Purpose: This study presents a translation, cultural adaptation, and psychometric evaluation of two instruments of the Fertility Awareness and Attitudes Towards Parenthood (FAAP) questionnaire (Conditions and Life changes) for use in South Korea. Methods: This methodological study included 166 university students for psychometric evaluation in the sixth step. The first five steps included forward translation, backward translation, committee review, assessment of content validity, and a pre-test. In the sixth step, psychometric properties, including internal consistency, construct validity, and criterion validity, were evaluated. Exploratory factor analysis and confirmatory factor analysis were conducted to identify the structure of the tool and to assess its validity. Results: The Korean version showed acceptable internal consistency. Cronbach's ⍺ was .73 for FAAPC-conditions and .83 for FAAP-Life changes. FAAP-Conditions showed a four-factor structure (social conditions, relationship with partner, external environment, and child-rearing support) and FAAP-Life changes had a two-factor structure (reward and burden). In the confirmatory analysis, CMIN/DF, TLI, IFI, SRMR, CFI, and RMSEA were satisfactory. Conclusion This study provided preliminary evidence of the acceptability, reliability, and validity of the Korean version of the FAAP questionnaire in university students in South Korea. Nonetheless, further evaluation among Korean young adults is warranted to validate this instrument.

A 56-year-old woman with emphysematous pyelonephritis underwent an emergent left nephrectomy due to her religious creed. Postoperative hemoglobin level was decreased to 4.4 g/dL from preoperative value of 13.9 g/dL. The patient completely recovered without transfusion and was discharged on the 40th postoperative day without complication.
Anemia* ; Female ; Humans ; Middle Aged ; Nephrectomy* ; Pyelonephritis

BACKGROUND AND PURPOSE: The functional outcome of traumatic brain injury (TBI) varies widely. The aim of this study was to identify the factors predicting outcome following TBI. METHODS: We prospectively enrolled acute TBI patients, and assessed them clinically and radiologically using brain magnetic resonance imaging (MRI). Functional outcome was measured using the Glasgow Outcome Scale (GOS) at 3 months after TBI. A GOS score of < or =4 was regarded as an unfavorable outcome. We performed multivariate analysis to investigate the association between clinicoradiological variables and outcome. RESULTS: Forty-two patients completed the clinical evaluation in the acute phase and outcome measurement at 3 months. Motorcycle accident was associated with unfavorable outcome [odds ratio (OR)=38.3, p=0.022]. If the patients were the victims of the accident, they were more likely to have an unfavorable outcome (OR=21.3, p=0.037). All seven patients with a low Glasgow Coma Scale (GCS) score (i.e., < or =8) at 24 or 48 h after TBI were also found to have an unfavorable outcome. The presence of diffuse axonal injury (DAI) was a significant predicting factor of an unfavorable outcome (OR=8.48, p=0.042). CONCLUSIONS: Motorcycle accident, being an accident victim, and a lower GCS score at 24 hours or more after the accident were found to be unfavorable prognostic variables. DAI was the only radiologic variable predicting an unfavorable outcome. Thus, it is important to identify DAI by applying MRI in the acute phase.
Brain ; Brain Injuries ; Diffuse Axonal Injury ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Magnetic Resonance Imaging ; Motorcycles ; Multivariate Analysis ; Neuroimaging ; Prospective Studies

BACKGROUND: High-dose melphalan (HDMEL) represents the standard conditioning regimen before autologous stem cell transplant (ASCT) in multiple myeloma (MM), but recent updates have suggested combination of melphalan with bulsulfan (BUMEL) is also associated with favorable outcomes. We performed the current study to address the lack of comparative studies between the two conditioning regimens in Asian populations. METHODS: Using the Korean National Health Insurance and Korean Health Insurance Review and Assessment Service databases, 1,304 patients newly diagnosed with MM undergoing ASCT between January 2010 and December 2014 were identified. Patients were divided according to conditioning regimen (HDMEL vs. BUMEL), and after case matching, 428 patients undergoing HDMEL conditioning were compared to 107 patients undergoing BUMEL conditioning with respect to clinical course and treatment outcomes. RESULTS: The 3-year progression-free survival (PFS) was 52.5% for the HDMEL conditioning group versus 70.3% for the BUMEL conditioning group (P=0.043). The 3-year overall survival (OS) was 82.0% versus 83.5% (P=0.525), respectively. Although not statistically significant, BUMEL conditioning was associated with more platelet transfusion, while HDMEL was associated with more granulocyte colony stimulating factor support. In multivariate analysis, BUMEL conditioning was not inferior to HDMEL conditioning in regard to both PFS and OS. CONCLUSION: Our study confirmed that BUMEL is an effective and well-tolerated alternative to HDMEL conditioning, with better PFS.
Asian Continental Ancestry Group ; Busulfan* ; Colony-Stimulating Factors ; Disease-Free Survival ; Granulocytes ; Humans ; Insurance, Health ; Melphalan* ; Multiple Myeloma* ; Multivariate Analysis ; National Health Programs ; Platelet Transfusion ; Stem Cell Transplantation* ; Stem Cells*

