PURPOSE: This study evaluates the effect of behavioral relaxation training on distress and cancer screening intention of patients with upper gastrointestinal endoscopy.METHODS: The research was conducted in a non-equivalent control group posttest design. Data were collected from endoscopy subjects in B city from October to November of 2018. Fifteen minutes of behavioral relaxation training were provided to the experimental group (n=40) and traditional relaxation therapy methods were provided to the control group (n=40). Outcome measures were distress and cancer screening intention of patients with upper gastrointestinal endoscopy. Data were analyzed with a χ²-test, independent t-test, Fisher's exact test with SPSS/PC version 23.0.RESULTS: The objective discomfort (t=8.81, p<.001) of the experimental group was lower than that of the control group; there were no significant differences in the subjective discomfort (t=1.73, p=.088). The cancer screening intention (t=−5.85, p<.001) of the experimental group was significantly higher than that of the control group.CONCLUSION: Behavioral relaxation training was effective in heightening cancer screening intention. Therefore it can be usefully applied to increase cancer screening intention.
Early Detection of Cancer ; Education ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Intention ; Outcome Assessment (Health Care) ; Relaxation Therapy ; Relaxation

Here, we aimed to evaluate the incidence and mortality of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHH) among very-low-birth-weight (VLBW) infants in Korea and assess the associated factors of PHH. This cohort study used prospectively collected data from the Korean Neonatal Network (KNN). Among 2,386 VLBW infants in the KNN database born between January 2013 and June 2014, 63 infants who died without brain ultrasonography results were excluded. Maternal demographics and neonatal clinical characteristics were assessed. The overall incidence of IVH in all the VLBW infants was 42.2% (987 of 2,323), while those of IVH grade 1, 2, 3, and 4 were 25.1%, 7.0%, 4.8%, and 5.5%, respectively. The incidence and severity of IVH showed a negatively correlating trend with gestational age and birth weight. PHH developed in 0%, 3.5%, 36.1%, and 63.8% of the surviving infants with IVH grades 1, 2, 3, and 4, respectively. Overall, in the VLBW infants, the IVH-associated mortality rate was 1.0% (24/2,323). Only IVH grade severity was proven to be an associated with PHH development in infants with IVH grades 3-4. This is the first Korean national report of IVH and PHH incidences in VLBW infants. Further risk factor analyses or quality improvement studies to reduce IVH are warranted.
Birth Weight ; Cerebral Hemorrhage/*epidemiology/mortality/pathology ; Cohort Studies ; Databases, Factual ; Echoencephalography ; Female ; Gestational Age ; Humans ; Hydrocephalus/*epidemiology/mortality/pathology ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; *Infant, Very Low Birth Weight ; Male ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Severity of Illness Index

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12+1 (9+3 to 27+1) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.

Preterm infants are vulnerable to the oxidative stress due to the production of large amounts of free radicals, antioxidant system insufficiency, and immature oligodendroglial cells. Reactive oxygen species (ROS) play a pivotal role in the development of periventricular leukomalacia. The three most common ROS are superoxide (O2*-), hydroxyl radical (OH*), and hydrogen peroxide (H2O2). Under normal physiological conditions, a balance is maintained between the production of ROS and the capacity of the antioxidant enzyme system. However, if this balance breaks down, ROS can exert toxic effects. Superoxide dismutase, glutathione peroxidase, and catalase are considered the classical antioxidant enzymes. A recently discovered antioxidant enzyme family, peroxiredoxin (Prdx), is also an important scavenger of free radicals. Prdx1 expression is induced at birth, whereas Prdx2 is constitutively expressed, and Prdx6 expression is consistent with the classical antioxidant enzymes. Several antioxidant substances have been studied as potential therapeutic agents; however, further preclinical and clinical studies are required before allowing clinical application.
Antioxidants ; Brain ; Brain Injuries ; Catalase ; Free Radicals ; Glutathione Peroxidase ; Humans ; Hydrogen Peroxide ; Hydroxyl Radical ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular ; Oxidative Stress ; Parturition ; Peroxiredoxins ; Reactive Oxygen Species ; Superoxide Dismutase ; Superoxides

