PURPOSE: The purpose of this study was to gain knowledge of successful aging for the Korean elderly and to identify the effects of an intervention program on the change of the knowledge. METHOD: Data were collected from 134 elders from 3 schools for the elderly in H City. The Successful Aging Scale was used to collect data and modified CDSMP was applied as the intervention. Descriptive statistics, t-test, ANOVA and ANCOVA were used. RESULTS: The total score of the knowledge of successful aging among the elderly cohort was 2.44 out of 3, and the scores of the factors making up old age were 2.66 for the success of children, 2.63 for self-control, 2.56 for self-efficacy, and 2.05 for happy marriage. Life satisfaction from the success of children and self-control were strongly correlated(r=0.7036, p=0.000). CONCLUSION: The self-management program brought positive changes to the knowledge of successful aging through the self-control parameter, and although it could not change the degree of knowledge of the overall successful aging among the elderly cohort, the program represents the first Korean nursing intervention focused on self-management techniques needed for successful aging.
Aged ; Aging* ; Child ; Cohort Studies ; Humans ; Marriage ; Nursing ; Self Care*

Ticlopidine hydrochloride is world-wide used antiplatelet agent that inhibit ADP pathway. Its clinical side effects are the change of the blood picture, allergic skin reaction and gastrointestinal symptoms. We report three patients with severe cholestatic hepatitis caused by ticlopidine. They developed jaundice about 20days after taking ticlopidine (500 mg/day). Infectious and immunological etiologies were excluded by serology. There was no history of alcohol or drug abuse. Their symptoms were gradually subsided for a few months after discontinuing ticlopidine.
Adenosine Diphosphate ; Hepatitis* ; Humans ; Jaundice ; Skin ; Substance-Related Disorders ; Ticlopidine

PURPOSE: To identify differences in ultrasonography (US) feature, clinical and pathological characteristics including immunohistochemical characteristics between small breast cancer (pathologic size ≤ 5 mm) and large breast cancer (> 5 mm). MATERIALS AND METHODS: A total of 528 invasive breast cancer lesions in 475 patients were included. US features with clinical and pathological characteristics were evaluated according to pathologic size. US Breast Imaging-Reporting and Data System findings and final assessments were recorded for each lesion. Standard references were based on surgical pathologies. RESULTS: Of 528 invasive breast cancer lesions, 62 were small breast cancers. Small breast cancers showed a higher rate of oval, round shape, parallel orientation; circumscribed margin; and iso/solid and cystic echo pattern, with no posterior feature. The final assessment of category 4 was also a dominant factor in small breast cancer. Early stage, asymptomatic state, and extensive ductal carcinoma in situ component were associated with small breast cancers. CONCLUSION Our results show that small breast cancers have less suspicious US features than large breast cancers.

OBJECTIVE: To evaluate whether lipopolysaccharide (LPS) modulates the expression of cyclooxy- genase-2 (COX-2) and also whether COX-2 is involved in the LPS induced matrix metalloproteinase-2 (MMP-2) and MMP-9 activation in human trophoblastic (TL) cell line. METHODS: We used the TL (trophoblast-like) cells and evaluated the effect of LPS on expression of COX-2 mRNA and protein and on activities of MMP-2 and MMP-9. Also, we pretreated cell line with LPS and NS398, a COX-2 inhibitor, and compared MMPs activities with LPS only group. In the present study, COX-2 was analyzed by RT-PCR and western blot analysis and gelatin zymography was done for the evaluation of gelatinase activities of MMP-2 and MMP-9. RESULTS: The mRNA and protein expressions of COX-2 were increased by LPS in time- and dose-dependant fashions. COX-2 mRNA expression began to rise from 1 hour of LPS treatment and was increased steadily thereafter. COX-2 protein expression was detected from 1 hour of LPS treatment, but maximally increased by the 3 hours of treatment. LPS also increased MMP-2 and MMP-9 activities in time and dose dependant fashions. Especially, active form of MMP-9 was observed in the high concentration of LPS (>50 microgram/ml). When adding COX-2 inhibitor (NS398) to LPS pretreated cell line, the MMPs activities increased in two or three fold compared to LPS only group. CONCLUSION: Our results suggested that LPS induces expression COX-2 and up-regulates activities of MMP-2 and MMP-9 in trophoblastic cell, but COX-2 although involved in LPS mediated MMP-2 and MMP-9 activation, may act through a different pathway than the commonly known prostaglandin metabolites mediated one.
Blotting, Western ; Cell Line* ; Gelatin ; Gelatinases ; Humans* ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; RNA, Messenger ; Trophoblasts*

