The purpose of this study was to investigate effects of nutrition education program and pamphlet for the lower grades elementary students focused on individual daily needed food exchange units using Food Exchange System. Program consisted of four lessons (40 min/lesson), "5 major nutrients & function", "6 food group and sources", "daily needed food exchange units for normal body weight", and "smart snack choice and exercise". Pamphlet as activity book was developed for the program. The subjects were 3rd grade elementary students (educated group, 31 vs. non-educated group, 31). Educated group were lessoned as group and/or individual. We examined the differences in nutrition knowledge, dietary attitudes, dietary intakes and satisfaction of the program and pamphlet. In educated group, there were positive improvements on nutrition knowledge score "function and foods of 5 nutrients" and on dietary attitudes "type of breakfast and snacks". In the evaluation of dietary intakes according to KDRI, there were positive improvements on intakes level of riboflavin, vit. C, folate, Ca, P, Fe and Zn in educated group. In satisfaction with the program and pamphlet, contents, font size, visual, figure, difficulty and program curriculum were over 2.90/3.0. It showed that the developed nutrition education program and pamphlet focused on individual daily needed food exchange units using Food Exchange System improved nutrition knowledge, dietary attitudes and nutrients intake level in the lower grades elementary students.
Breakfast ; Curriculum ; Folic Acid ; Humans ; Pamphlets ; Riboflavin ; Snacks

This study was designed to compare the incidence and severity of premenstrual syndrome (PMS) between normal (N = 85) and overweight or obese (N = 28) college female students and investigated correlation between PMS, nutrient intake, hematological index and psychological index (depression, anxiety, stress). Each subject was asked a Menstrual Discomfort Questionnaire (MDQ) for PMS by 5 Likert scale. The PMS scores of women in the normal weight subjects ranked in order of severity were water retention (2.71), followed by behavioral change (2.58), negative affect (2.46), pain (2.31), autonomic reaction (2.27), decreased concentration (2.16). The symptoms of 'pain' and 'behavioral change' of overweight or obese subject were significantly higher than those of normal subject (p < 0.05). And total cholesterol concentration of overweight or obese subjects was significantly higher than in normal subject (p < 0.05). There was a significant positive correlation (p < 0.05) between the symptoms of 'negative effect' and BMI. And the triglyceride concentration was positively related with 'water retention (p < 0.01)'. The symptoms of 'decreased concentration' were negatively correlated with calcium (p < 0.01) and vitamin B6 intake (p < 0.05). The depression score were positively related with symptoms of 'behavioral change (p < 0.05)', 'negative affect' (p < 0.01), and the anxiety score was positively correlated with 'behavioral change (p < 0.05)' and 'decreased concentration (p < 0.05)'. The stress score was positively correlated with 'decreased concentration (p < 0.01)', 'behavioral change (p < 0.05)' and 'negative affect (p < 0.05)'. This suggests that PMS represents the clinical manifestation of a calcium, vitamin B6 deficiency and psychological disorder. Therefore we concluded that nutrient supplementation, depression and stress management may help to relieve PMS symptoms.
Anxiety ; Calcium ; Cholesterol ; Depression ; Female ; Humans ; Incidence ; Obesity ; Overweight ; Premenstrual Syndrome ; Surveys and Questionnaires ; Retention (Psychology) ; Vitamin B 6 ; Vitamin B 6 Deficiency ; Water

PURPOSE: The purpose of this study was to identify the factors of pain and pain management after transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). METHODS: Participants were 99 inpatients with HCC who underwent TACE at C University in Seoul from May to October 2016. The instruments used in this study were the Numerical Rating Scale (NRS), the Pain Management Index (PMI), and the modified Patient Outcome Questionnaire (American Pain Society). The data were analyzed using SPSS 24.0, specifically descriptive statistics, t-test, ANOVA, and multiple regression. RESULTS: The percentage of patients who experienced pain after TACE was 66.7%. The mean pain score immediately after TACE was 4.43±2.36 and the highest score on average was 6.58±2.32. The pain score was highest at 5.24±5.67 hours after TACE. Significant factors influencing pain after TACE were the extent of embolization and the ECOG (Eastern Cooperative Oncology Group) score, which explained 26% of the variance in pain. PMI scores revealed that 33.3% of the participants were inadequately treated for pain. CONCLUSION: In order to properly manage pain after TACE, medical staff need accurate understanding of pain and to administer the appropriate dosage of analgesics. The development of pain management protocol for patients who have undergone TACE would help achieve these goals.
Analgesics ; Carcinoma, Hepatocellular* ; Humans ; Inpatients ; Medical Staff ; Pain Management* ; Seoul