BACKGROUND: The useful tools for early diagnosis and diagnostic criteria need to be developed for controlling invasive aspergillosis (IA) which causes life-threatening conditions in high risk group such as immunocompromised hematology-oncology patients.METHODS: 103 cases of suspected IA on the ground of pathologic or Aspergillus Galactomannan (AG) test from March 2006 to March 2011 were reviewed. The patients with IA was classified into 4 groups 'Proven', 'Probable', ('Probable-1'), 'Possible' and 'Non' based on the criteria of European Organization for Research and Treatment of Cancer/Mycoses study Group (EORT/MSG) 2008 (and 2002).RESULTS: Of the 103 patients who underwent AG test, 16 cases were diagnosed as IA; 2 'Proven', 9 'Probable', 5 'Probable-1' and 4 'non' (false-positive). Underlying diseases were acute lymphoblastic leukemia (N=8), acute myeloid leukemia (N=5), severe aplastic anemia (N=4), neuroblastoma (N=2) and non-Hodgkin lymphoma (N=1). Risk factors were severe neutropenia for 10 days (80%), prolonged use of steroid (70%), receipt of an allogeneic stem cell transplant (45%) and treatment with immunosuppressants (40%). Major involved organs of IA were lung (N=15) and sinus (N=1). Overall sensitivity, specificity, positive predictive value and negative predictive value of the AG test were 94%, 95%, 79% and 99%, respectively. The mortality of 16 patients with IA was 50%.CONCLUSION: A combined use of the AG test and modified criteria of EORT/MSG 2008 allows not only early diagnosis but also prompt classifying risk groups of IA so that proper antifungal agents were used in pediatric hematology-oncology patients.
Anemia, Aplastic ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Early Diagnosis ; Hematology ; Humans ; Immunosuppressive Agents ; Leukemia, Myeloid, Acute ; Lung ; Lymphoma, Non-Hodgkin ; Mannans ; Neuroblastoma ; Neutropenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Risk Factors ; Sensitivity and Specificity ; Stem Cells ; Transplants

Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness. Characteristics of tsutsugamushi disease are fever, rash and eschar. However, severe complications might rarely occur, such as acute fulminant myocarditis caused by scrub typhus. Thus, there are few reports of recovery from seriously complicated cases. We report on an adult male with scrub typhus complicated with acute fulminant myocarditis with no previous comorbid illness who recovered successfully with proper treatment including antibiotics, ventilator support, percutaneous cardiopulmonary support, and continuous renal replacement therapy.
Adult ; Anti-Bacterial Agents ; Exanthema ; Extracorporeal Circulation ; Fever ; Humans ; Male ; Myocarditis* ; Orientia tsutsugamushi ; Renal Replacement Therapy ; Scrub Typhus* ; Ventilators, Mechanical

Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm characterized by sustained neutrophilia, splenomegaly, and hypercellular bone marrow without Philadelphia chromosome. Diagnosis of CNL requires exclusion of identifiable causes of reactive neutrophilia, such as infection and tumors. Our patient presented with general weakness and weight loss. Computed tomography (CT) showed a mass in the distal rectum, which was confirmed to be an adenocarcinoma by colonoscopic biopsy. Positron emission tomography-CT showed multiple liver, bone, and lymph node metastases. Liver and lymph node biopsies revealed neutrophilic infiltration with no evidence of adenocarcinoma. The pathological findings of the bone marrow were compatible with CNL. Cytogenetic analysis revealed a normal karyotype, and molecular analysis was negative for BCR/ABL. Here, we present a 73 year-old man diagnosed with concurrent CNL and rectal cancer.
Adenocarcinoma ; Biopsy ; Bone Marrow ; Cytogenetic Analysis ; Diagnosis ; Electrons ; Humans ; Karyotype ; Leukemia ; Leukemia, Neutrophilic, Chronic* ; Leukemoid Reaction ; Leukocytosis ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Neutrophils ; Philadelphia Chromosome ; Rectal Neoplasms* ; Rectum ; Splenomegaly ; Weight Loss

