PURPOSE: This study was conducted to evaluate the effectiveness of a mother/infant-toddler health program developed to enhance parenting knowledge, behavior and confidence in low income mothers and home environment. METHODS: A one-group pretest-posttest quasi-experimental design was used. Sixty-nine dyads of mothers and infant-toddlers (aged 0-36 months) were provided with weekly intervention for seven session. Each session consisted of three parts; first, educating to increase integrated knowledge related to the development of the infant/toddler including nutrition, first aid and home environment; second, counseling to share parenting experience among the mothers and to increase their nurturing confidence; third, playing with the infant/toddler to facilitate attachment-based parenting behavior for the mothers. RESULTS: Following the programs, there were significant increases in parenting knowledge on nutrition and first aid. A significant improvement was found in attachment-based parenting behavior, but not in home safety practice. Nurturing confidence was not significantly increased. The program led to more positive home environment for infant/toddler's health and development. CONCLUSION: The findings provide evidence for mother-infant/toddler health program to improve parenting knowledge, attachment-based parenting behavior and better home environment in low income mothers. Study of the long term effectiveness of this program is recommended for future research.
Adult ; Behavior ; Child, Preschool ; Female ; First Aid ; Health Promotion ; Humans ; Infant ; Infant Welfare ; Infant, Newborn ; Interviews as Topic ; Male ; Mothers/*psychology ; Nutrition Assessment ; Parenting/*psychology ; Poverty ; Program Development ; Program Evaluation ; Self Efficacy

PURPOSE: This study examined the prevalence of food allergies and allergenic factors in a selected sample of children living in Seoul, Korea, along with their dietary habits, environmental factors, and diseases as risk factors for food allergy. The results of this study will provide basic data for addressing food allergies.METHODS: We selected 3,004 pre-school and school-age children, aged 0 ~ 12, in the 25 districts of Seoul as the study sample. Structured self-report questionnaires were administered over a two-month period in July-August 2018, and the children's parents recorded the answers on their children's behalf. The research tools in this study included the Korean version of the questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC).RESULTS: The physician-diagnosed prevalence rate of food allergies was 14.2%, while 20.4% of the children experienced allergic symptoms at least once and 17.4% reported symptoms within the previous 12 months. The children's symptoms included skin problems (88.1%), gastrointestinal issues (19.2%), oral issues (16.7%), respiratory issues (12.7%), and systemic issues (1.3%). The causes of allergies included eggs, peaches, milk, peanuts, and shrimps. The factors influencing the experience of food allergies were the consumption of cereal (aOR, 1.52; 95% CI, 1.09 ~ 2.10; p = 0.013), potatoes (aOR, 1.88; 95% CI, 1.33 ~ 2.65; p < 0.001), and fast food (aOR, 1.73; 95% CI, 1.10 ~ 2.72; p = 0.017). Having food allergy symptoms was associated with a higher risk of experiencing asthma (aOR, 4.22 95% CI, 3.10 ~ 5.76; p < 0.001), allergic rhinitis (aOR, 2.53; 95% CI, 2.03 ~ 3.15; p < 0.001), and atopic dermatitis symptoms (aOR, 3.56; 95% CI, 2.88 ~ 4.40; p < 0.001).CONCLUSION: Episodes of food allergies warrant examining regular food consumption and placing dietary restrictions through early diagnosis as these episodes may imply the presence of other allergies. Our findings offer basic insights into the patterns, prevalence and symptoms of children's food allergies in Seoul, and our findings will contribute to identifying effective interventions for food allergies.
Arachis ; Asthma ; Child ; Dermatitis, Atopic ; Early Diagnosis ; Edible Grain ; Eggs ; Fast Foods ; Food Habits ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Korea ; Milk ; Ovum ; Parents ; Prevalence ; Prunus persica ; Rhinitis, Allergic ; Risk Factors ; Seoul ; Skin ; Solanum tuberosum

PURPOSE: The purpose of this study was to assess the reliability of automated breast ultrasound (ABUS) examinations of suspicious breast masses in comparison to handheld breast ultrasound (HHUS) with regard to Breast Imaging Reporting and Data System (BI-RADS) category assessment, and to investigate the factors affecting discrepancies in categorization. METHODS: A total of 135 masses that were assessed as BI-RADS categories 4 and 5 on ABUS that underwent ultrasound (US)-guided core needle biopsy from May 2017 to December 2017 were included in this study. The BI-RADS categories were re-assessed using HHUS. Agreement of the BI-RADS categories was evaluated using kappa statistics, and the positive predictive value of each examination was calculated. Logistic regression analysis was performed to identify the mammography and US findings associated with discrepancies in the BI-RADS categorization. RESULTS: The overall agreement between ABUS and HHUS in all cases was good (79.3%, kappa=0.61, P<0.001). Logistic regression analysis revealed that accompanying suspicious microcalcifications on mammography (odds ratio [OR], 4.63; 95% confidence interval [CI], 1.83 to 11.71; P=0.001) and an irregular shape on US (OR, 5.59; 95% CI, 1.43 to 21.83; P=0.013) were associated with discrepancies in the BI-RADS categorization. CONCLUSION: The agreement between ABUS and HHUS examinations in the BI-RADS categorization of suspicious breast masses was good. The presence of suspicious microcalcifications on mammography and an irregular shape on US were factors associated with ABUS yielding a lower level of suspicion than HHUS in terms of the BI-RADS category assessment.
Biopsy, Large-Core Needle ; Breast Neoplasms ; Breast ; Information Systems ; Logistic Models ; Mammography ; Ultrasonography

Automated breast ultrasonography (ABUS) is a recently introduced technology. Similar to handheld ultrasound (HHUS), it is a supplementary screening test for breast cancer to be used along with mammography. It is particularly useful for detecting invasive breast cancers that may be overlooked by mammography in denser breast tissue. The use of ABUS is becoming more common because of the advantages of low operator dependency during image acquisition, high reproducibility, a wide field-of-view, and unavailability of better coronal imaging with HHUS. Consequently, there have been suggestions to extend ABUS use to diagnostic screening. Therefore, in this paper, we provide a review of the literature and discuss the usefulness and value of ABUS in breast cancer screening.

