PURPOSE: This study was designed to examine the effect of aroma massage therapy on lower extremity edema of terminal cancer patients. METHODS: A total of thirty-six terminal cancer patients with lower extremity edema were divided into two groups: the aroma massage group received massage with blending oil which was applied from toes to 10 cm above the knee of the subject for 15 to 20 minutes in each turn, while the control group received sham aroma massage (applied with carrier oil only). The circumferences of the fore-foot, ankle and calf were measured before massage and 30 minutes, 2 hours, and 12 hours after massage. The blood pressure, pulse and body temperature were also measured to find the change of subject's physiologic conditions. RESULTS: There were no significant differences in blood pressure, heart rate, body temperature and lower extremity circumferences between two groups. However, edema at each site was slightly improved in the treatment group after the aroma massage therapy, compared to baseline data (P<0.05). In addition, the reduction of lower extremity circumference was maximal at 2 hours in foot, 30 min in right ankle and 12 hours in right calf after aroma massage therapy (P<0.05). CONCLUSION: Our results suggest that aroma massage therapy is not effective on the lower extremity edema of terminal cancer patients.
Animals ; Ankle ; Aromatherapy ; Blood Pressure ; Body Temperature ; Edema ; Foot ; Heart Rate ; Hospices ; Humans ; Knee ; Lower Extremity ; Massage ; Salicylamides ; Toes

BACKGROUND: It is well documented that BIS reflects the level of sedation but conflicting results exist about whether BIS can reflect the depth of anesthesia. We intended to identify this issue by investigating the correlation between the pre-incision bispectral index (BIS) values and the hemodynamic responses to skin incision during sevoflurane-N2O anesthesia in children. METHODS: In total, 117 ASA physical status I or II pediatric patients, aged 6 mo-12 yr, were enrolled. After induction and intubation with thiopental, rocuronium, sevoflurane and N2O, patients were randomly allocated to one of the four end-tidal sevoflurane concentrations (ETsevo); 2.0, 2.5, 3.0, and 3.5 %; with 60% N2O. The ETsevo was maintained constant for more than 15 min before and 5 min after skin incision. BIS, heart rate (HR), and systolic arterial pressure (SAP) before and after skin incision were recorded. RESULTS: Although there were no correlation between pre-incision BIS and change in BIS, SAP, and HR (Pearson's coefficient -0.120, -0.102, and -0.080, respectively), there were correlations between changes of BIS and changes in SAP and HR (Pearson's coefficient 0.318 and 0.309, respectively, P < 0.05). CONCLUSIONS: There was a correlation between the change of BIS, but not BISpre, and change in hemodynamic variables with skin incision during sevoflurane anesthesia in children.
Anesthesia* ; Arterial Pressure ; Child* ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Skin* ; Thiopental

OBJECTIVE: To describe factors associated with the severity of post-stroke dysphagia. METHODS: We reviewed retrospectively medical records of patients having dysphagia following stroke in Seoul National University hospital from April 2002 through Dec 2009. A total of 578 patients (male and female, 331 and 247) were included. The following parameters were recorded and analyzed: patient's sex, age, type of stroke, onset of dysphagia, location of lesion and the American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA NOMS). Using Binary logistic regression and multiple regression analysis, the relationship between dysphagia severity and other factors were analyzed. RESULTS: Their average duration between onset of stroke and the date of videofluoroscopic swallowing study (VFSS) was 32.3 +/- 18.4 days. Patients with hemorrhagic stroke (172 patients, ASHA 4.06 +/- 1.98) showed poorer swallowing function than those with ischemic stroke (406 patients, ASHA 4.49 +/- 2.02, p=0.013). Binary logistic regression analysis showed that patients who had longer duration from onset to the first study, hemorrhagic stroke, bilateral lesion and older age were at higher risk for dysphagia requiring non-oral supplements (p=0.031, 0.039, 0.042, and 0.043, respectively). Multiple regression analysis revealed that longer duration from onset to study, older age and hemorrhagic stroke were associated with the lower ASHA NOMS (p=0.006, 0.009 and 0.021, respectively). Bilateral lesion, sex, history of previous stroke and involvement of the brainstem, however, were not significant factors. CONCLUSION: Hemorrhagic stroke, longer duration from stroke onset to the initial evaluation, and older age were identified as associated factors with the poorer swallowing function after stroke. Further prospective studies will be required to evaluate the prognostic value of these characteristics.
American Speech-Language-Hearing Association ; Brain Stem ; Deglutition ; Deglutition Disorders ; Female ; Humans ; Logistic Models ; Medical Records ; Regression Analysis ; Retrospective Studies ; Stroke