Gastritis cystica profunda is an uncommon benign mass that usually occurs on the gastric side of the site of a gastroenterostomy, but has also been known to develop in which has not been operated on. We report the case of stomach a 51-years-old man with pathologically proven gastritis cystica profunda. This patient had not undergone gastric surgery and CT showed a well-defined, 3 cm sized, cystic mass at the gastric antrum.
Gastritis* ; Gastroenterostomy ; Humans ; Pyloric Antrum ; Stomach

Background: Preterm infants are prone to sepsis owing to their immature innate immunity and prolonged hospitalization. We aimed to evaluate the association between late-onset sepsis (LOS) during hospitalization and neurodevelopmental delay at 18–24 months of corrected age in very low birth weight infants (VLBWIs), and to ascertain this association when adjusted for perinatal risk factors. Methods: This is a population-based study of VLBWIs born at 23–32 weeks of gestation between January 2014 and December 2017 who were enrolled in the Korean Neonatal Network. Bayley scales of infant development were evaluated at 18–24 months of corrected age in 2,098 infants. To test for LOS as a risk factor for neurodevelopmental delay, multiple logistic regression was used and adjusted for parental education status and clinical variables. Results: Blood culture positive LOS was identified in 419 (20.0%) infants. Cognitive and motor delays were found in 392 (18.7%) and 347 (16.5%) infants, respectively. When multivariate analysis was performed, LOS had a significant association with cognitive delay (odds ratio, 1.48; 95% confidence interval, 1.02–2.16), but no association with motor delay in VLBWIs. Both delays were significantly more frequent in cases of intraventricular hemorrhage (IVH) ≥ grade 3, periventricular leukomalacia (PVL), and intrauterine growth restriction (IUGR) and duration of mechanical ventilation. Male sex and necrotizing enterocolitis ≥ grade 2 had an effect on motor delay, whereas paternal college graduation affected cognitive delay. Conclusion In VLBWIs with LOS, there is a heightened risk of cognitive delays at 18–24 months of corrected age. Brain injury, such as severe IVH and PVL, duration of mechanical ventilation, and IUGR, were also associated with cognitive and motor delays.

Background: Preterm infants are prone to sepsis owing to their immature innate immunity and prolonged hospitalization. We aimed to evaluate the association between late-onset sepsis (LOS) during hospitalization and neurodevelopmental delay at 18–24 months of corrected age in very low birth weight infants (VLBWIs), and to ascertain this association when adjusted for perinatal risk factors. Methods: This is a population-based study of VLBWIs born at 23–32 weeks of gestation between January 2014 and December 2017 who were enrolled in the Korean Neonatal Network. Bayley scales of infant development were evaluated at 18–24 months of corrected age in 2,098 infants. To test for LOS as a risk factor for neurodevelopmental delay, multiple logistic regression was used and adjusted for parental education status and clinical variables. Results: Blood culture positive LOS was identified in 419 (20.0%) infants. Cognitive and motor delays were found in 392 (18.7%) and 347 (16.5%) infants, respectively. When multivariate analysis was performed, LOS had a significant association with cognitive delay (odds ratio, 1.48; 95% confidence interval, 1.02–2.16), but no association with motor delay in VLBWIs. Both delays were significantly more frequent in cases of intraventricular hemorrhage (IVH) ≥ grade 3, periventricular leukomalacia (PVL), and intrauterine growth restriction (IUGR) and duration of mechanical ventilation. Male sex and necrotizing enterocolitis ≥ grade 2 had an effect on motor delay, whereas paternal college graduation affected cognitive delay. Conclusion In VLBWIs with LOS, there is a heightened risk of cognitive delays at 18–24 months of corrected age. Brain injury, such as severe IVH and PVL, duration of mechanical ventilation, and IUGR, were also associated with cognitive and motor delays.