PURPOSE: This study was aimed to evaluate the clinical features of seizures in breastfed children with vitamin D deficient rickets. METHODS: Seventeen children, breastfed and diagnosed as vitamin D deficient rickets at Inha University Hospital from January 2000 to July 2010, were retrospectively investigated. Subjects were divided into two groups according to the presence/absence of seizures. Demographic and biochemical results were compared and statistically analyzed between the two groups, and the relative risk for seizure occurrence was estimated. Clinical features of seizures were also analyzed. RESULTS: Out of the 17 subjects, nine patients (53.0%) had seizures, while eight patients (47.0%) did not. The mean age for the two groups were 4.1+/-2.0 months and 9.3+/-2.7 months, respectively, which was statistically different between the two groups (P<0.0001). Serum calcium (Ca) and 25-hydroxyvitamin D3 (25-OHD3) levels were significantly lower in the 'seizure' group (5.7+/-1.0 vs. 9.5+/-0.9 mg/dL, P<0.0001; 5.7+/-0.8 vs. 15.3+/-4.2 IU/L, P<0.0001). The relative risk for seizure occurrence was 8 times higher in hypocalcemia and 17 times higher in 25-OHD3<8 ng/mL. Seizures occurred several times as generalized or focal types, but none of them developed epilepsy nor showed developmental abnormalities later on. CONCLUSION: Seizures in breastfed children with vitamin D deficiency rickets are mainly due to hypocalcemia, which is affected by 25-OHD3 levels. Seizures may also occur more frequently in children in the stages of rapid growth. Although seizures occurred multiple times, future outcomes were favorable. Further large-scaled prospective studies are required in the future.
Breast Feeding ; Calcifediol ; Calcium ; Child ; Epilepsy ; Humans ; Hypocalcemia ; Retrospective Studies ; Rickets ; Seizures ; Vitamin D ; Vitamin D Deficiency

PURPOSE: This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. PATIENTS AND METHODS: We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria(<40 mg/m2/day) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(> or =40 mg/m2/day), hypertension, and chronic renal failure. RESULTS: The mean age at presentation was 9.5+/-2.8 years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26 %), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of 7.0+/-3.5 years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events:4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed impaired renal function. By univariate analysis using the chi-square test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. CONCLUSION: We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.
Biopsy ; Blood Pressure ; Child* ; Classification ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Male ; Natural History ; Prognosis* ; Proteinuria ; Urinalysis

A 28-year-old female presented with a palpable mass lesion on the superonasal aspect of her right globe and she had a progressive diplopia. She had a scleral encircling surgery with a Miragel explant (MIRA, Waltham, Mass, USA) for the tractional retinal detachment associated with pars planitis 9 years previously. On examination, she revealed restricted eye movements of her right eye. The magnetic resonance imaging documented a swelling of the Miragel explant that mimicked a periorbital mass lesion. The Miragel explant was removed and fragmentation of the explant was found intraoperatively. The removed Miragel explant was examined by a scanning electron microscopy, and this demonstrated a disintergrated and swollen structural composition of the Miragel explant. Postoperatively, her extraocular movement was almost restored and the retina remained well attached. Alterations in the structural composition of the Miragel explant results in an excessive swelling that causes a restriction of the extraocular movement, and this can mimick a periorbital mass lesion.
Adult ; Diplopia/*etiology ; Female ; Granuloma, Plasma Cell, Orbital/*etiology ; Humans ; Magnetic Resonance Imaging ; Polyhydroxyethyl Methacrylate/*adverse effects/*analogs & derivatives ; Retinal Detachment/surgery ; Scleral Buckling/*adverse effects ; Visual Fields

