No abstract available.
Follow-Up Studies*

BACKGROUND: This study aimed to examine (1) the patterns of online health information search with respect to seeking and scanning, and (2) how online search, along with eHealth literacy, predicts perceived information usefulness in the context of diet and weight control. METHODS: Online survey was conducted with 299 adults from the consumer panel recruited for the purpose of quality assessment of the Korean National Health Information Portal in 2016. We conducted paired sample t-test and multiple logistic regression to address the research questions. Data analysis was performed using IBM SPSS Statistics ver. 24.0 (IBM Corp., Armonk, NY, USA) and SAS ver. 9.3 (SAS Institute Inc., Cary, NC, USA). RESULTS: Of the respondents, 38.8% were ‘high seek-high scanners,’ 35.8% were ‘low seek-low scanners,’ 13.0% were ‘high seek-low scanners,’ and 12.4% were ‘low seek-high scanners.’ eHealth literacy was a significant, positive predictor of online information scanning (odds ratio [OR], 2.46; 95% confidence interval [CI], 1.41–4.29), but not for online information seeking (OR, 1.75; 95% CI, 1.00–3.05). With respect to perceived usefulness of online information seeking, online seeking (OR, 4.90; 95% CI, 2.19–11.00) and eHealth literacy (OR, 2.30; 95% CI, 1.11–4.75) were significant predictors. Perceived usefulness of online scanning had a significant association with online scanning (OR, 2.38; 95% CI, 1.08–5.22), but not with eHealth literacy. CONCLUSION: To increase the effectiveness of the health policy for online information search and related outcomes in the context of diet and weight control, it is important to develop education programs promoting eHealth literacy.
Adult ; Diet ; Education ; Health Policy ; Humans ; Information Seeking Behavior ; Literacy ; Logistic Models ; Statistics as Topic ; Surveys and Questionnaires ; Telemedicine ; Weight Loss

BACKGROUND: Community-acquired pneumonia (CAP) is a common respiratory disorder in children, which necessitates hospitalization. Bacterial pneumonia, especially lobar pneumonia and parapneumonic effusions, is associated with considerably severe clinical course and extensive alveolar infiltrates. Serum procalcitonin (PCT) level has been used to distinguish bacterial from viral infections, but its usefulness is disputed. The diagnostic accuracy and usefulness of PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count were determined by comparing their values in the patients with CAP with those in healthy controls. METHODS: The serum PCT levels, as well as CRP level, ESR, and WBC counts, were measured in 76 hospitalized patients with CAP (lobar pneumonia, 16; bronchopneumonia, 60) and 18 healthy controls. Serum PCT level was measured using VIDAS(R) BRAHMS PCT (Biomerieux, France), and ROC curve analysis was performed to evaluate its diagnostic accuracy. RESULTS: Serum PCT levels were higher in the patients with CAP than in healthy controls, especially in the patients with lobar pneumonia than in those with bronchopneumonia. Serum CRP level was also significantly elevated in the patients with CAP, especially in those with lobar pneumonia. The diagnostic accuracy of serum PCT level for the diagnosis of lobar pneumonia was better than those of serum CRP level and ESR. The serum PCT level was significantly correlated with the CRP level, ESR, and WBC count. CONCLUSIONS: Serum PCT level was a better marker than CRP level or ESR for the diagnosis of lobar pneumonia in children with CAP.
Adolescent ; Biological Markers/blood ; Blood Sedimentation ; Bronchopneumonia/complications ; C-Reactive Protein/analysis ; Calcitonin/*blood ; Child ; Child, Preschool ; Community-Acquired Infections/complications/*diagnosis ; Female ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Pneumonia/complications/*diagnosis ; Protein Precursors/*blood ; ROC Curve

