Peripheral artery disease (PAD) and diabetes increase the risk of significant morbidity and mortality and can affect quality of life. PAD is a progressive disease, and the presence of diabetes mellitus increases the risk of adverse outcomes among patients with PAD. Diabetes patients should undergo an initial screening for PAD that evaluates walking speed, leg fatigue, claudication, and pedal pulses. Healthcare providers should discuss with their patients controllable risk factors for PAD that can be modified. A comprehensive care plan for patients with PAD and diabetes mellitus is important and may include smoking cessation, structured exercise therapy, foot care, glycemic control and management of other cardiovascular risk factors (weight management, diet, and control of blood pressure and cholesterol). PAD with diabetes mellitus is a lifelong chronic medical condition, and prompt identification and treatment of PAD are crucial. Patient education is needed to prevent complications and to encourage a healthy and active lifestyle.
Blood Pressure ; Diabetes Mellitus ; Diet ; Education ; Exercise Therapy ; Fatigue ; Foot ; Health Education ; Health Personnel ; Humans ; Leg ; Life Style ; Mass Screening ; Mortality ; Patient Education as Topic ; Peripheral Arterial Disease ; Quality of Life ; Risk Factors ; Smoking Cessation ; Walking

The number of adults living with type 1 diabetes is increasing due to an increase in the number of newly diagnosed adult type 1 patients, and the longevity of individuals with childhood-onset diabetes.In addition, adults with type 1 diabetes currently span a wide range of ages, from 18 to 100 years of age, and diabetes self-management may vary by developmental stage. A reasonable A1C goal for many nonpregnant adults with type 1 diabetes is < 7%. But, as with all management issues for people with type 1 diabetes, providers need to individualize assessment and treatment options by individual patient.A structured education program for type 1 diabetes patients includes procedures for blood glucose self-monitoring, carbohydrate counting, and insulin dose adjustment at mealtimes to achieve optimal glycemic control and quality of life. Diabetes self-management education is the ongoing process of facilitating the knowledge, skill, and abilities necessary for diabetes patients to accomplish self-care, which includes the needs, goals, and life experiences of each individual with diabetes.

The number of adults living with type 1 diabetes is increasing due to an increase in the number of newly diagnosed adult type 1 patients, and the longevity of individuals with childhood-onset diabetes.In addition, adults with type 1 diabetes currently span a wide range of ages, from 18 to 100 years of age, and diabetes self-management may vary by developmental stage. A reasonable A1C goal for many nonpregnant adults with type 1 diabetes is < 7%. But, as with all management issues for people with type 1 diabetes, providers need to individualize assessment and treatment options by individual patient.A structured education program for type 1 diabetes patients includes procedures for blood glucose self-monitoring, carbohydrate counting, and insulin dose adjustment at mealtimes to achieve optimal glycemic control and quality of life. Diabetes self-management education is the ongoing process of facilitating the knowledge, skill, and abilities necessary for diabetes patients to accomplish self-care, which includes the needs, goals, and life experiences of each individual with diabetes.

No abstract available.
Leukemia*

PURPOSE: To investigate whether a correlation exists between the semi-quantitative breast-specific gamma imaging (BSGI) findings and dynamic contrast-enhanced (DCE) MRI parameters assessed by a computer-aided evaluation program. MATERIALS AND METHODS: Semi-quantitative index of the lesion to non-lesion (L/N) ratio in BSGI and DCE-MRI parameters was assessed by a computer-aided evaluation program, where 47 cases of invasive breast cancer were obtained. Correlations between the L/N ratio and DCE-MRI parameters were assessed by a computer-aided evaluation program. Tumor diameter (cm), angio-volume (cc), degree of initial peak enhancement (%), persistent enhancement proportion (%), and washout enhancement proportion (%) were analysed. The relationships between the L/N ratio and DCE-MRI parameters were evaluated by a univariate and multivariate regression analysis. RESULTS: The mean L/N ratio of the 47 tumors was 3.63 ± 2.19 (range: 1–13.1). The L/N ratio was higher in tumors with larger diameters (p < 0.001), increased angio-volume (p < 0.001), higher degree of initial peak enhancement (p = 0.005) and increased washout enhancement proportion (p = 0.004). In the multivariate regression analysis, angio-volume (cc) and washout enhancement proportion (%) were associated with L/N ratio (p = 0.007 and p = 0.024, respectively). CONCLUSION There was a correlation between the semi-quantitative L/N ratio in BSGI and DCE-MRI parameters assessed by a computer-aided evaluation program for breast cancer.

PURPOSE: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. MATERIALS AND METHODS: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. RESULTS: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. CONCLUSION: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.
Breast Neoplasms ; Breast* ; Diagnosis ; Korea ; Magnetic Resonance Imaging* ; Mammography ; Surveys and Questionnaires ; Ultrasonography

PURPOSE: Research related to social support in Korea has been hampered by paucity of measurement tools reflecting Korean culture. The aim of the study was to develop Korean social support questionnaire (KSSQ) based on the Korean social support pyramid and to test psychometric properties of the KSSQ. METHODS: The questionnaire was administered to 701 subjects and 658 college students. Psychometric analyses included factor analyses, expert validity, criterion-related validity, internal consistency, and test-retest reliability. RESULTS: A principal components analysis support for construct validity, eliciting a three factor solution accounting for 65.46% of variance in scores. Concurrent and discriminant validity supported criterion-related validity. Internal consistency of reliability was support with Cronbach's alpha of .97-.98 for the entire scale. Test-retest reliability was .76. CONCLUSION: This initial testing of KSSQ to measure Korean social support demonstrates evidence of reliability and validity. Assessment of known-group validity and norm establishment of KSSQ are suggested to provide further sound psychometric properties and practical measurement tools.
Adolescent ; Adult ; Female ; Humans ; Korea ; Male ; Middle Aged ; *Psychometrics ; *Questionnaires ; *Social Support ; Students/psychology ; Universities ; Young Adult

