Purpose: This study aimed to examine the level of self-concept and psychosocial well-being among women with BRCA1 or BRCA2 gene mutations and to identify factors affecting their psychosocial well-being. Methods: A cross-sectional design was used.Data were collected from an online community comprising Korean patients with breast cancer and their families. A total of 98 women with BRCA1 or BRCA2 gene mutations completed the online questionnaire comprising the BRCA self-concept scale, the psychosocial well-being index-short form, demographic characteristics, and disease-related characteristics. Descriptive statistics, frequencies, independent t-tests, one-way ANOVA, Pearson’s correlation, and multiple regression were used for data analysis. Results: The total self-concept level at 82.13±15.45 (range: 17~119), and the psychosocial well-being level at 28.81±9.51 (range: 0~54) indicated a high-risk group of psychosocial well-being among the surveyed women with BRCA gene mutations compared with Korean general office workers. Self-concept (β=.57, p<.001) and monthly family income (≥4,500 USD)(β=-.24, p=.048) significantly affected the psychosocial well-being of women with BRCA1 or BRCA2 gene mutations. Conclusion The level of self-concept and psychosocial well-being of women with BRCA1 or BRCA2 gene mutations should be assessed carefully, and tailored consultation and educational programs should be developed to overcome a negative self-concept. Supportive systems for financially vulnerable women with BRCA1 or BRCA2 gene mutations should be considered.

The title of page 189 should be corrected.

INTRODUCTION: Human attachment is known to be closely associated with psychophysiological phenomenon. However, there have not been enough researches on the relationship of the attachment with sleep, especially with insomnia. The objective of the present study was to investigate the relationship between adult attachment styles and insomnia in community-dwelling population. METHODS: One hundred seventy seven community-dwelling adults (74 males and 103 females ;mean age 41.23+/-8.44) participated in the current study. To assess the attachment styles (secure, dismissing, preoccupied and fearful), self-reporting Relationship Style Questionnaires (RSQ) were completed by the participants. Presence, type, frequency and duration of insomnia in the last month were also investigated. RESULTS: Compared to subjects without insomnia, subjects with insomnia had higher fearful attachment scores (t =2.87, p=0.005). Higher fearful attachment score were found in all subtypes of insomnia (sleep-onset insomnia, t =2.33, p=0.021;maintenance insomnia, t=2.92, p=0.004;terminal insomnia, t=2.89, p=0.004). Subjects with frequent (>or =3 per week) insomnia had higher fearful attachment scores than subjects with infrequent (or =6 months) had higher preoccupied attachment scores relative to subjects with transient insomnia (<6 months), (t=2.57, p=0.012). CONCLUSION: In the current study, attachment styles were different depending on the characteristics of insomnia. The fearful attachment was associated with the presence of insomnia, while the preoccupied attachment was associated with the chronicity of insomnia. These findings suggest that there may be some relationship between the adult attachment styles and the clinical features of insomnia.
Adult ; Female ; Humans ; Male ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children’s facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject’s compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children’s facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.

BACKGROUND: Midazolam has been reported to have a spinally mediated antinociceptive effect. In this randomized, double-blind study, we evaluated whether a small dose of midazolam added to fentanyl-ropivacaine mixture for PCEA (patient controlled epidural analgesia) improves epidural analgesia in patients underwent elective subtotal gastrectomy. METHODS: Forty five patients, ASA physical status I and II, undergoing subtotal gastrectomy were randomly allocated to receive 0.2% ropivacaine mixed with fentanyl 4microg/ml or 0.2% ropivacaine mixed with fentanyl 4microg/ml and midazolam 0.2 mg/ml. The infusion rate was set to deliver 4 ml/hr of the study solution, with a bolus of 2 ml per demand and a 20 minutes lockout time. RESULTS: Infused volume (P < 0.05) and VAS scores (P < 0.05) was significantly lower in the patients receiving midazolam. However, there were no differences in requiring rescue analgesics, PONV (postoperative nausea and vomiting), sedation scores, urinary retention, and pruritus between groups. CONCLUSIONS: Small dose of midazolam could augment analgesia without adverse effects when added to thoracic epidural infusion of fentanyl and ropivacaine.
Amides ; Analgesia ; Analgesia, Epidural ; Analgesics ; Double-Blind Method ; Fentanyl ; Gastrectomy ; Humans ; Midazolam ; Nausea ; Postoperative Nausea and Vomiting ; Pruritus ; Urinary Retention