Systemic amyloidosis after gastric cancer surgery is a very rare phenomenon. Less than ten such cases have been reported in the international literature. Although systemic amyloidosis has been reported to be associated with lymphoma, multiple myeloma, and renal cell carcinoma, its association with gastric cancer remains unclear. We report a case of a 64-year-old male who developed systemic amyloidosis 24 months after a Billroth-I gastrectomy for gastric cancer, and provide a brief review of the literature.
Amyloidosis* ; Carcinoma, Renal Cell ; Gastrectomy ; Humans ; Lymphoma ; Male ; Middle Aged ; Multiple Myeloma ; Stomach Neoplasms*

Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES.
Advisory Committees ; Family Characteristics ; Focus Groups ; Food Supply ; Government Agencies ; Nutrition Surveys ; Public Health ; Surveys and Questionnaires

BACKGROUDN: The ratio of mitral inflow (E) and annular velocity (E') to stroke volume (E/E'/SV) has been used as an index of diastolic elastance (Ed). However, its change during exercise has not been evaluated. We hypothesized that Ed values obtained during exercise would be abnormal in patients with apical hypertrophic cardiomyopathy (ApHCM). METHODS: Ed was measured at rest and during graded supine bicycle exercise (25 Watts, 3 minute increments) in 15 patients with ApHCM (12 male; mean age, 57 years) and in 15 age- and gender-matched control subjects. RESULTS: Ed was not significantly different at rest and during 25 W of exercise. However, Ed was significantly higher at 50 W of exercise in patients with ApHCM compared to control subjects (0.21+/-0.05 vs. 0.15+/-0.04 cm/s, p=0.0059). There was significant positive correlation between the magnitude of change in proBNP levels during exercise and the change of Ed from rest to 50 W of exercise (r2=0.69, p<0.0001). CONCLUSION: Noninvasively-determined Ed was similar at rest and during mild exercise between patients with ApHCM and control subjects. However, Ed was significantly higher during moderate exercise in ApHCM patients, suggesting a dynamic change in LV stiffness during exercise in these patients.
Cardiomyopathy, Hypertrophic* ; Humans ; Male ; Stroke Volume

BACKGROUDN: The ratio of mitral inflow (E) and annular velocity (E') to stroke volume (E/E'/SV) has been used as an index of diastolic elastance (Ed). However, its change during exercise has not been evaluated. We hypothesized that Ed values obtained during exercise would be abnormal in patients with apical hypertrophic cardiomyopathy (ApHCM). METHODS: Ed was measured at rest and during graded supine bicycle exercise (25 Watts, 3 minute increments) in 15 patients with ApHCM (12 male; mean age, 57 years) and in 15 age- and gender-matched control subjects. RESULTS: Ed was not significantly different at rest and during 25 W of exercise. However, Ed was significantly higher at 50 W of exercise in patients with ApHCM compared to control subjects (0.21+/-0.05 vs. 0.15+/-0.04 cm/s, p=0.0059). There was significant positive correlation between the magnitude of change in proBNP levels during exercise and the change of Ed from rest to 50 W of exercise (r2=0.69, p<0.0001). CONCLUSION: Noninvasively-determined Ed was similar at rest and during mild exercise between patients with ApHCM and control subjects. However, Ed was significantly higher during moderate exercise in ApHCM patients, suggesting a dynamic change in LV stiffness during exercise in these patients.
Cardiomyopathy, Hypertrophic* ; Humans ; Male ; Stroke Volume