The axillary arch of Langer (Axillopectoral muscle) is the most common anatomical variant of the axillary musculature. The incidence of the variant is about 7% or less in the population and despite the reported frequency, its presence has been rarely reported. A 33-yr-old woman visited our institution due to the presence of a right breast mass and was diagnosed with right breast cancer by an ultrasound guided core biopsy. Previously, the patient had had no complaints of sensory and motor dysfunction of the right arm. The patient underwent a modified radical mastectomy and we identified an abnormal muscle that originated from the latissimus dorsi, and was inserted in the trilaminar tendon of the pectoralis major during axillary lymph node dissection. The muscle interfered the level I area due to its longitudinally oblique direction. We separated this muscle, and carefully dissected the medial axillary group and lateral axillary group. After follow-up for two years, there was no evidence of axillary recurrence, lymphedema or any limitation of motion of the right arm. We discuss the definition, clinical complications and clinical importance of the axillary arch of Langer. We report here the first case of axillary arch of Langer that was identified during surgery in Korea.
Arm ; Biopsy ; Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema ; Mastectomy, Modified Radical ; Muscles ; Recurrence ; Tendons

Cholesterol granuloma of the breast is a rare, benign disease. Here, we present the unique ultrasonographic findings of breast cholesterol granuloma manifesting as an intracystic mass. The findings of this case report may help expand existing knowledge regarding differential diagnosis of intracystic breast masses, which are found on ultrasonographic examination.
Biopsy, Needle ; Breast Diseases/pathology/surgery/*ultrasonography ; *Cholesterol ; Diagnosis, Differential ; Female ; Granuloma, Foreign-Body/pathology/surgery/*ultrasonography ; Humans ; Mammography ; Middle Aged ; *Ultrasonography, Mammary

OBJECTIVE: To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. MATERIALS AND METHODS: Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. RESULTS: MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. CONCLUSION: MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.
Adult ; Biopsy, Needle ; Breast Neoplasms/*pathology ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Feasibility Studies ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Magnetic Resonance Imaging/*instrumentation ; Magnetic Resonance Imaging, Interventional/*methods ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Vacuum

A 26-yr-old woman (Para: 0-0-0-0) was referred to the breast clinic for the management of bilateral breast enlargement that she experienced at 29 weeks of gestation. The progressive enlargement of both breasts started at 6 weeks of gestation. She also had pain on both her breasts, her shoulders and her back and accompanying skin lesions. On physical examination, the skin over the breasts was red and edematous, with overlying dilated veins. Also on the left side, a patch of desquamation and ulcerative lesion was noticed. Ultrasonography of the breasts showed bilateral parenchymal enlargement with vessel engorgement and ductal dilatation. A 4.2 cm sized well-circumscribed probably benign oval hypoechoic nodule (BI-RADS Category 3) was identified at the upper inner quadrant of the left breast. The patient was conservatively managed until the end of her pregnancy. She delivered a normal full-term baby at 39 weeks of gestation. She did not breast-feed the baby due to severe pain and she revisited the breast clinic at 4 months after the delivery. The size of both breasts was markedly decreased compared to that at the initial visit and the skin lesions on her left breast were completely healed. We report here on the first case of gestational gigantomastia that was treated with conservative care in Korea.
Breast ; Dilatation ; Female ; Humans ; Korea ; Physical Examination ; Pregnancy ; Shoulder ; Skin ; Ulcer ; Ultrasonography ; Veins

PURPOSE: The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excision due to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. MATERIALS AND METHODS: We reviewed the records of 286 consecutive breast cancer patients who received BCT between January 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediate further surgery due to positive margin status. We analyzed the MRI findings using chi2 test, Fisher's exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. RESULTS: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p < 0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (> or = 5 cm) (odds ratio = 2.96), NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In cases involving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. CONCLUSION: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breast cancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.
Breast ; Breast Neoplasms* ; Humans ; Logistic Models ; Magnetic Resonance Imaging*

OBJECTIVE: To compare the diagnostic performances of conventional ultrasound (US) and US elastography for the differentiation of nonpalpable breast masses, and to evaluate whether elastography is helpful at reducing the number of benign biopsies, using histological analysis as a reference standard. MATERIALS AND METHODS: Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant). Two experienced radiologists unaware of the biopsy and clinical findings analyzed conventional US and elastographic images by consensus, and classified lesions based on degree of suspicion regarding the probability of malignancy. Results were evaluated by receiver operating characteristic curve analysis. In addition, the authors investigated whether a subset of lesions was categorized as suspicious by conventional US, but as benign by elastography. RESULTS: Areas under the ROC curves (Az values) were 0.901 for conventional US and 0.916 for elastography (p = 0.808). For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign. CONCLUSION: Elastography was found to have a diagnostic performance comparable to that of conventional US for the differentiation of nonpalpable breast masses. The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.
Adult ; Aged ; Biopsy, Fine-Needle ; Breast/pathology/*ultrastructure ; Breast Neoplasms/*ultrasonography ; *Elasticity Imaging Techniques ; Female ; Humans ; Middle Aged ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography, Interventional