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

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

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

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

No abstract available.
Adult ; Aged ; Aged, 80 and over ; Blood Chemical Analysis/instrumentation ; Blood Platelets/*cytology/physiology ; Female ; Flow Cytometry/*instrumentation/standards ; Humans ; Male ; Middle Aged ; Platelet Count/*instrumentation/standards ; Reference Values ; Republic of Korea ; Young Adult

OBJECTIVE: To investigate associations between angiotensin-converting enzyme (ACE) polymorphisms and muscle fatigability in 65-year-old Koreans. METHOD: The study participants were 49 Koreans aged 65 years. ACE insertion/deletion (I/D) polymorphisms were determined by polymerase chain reaction and serum ACE activity, by spectrophotometry. Body mass index (BMI), body fat mass (BFM), and lean body mass (LBM) were determined. To evaluate muscle fatigability, dynamic Electromyography was used to measure maximum voluntary isometric contractions (MVICs) of ankle plantar flexor muscles. Patients were seated with their hips flexed at 90degrees, knees fully extended, and ankles at 0degrees. Continuous submaximal VICs (40% MVIC) were then performed, and contraction duration and EMG frequency changes during the initial 2 min were measured. A self-reported physical activity questionnaire was used to evaluate effects of ACE activity levels on muscle fatigability. RESULTS: Among the 49 volunteers, 15 showed II genotype; 22, ID genotype; and 12, DD genotype. Serum ACE activity levels were significantly higher in DD genotype subjects than in II genotype subjects (p<0.05). Furthermore, the duration of submaximal isometric contractions was longer in II and ID genotype subjects than in DD genotype subjects (p<0.05). Dynamic EMG showed significantly lower mean frequency changes in II genotype subjects than in DD genotype subjects (p<0.05). However, LBM, BFM, and BMI were independent of ACE genotypes. CONCLUSION: ACE II genotype subjects showed significantly higher resistant to muscle fatigue than that by DD genotype subjects. However, body composition and BMI showed no correlations with ACE I/D polymorphisms.
Adipose Tissue ; Aged ; Animals ; Ankle ; Body Composition ; Body Mass Index ; Contracts ; Electromyography ; Genotype ; Hip ; Humans ; Isometric Contraction ; Knee ; Motor Activity ; Muscle Fatigue ; Muscles ; Peptidyl-Dipeptidase A ; Polymerase Chain Reaction ; Spectrophotometry ; Surveys and Questionnaires

OBJECTIVE: To assess the practical diagnostic value of facial nerve antidromic evoked potential (FNAEP), we compared it with the diagnostic value of the electroneurography (ENoG) test in Bell's palsy. METHODS: In total, 20 patients with unilateral Bell's palsy were recruited. Between the 1st and 17th days after the onset of facial palsy, FNAEP and ENoG tests were conducted. The degeneration ratio and FNAEP latency difference between the affected and unaffected sides were calculated in all subjects. RESULTS: In all patients, FNAEP showed prolonged latencies on the affected side versus the unaffected side. The difference was statistically significant. In contrast, there was no significant difference between sides in the normal control group. In 8 of 20 patients, ENoG revealed a degeneration ratio less than 50%, but FNAEP show a difference of more than 0.295+/-0.599 ms, the average value of normal control group. This shows FNAEP could be a more sensitive test for Bell's palsy diagnosis than ENoG. In particular, in 10 patients tested within 7 days after onset, an abnormal ENoG finding was noted in only four of them, but FNAEP showed a significant latency difference in all patients at this early stage. Thus, FANEP was more sensitive in detecting facial nerve injury than the ENoG test (p=0.031). CONCLUSION: FNAEP has some clinical value in the diagnosis of facial nerve degeneration. It is important that FNAEP be considered in patients with facial palsy at an early stage and integrated with other relevant tests.
Bell Palsy* ; Diagnosis ; Evoked Potentials* ; Facial Nerve Injuries ; Facial Nerve* ; Facial Paralysis ; Humans

BACKGROUND/AIMS: Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat and a commonly encountered clinical condition. We aim to evaluate the prevalence of gastroesophageal reflux disease (GERD) and to determine the parameters for predicting the response to treatment with proton pump inhibitor (PPI) using wireless pH monitoring in patients with globus sense. METHODS: We retrospectively reviewed the medical records of 37 patients with atypical GERD symptoms. A total of 27 patients with dominant globus sense were enrolled. Endoscopic examination and 48-hour wireless esophageal pH monitoring were performed, and the patients underwent a therapeutic trial of full dose PPIs daily over a period of 4 weeks. RESULTS: Both typical and atypical GERD symptoms co-existed in 14 patients (51.9%, 14/27). According to ROME III criteria, 19 patients (70.4%, 19/27) were diagnosed as GERD. Twelve patients (44.4%, 12/27) were PPI responders. A significant difference in the frequency of symptom index (+) or symptom associated probability (+) was observed between the PPI responder group and the non-responder group (p<0.01). CONCLUSIONS: In patients with globus sense, 70.4% were diagnosed with GERD. Symptom index/symptom associated probability in wireless ambulatory pH monitoring was a good objective parameter for PPI responder.
Adult ; Aged ; Case-Control Studies ; Endoscopy, Digestive System ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux/*diagnosis/drug therapy/pathology ; Humans ; Male ; Manometry ; Middle Aged ; Proton Pump Inhibitors/therapeutic use ; Retrospective Studies ; Severity of Illness Index ; Wireless Technology