OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment

PURPOSE: The purpose of this study was to investigate the current status of dietary education carried out by dieticians or nutrition teachers at elementary, middle, and high schools in Gyeonggi province. We compared dietary education status not only among school level but also between dieticians and nutrition teachers. METHODS: The survey using self-administered questionnaires was conducted by dieticians or nutrition teachers at 91 schools (43 elementary schools, 33 middle schools, and 15 high schools) in Gyeonggi province in December, 2015. The questionnaire consisted of questions regarding general characteristics of respondents, current status of dietary education, opinion about dietary education methods, and cooperation level of persons concerned. RESULTS: The placement rate of nutrition teachers was 50.5% overall. Only 36 out of 91 schools conducted regular dietary education, and the percentage of schools conducting regular dietary education was significantly different according to school level with the lowest percentage in high schools, equivalent to 20% (p = 0.003). The average annual dietary education time was 12.4 hours, and it was very low in high schools (5.1 hours) and in schools without a nutrition teacher (1.6 hours). The levels of cooperation and support from principals, teachers, parents, and students were significantly lower in high schools than elementary and middle schools (all p < 0.001) and in schools without a nutrition teacher than schools with a nutrition teacher (all p < 0.05). CONCLUSION: The results show that the level of dietary education is not enough and needs to be improved, especially at middle and high schools and at schools without a nutrition teacher. Government support polices need to be implemented to encourage dietary educational activities.
Education* ; Gyeonggi-do* ; Humans ; Nutritionists ; Parents ; Surveys and Questionnaires

beta-amyloid peptide (Abeta) consisting of 40 to 42 amino acid is the principle constituent of senile plaques in Alzheimer's disease. Although, the hypothesis that deposition of AP triggers a cascade of events leading to the pathology of Alzheimer's disease has been widely accepted, direct evidence for triggering accumulation of phosphorylated tau in paired helical filament is rare. In this study, we examined neurotoxicity induced by 3 kinds of beta-amyloid peptides 1 ~28, 25~,35 and 1~40 to elucidate the way of mechanism trading to neuronal cell death caused by Abeta using cultured hippocampal neurons. For this purpose, we measured lactate dehydrogenase (LDH) in the culture media after treatment with Abeta combined with anti-oxidant drug, trolox, or not. By histochemical and TUNEL method, we studied the change of immunoreaction to anti-MAP-2 (microtubule associated protein -2, the main component of neuritis) and detected apoptotic cells, respectively, in the hippocampal neurons treated with Abeta. To investigate whether tau phosphorylation involve neurotoxicity induced by Abeta, we immunostained the neurons with anti-SMI-31 to recognize phosphorylated Ser 396/404 of tau. From our data, we suggested that Abeta1-40 and Abeta25-35 induced marked neurodegenerative changes, and the mechanism responsible for cell death caused by Abeta -neurotoxicity was associated with the apoptosis. Because Abeta-neurotoxicity was not inhibited by anti-oxidant, trolox, we suggested that anti-oxidant did not protect the neuronal cells against the damage induced by Abeta in ou. expo.imental envi.onment. Finally, we suggested that AP treatment did not potentiate the immunoreactivity to anti-phosphorylated tau antibody and we speculated that Abeta-neurotoxicity led hippocampal cells to apoptosis without tau phosphorylation.
Alzheimer Disease ; Apoptosis* ; Cell Death ; Culture Media ; In Situ Nick-End Labeling ; L-Lactate Dehydrogenase ; Neurons* ; Pathology ; Peptides* ; Phosphorylation* ; Plaque, Amyloid

