Breast cancer is the school most common cancer in Korea women. The incidence of breast cancer is around 25 per 100,000 women, and more than 5,500 women are diagnosed as breast cancer annually. Epidemics show that the incidence and mortality of breast cancer are increasing due to rapid changes of women's life style and westernized food and so on. The risk factors for breast cancer include hormone-related factors (early menarche, late menopause, no or late birth, hormone replacement therapy) and genetic background. It is hard to change risk factors for breast cancer but early detection strategies are best for decreasing the mortality rate from breast cancer. Breast self examination, clinical breast examination, and mammography can be used for screening of breast cancer. Breast self examination is not sensitive enough to detect a small cancer but monthly exam makes women be awakening about breast cancer and feel changes of her breast. Meta-analysis shows annual mammography reduces breast cancer mortality around 35% in the ages over 50. Some randomized clinical trials also showed mortality reduction by mammography in the ages of 40s. Surprisingly, breast cancer is rapidly increasing in late thirties with a peak incidence in forties among Korean women. Whether the early peak makes mammography less accurate is controversial. However, data from qualified screening centers showed mammography has same sensitivity with that in westerns. Korean Breast Cancer Society and National Cancer Center organized the 1st Consensus meeting for the national guidelines for breast cancer screening on July 24, 2001. We recommend that women should have monthly self examination beginning at age 30, should receive biannual clinical breast exam from healthcare providers from age 35, and should receive clinical breast exam and mammography at 1~2-year intervals after age 40.
Breast Neoplasms* ; Breast Self-Examination ; Breast* ; Consensus ; Female ; Genetic Background ; Health Personnel ; Humans ; Incidence ; Korea ; Life Style ; Mammography ; Mass Screening* ; Menarche ; Menopause ; Mortality ; Parturition ; Risk Factors ; Self-Examination

PURPOSE: The purpose of this study was to analysis the financial statements of university hospitals and to apply the results to build nursing management strategies. METHODS: Data on the financial statements of university hospitals were collected each hospital's homepage or internet search from February to June, 2010. Financial statements of 11 hospitals were analyzed using the 4 categories of financial ratio analysis method: liquidity, performant, growth and turnover. RESULTS: Overall results showed that the financial status the university hospitals were unstable, and many financial indicators did not meet financial standard ratios. Only 8 financial indicators of total 19 indicators satisfied financial standard ratios. CONCLUSION: The results of financial statements analysis suggest that nurse managers should develop the blue ocean strategy for diversification of nursing services to improve financial ratios of liquidity, performance, and growth. Using a unit-based just-in-time system for effective supply management would help to increase profits and to decrease costs of hospital by improving financial ratios of turnover.
Financial Management ; Hospitals, University ; Humans ; Internet ; Nurse Administrators ; Nursing Services

BACKGROUND: It is a popular notion that cutaneous ageing includes two distinct phenomenon; true ageing, a universal presumably inevitable change attributable to the passage of time alone, and photoageing, changes attributable to chronic habitual sun exposure that are neither universal nor inevitable. Numerous investigations with experimental animals, in vitro skin models have been conducted, although, few histological studies to date have attempted to announce fundamental morphological changes with innate ageing. OBJECTIVE: We compared skin derived from the breast of old and young persons using light microscopy to discern structural changes in epidermal and dermal morphology with advancing age. METHODS: The histological, immunohistochemical studies were performed with normal skin sections of thirty donors who were diagnosed with breast cancer. They were classified into three age cohort groups; nine into group I (22 to 38), twelve into group II(40 to 52), and nine into group III(54 to 87). We chose the breast as an area that might closely resemble intrinsically aged skin. This region is relatively shielded from photoageing by its anatomical location. Analysis of data was performed using the Kruskal-Wallis and ANOVA test for dermal parameters based on a 5-point rating scale, and a simple regression test for a positive rate of immunoreactants. Results : 1. Light microscopic appearance of aged skin revealed a more flattened epidermis than young skin. There was no trend for an increase in epidermal melanin content per unit area on Fontana-Masson staining. There was an age-associated decrease in the Ki-67 positive rate(p<0.001), the density of Ki-67 positive cells declined approximately 1.16% per decade in photoprotected skin(p<0.001). The number of S-100 positive cells declined approximately 4.4/mm width along the dermo-epidermal juction per decade in photoprotected skin(p<0.001). The expression of differentiation markers(keratin 1, involucrin, filaggrin, loricrin) were not different among the three age cohort groups. 2. With advancing age, there was an attenuation in the number and diameter of elastic fibers in the papillary dermis and an increase in the number and straightness of the same fibers in the reticular dermis. The collagen fibers are arranged in sparse bundles in disarray, and/or aggregates of loosely woven, straight fibers in the aged skin. There was an apparent, age-related decrease in the stainability of ground substances in the papillary dermis on colloidal iron staining. Conclusions : Our data documents semi-quantitative differences among three groups in intrinsically aged breast skin and provide the framework for future research to evaluate the ageing process.
Animals ; Breast ; Breast Neoplasms ; Cohort Studies ; Collagen ; Colloids ; Dermis ; Elastic Tissue ; Epidermis ; Humans ; Iron ; Melanins ; Microscopy ; Skin* ; Solar System ; Tissue Donors