BACKGROUND: Propranolol, a beta-blocker and well known anti-hypertensive medication, has been used as the first-line therapy for pediatric hemangioma since 2010. The objective of this study is to analyze the efficacy and safety of propranolol when used to treat pediatric hemangioma patients for one year or longer in a single institution.METHODS: A retrospective chart review analysis was done of 65 pediatric hemangioma patients treated with oral propranolol as the first-line therapy from 2010 to 2016. The patients were examined regularly at an interval of 1 to 2 months for changes in hemangioma size, growth and development, and occurrence of acute side effects of propranolol such as hypotension, hypoglycemia and bronchial constriction.RESULTS: Twenty patients were treated with propranolol for a year or longer and their median age was 202 days (range, 36 to 4,284 days) and mean duration of treatment was 22.5 months (range, 12 to 49 months). At 12 months of treatment, the average percentage of size decrement was 40.5%. When the weight and height percentile were compared between at diagnosis and 12 months post-treatment, all 20 patients showed normal growth curve and development. Patients did not show any acute side effects of propranolol during 12 months of treatment. One patient experienced hypoglycemia induced seizure, but this event was subsequently diagnosed as ketotic hypoglycemia induced from prolonged fasting.CONCLUSION: Propranolol was effective and well tolerated in children with hemangioma when used for one year or longer.
Bronchoconstriction ; Child ; Diagnosis ; Fasting ; Growth and Development ; Hemangioma ; Humans ; Hypoglycemia ; Hypotension ; Propranolol ; Retrospective Studies ; Seizures

BACKGROUND: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time dependent. Patients with acute stroke often arrive at the hospital too late to receive the maximum benefit from these new stroke therapies. Efforts to reduce delay time of therapy for acute stroke may be more effective if the factors that delay hospital arrival are identified and targeted for specific intervention. So we studied about reason of delay of hospital presentation in patients with acute stroke. METHODS: The 85 acute stroke patients group who admitted to the Young-dong severance hospital from April to August 1999 were enrolled in this study. We collected clinical data from the medical record, including demographic characteristics, date and time of symptom onset, date and time of presentation to the hospital, medical history, and symptoms at stroke onset. And informants about stroke, method of transportation, the patient's interpretation of the symptoms were interviewed. We defined early arrival as within 3 hours of awareness of symptoms. RESULTS: The 85 patient were interviewed, early arrival were more likely to arrive by ambulance(P<0.001), admit via emergency department(P=0.001), interpret their symptoms as a stroke(P=0.005) and use readings as a informants about stroke(P=0.027) than late arrivals. Also they were younger than late arrivals(P=0.027). Main reason of delay of hospital presentation was because they expect spontaneous improvement(43%), mistake as other disease(23.3%), arrive via other medical institute(20%). CONCLUSION: Late arrivals expected spontaneous improvement, misinterpreted their symptoms as those of other disease and didn't choose proper medical institute for acute management. Considerable education is needed to increase the knowledge about stroke and proper acute management.
Education ; Emergencies ; Humans ; Medical Records ; Reading ; Stroke* ; Transportation

Recently, the number of Korean travelers and workers to malaria-endemic regions has increased, and the number of patients with imported malaria cases has increased as well. In Korea, most cases of imported malaria infections are caused by Plasmodium falciparum and P. vivax. Only one report of imported P. malariae infection has been published thus far. Here, we describe a case of imported P. malariae infection that was confirmed by peripheral blood smear and nested PCR targeting the small subunit ribosomal RNA (SSU rRNA) gene. A 53-yr-old man, who had stayed in the Republic of Guinea in tropical West Africa for about 40 days, experienced fever and headache for 3 days before admission. The results of rapid malaria test using the SD Malaria Antigen/Antibody Kit (Standard Diagnostics, Korea) were negative, but Wright-Giemsa stained peripheral blood smear revealed Plasmodium. To identify the Plasmodium species and to examine if the patient had a mixed infection, we performed nested PCR targeting the SSU rRNA gene. P. malariae single infection was confirmed by nested PCR. Sequence analysis of the SSU rRNA gene of P. malariae showed that the isolated P. malariae was P. malariae type 2. Thus, our findings suggest that when cases of imported malaria infection are suspected, infection with P. malariae as well as P. falciparum and P. vivax should be considered. For the accurate diagnosis and treatment of imported malaria cases, we should confirm infection with Plasmodium species by PCR as well as peripheral blood smear and rapid malaria antigen test.
Africa, Western ; Coinfection ; Diagnosis ; Fever ; Genes, rRNA ; Guinea* ; Headache ; Humans ; Korea ; Malaria ; Plasmodium ; Plasmodium falciparum ; Plasmodium malariae* ; Polymerase Chain Reaction ; RNA, Ribosomal ; Sequence Analysis