PURPOSE: To evaluate the effects of photodynamic therapy with verteporfin on visual acuity and fluorescein angiography in choroidal neovascularization (CNV) associated with pathologic myopia and to determine if this treatment could reproduce the results achieved in the Verteporfin in Photodynamic Therapy (VIP) Trial in Korean patients. METHODS: Forty-two eyes of 39 patients with CNV secondary to pathologic myopia were included. A retrospective review of their clinical records and fluorescein angiography was done. The patients underwent photodynamic therapy with verteporfin and were followed up for more than 6 months after the therapy. The change in best corrected visual acuity (BCVA) and leakage in fluorescein angiography were evaluated. RESULTS: The mean age of the patients was 39.6 and mean follow-up period was 23.5 months. The BCVA of the patients improved in 22 (52.4%) eyes, was unchanged in 13 (30.9%), and worsened in 7 (16.7%). The leakage in fluorescein angiography decreased in 25 (59.5%) eyes. CONCLUSIONS: Photodynamic therapy with verteporfin for myopic CNV in Korean patients appeared to be effective in stabilization of the lesions and improvement of visual acuity.
Choroidal Neovascularization ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Myopia ; Photochemotherapy* ; Retrospective Studies ; Visual Acuity

A pancreatic pseudocyst with a mediastinal extension is a rare clinical entity. Intrathoracic symptoms such as dysphagia or dyspnea due to compression or associated pleural effusions are quite common. The pseudocysts transverse the diaphragm via the esophageal hiatus or aortic hiatus or by eroding directly through the diaphragm. Here, we report a case of a pancreatic pseudocyst with a mediastinal extension presenting as dysphagia and dyspnea. The diagnosis was confirmed by computerized axial tomography of the chest and abdomen. Usually, the proper management of a larger pseducocyst includes percutaneous or surgical internal drainage, but in this case the mediastinal components disappeared with conservative medical treatment.
Abdomen ; Cytochrome P-450 CYP1A1 ; Deglutition Disorders ; Diagnosis ; Diaphragm ; Drainage ; Dyspnea ; Mediastinum ; Pancreatic Pseudocyst* ; Pleural Effusion ; Thorax

BACKGROUND: Cortical blindness is one of the less known clinical syndromes caused by bilateral occipital lobe lesions. The most common etiology is bilateral posterior cerebral artery (PCA) infarction, and the prognosis has been reported to be bad and incomplete. METHODS: We reviewed our registry from January 1999 to March 2002, and found seventeen patients who were diagnosed with cortical blindness. We analyzed their clinical features, neurologic examinations, radiologic findings, electrophysiological studies, and follow up their visual acuities. RESULTS: Of the sixteen cases, ten were bilateral PCA infarction, three were postpartum eclampsia, two were cyclosporin-induced blindness and the other was the case recovered from cardiac arrest. Most patients' presenting symptoms were headache and sudden visual loss, ranged from finger count to complete blindness. There were two patients with complete blindness. On the follow up examination, twelve patients regained some visual acuity. The wider lesion involved bilateral occipital lobes; the worse was initial visual acuity. The prognosis was better when the lesion size was small and extrastriate cortex was spared. The electroencephalography and visual evoked potential findings were compatible with clinical symptom, but not exactly correlated with the prognosis. CONCLUSIONS: Contrary to the general concept that cortical blindness is caused by bilateral occipital lobe infarction has a poor prognosis, our cases showed a fair outcome of vision. It was a good predictor for prognosis whether extrastriate cortex was spared or not, suggesting its role in visual recovery.
Blindness ; Blindness, Cortical* ; Eclampsia ; Electroencephalography ; Evoked Potentials, Visual ; Female ; Fingers ; Follow-Up Studies ; Headache ; Heart Arrest ; Humans ; Infarction ; Infarction, Posterior Cerebral Artery ; Neurologic Examination ; Occipital Lobe ; Posterior Cerebral Artery ; Postpartum Period ; Pregnancy ; Prognosis* ; Visual Acuity