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are main pathogens of bloodstream infection. We compared the epidemiology of ESBL-producing E. coli and K. pneumoniae. METHODS: From January 2003 through March 2007, we retrospectively investigated the clinical characteristics and comorbidities of patients with bloodstream infection by ESBL-producing E. coli and K. pneumoniae. RESULTS: During the study period, 79 patients (54 with E. coli and 25 with K. pneumoniae) with blood cultures positive for ESBL-producing E. coli or K. pneumoniae were studied. When comparing the source of bloodstream infections, urinary tract infections (UTIs) were more commonly caused by E. coli (24% vs. 0; P=0.007), and respiratory tract and soft tissue infection (36% vs. 15%; P=0.04, 12% vs. 0; P=0.03, respectively) were more commonly associated with K. pneumoniae. Among hospital-acquired bloodstream infection, third-generation cephalosporin was more commonly used in patients with E. coli than patients with K. pneumoniae (81% vs. 24%, P<0.001). Medical devices (central venous catheter and urinary catheter) were more commonly used in patients with K. pneumoniae. CONCLUSION: ESBL-producing E. coli bloodstream infection is more common in urinary tract infections. ESBL-producing K. pneumoniae is more common in respiratory tract infections and in skin and soft tissue infections. In hospital-acquired infections, ESBL-producing E. coli bloodstream infection is more common in biliary tract infection. ESBL-producing E. coli was more commonly associated with prior frequent antibiotics use and K. pneumoniae was more commonly associated with use of medical devices.
Anti-Bacterial Agents ; beta-Lactamases ; Biliary Tract ; Catheters ; Comorbidity ; Epidemiology* ; Escherichia coli* ; Humans ; Klebsiella pneumoniae* ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Urinary Tract Infections

Purpose: The study aimed to classify patient safety accident and nursing malpractice types through a content analysis of litigation cases in which nurses were found guilty. Methods: Data on malpractice cases were collected from the official website of the Korean judiciary. This analysis was conducted in stages according to the systematic content analysis method. A total of 46 cases consisting of 14 criminal cases and 32 civil cases were selected for analysis, and classified based on the types of safety accident and nursing malpractice. Results: Eleven categories and 14 subcategories of accidents were extracted from 71 significant statements. The 11 categories of accidents consisted of falls, medication, burns, treatment, diet, medical equipment, delivery, exams, surgery, infection, and suicide. Five categories and 14 subcategories of nursing malpractice were extracted from 71 significant statements. The five categories of malpractice were as follows: failure to take affirmative action to prevent accidents, monitor, follow guidelines, use equipment properly, and reports. Conclusion These findings highlight the importance of nurses’ independent roles as patients’ safety managers. It can be used as primary data to develop organizational and educational support for nurses seeking to perform their professional roles in ensuring patient safety.

The small scale industries in Korea are important in occupational health care management due to high accident rate and poor working condition. The authors surveyed the 4,811 small scale industries participated in the 1997 subsidiary program on health care management. The contents of survey were the general characteristics of the factory, the results of workers' general and occupational health examination, the results of workplace environmental monitoring, and the number of occupational accident and injured person at 1995 and 1996. We classified all industries by 67 groups. The prevalence of the general disease was higher in 'Manufacture of other fabricated metal productsj. rManufacture of textiles', 'Manufacture of basic metalsj. In occupational disease, that was higher in FManufacture of metal products', 'Manufacture of basic metals', so in environmental monitoring in 'Manufacture of textiles', 'Manufacture of other fabricated metal products' 'Printfrig' in occupational injuries in 'Manufacture of chemical products', 'Manufacture of basic metals'. However the factories of 'manufacture of motor vehicle', 'manufacture of machine and equipment', 'manufacture of electric product' in the program are large in magnitude, but less important in occupational health management. We observed that the prevalence of general disease, occupational disease, workplace environmental monitoring, occupational injuries of subsidized industries in 1996 were increased compared with those in 1995. and were larger than those of nationwide statistics. These phenomenon shows that the subsidiary health program for participated industries is important and to be urgent. We observed that the major groups in district were different and so the approaching method of each district must be various and different. And the health program manager should focus on the C grade in health examination and the action level in workplace monitoring more than the D grade and the permissible level.
Accidents, Occupational ; Delivery of Health Care* ; Environmental Monitoring ; Humans ; Korea ; Occupational Diseases ; Occupational Health* ; Occupational Injuries ; Prevalence