We tested the hypothesis that the extent of necrosis at the initial MRI predicts the subsequent risk of collapse of the femoral head in a randomized clinical trial conducted to compare the core decompression to the conservative treatment. After the initial clinical evaluation including plain roentgenography and MRI, 37 hips of early-stage osteonecrosis (ON) in 33 patients were randomly assigned to core decompression group or conservative treatment group. All the patients were regularly followed by clinical evaluation including plain roentgenography and MRI at three-month intervals. The extent of ON was estimated on the basis of the percentage of abnormal signal intensity in the weight-bearing portion of the femoral head as determined on a combination in coronal aod sagittal MR images. The angle of necrotic portion in mid-coronal image (A) and that in mid-sagittal image (B) were used to quantify the extent of necrotic portion by the formula; (A/180) x (B/180) x 100%. A strong association was observed between the percentage of necrotic portion and the development of collapse. We concluded that the extent of necrotic portion is a major risk factor of the collapse and proposed a systematic method of classifying the percentage of necrotic portion, which might be useful as a predictive index for the fate of early-stage ON.
Classification* ; Decompression ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Radiography ; Risk Factors ; Weight-Bearing

Recently there has been a progressive increase of thoracolumbar fractures with neurologic symptoms. It has been thought that laminectomy increased instability and was therefore considered a contraindication. Currently, with the development of instrument for posterior stabilization, it is possible to perform posterior fusion and instrumentation, both with and without laminectomy. To compare the effect of neurologic recovery with and without laminectomy, we analyzed the clinical records of 38 patients with neurologic symptoms who were evaluated with plain radiographs and CT before and after surgery from 1989 to 1996 in Gyeong-Sang National University Hospital. We divided our cases into two groups, one group consisted open reduction with laminectomy and instrumentation with posterior fusion. The other group consisted of open reduction without laminectomy and instrumentation with posterior fusion. Twenty three of 38 were operated with open reduction and internal fixation with laminectomy and others were operated without laminectomy. The results were that both groups had improvement of neurologic symptoms after surgery and at follow-up. There was no significant statistical difference between the two groups. Depending on the time interval between injury and surgery, patients who were underwent emergency surgery had an marked improvement of neurologic symptoms. Except cases of complete paraplegia, incomplete paraplegic patients who were operated within 24 hours with laminectomy group had greater improvement than those without laminectomy. The improvement was statistically significant(P<0.05).
Emergencies ; Follow-Up Studies ; Humans ; Laminectomy* ; Neurologic Manifestations* ; Paraplegia

Purpose: We evaluated changes in the tear film parameters of the corneal surface, and their correlations with Munk scores,based on corneal topographic scans of patients with nasolacrimal duct obstructions who underwent dacryocystorhinostomy(DCR). We explored whether tear parameters can serve as useful indicators of functional surgical success. Methods: We assessed 72 eyes of 45 patients diagnosed with nasolacrimal duct obstruction who underwent DCR. Tear film parameterswere measured via corneal topography (Keratograph® 5M) once before, and three times after surgery, and includedtear meniscus height (TMH), and the initial and average keratographic tear break-up time (NIKBUT-first and NIKBUT-average,respectively; measured noninvasively). Results: The three postoperative TMH values were 0.31 ± 0.20, 0.30 ± 0.22, and 0.29 ± 0.15 mm, all of which were significantlylower than the preoperative value of 0.48 ± 0.29 mm (all, p < 0.001). Three months after surgery, the NIKBUT-first (6.90 ± 3.39seconds) was significantly shorter than the preoperative value (8.39 ± 5.34 seconds; p = 0.030). The preoperative NIKBUT-averagedid not differ significantly from the values at the three postoperative timepoints (p = 0.756, p = 0.753, and p > 0.999).Changes in the Munk score after surgery correlated significantly with changes in the TMH (r = 0.46, p < 0.001). When functionalsuccess was defined as a Munk score ≤ 1, the area under the curve (AUC) value corresponding to the ability of TMH to definefunctional success of 0.995, was statistically significant (cut-off of 0.31 mm; p < 0.001). Conclusions The TMH DCR correlated significantly with the Munk score, which is a quantitative measure of clinical symptomseverity. The ability of TMH to define functional surgical success was excellent.

