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

This study was conducted to develop a nutrition education workbook to improve picky eating in children and to evaluate the effect of nutrition education using this developed workbook. The developed workbook focused on 2nd and 3rd grade students and consisted of five units. The contents included: multi-grain, vegetables (2 units), fish, and milk. The activities, including observation, and learning the roles and names of the foods, were developed mainly to increase motivation for eating a balanced diet. This workbook was developed from April to December 2008, and was applied at 15 elementary schools containing 1,674 students from April to September 2009 in Changwon City, Korea. We evaluated changes in knowledge before and after education on nutrition, eating behavior, dietary habits, and educational activities using self-administered questionnaires. The children demonstrated significant improvements in nutritional knowledge (P<0.001), eating behavior (P<0.001), and dietary habits (P<0.001). Most of the children answered that the education program was helpful and exciting. Based on these results, we believe that the developed workbook is suitable for children picky eaters, and hope it will be used in the field of child nutrition education.
Child ; Diet ; Eating ; Feeding Behavior ; Food Habits ; Humans ; Korea ; Learning ; Milk ; Motivation ; Surveys and Questionnaires ; Vegetables

OBJECTIVES: The purpose of this study was to investigate the clinical utility of the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV) and General Ability Index (GAI) in children with attention-deficit hyperactivity disorder (ADHD). METHODS: The GAI and Full Scale IQ (FSIQ) in K-WISC-IV were compared for a group of 79 children with ADHD and 234 normal children. The mean differences within each group were testified by the t-test and Cohen's d. The Wechsler's descriptive classifications for each GAI and FSIQ score were analyzed in the children with ADHD. Additionally, the critical value for the difference between the means of the FSIQ and GAI was calculated in the normal children. RESULTS: The score on the GAI was higher than that on the FSIQ in the children with ADHD, with a mean difference of 2.19 points. The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. According to Wechsler's descriptive classification, the application of the GAI showed a lower (7.59%), equal (61.65%) or higher (60.76%) prevalence of ADHD compared to the application of FSIQ. CONCLUSION: The implications of these findings are discussed regarding the cognitive characteristics of the children with ADHD. The GAI reflecting the attention and behavioral problems in children with ADHD could be utilized as an alternative global intelligence estimate that considers their potential for development.
Child ; Classification ; Humans ; Intelligence* ; Prevalence ; Problem Behavior

Charcot-Leyden crystals are slender, hexagonal, bipyramidal crystals formed predominantly from eosinophil but also from basophil granules composed of a single protein of 17,400 daltons of lysophospholipase activity. It has been identified in a variety of body fluids and tissues in human tissues and secretions in association with eosinophilic inflammatory reactions, asthma, myeloid leukemias, and allergic, parasitic, and other diseases. In this report, we describe a child with bronchial obstruction and subsequent atelectasis caused by Charcot-Leyden crystals containing fibronous material who was treated with flexible bronchofiberscope to remove it.
Asthma ; Basophils ; Body Fluids ; Child ; Eosinophils ; Humans ; Leukemia, Myeloid ; Lysophospholipase ; Pulmonary Atelectasis

BACKGROUND/AIMS: Angiodysplasia is important in the differential diagnosis of upper gastrointestinal bleeding (UGIB), but the clinical features and outcomes associated with UGIB from angiodysplasia have not been characterized. We aimed to analyze the clinical characteristics and outcomes of angiodysplasia presented as UGIB. METHODS: Between January 2004 and December 2013, a consecutive series of patients admitted with UGIB were retrospectively analyzed. Thirty-five patients with bleeding from angiodysplasia were enrolled. We compared them with an asymptomatic control group (incidental finding of angiodysplasia in health screening, n = 58) and bleeding control group (simultaneous finding of angiodysplasia and peptic ulcer bleeding, n = 28). RESULTS: When patients with UGIB from angiodysplasia were compared with the asymptomatic control group, more frequent rates of nonantral location and large sized lesion (≥ 1 cm) were evident in multivariate analysis. When these patients were compared with the bleeding control group, they were older (mean age: 67.94 ± 9.16 years vs.55.07 ± 13.29 years, p = 0.03) and received less transfusions (p = 0.03). They also had more frequent rate of recurrence (40.0% vs. 20.7%, p = 0.02). CONCLUSIONS: Non-antral location and large lesions (≥ 1 cm) could be risk factors of UGIB of angiodysplasia. UGIB due to angiodysplasia was more common in older patients. Transfusion requirement would be less and a tendency of clinical recurrence might be apparent.
Angiodysplasia* ; Diagnosis, Differential ; Endoscopy ; Hemorrhage* ; Humans ; Mass Screening ; Multivariate Analysis ; Peptic Ulcer ; Recurrence ; Retrospective Studies ; Risk Factors*

No abstract available.
Aged, 80 and over ; DNA, Ribosomal/chemistry ; Diabetes Mellitus, Type 2/*complications/diagnosis ; Fatal Outcome ; Humans ; Male ; Mucormycosis/*complications/diagnosis/*microbiology ; Rhizopus/*isolation & purification ; Sequence Analysis, DNA ; Sequence Homology ; Tomography, X-Ray Computed