OBJECTIVES: Clinical utility of the Short Form of the Samsung Dementia Questionnaire (S-SDQ) as a screening instrument for Mild Cognitive Impairment (MCI). METHODS: Three groups (n=27, Subjective Memory Impairment (SMI); n=41 MCI; n=79, Early Alzheimer's Disease(AD)) recruited from memory clinic were administered a battery of neuropsychological tests including S-SDQ and Korean version-Mini Mental State Examination (K-MMSE). RESULTS: S-SDQ, unlike the K-MMSE, had no association with the age and education of the subjects. Scores of S-SDQ was found to correlate (r=-.496) with scores of K-MMSE. Result of Receiver Operating Characteristic (ROC) analysis revealed that S-SDQ discriminated between the SMI and the MCI groups. CONCLUSION: S-SDQ may be a solution to the problem of contamination by education and age which affect traditional cognitive screening instruments like K-MMSE, and it may be a useful tool for screening MCI.
Dementia* ; Education ; Mass Screening ; Memory ; Mild Cognitive Impairment* ; Neuropsychological Tests ; Surveys and Questionnaires* ; ROC Curve

Pheochromacytoma, although occasionally present with adrenal cortical hyperfunction, is rarely associated with nonfunctioning adrenal cortical tumor. To our knowledge, eight cases of phemchromocytoma associated with adrenocortical adenoma have been reported in the literature, including a case in a Korean adult female. An adrenal mass is considered an incidentaloma when there is no history or physical findings suggesting an adrenal functional disorder or tumor. The majority of adrenal masses are nonfunctioning adrenocortical adenomas. In our case, left adrenal mass was found incidentally by ultrasonography after birth, done because of mother's oligohydroamnios. Abdomial CT study revealed an adrenal tumor, and a surgical resection was performed. The specimen showed a coincident pheochromocytoma and adrenocortical adenoma. The patient seems to be the first case of coexistence of nonfunctioning pheochromocytoma and adrenocortical adenoma in one adrenal tumor. We report this case with the review of literatures.
Adrenocortical Adenoma* ; Adult ; Female ; Humans ; Infant* ; Parturition ; Pheochromocytoma* ; Ultrasonography

PURPOSE: We encountered a rare case of optic neuritis that developed in a sphenoid sinusitis. This case has not been reported at any of the Korean Ophthalmological Society meetings. CASE SUMMARY: A 12-year-old boy with swollen optic disc was diagnosed with optic neuritis secondary to sphenoid sinusitis, through orbit MRI (magnetic resonance imaging) and paranasal sinus CT (computed tomography). We observed the recovery of visual acuity and the improvement of papilledema after treatment. In the initial examination, the BCVA (best-corrected visual acuity) of the right eye was only hand movement. Papilledema was detected by ophthalmoscopy. Orbit MRI and paranasal sinus CT were then performed, which revealed that sphenoid sinusitis had invaded the right optic nerve. Treatment included the use of antibiotics, systemic steroid therapy, and endoscopic sinus surgery. One month after treatment, the BCVA of the right eye was 1.0 and the papilla of right eye had a normal ophthalmoscopic finding. CONCLUSIONS: Sphenoid sinusitis can be a cause of optic neuritis. The treatment of optic neuritis caused by paranasal sinusitis must include antibiotics use or endoscopic sinus surgery to remove the sinus inflammation as well as high dose steroid therapy.
Anti-Bacterial Agents ; Child ; Hand ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Male ; Ophthalmoscopy ; Optic Nerve ; Optic Neuritis* ; Orbit ; Papilledema ; Sinusitis ; Sphenoid Sinus* ; Sphenoid Sinusitis* ; Visual Acuity

Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.
Abdomen ; Cecum ; Cerebral Palsy ; Constipation ; Decompression ; Epilepsy ; Humans ; Intestinal Volvulus ; Laparotomy ; Lissencephaly ; Male