most frequent clinical presentation was a renal problem (71%), followed by fever (53%) and neurologic symptoms (24%). The causes of TTP/HUS followed in the order of frequency: idiopathic (41%), suspicious for Escherichia coli O157: H7 infection (24%), systemic lupus erythematosus (18%), mitomycin C induced (12%), and preeclampsia (6%). A total of 229 TPE procedures were performed for 17 patients (mean: 13 procedures). The replacement fluids for TPE were fresh frozen plasma (59%) and cryosupernatant (41%). Thirteen patients (76%) survived and three of them relapsed (23%); however, they responded to further treatment. In comparing the laboratory results between pre and post TPE, significant changes were found in the white blood cells and platelet counts, creatinine, total bilirubin, and lactic dehydrogenase. The initial symptoms did not indicate a recurrence rate and a variety of drugs were used, except for corticosteroid administration. CONCLUSIONS: TTP/HUS patients responded well to TPE. The overall efficacy of TPE for TTP/HUS was 76%. The causes of TTP/HUS, the administered drugs and the replacement fluid did not affect the patient's prognosis.
Anemia, Hemolytic ; Bilirubin ; Creatinine ; Escherichia coli O157 ; Female ; Fever ; Hemolytic-Uremic Syndrome ; Humans ; Leukocytes ; Lupus Erythematosus, Systemic ; Male ; Mitomycin ; Mortality ; Neurologic Manifestations ; Oxidoreductases ; Pathology, Clinical ; Plasma Exchange* ; Plasma* ; Platelet Count ; Pre-Eclampsia ; Prognosis ; Recurrence ; Retrospective Studies ; Thrombocytopenia

PURPOSE: Carotid duplex scan is a frequent option for initial carotid artery evaluation. There has been debates about accuracy of peak systolic velocity (PSV) >125 cm/s, which has been used to diagnose >50% carotid artery stenosis (CAS) in most vascular laboratories. This study is conducted to evaluate PSV >125 cm/s as a diagnostic tool for 50%> CAS. METHODS: The retrospective review was done for subjects, who had PSV >125 cm/s in carotid artery screening test in == Hospital from November 2008 to June 2011. The screening study was conducted to healthy senior volunteers to screen CAS. The subject who has PSV >125 cm/s was evaluated by carotid computed tomography (CT) scan. The clinical characteristics were surveyed. RESULTS: One hundred forty seven subjects were diagnosed with CAS using duplex scan from 1,953 subjects who underwent screening tests. Twenty eight with 33 lesions underwent carotid CT scan. There were 71% hypertension, 21% diabetes mellitus, 21% ischemic heart disease, 17% lipid disorder, and 67% smoking history. Seventeen lesions showed >50% CAS while 16 showed <50% CAS. The false positive rate was 49%. Its causes were severe tortuosity of carotid artery and extensive plaque calcification. CONCLUSION: The false positive rate of PSV >125 cm/s was 49% in this study. For diagnostic accuracy, diagnostic criteria should be established in each vascular lab.
Carotid Arteries ; Carotid Stenosis ; Diabetes Mellitus ; Hypertension ; Mass Screening ; Myocardial Ischemia ; Pyridines ; Retrospective Studies ; Smoke ; Smoking ; Thiazoles

PURPOSE: The purpose of this study is to evaluate the results of femoral artery stenting as a treatment of femoral artery occlusive disease, and to compare the primary patency and target lesion revascularization (TLR). METHODS: A retrospective review identified 38 patients who underwent femoral artery stenting from November 2008 to December 2010 in Inha University Hospital. Each lesion was classified according to the Trans-Atlantic Inter-Society Consensus II. Demographic, preoperative, intraoperative, and postoperative variables were collected. RESULTS: Forty cases of femoral artery stenting were done for 38 patients. The indications were claudication (47.4%), rest pain (13.2%), unhealed ulcer (13.2%), and toe gangrene (26.3%). The mean age and mean body mass index (BMI) were 72.50+/-8.19 years, and 23.0+/-0.05 kg/m2. There were 57.9% diabetes mellitus, 65.8% hypertension, 44.7% ischemic heart disease, 39.5% current smoker, 71.1% hyperlipidemia, 28.9% chronic renal failure (creatinine>1.5), 23.7% obesity (BMI>25), and 10.5% stroke. The mean follow-up was 12.1+/-0.03 months. There were no in-hospital mortality and 3 complications: 1 femoral artery dissection and 2 branch perforations. Six patients died and two symptomatic stent fractures were noted during the follow-up. One years' primary patency rate and TLR rate were 81.1% and 5.5%. CONCLUSION: Femoral artery stenting showed good results and can be a reasonable option. TLR can be considered as a new standard to evaluate the endovascular treatment.
Angioplasty ; Atherosclerosis ; Body Mass Index ; Consensus ; Diabetes Mellitus ; Femoral Artery ; Follow-Up Studies ; Gangrene ; Hospital Mortality ; Humans ; Hyperlipidemias ; Hypertension ; Kidney Failure, Chronic ; Myocardial Ischemia ; Obesity ; Retrospective Studies ; Stents ; Stroke ; Toes ; Ulcer