Cerebral hemorrhage is one of the most common causes of dysphagia. In many cases, dysphagia gets better once the acute phase has passed. Structural lesions such as thyromegaly, cervical hyperostosis, congenital web, Zenker's diverticulum, neoplasm, radiation fibrosis, and retropharyngeal abscess must be considered as other causes of dysphagia as well. Retropharyngeal abscess seldom occur in adults and if it does so, a search for a prior dental procedure, trauma, head and neck infection is needed. The symptoms may include neck pain, dysphagia, sore throat, and in rare cases, dyspnea accompanied by stridor. We present a case and discuss a patient who had dysphagia and neck pain after a cerebral hemorrhage. Testing revealed a retropharyngeal abscess. The symptoms were successfully treated after the administration of antibiotics.
Adult ; Anti-Bacterial Agents ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Deglutition Disorders ; Dyspnea ; Humans ; Hyperostosis ; Neck ; Neck Pain ; Pharyngitis ; Radiation Pneumonitis ; Respiratory Sounds ; Retropharyngeal Abscess ; Subarachnoid Hemorrhage ; Zenker Diverticulum

OBJECTIVE: To investigate the effect of gastrocnemius muscle fatigue on postural control ability in elderly people. METHODS: Twenty-four healthy elderly people participated in this study. The postural control ability of single leg standing was evaluated with Health Improvement & Management System (HIMS) posturography before and after fatiguing exercises. After evaluating initial postural control ability, the maximal voluntary contraction (MVC) of ankle plantarflexion was assessed using a surface electromyogram from the medial belly of the gastrocnemius muscle. After a 5-minute resting period, subjects began submaximal isometric ankle plantarflexion (40% MVC) until 40% of MVC was dropped below 95% for 5 seconds, or subject couldn't continue working out due to muscle fatigue. And postural control ability was assessed after fatiguing exercise. The mean deviation of center of pressure (COP), length of COP movement, occupied area of COP were measured, and analyzed by paired t-test. RESULTS: Mediolateral deviation, length of COP movement, and area of COP occupied were increased after fatiguing exercise of the gastrocnemius muscle. Anteroposterior deviation and length of COP movement were also increased, but had low statistical significance. CONCLUSION: These findings suggest that the gastrocnemius muscle fatigue affects mediolateral stability and accuracy during single leg standing in elderly people. Therefore muscle endurance training is necessary to prevent falls in elderly people.
Aged ; Animals ; Ankle ; Contracts ; Exercise ; Fatigue ; Humans ; Leg ; Muscle Fatigue ; Muscle, Skeletal ; Muscles ; Posture

This study provides standardized scientific criteria for education materials on nutrition and diet that could be used in schools, workplaces, and health and medical facilities. The study was conducted from April 2011 to October 2011. Literature reviews, institutional visits, and telephone interviews were conducted for the first draft of the accreditation criteria. Expert meeting and advisory councils were conducted in order to obtain feedback after development of the first draft of accreditation criteria. In order to verify the validity and reliability of the first draft on certification criteria, a survey was sent out to 143 professionals, including professors, researchers, health and medical experts, teachers, nutrition teachers, dietitians, and clinical nutritionists. After several modifications, the final accreditation criteria were established for 1) printed materials (authority, credibility, objectivity, organization, editing, real-life usability, activities and participation, and public interest), 2) web-sites (authority, credibility, objectivity, design, real-life usability, accessibility, currency, and public interest) and 3) materials with activities (credibility, organization, design, convenience of utilizing, safety, and public interest). Out of several criteria, contents (authority, credibility. and objectivity) and publicity (public interest) areas are mandatory requirements. For the accreditation, books for learning and materials with activities are required to meet more than six evaluation components, and the other materials are required to meet more than five evaluation components, including the required area. Accreditation criteria developed in this study could be used as a standard for development or selection of good education materials for nutrition and dietary life.
Accreditation* ; Certification ; Diet ; Humans ; Interviews as Topic ; Learning ; Reproducibility of Results

OBJECTIVE: To confirm a relationship between the pharyngeal response and bolus volume, and examine whether increasing the fluid bolus volume can improve penetration and aspiration for stroke dysphagic patients. METHODS: Ten stroke patients with a delayed pharyngeal response problem confirmed by a videofluoroscopic swallowing study (VFSS) were enrolled. Each subject completed two swallows each of 2 mL, 5 mL, and 10 mL of barium liquid thinned with water. The pharyngeal delay time (PDT) and penetration-aspiration scale (PAS) were measured and the changes among the different volumes were analyzed. RESULTS: PDTs were shortened significantly when 5 mL and 10 mL of thin barium were swallowed compared to 2 mL. However, there was no significant difference in PAS as the bolus volume increased. CONCLUSION: The increased fluid bolus volume reduced the pharyngeal delay time, but did not affect the penetration and aspiration status.
Barium ; Deglutition Disorders* ; Deglutition* ; Fluoroscopy ; Humans ; Pilot Projects* ; Reaction Time ; Respiratory Aspiration ; Stroke ; Swallows ; Water