Psoriasis is a multi-factorial disease with various clinical manifestations. We present a case of unilateral psoriasis associated with ipsilateral lymphedema that developed after mastectomy for breast cancer. A 42-year-old Korean woman was referred to our clinic with a 1-month history of multiple erythematous scaly patches on the right arm, back, and breast and was diagnosed with psoriasis by a skin biopsy. Three years previously, she had been diagnosed with breast cancer (T1N2), underwent a right quadrantectomy and axillary lymph node dissection, and completed adjuvant chemotherapy followed by high-dose adjuvant radiotherapy. She had started rehabilitation therapy on the right arm for secondary lymphedema 30 months previously. Because of the long interval between radiation and psoriasis, we speculated that changes in the local milieu caused by the lymphedema might be a causative factor. We hereby report a rare case of unilateral psoriasis following post-mastectomy lymphedema.
Adult ; Arm ; Biopsy ; Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Lymphedema ; Mastectomy ; Psoriasis ; Radiotherapy, Adjuvant ; Skin

Clear cell acanthoma (CCA) is a rare benign epidermal tumor. It usually presents as a flat nodule or dome-shaped plaque and is often localized on the legs of the elderly. We observed an unusual case of polypoid CCA on the nipple of a 14-year-old girl. At present, a few cases of CCA on the nipple area have been reported in the literature. However, CCA presented as a polypoid tumor on the nipple area has been reported very rarely. We herein report the very rare case of polypoid CCA on the nipple and suggest that CCA should be included in the clinical differential diagnosis of polypoid lesions on the nipple.
Acanthoma ; Adolescent ; Aged ; Diagnosis, Differential ; Humans ; Leg ; Nipples

PURPOSE: The purpose of this study was to identify the self-care agency and quality of life (QOL) among patients with brain tumors after craniotomy. METHODS: A sample of 96 patients was recruited from a university hospital in Seoul. Data were collected through a structured questionnaire from August 2017 to December 2018. Data were analyzed with descriptive statistics, t-tests, ANOVA, Pearson correlations and multiple regression analyses with SPSS 24.0, IBM. RESULTS: The mean scores of the 1st and 2nd stages in the self-care agency increased from 4.75 to 5.15, and in the quality of life rose from 67.94 to 78.60. The score of the second stage was higher than the first in all sub-scales of the self-care agency and the quality. Physical function was the only sub-scale of the self-care agency that affected quality of life in both stages (1st: β=.71, p<.001, 2nd : β=.77, p<.001). CONCLUSION: Based on the result, to improve QOL with brain tumor after craniotomy, it is important to assess physical function of patients and provide appropriate interventions.
Brain Neoplasms ; Brain ; Craniotomy ; Humans ; Quality of Life ; Self Care ; Seoul

PURPOSE: Ghrelin stimulates the secretion of growth hormone and other pituitary hormones, and has orexigenic effects. It may have a physiologic role in fetal and neonatal growth. Leptin secreted by the adipocytes reflects fat mass in infants as well as adults. The aim of this study was to evaluate the relation of cord blood ghrelin and leptin levels to body weight(BW), body mass index(BMI), insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3) levels in appropriate for gestational age(AGA) newborns. METHODS: Sixty healthy AGA newborns(31 males and 29 females, gestational age[GA] 34-42 weeks) were included in this study, whose BW and BMI were measured at delivery. Umbilical cord venous blood samples were withdrawn, and ghrelin and leptin were measured by radioimmunoassay. Cord blood IGF-I and IGFBP-3 were determined by immunoradiometric assay. RESULTS: The mean levels of ghrelin were inversely correlated with BW(r=-0.29, P<0.05) and GA (r=-0.28, P<0.05), but were not affected by gender. The mean levels of leptin levels showed positive correlation with BW(r=0.44, P<0.01), GA(r=0.36, P<0.01), and BMI(r=0.28, P<0.05). The leptin levels of females were higher than those of males. There was no gender difference in leptin levels in neonates under GA 37 weeks. However, the leptin levels of females were higher than those of males (P<0.01) in newborns with GA 37 weeks or over. There was no correlation between ghrelin and leptin levels. Ghrelin and leptin levels showed no relations to cord blood IGF-I and IGFBP-3 levels. CONCLUSION: These data suggest that cord blood ghrelin may have an inverse correlation with BW in AGA newborns, and leptin levels are positively correlated with BW and fat mass. Further study of ghrelin concentrations in cord blood is necessary to elucidate the physiological and pathological roles of ghrelin during the fetal and neonatal periods.
Adipocytes ; Adult ; Anthropometry* ; Female ; Fetal Blood* ; Gestational Age* ; Ghrelin* ; Growth Hormone ; Humans ; Immunoradiometric Assay ; Infant ; Infant, Newborn* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Pituitary Hormones ; Radioimmunoassay ; Umbilical Cord