The objective of this study was to assess the reliability and validity of food security measures, which was developed based on the US household food security survey module (US HFSSM) with content validity in the Korean population. The reliability and validity were assessed by internal consistency, construct validity and criterion-related validity. The study included 446 households. Among those, 46.2% were households with children. The proportion of food insecure households was 33.3%. Among those, 35.4% and 64.6% households were food insecure with hunger and without hunger, respectively. The Cronbach's alpha coefficients were 0.84 and the infit value by the Rasch model analysis ranged from 0.68 to 1.43. The scale item response curves by food insecurity severity explained well the nature and characteristics of food security, indicating the highest proportion of "yes" for the items on diet quality, followed by those with diet quantity. The result of criterion-related validity showed that food insecurity status was significantly related in a dose-response manner with the household income level, food expenditure, subjective health state, subjects' educational level. Household food security status was also related to dietary diversity regarding protein foods, fruits and fruit juice, and milk and dairy product. These findings suggest that the food security instrument is reliable and valid and would be used to assess food security status in the Korean population.
Child ; Dairy Products ; Diet ; Family Characteristics ; Food Supply ; Fruit ; Health Expenditures ; Humans ; Hunger ; Milk ; Nutrition Surveys ; Reproducibility of Results

No abstract available.
Acute Kidney Injury/diagnosis/*etiology/therapy ; Biopsy ; Fluid Therapy ; Glucocorticoids ; Humans ; Hypercalcemia/diagnosis/*etiology/therapy ; Male ; Middle Aged ; Multimodal Imaging ; Positron-Emission Tomography ; Renal Dialysis ; Sarcoidosis/*complications/diagnosis/therapy ; Subcutaneous Tissue/pathology ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVE: This study was performed to evaluate the status of p16 tumor suppressor gene in 25 endometrial carcinomas (ECs) and to correlate the loss of heterozygosity (LOH) at p16 locus, the presence of inactivating mutations, the methylation status of the promotor, and the expression of p16 protein with clinicopathological parameters. METHODS: Methylation-specific PCR (MSP) distinguishes unmethylated from methylated alleles in a given gene on sequence changes produced after bisulfite treatment of DNA. Allelic losses were determined at two polymorphic dinucleotide repeat microsatellite markers of the p16 gene on chromosome 9p21 that included D9S974 and D9S1748 at CDKN2A. Mutations were analyzed by exons 1 and 2 of p16 PCR-SSCP. Immunohistochemical staining for p16 protein was performed. The associations between genetic alterations of the p16 and the clinicopathological parameters of ECs were evaluated by chi-squared or Fisher's extraction tests. RESULTS: The median age of the 25 cases was 52 years, ranging from 32 to 72. The median tumor size was 3.6 cm, ranging from 0.8 to 9.5 cm. Histologically, the ECs were 21 endometrioid, 2 adenosquamous, 1 secretory and 1 papillary serous types. Nine cases of p16 protein staining were negative or minimal positive in 25 ECs (36%). Allelic losses were found in 6 loci (66.7%) of 5 ECs without p16 protein expression (Fisher's extraction test, p=0.0029), In this study, only 2 of 25 ECs (8%) disclosed mutations. Non-endometrioid (secretory and adenosquamous) carcinomas showed more frequent mutation and methylation than endometrioid carcinomas (p=0.043) and high grades (G3, p=0.018) showed more frequent mutation and methylation than low grade ECs. CONCLUSION: This study suggests that methylation of p16 promoter region seems not to be common (only 9.5% in our present series) and not to be associated with loss of nuclear p16 protein expression. Loss of p16 protein indicates a higher frequency of LOH, which contributes to the development of high grade or aggressive ECs. The mechanism of p16 inactivation is not clear, so other genetic or nongenetic mechanisms for inactivation should be further studied.
Alleles ; Carcinoma, Endometrioid ; Dinucleotide Repeats ; DNA ; Endometrial Neoplasms* ; Exons ; Female ; Genes, p16 ; Genes, Tumor Suppressor ; Loss of Heterozygosity ; Methylation ; Microsatellite Repeats ; Polymerase Chain Reaction ; Promoter Regions, Genetic*