Purpose: Diabetes Mellitus (DM) is a leading cause of death with a prevalence rate of 12.4% in South Korea. Self-management is crucial for patients with DM, because many studies have reported that self-management intervention based on the Health Belief Model (HBM) is effective. The purpose of this study was to investigate the current state of HBM based intervention studies and the components and effects of the theories used in the study for diabetes patients. Methods: A systematic review was conducted using the Pubmed, Cochrane Library and Embase databases from January 2009 to May 2019. We reviewed characteristics of intervention based on the HBM in randomized controlled clinical trials (RCTs), quasi-experimental study intervention. Results: Eight studies published in English between 2009 and 2019 were included in this review. The key components of the health behavior promotion program applied to the DM patients were perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy. The intervention based on these components has reported to significantly increase the health behavior change, likelihood of taking health action and improve physiological indicators (HbA1c, and fasting blood sugar etc.). Conclusion This study highlighted the importance of intervention programs based on the HBM for DM patients.

Purpose: The role of medical staff gained immense significance in the context of the prolonged coronavirus disease (COVID-19) pandemic.However, few studies had explored the impact of simulation-based education on the ability of nursing students to care for the patients of COVID-19. This study provided nursing students with simulation-based education in caring for the patients of COVID-19 and confirmed its effectiveness. Methods: This study used a non-equivalent control group pretest-posttest design. The participants were recruited from the nursing departments of two universities in Korea through convenience sampling. A total of 79 participants were included: 37 in the intervention group and 42 in the control group. The intervention group received four sessions of simulation training based on the National League for Nursing Jeffries simulation theory. Results: The intervention group showed an improvement compared to the control group in terms of knowledge related to coronavirus, confidence in performing infection control skills, and perception of preparedness for caring for the patients of COVID-19, with a high-level of satisfaction and self-confidence in learning. There was no significant difference between the two groups in terms of anxiety. Conclusion This simulation is expected to be a significant strategy for alleviating the global burden in terms of staff safety and patient outcomes by improving the competencies of prospective medical staff in responding to pandemics.

Although severe hemolytic diseases of the newborn triggered by anti-M are very rare, anti-M alloantibodies have been known to be associated with a cause of multipie intrauterine death. Serological and hematological investigations have been reported on a woman who experienced four multiple intrauterine deaths due to anti-M. The mothers blood type was of group A, NN and the husbands cells were of group B, MN. In the serological examination at 9th week's gestation of the fifth pregnancy, anti-M antibodies were identified in her serum. The antibodies comprised IgM saline agglutinin at a titer of 16 at 4 degrees C and IgG agglutinin reacted in an indirect antiglobulin technique at a titer of 4 at 37 degrees C. She underwent high-dose immunoglobulin infusion therapy on a monthly program from 3rd month gestation and a total of 6 times of intravenous immunoglobulin was given. The anti-M titer did not rise during the pregnancy. She delivered a live girl by cesarean section at the 37th week because of a failure of induction. The childs blood type was of group O, MN. The child was discharged and developed normally.
Antibodies ; Cesarean Section ; Child ; Female ; Humans ; Immunization, Passive* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant, Newborn ; Isoantibodies ; Mothers ; Pregnancy* ; Spouses

