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

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.

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

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

PURPOSE: Primary systemic therapy (PST) downstages up to 40% of initial documented axillary lymph node (ALN) metastases in breast cancer. The current surgical treatment after PST consists of breast tumor resection and axillary lymph node dissection (ALND). This strategy, however, does not eliminate unnecessary ALND in patients with complete remission of axillary metastases. The aim of this study was to examine the accuracy of sentinel lymph node biopsy (SLNB) after PST among patients with documented ALN metastasis at presentation and to identify the rate of pathologic complete-remission (CR) with ALN after PST. METHODS: We analyzed 66 patients with ALN metastasis that was pathologically proven preoperatively who underwent SLNB and concomitant ALND after PST. Axillary ultrasound (AUS) was used to evaluate the clinical response of initially documented ALN metastasis after PST. Intraoperative lymphatic mapping was performed using blue dye with or without radioisotope. RESULTS: After PST, 34.8% of patients had clinical CR of ALN on AUS and 28.8% patients had pathologic CR of ALN. The overall success rate of SLNB after PST was 87.9%, and the sentinel lymph node identification rate in patients with clinical CR was 95.7%. In patients with successful lymphatic mapping, 70.7% of patients had residual axillary metastases. The overall accuracy and false-negative rate were 87.9% and 17.1% in all patients: 95.5% and 10.0% in patients with clinical CR of ALN, and 83.3% and 19.4% in patients with residual axillary disease after PST. CONCLUSION: Our findings suggest that SLNB may be feasible in patients with initial documented ALN metastasis who have clinical CR for metastatic ALN after PST. Further investigation in a prospective setting should be performed to confirm our results.
Breast ; Breast Neoplasms ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

Adenoma of the nipple (AN) is an uncommon benign tumor of the breast. This tumor usually arises from the lactiferous ducts of the nipple. The common clinical findings are unilateral serosanguinous discharge with crust and a palpable nodule in the nipple. The symptoms and signs of AN are similar to those of Paget's disease and this confusion sometimes leads to unnecessary mastectomy. Thus performing careful clinical and histological examinations along with radiologic investigations are very important for the proper management of AN. This tumor is usually treated by total excision of the nipple. We report here on two cases of AN in two women who presented with red swelling, serosanguinous discharge and erosion of the nipple. We successfully managed them with partial excision or total excision along with reconstruction. Although AN is a relatively rare disease, surgeons should keep the diagnosis in mind for the proper management of this disease.
Adenoma ; Breast ; Female ; Humans ; Mastectomy ; Nipples ; Rare Diseases

PURPOSE: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. MATERIALS AND METHODS: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. RESULTS: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. CONCLUSION: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.
Breast Neoplasms ; Breast* ; Diagnosis ; Korea ; Magnetic Resonance Imaging* ; Mammography ; Surveys and Questionnaires ; Ultrasonography