BACKGROUND: About more than 70% of Staphylococcus aureus isolates in tertiary-care hospitals are known to be resistant to methicillin in Korea. But the prevalence of methicillin-resistant S. aureus (MRSA) in the community and non-tertiary hospitals has not been known yet. The aim of this study was to determine the prevalence of resistance among S. aureus isolates in non-tertiary hospitals. METHODS: The isolates were collected at one laboratory center from August 1998 to May 1999. Antimicrobial susceptibility tests against 11 antibiotics were performed by disk diffusion method. Minimum inhibitory concentrations (MIC) for oxacillin and vancomycin were determined by microbroth dilution method. The mecA gene was detected by polymerase chain reaction. The medical facilities which sent specimen to the laboratory were classified into 3 groups; clinic, hospital and general hospital. RESULTS: Of total 469 S. aureus isolates, 296 (63.1%) were from pus, 47 (10.0%) from sputum, 23 (5.0%) from urine, and 22 (4.6%) from blood. Overall prevalence of MRSA in non-tertiary hospital was 43.5% (204/469). Among 3 hospital groups, MRSA in general hospitals (55%) was significantly more prevalent than in hospitals (40%) or clinics (37%). MICs of oxacillin against MRSA isolated from pus and blood ranged from 8 to > or =256 microgram/mL, but 74% (83 isolates) of them was > or =256 microgram/mL. MICs of vancomycin were distributed from 1 to 2 microgram/mL, irrespective of methicillin resistance or hospital groups. The mecA gene was detected in all of methicillin-resistant isolates with MICs of < or =128 microgram/mL. CONCLUSION: In non-tertiary hospitals, 43% of S. aureus isolates were methicillin resistant. This result showed that MRSA in non-tertary hospitals was less prevalent than in tertiary hospitals.
Anti-Bacterial Agents ; Diffusion ; Drug Resistance, Microbial* ; Hospitals, General ; Humans ; Korea ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxacillin ; Polymerase Chain Reaction ; Prevalence ; Sputum ; Staphylococcus aureus* ; Staphylococcus* ; Suppuration ; Tertiary Care Centers ; Vancomycin

OBJECTIVE: To evaluate the additional effect of sonoelastography on the radiologist's ability for distinguishing benign from malignant complex breast masses and to decide whether to perform biopsy by B-mode US. MATERIALS AND METHODS: One hundred eighteen complex breast masses (15 malignant lesions, 103 benign lesions) were included. Five blinded readers independently assessed the likelihood of the malignancy score from 1 to 5 for two data sets (B-mode ultrasound alone and B-mode ultrasound with sonoelastography). Elasticity scores were categorized as 0, 1, or 2 based on the degree and distribution of strain of the echogenic component within complex masses. The readers were asked to downgrade the likelihood of the malignancy score when an elasticity score of 0 was assigned and to upgrade the likelihood of the malignancy score when an elasticity score of 2 was assigned. The likelihood of the malignancy score was maintained as it was for the lesions with an elasticity score of 1. The Az values, sensitivities, and specificities were compared. RESULTS: The Az value of B-mode ultrasound with sonoelastography (mean, 0.863) was greater than that of B-mode ultrasound alone (mean, 0.731; p = 0.001-0.007) for all authors. The specificity of B-mode ultrasound with sonoelastography (mean, 37.1%) was greater than that of B-mode ultrasound alone (mean, 3.8%; p < 0.001) for all readers. The addition of sonoelastography led to changes in decisions. A mean of 33.6% of benign masses were recommended for follow-up instead of biopsy. CONCLUSION: For complex breast masses, sonoelastography allows increase in both the accuracy in distinguishing benign from malignant lesions and the specificity in deciding whether to perform biopsy.
Adult ; Aged ; Biopsy/*methods ; Breast Diseases/pathology/*ultrasonography ; Breast Neoplasms/diagnosis ; Diagnosis, Differential ; Elasticity Imaging Techniques/*methods ; Female ; Humans ; Middle Aged ; Pregnancy ; Reproducibility of Results ; Retrospective Studies ; *Ultrasonography, Mammary ; Young Adult

PURPOSE: The purpose of this study was to identify the quality of life and its predictors in low income Korean aged. METHODS: This was a predictive correlational study. An accessible sample from the population of people who were 65 and over and were supported by the basic livelihood security system was 1,040. Quota sampling with strata of state division in the nation was chosen. Quality of life and its predictors in the subjects were measured. RESULTS: The mean quality of life in the subjects was 47.0+/-10.7. Predictors of this study significantly explained 54.3% of the total variance of quality of life. Depression was the most significant predictor of quality of life. Health problems, district, social support, leisure activity, and health behavior had effects on quality of life. CONCLUSION: This finding indicates that quality of life in lower income Korean aged is different from other populations by economic status. Demographics, health status and social status were predictors of quality of life in the aged with a small income.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Demography ; Depression ; Female ; Health Behavior ; Health Status ; Humans ; Korea ; Male ; *Poverty ; Predictive Value of Tests ; *Quality of Life ; Social Welfare