OBJECTIVE: Mid-sized hospital websites were assessed to examine how their attributes influence outcome indicators as a potential marketing strategy. Specifically, the website attributes considered were accessibility, content sufficiency, and layout design, while outcome indicators were evaluated, based on satisfaction with the website, intention to revisit the website, and intention to recommend the hospital. METHODS: Five representative websites were selected according to their ranks derived from major ranking sites. The diversity of the websites were emphasized. Then, a questionnaire survey was conducted on 74 respondents. Collected data was analyzed, using frequency, correlation, and repeated measures analysis of variance. RESULTS: All three attributes were related to satisfaction with the website; in addition, both content sufficiency and layout design were significantly related to the intention to revisit. As for the intention to recommend the hospital, only the content sufficiency was significant. In particular, the sufficiencies on 'disease or symptoms' and 'question and answer' were important to all three outcome indicators. CONCLUSION: The websites serve as a marketing tool in managing mid-sized hospitals. Well-designed websites containing sufficient contents facilitate visitor's satisfaction and intention to revisit the website, as well as furthering their intention to recommend the hospital.
Surveys and Questionnaires ; Hospital Administration ; Intention ; Internet ; Marketing ; Personal Satisfaction

Linoleic acid [LA; 18: 2 (n-6)] is the most abundant polyunsaturated fatty acid in human skin. The exclusion of LA from diet induces epidermal hyperproliferation, which is reversible by the inclusion of LA in diet, and hence, LA is heralded as an essential fatty acid (EFA). Since safflower oil (SO) has been widely recognized as the major dietary source of LA and Arctii Fructus (Arctium lappa L.) is recently reported to contain high level of LA, we compared the antiproliferative effects of SO and Arctii Fructus in this study. Epidermal hyperproliferation was induced in guinea pigs by hydrogenated coconut oil (HCO) diet for 8 wk. During following 2 wk, EFA deficient guinea pigs were fed diets of safflower oil (group HS), water extract of Arctii Fructus (group AW) or organic extract of Arctii Fructus (group AO). Normal control group was fed SO containing diet (group SO) and EFA deficient group was fed HCO containing diet (group HCO) for 10 wk. Epidermal hyperproliferation was reversed in groups AO (55.9% of group HCO) and HS(74.1% of group HCO). However, the thymidine incorporation into epidermal DNA of group HS was greater than of normal control group SO. Epidermal hyperproliferation was not reversed in group AW. The accumulations of LA into phospholipids and ceramides, and of 13-hydroxyoctadecadienoic acid (13-HODE), the potent antiproliferative metabolite of LA in the epidermis of group AO were greater than of group HS. In contrast, the de novo synthesis of ceramides, the major lipids maintaining epidermal barrier, did not differ between all of groups. Together, our data demonstrate that organic extract of Arctii Fructus is more prominent than safflower oil in reversing epidermal hyperproliferation by inducing the higher accumulations of LA and 13-HODE in the epidermis of guinea pigs.
Animals ; Ceramides ; Cocos ; Diet ; DNA ; Epidermis ; Guinea Pigs* ; Guinea* ; Humans ; Hydrogen ; Linoleic Acid* ; Phospholipids ; Safflower Oil ; Skin ; Thymidine ; Water

