PURPOSE: Weight gain after diagnosis of breast cancer is a profound issue that may negatively impact cancer prognosis. However, most existing research on weight change has been conducted in Western countries. In addition, several factors related to weight gain have been reported; however, the evidence is inconsistent. The purpose of this study was to examine weight gain and its correlates among Korean breast cancer survivors. METHODS: A total of 132 female breast cancer survivors were recruited from one university hospital in South Korea. Participants completed anthropometric measurements (i.e., body weight, height) and a self-reported questionnaire, including the International Physical Activity Questionnaire Short Form and Mini Dietary Assessment. RESULTS: The mean weight change was -0.09 kg (SD = 4.28). Only 27 women (19.7%) gained more than 5% of their weight at diagnosis, 59.1% maintained weight, and 21.2% lost weight. In multivariate logistic regression analysis, significant correlates of weight gain were younger age, obesity at diagnosis, duration of more than 36 months since diagnosis, and low diet quality. CONCLUSION: Younger women, women who were obese at diagnosis, women with more than 36 months since diagnosis, or women who showed lower diet quality should be considered at high-risk for weight gain. Findings from our study suggest that optimal weight management strategies should be developed using ethnically- or culturally-appropriate approaches.
Body Weight ; Body Weight Changes ; Breast Neoplasms* ; Breast* ; Diagnosis ; Diet ; Female ; Humans ; Korea ; Logistic Models ; Motor Activity ; Obesity ; Prognosis ; Republic of Korea ; Survivors* ; Weight Gain* ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify relationships of periodontal disease and health related quality of life (HRQoL) in pregnant women. METHODS: The participants in this study were 129 pregnant women. Data were collected using questionnaires of characteristics of the participants and subjective perception of periodontal disease and a dentist's assessment of periodontal disease. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. RESULTS: The physical QoL showed significant negative correlation with subjective perception of periodontal disease (r=-.21, p=.013). Mental QoL had significant negative correlations with subjective perception of periodontal disease (r=-.32, p<.001) and objective periodontal disease (r=-.34, p<.001). Hierarchical multiple regression analyses revealed that pregnant women who had a history of abortion and had higher subjective perception of periodontal disease tended to report lower levels of physical QoL. Pregnant women whose age are between 30-34 years and higher subjective perception and objective periodontal disease tended to report lower mental QoL. CONCLUSION: To improve HRQoL of pregnant women, nurses should pay attention on the status of periodontal disease. Careful assessment of oral healthy behaviors and proper intervention for oral health of pregnant women are needed to enhance HRQoL of pregnant women.
Female ; Humans ; Oral Health ; Periodontal Diseases* ; Pregnant Women* ; Quality of Life*

We report a case of Kasabach-Merritt syndrome arising from a tufted angioma successfully treated with systemic corticosteroid. A 2-month-old male infant presented with a palm-sized, erythematous induration on his left pubis. The lesion was diagnosed as tufted angioma histopathologically. After 1 month, the lesion suddenly expanded to the abdomen and scrotum. Initial laboratory tests were consistent with consumptive coagulopathy. He was diagnosed with Kasabach-Merritt syndrome and treated with intravenous dexamethasone at 0.32 mg/kg/day (equivalent to prednisolone 2.0 mg/kg/day). Two days after initiating the treatment, his platelet counts recovered and the lesion ceased to expand. Steroid therapy was converted to oral prednisolone and the dosage was subsequently tapered, and the lesion gradually involuted with no signs of recurrence for a year.
Abdomen ; Dexamethasone ; Hemangioma ; Humans ; Infant ; Kasabach-Merritt Syndrome ; Male ; Platelet Count ; Prednisolone ; Recurrence ; Scrotum ; Skin Neoplasms

Herein, we report five cases of occult breast cancer treated with axillary node dissection only, without breast surgery or whole breast radio-therapy. The patients complained of a large, hard mass in the axillary area, although no breast masses were palpable. Biopsy of the axillary mass was performed in each case, and histological examination showed a metastatic carcinoma. No malignant findings were observed by mammography or ultrasonography. Magnetic resonance imaging and systemic examinations revealed no extramammary primary lesions. All patients underwent axillary lymph node dissection without breast surgery, and were administered adjuvant chemotherapy but not whole breast radiation therapy. The median follow-up period was 56 months (range, 15–241 months). The patients were all alive with no evidence of disease at the end of the follow-up period.
Axilla ; Biopsy ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Magnetic Resonance Imaging ; Mammography ; Neoplasms, Unknown Primary ; Ultrasonography