BACKGROUND: The neurological complications of childhood patients with cancer are caused by brain metastasis, chemotherapy, and infection. Seizure is one of the most important neurological complications of pediatric patients receiving chemotherapy. This study was designed to identify the causes, clinical manifestations, and prognosis of seizures in children receiving cancer treatment.METHODS: We retrospectively reviewed the medical records of pediatric cancer patients with seizures at Pusan National University Hospital from January 2005 to December 2010.RESULTS: Among 271 patients, 31 experienced seizures (19 males and 12 females), and the mean age at the first seizure was 8.6 years (1.7-18.0 years). Seizures frequently occurred in patients with brain tumors (27.8%), and the types of seizures were generalized seizure in 15 patients (48.4%) and partial in 16 cases (51.6%). Eighteen (62.0%) of 29 patients who underwent a brain magnetic resonance imaging study and 21 (75.0%) of 28 cases who received an electroencephalogram recorded abnormal findings. The causes of seizures were drugs, CNS infections, and brain metastasis each in five cases (16.2%). Drugs were the most common cause in patients with a hematological malignancy (16.2%), whereas brain metastasis was the most common cause in patients with solid tumors (12.9%). Eight (40.0%) of 20 patients who survived received anticonvulsants. Eleven patients (35.5%) expired, and the most common cause of death was progression of the malignancy.CONCLUSION: Drugs, CNS infection, and brain metastasis of tumors were the most common causes of seizure in children with malignancy.
Anticonvulsants ; Brain ; Brain Neoplasms ; Cause of Death ; Child ; Electroencephalography ; Hematologic Neoplasms ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Seizures

Cervicogenic headache is a syndrome characterized by chronic hemicranial pain referred to the head from either bony structures or soft tissues of the neck. Although the pathophysiology and source of pain in this condition have been debated, the pain is believed to be referred from one or more muscles, occipital nerves, facet joints, intervertebral discs, or vascular structures. Among the various possible pain sources, cervicogenic headache from discogenic origin (disc herniation or damaged annulus fibrosus) has been called "discogenic cervical headache". We report a case of cervicogenic headache caused by C3-C4 intervertebral disc herniation. A 33-year-old man presented with headache and posterior neck and right shoulder pain. These symptoms did not improve after therapy with medication, trigger point injection, intramuscular stimulation, greater occipital nerve block, third occipital nerve block, or cervical medial branch block. However, after diagnostic cervical epidural block, the patient's symptoms improved dramatically. Diagnostic magnetic resonance imaging findings confirmed C3-C4 intervertebral disc herniation.
Adult ; Head ; Headache ; Humans ; Injections, Intramuscular ; Intervertebral Disc ; Magnetic Resonance Imaging ; Muscles ; Neck ; Nerve Block ; Post-Traumatic Headache ; Shoulder Pain ; Trigger Points ; Zygapophyseal Joint

PURPOSE: The length of a patient's stay in a hospital is an indication of the patient's recovery rate. The length of the hospital stay has an important economic factor for hospitals. This study was conducted to determine the relationship of the nutritional status at the time of admission to mortality and the length of the hospital stay (LOHS). METHODS: The study subjects were 1,619 patients who suffered with cancer, were admitted to Kosin University Gospel Hospital during 2005 and they met the study criteria. The patients were classified to the not at risk group, the patients having one risk factor for malnutrition were the I group, the patients having two risk factors for malnutrition were the II group, the patients having three risk factors for malnutrition were the III group and the patients having 4 risk factors for malnutrition were the IV group, based on the established criteria of serum albumin <3.0 g/dl, a total lympocyte count of <1,500 cells/mm3, a cholesterol level of > or =240 mg/dl or < or =130 mg/dl, weight for height > or =120% or <90% ideal body weight. RESULTS: 24.3% of the patients were classified into the not at risk group, 37.6% were classified into the at risk group I, 24.2% were classified into the at risk group II, 10.3% were classified into the at risk group III and 3.6% were classified into the at risk group IV. The at risk group (at risk III, at risk IV) had a significantly higher prevalence of liver disease. The relationship between liver disease and low serum albu-min levels may have confounded the data. Although the estimated LOHS was similar in all the groups, the average length of stay was 14.4+/-16.38 days in the malnourished group (at risk group IV) compared to approximately 2.8 days in the not at risk group. The more nutritional risk factors the patients had, the longer was the LOHS and the mortality rates were higher. Correlation was not observed between the risk factors and the length of the hospital stay, as well as the lack of correlation with the mortality rate. CONCLUSION: These results suggest that a patient's nutritional status upon admission has an effect on the length of the hospital stay for patients with carcinoma.
Cholesterol ; Humans ; Ideal Body Weight ; Length of Stay* ; Liver Diseases ; Malnutrition ; Mortality* ; Nutritional Status* ; Prevalence ; Risk Factors ; Serum Albumin