More than half of the world’s populations are considered to be infected by Helicobacter pylori. It causes a chronic inflammation of the stomach, which is implicated in the pathogenesis of gastric ulcer and cancer. Silibinin, a polyphenolic flavonoid derived from milk thistle, has been known for its hepatoprotective effects, and recent studies have revealed its chemopreventive potential. In the present study, we examined the anti-inflammatory effects of silibinin in human gastric cancer MKN-1 cells and in the stomach of C57BL/6 mice infected by H. pylori. Pretreatment with silibinin attenuated the up-regulation of COX-2 and inducible nitric oxide synthase (iNOS) in H. pylori-infected MKN-1 cells and mouse stomach. In addition, the elevated translocation and DNA binding of NFκB and STAT3 induced by H. pylori infection were inhibited by silibinin treatment. Moreover, H. pylori infection in combination with high salt diet resulted in dysplasia and hyperplasia in mouse stomach, and these pathological manifestations were substantially mitigated by silibinin administration. Taken together, these findings suggest that silibinin exerts anti-inflammatory effects against H. pylori infection through suppression of NF-κB and STAT3 and subsequently, expression of COX-2 and iNOS.

More than half of the world’s populations are considered to be infected by Helicobacter pylori. It causes a chronic inflammation of the stomach, which is implicated in the pathogenesis of gastric ulcer and cancer. Silibinin, a polyphenolic flavonoid derived from milk thistle, has been known for its hepatoprotective effects, and recent studies have revealed its chemopreventive potential. In the present study, we examined the anti-inflammatory effects of silibinin in human gastric cancer MKN-1 cells and in the stomach of C57BL/6 mice infected by H. pylori. Pretreatment with silibinin attenuated the up-regulation of COX-2 and inducible nitric oxide synthase (iNOS) in H. pylori-infected MKN-1 cells and mouse stomach. In addition, the elevated translocation and DNA binding of NFκB and STAT3 induced by H. pylori infection were inhibited by silibinin treatment. Moreover, H. pylori infection in combination with high salt diet resulted in dysplasia and hyperplasia in mouse stomach, and these pathological manifestations were substantially mitigated by silibinin administration. Taken together, these findings suggest that silibinin exerts anti-inflammatory effects against H. pylori infection through suppression of NF-κB and STAT3 and subsequently, expression of COX-2 and iNOS.

Objective: This study aimed to investigate the regional amyloid burden and myocardial deformation using T1 mapping and strain values in patients with cardiac amyloidosis (CA) according to late gadolinium enhancement (LGE) patterns. Materials and Methods: Forty patients with CA were divided into 2 groups per LGE pattern, and 15 healthy subjects were enrolled. Global and regional native T1 and T2 mapping, extracellular volume (ECV), and cardiac magnetic resonance (CMR)-feature tracking strain values were compared in an intergroup and interregional manner. Results: Of the patients with CA, 32 had diffuse global LGE (group 2), and 8 had focal patchy or no LGE (group 1). Global native T1, T2, and ECV were significantly higher in groups 1 and 2 than in the control group (native T1: 1384.4 ms vs. 1466.8 ms vs. 1230.5 ms; T2: 53.8 ms vs. 54.2 ms vs. 48.9 ms; and ECV: 36.9% vs. 51.4% vs. 26.0%, respectively; all, p < 0.001). Basal ECV (53.7%) was significantly higher than the mid and apical ECVs (50.1% and 50.0%, respectively; p < 0.001) in group 2. Basal and mid peak radial strains (PRSs) and peak circumferential strains (PCSs) were significantly lower than the apical PRS and PCS, respectively (PRS, 15.6% vs. 16.7% vs. 26.9%; and PCS, -9.7% vs. -10.9% vs. -15.0%; all, p < 0.001). Basal ECV and basal strain (2-dimensional PRS) in group 2 showed a significant negative correlation (r = -0.623, p < 0.001). Group 1 showed no regional ECV differences (basal, 37.0%; mid, 35.9%; and apical, 38.3%; p = 0.184). Conclusion Quantitative T1 mapping parameters such as native T1 and ECV may help diagnose early CA. ECV, in particular, can reflect regional differences in the amyloid deposition in patients with advanced CA, and increased basal ECV is related to decreased basal strain. Therefore, quantitative CMR parameters may help diagnose CA and determine its severity in patients with or without LGE.