OBJECTIVE: The aim of this study was to present experiences in localization and removal of non-palpable subdermal contraceptive implants with ultrasonography. METHODS: Medical records from January 1, 2016, to April 30, 2018, were retrospectively reviewed for 21 patients who were referred to a single institution and had an impalpable implant despite following the removal instruction. In all the cases, more than one attempt was made to remove the implant before referral. The rod was detected using radiography and ultrasonography. In all the cases, localization of the single implant was achieved with ultrasonography. The distal depth of the rod was measured, and skin marking was made following the echogenicity. The implants were subsequently removed under anesthesia. RESULTS: In 18 cases, the rods were localized using ultrasonography and successfully removed under local anesthesia. In the other three cases, removal with local anesthesia failed. Although the rod was detected successful with ultrasonography, the implants were removed under general anesthesia in the operating room. The depth from skin to rod, measured with ultrasonography, was >12.0 mm in all the cases and located deep in the muscular layer in the failure cases. The depth of the implants positively correlated with the time spent for removal (r=0.525; P=0.015). CONCLUSION: High frequency ultrasonography is a highly accurate tool for localization and measurement of the skin-to-rod depth. It is also useful for removing non-palpable implants. If the depth of the implant is >12.0 mm, removal of the implant in the operating room under general anesthesia is recommended.
Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Contraception ; Device Removal ; Humans ; Medical Records ; Operating Rooms ; Radiography ; Referral and Consultation ; Retrospective Studies ; Skin ; Ultrasonography

Background: and PurposeSleep disturbance is common in patients with primary headache disorders. We were interest in whether poor sleep quality affects patients directly or via increases in the frequency and severity of headaches. To that end, we investigated the direct and indirect effects of sleep quality on the headache-related impact among patients with primary headache disorders. Methods: We analyzed migraine and tension-type headache (TTH) in patients included in the headache registry of our headache clinic from October 2015 to May 2018. We collected information on the headache frequency, severity, and psychological status. Sleep quality and headache-related impact were measured using the Pittsburgh Sleep Quality Index and Headache Impact Test-6, respectively. We performed path analyses with headache frequency and severity as covariates to determine the direct effect of sleep quality on the headache-related impact, and the indirect effects mediated by increases in the headache frequency and severity. Results: This study included 915 patients: 784 with migraine and 131 with TTH. Worse sleep quality was independently associated with greater headache-related impact in both patients with migraine and those with TTH. Path analysis revealed a direct effect (β=0.207,p<0.001) of sleep quality and an indirect effect mediated by headache frequency and severity (β=0.067, p=0.004) on the headache-related impact in migraine. In TTH, only direct effects of sleep quality on the headache-related impact were significant (β=0.224, p=0.004). Conclusions We suggest that poor sleep quality can directly increase the headache-related impact in both patients with migraine and TTH as well as indirectly by increasing the headache frequency and severity in patients with migraine.

Background: and Purpose Oxygen treatment is the first-line acute treatment for cluster headaches (CHs), but this can be impeded by insurance coverage and oxygen-tank maintenance. Oxygen concentrators filter nitrogen from ambient air to produce oxygen-rich gas, and can therefore be an alternative to conventional oxygen therapy using a tank. We investigated the effectiveness and safety of using two home oxygen concentrators and compared them with using oral zolmitriptan for the acute treatment of CHs. Methods: Forty patients with episodic CHs in an active cluster period were enrolled in this randomized, crossover, multicenter study. Two attacks during the cluster period were treated using oxygen delivered by connecting two home oxygen concentrators, whereas the other two attacks were treated using oral zolmitriptan (5 mg) in a random sequence. The primary endpoint was substantial pain reduction (0 or 1 on a five-point rating scale from 0 to 4 points) at 15 min after treatment. Results: In total, 125 attacks among 32 patients were randomized and treated (63 attacks using oxygen and 62 using zolmitriptan) according to the study protocol. More attacks treated using oxygen reached the primary endpoint than did those treated using zolmitriptan (31.7% [20/63] vs. 12.9% [8/62], p=0.013). After 30 min, 57.1% of the patients who received oxygen and 38.7% who received zolmitriptan reported pain relief (p=0.082). All patients treated using oxygen reported an improvement in pain, and 61.3% preferred oxygen while only 9.7% preferred zolmitriptan. No adverse events occurred during the oxygen treatment. Conclusions Oxygen treatment administered using two home oxygen concentrators resulted in better pain relief than oral zolmitriptan in patients with episodic CHs. Our results suggest that home oxygen concentrators are capable of efficiently supplying oxygen in a similar manner to using an oxygen tank.

We present a case of ileal stenosis with delayed presentation 3 months after car accident. Ileal stenosis after blunt abdominal trauma is a rare clinical entity. We present CT and small bowel series 3 months after trauma. Image showed segmental thickening of intestinal wall and proximal bowel dilation. At surgery, a stenotic bowel loop was adjacent to a fibrotic mesentery. Histological examination showed ulcers, inflammatory cells and fibroblasts infiltrated to the muscularis mucosae, submucosa, and mesentery. The most likely cause, supported by most authors, implicates an injury to the mesentery. Post-traumatic ischemic bowel stenosis may result from even small tears and contusions of mesentery. Posttraumatic intestinal stenosis should be included in the differential diagnosis in a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.

No abstract available.
Electroencephalography ; Flumazenil* ; Status Epilepticus*