Richter's syndrome refers to the development of aggressive lymphoma in a patient with chronic lymphocytic leukemia (CLL). It occurs in about 2% to 10% of patients with CLL. The most frequent manifestation of Richter's syndrome is diffuse large B cell lymphoma (DLBCL). Extranodal involvement is rare but can occur. The prognosis of Richter's syndrome is very poor. We herein report a case of a rare presentation of Richter's syndrome. A 42-year-old man diagnosed with CLL 2 years previously developed nodules on the bilateral thighs and buttocks. A positron emission tomography (PET)-CT scan revealed high fluorodeoxyglucose uptake in multiple lymph nodes, skeletal muscles, and the myocardium. An ultrasonography-guided biopsy confirmed Richter's syndrome from CLL to DLBCL. The patient was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy. After six cycles of chemotherapy, we performed a PET-CT scan that revealed a complete response. However, 3 months later, the syndrome recurred. The patient was undergoing salvage chemotherapy at the time of this writing.
Adult ; Biopsy ; Buttocks ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell* ; Muscle, Skeletal ; Myocardium ; Positron-Emission Tomography ; Prednisone ; Prognosis ; Thigh ; Vincristine ; Writing ; Rituximab

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) is causally associated with gastritis and peptic ulcer diseases. Recent data have demonstrated that triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor has an eradication rate of only 74~76% and new therapeutic protocols may be necessary. The aim of this study was to investigate the effects of Lactobacillus as supplementation to anti-H. pylori regimens on H. pylori eradication rates and therapy-associated side effects. MATERIALS AND METHODS: The PubMed, Medline and Korean Medical Database were searched in January 2012, with no language restrictions, for randomized controlled trials; additional references were obtained from reviewed articles. We included trials comparing Lactobacillus supplementation to placebo or no treatment during anti-H. pylori regimens. Meta-analysis was performed with Review Manager. RESULTS: Eleven trials involving a total of 1,107 participants met the inclusion criteria. Compared with placebo or no intervention, Lactobacillus given along with anti-H. pylori regimens significantly increased the eradication rate [84.7% vs. 78.8%, odds ratio (OR) 1.75, 95% confidence interval (CI) 1.26~2.42] and reduced the risk of overall H. pylori therapy related adverse effects (35.4% vs. 48.6%, OR 0.56, 95% CI 0.38~0.81), particularly of diarrhea (7.5% vs. 20.6%, OR 0.31, 95% CI 0.18~0.54), bloating (19.2% vs. 29.9%, OR 0.53, 95% CI 0.32~0.88) and taste disturbance (17.6% vs. 34.8%, OR 0.37, 95% CI 0.21~0.64). There were no significant differences between groups in the risk of other adverse effects. CONCLUSIONS: Our review suggests that supplementation with Lactobacilli could be effective in increasing eradication rates of anti-H. pylori therapy. Furthermore, Lactobacilli showed a positive impact on some H. pylori therapy-related side effects, particularly diarrhea, bloating and taste disturbance.
Amoxicillin ; Clarithromycin ; Diarrhea ; Gastritis ; Helicobacter ; Helicobacter pylori ; Lactobacillus ; Odds Ratio ; Peptic Ulcer ; Proton Pumps

BACKGROUND: Venous thromboembolism (VTE) is rare in pediatric patients compared to adults, but it's incidence is gradually increasing. The purpose of this study was to analyze the incidence, risk factors, and prognosis of pediatric patients with VTE in Korea. METHODS: Between January 2000 and July 2017, 249,312 medical records of the patients older than 1 year who were hospitalized in the department of pediatrics of 10 university hospitals in Yeungnam region were retrospectively reviewed. RESULTS: The overall incidence of VTE was 4.9 per 10,000 admissions. Of the total 123 patients, 80 (65.0%) were male and the median age was 10.8 years (range, 1.0–23.5 years). Magnetic resonance imaging was performed most frequently to confirm the diagnosis of VTE (43.1%). Thrombosis occurred in the cerebral vessels (46.3%), lower extremities (23.8%), pulmonary (19.5%), abdomen (9.8%), and upper extremities (4.1%). One hundred and six patients had underlying causes such as cancer (27.6%), infection (26.8%), intravenous catheter insertion (17.9%), and surgery (14.6%). Protein C was evaluated in 39 patients (31.7%), protein S in 40 (32.5%), antithrombin (AT) III in 52 (42.3%), and homocysteine in 21 (17.1%). Among them, one patient with a family history of AT III deficiency had SERPINC gene mutation. Seventy-seven patients (62.6%) started anticoagulation treatment. Most (52.0%) were treated for more than 90 days. CONCLUSION: Healthcare providers must be aware of the potential for VTE development in childhood. In the near future, a nationwide survey should be investigated to determine the incidence rate and the trends in VTE among Korean children.
Abdomen ; Adult ; Catheters ; Child ; Diagnosis ; Epidemiology ; Health Personnel ; Homocysteine ; Hospitals, University ; Humans ; Incidence ; Korea* ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Medical Records ; Pediatrics ; Prognosis ; Protein C ; Protein S ; Retrospective Studies ; Risk Factors ; Thrombosis ; Upper Extremity ; Venous Thromboembolism*