Hyperinsulinemic hypoglycemia in the absence of exogenous insulin use is caused by disorders such as insulinoma, diffuse beta-cell hyperplasia/nesidioblastosis, and autoimmune hypoglycemia. Nesidioblastosis is a rare cause of hypoglycemia in adults, accounting for 0.5~7.0% of organic hyperinsulinemia cases. Although pancreatic resection is considered the best treatment modality for curing nesidioblastosis, there is no consensus regarding the indications for and extent of the surgery due to its high risk and complication rate. A 75-year-old woman presented with an altered mental state, a mass suspected of being an insulinoma, and insulin receptor antibodies. The patient underwent surgery because of recurrent life-threatening hypoglycemia. Postoperative pathology of her pancreas revealed nesidioblastosis.
Accounting ; Adult ; Aged ; Antibodies ; Consensus ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia ; Insulin ; Insulinoma ; Nesidioblastosis ; Pancreas ; Receptor, Insulin

Background: The present study aimed to analyze several aspects of the working conditions and health status of platform workers in the Republic of Korea, such as ergonomic and emotional hazards. We also compared the health status of the platform workers with that of the general population. Methods: A total of 1,000 platform workers participated in this survey from August 7 to August 17, 2022. The participants included 400 designated drivers, 400 food-delivery drivers, and 200 housekeeping managers. A face-to-face survey with a structured questionnaire was conducted by researchers who had received specific instructions. The focus of the survey extended to the work environment, encompassing factors such as workplace violence, as well as physical, chemical, and ergonomic hazards. Health-related data for the previous year were also collected, covering a range of issues such as hearing problems, skin problems, musculoskeletal symptoms, headaches, injuries, mental health issues, and digestive problems. Subsequently, we compared the health symptom data of the responders with those of the general population in the Republic of Korea. Results: Platform workers, including designated drivers, food-delivery drivers, and housekeeping managers, existed in the blind spot of social insurance, facing frequent exposure to physical and chemical hazards, ergonomic risk factors, and direct or indirect violence. The prevalence of health problems, including musculoskeletal symptoms, general fatigue, and depressive symptoms, in each occupational group was statistically higher than that in the general population after standardization for age and gender. Conclusion The results revealed unfavorable working environment and inferior occupational health of platform workers compared with those of the general population.

Background: Cervical cancer is the fourth common cancer in women worldwide. The Papanicolau test is the primary screening procedure to detect abnormal cervical cells.Colposcopy is the main procedure for discriminating high-grade cervical lesions. The study aimed at clarifying the discrepancy between cervical cytology and colposcopic biopsy histology as well as confounding factors. Methods: Eligible patients visited thirteen tertiary hospitals for colposcopic biopsy following cervical cytology and human papillomavirus (HPV) genotypes between January and December 2018. Baseline characteristics including age, body mass index (BMI), and parity were collected. Results: In our study, 3,798 eligible patients were included. Mean age of patients was 42.7(19–88) years and mean BMI was 22.5 (16.9–34.1) kg/m2 . The referred cervical cytologic findings consisted of 495 normal, 1,390 atypical squamous cells of undetermined significance, 380 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, 792 low-grade squamous intraepithelial lesion, 593 high-grade squamous intraepithelial lesion, 79 atypical glandular cells, 46 squamous cell carcinoma, and 23 adenocarcinoma. HPV-positive findings were found in 3,008 (79.2%) patients and were not detected in 914 (24.1%) cases. The risk of unexpected low-grade lesions from histology was higher in patients > 45 years (odds ratio [OR], 2.137; 95% confidence intervals [CIs], 1.475–3.096). In contrast, the risk of unexpected high-grade lesions from colposcopic biopsy was lower in patients ≥ 45 years (OR, 0.530; 95% CI, 0.367–0.747) and HPV 16/18 infection was higher than other HPV (OR, 1.848; 95% CI, 1.385–2.469). Conclusion Age and HPV genotypes were responsible for the discrepancies between cytology and histology. Precautions should be taken for women over the age of 45 in triage for colposcopy in order to avoid unnecessary testing.