BACKGROUND: ABO genotyping is being used increasingly when the results of serologic typing are unclear or there is some suspicion of rare ABO subtypes. Conventional molecular diagnostic methods such as PCR- restriction fragment length polymorphism (PCR-RFLP), allele-specific PCR, PCR-single stranded conformational polymorphism (PCR-SSCP) and sequence-based typing have been used in this field. Recently, a pyrosequencing technique was introduced into clinical laboratories. This study evaluated the possibility of applying pyrosequencing to ABO genotyping. METHODS: A total of 36 samples, which had previously been analyzed by PCR-RFLP and serological method in the Blood Genetics Clinic of Seoul National University Hospital between August 2001 and September 2004 and shown to have the A/A, A/B, A/O, B/B, B/O, O/O, cis-AB/O, cis-AB/A, or cis-AB/B genotypes, were analyzed by pyrosequencing analysis. Briefly, two PCR reactions were carried out separately for one region including nucleotide 261, and for another region including nucleotides 796 and 803. Pyrosequencing was then performed, and the pyrograms were interpreted using an automated interpretation program from the manufacturer and by researchers independently to determine the nucleotides 261, 796 and 803 for ABO genotyping. RESULTS: The ABO genotypes from pyrosequencing and the interpretation of the pyrograms according to the researcher on 36 samples were in complete concordance with the results obtained by PCR-RFLP. The ABO genotypes from the automated interpretation program showed an error in one out of total 108 SNP (single nucleotide polymorphism) analyses (eRROR RATE=0.9%) OF 36 SAMPLES. CONCLUSION: ABO genotyping for A, B, O, cis-AB alleles by pyrosequencing of nucleotides 261, 796 and 803 was relatively simple and accurate and could be an another field we can use in clinical laboratories.
Alleles ; Genetics ; Genotype ; Nucleotides ; Pathology, Molecular ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Seoul

PURPOSE: The purpose of this study is to analyze left ventricular (LV) radial strain (S) and strain rate (SR) in children with dilated cardiomyopathy (DCM) and to evaluate whether the impairment of global radial wall motion correlates with global ventricular dysfunction in DCM. METHODS: In 10 DCM patients (range 0.6-15 years, median age 6.5 years, 3 females) and 17 age and sex matched normal controls (range 0.5-14 years, median age 5 years, 5 females) conventional echocardiography and real time tissue Doppler imaging analysis were performed. Using an automatic two dimensional speckle tracking imaging (STI) method radial S and SR were calculated for each LV segment in 18 segment model. To evaluate the correlation between the impairment of radial motion and LV global function, the average values of radial S and SR of each LV level were obtained, and defined as global (G) S or SR. RESULTS: LV radial S and SR were markedly heterogeneous and decreased in almost all segments of LV in DCM. Impaired radial S and SR were associated with global LV dysfunction. CONCLUSION: In DCM, decreased and disorganized radial S and SR contribute to LV dysfunction. Analysis of radial S and SR with STI method can give further information on LV function in DCM.
Cardiomyopathy, Dilated* ; Child* ; Echocardiography ; Humans ; Ventricular Dysfunction

No abstract available.
Hyponatremia* ; Hypopituitarism*

PURPOSE: We evaluated the easily-assessable risk and prognostic factors of septic shock in children with neutropenic fever (NF) which developed after anticancer chemotherapy. METHODS: We retrospectively reviewed the medical records and laboratory data of 97 children who received anticancer chemotherapy at Dong-A University Hospital and had NF between March, 1993 and February, 2001. RESULTS: There were 223 episodes of NF in 97 children, of which 71 episodes (31.8%) of bacteremia and 18 episodes (8.1%) of septic shock developed. The incidence of septic shock was associated with fever duration (> 5 days, odds ratio=7.367, P=0.0159), tachycardia (odds ratio=11.857, P=0.0001), and serum bicarbonate level (<24 mEq/L, odds ratio=6.235, P=0.0378), whereas not with the underlying disease, age, sex, causative organisms, absolute neutrophil count, absolute monocyte count, absolute phagocyte count, the presence of central venous catheter, the accompanied focal infection, and the use of hematopoietic growth factor. Septic shock developed 3.2 (1~11) days after NF. The prognosis of septic shock patients was not associated with the therapeutic timing, antibiotics, fever duration, tachycardia, or serum bicarbonate level. CONCLUSION: We suggest that the fever duration, tachycardia, and serum bicarbonate level could be important risk factors of septic shock in children with NF. Although We could not reveal the prognostic factors in children with septic shock, further studies will be required.
Anti-Bacterial Agents ; Bacteremia ; Central Venous Catheters ; Child ; Drug Therapy ; Fever* ; Focal Infection ; Humans ; Incidence ; Medical Records ; Monocytes ; Neutropenia ; Neutrophils ; Phagocytes ; Prognosis ; Retrospective Studies ; Risk Factors* ; Shock, Septic* ; Tachycardia