BACKGROUND: Today, the eradication of H. pylori represents a generally accepted and beneficial therapeutic strategy for treatment and prevention of peptic ulcer relapse. Major factors that have affected H. pylori eradication are eradication rate of regimen, compliance of patients and complications of drugs. Recently, the combination of omeprazole, amoxicillin and clarithromycin has been accepted as one of the most effective treatment for the eradication of H. pylori. The primary aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. METHODS: Two hundred twenty three patients with peptic ulcer and H. pylori infection were taken two types of triple therapy. Group A were treated with omeprazole 20 mg bid, amoxicillin 500 mg tid, clarithromycin 500 mg tid daily for 14 days. Group B were treated with omeprazole 20 mg bid, amoxicillin 1g bid, clarithromycin 500 mg bid daily for 7 days. Endoscopy with H. pylori tests was repeated 4 weeks after the end of treatment and then biopsy specimens were taken in antrum and body. CLO test and Warthin Starry silver stain were conducted concordantly. RESULTS: The H. pylori eradication rate was 92.5% in group A, 90.4% in group B. There was no significant difference in eradication rate. More than 50% of ulcer size reduction was observed 90.5% in group A, 86.3% in group B. There was no significant difference in ulcer healing(p > 0.05). The incidence of all side effects in both group were as follows; 22.6% in group A, 19.1% in group B. But major side effect was found only group A, of whom the symptom was too serious for the treatment to continue. CONCLUSION: We concluded that the seven days regimen was more favorable, because the eradication rate was almost the same as the 14 days regimen. And drug compliance and cost effectiveness were better than 14 days treatment regimen.
Amoxicillin* ; Biopsy ; Clarithromycin* ; Compliance ; Cost-Benefit Analysis ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Omeprazole* ; Peptic Ulcer ; Recurrence ; Silver ; Ulcer

BACKGROUND: The prevalence of stomach cancer had decreased in developed countries, but still remains high in Korea. There was an agreement that dietary factors were the most important factors in gastric carcinogenesis. We undertook a meta-analysis to verify the relation between Korean food items and stomach cancer. METHODS: We searched all studies compatible for meta-analysis by computer and by manual and found two studies. We analyzed 14 dietary factors presented in the two studies by Peto's method. We calculated summary odds ratios and test for homogeneity. RESULTS: Among the 14 dietary factors, salt preference (odds ratio 1.72 [95%CI 1.29-2.30] P<0.001), soybean paste stew (odds ratio 4.19 [95%CI 2.99-5.89] P<0.001), hot pepper soybean paste stew (odds ratio 1.96 [95%CI 1.45-2.64] P<0.001), Kimchi (odds ratio 2.05 [95%CI 1.43-2.94] P<0.001), meat/fish stew (odds ratio 1.58 [95%CI 1.17-2.13] P=0.003), Bulgogi/broiled fish (odds ratio 1.84 [95%CI 1.37-2.49] P<0.001), salted side dishes (odds ratio 1.96 [95%CI 1.47-2.61] P<0.001), and chemical seasoning (odds ratio 2.55 95%CI 1.62-4.02 P<0.001) were risk factors to gastric cancer. But mung bean pancake (odds ratio 0.2 [95%CI 0.14-0.31] P<0.001) Dubu (odds ratio 0.59 [95%CI 0.43-0.83] P=0.002), and garlic (odds ratio 0.45 [95%CI 0.32-0.63] P<0.001) were preventable factors against gastric cancer. Red pepper (odds ratio 1.21 [95%CI 0.91-1.63] P=0.19) and boiled rice (odds ratio 1.39 [95%CI 0.87-2.2] P=0.16) were risk factors to gastric cancer, and sesame oil preference (odds ratio 0.68 [95%CI 0.46-1.01] P=0.06) was a preventable factor against gastric cancer, but these results were not statistically significant.
Capsicum ; Carcinogenesis ; Developed Countries ; Garlic ; Korea ; Odds Ratio ; Prevalence ; Risk Factors ; Seasons ; Sesame Oil ; Soybeans ; Stomach Neoplasms* ; Stomach*

PURPOSE: This study aimed to quantitatively measure the movement of tumors in real-time and evaluate the treatment accuracy, during the treatment of a liver tumor patient, who underwent radiosurgery with a Synchrony Respiratory motion tracking system of a robot CyberKnife. MATERIALS AND METHODS: The study subjects included 24 liver tumor patients who underwent CyberKnife treatment, which included 64 times of treatment with the Synchrony Respiratory motion tracking system (Synchrony(TM)). The treatment involved inserting 4 to 6 acupuncture needles into the vicinity of the liver tumor in all the patients using ultrasonography as a guide. A treatment plan was set up using the CT images for treatment planning uses. The position of the acupuncture needle was identified for every treatment time by Digitally Reconstructed Radiography (DRR) prepared at the time of treatment planning and X-ray images photographed in real-time. Subsequent results were stored through a Motion Tracking System (MTS) using the Mtsmain.log treatment file. In this way, movement of the tumor was measured. Besides, the accuracy of radiosurgery using CyberKnife was evaluated by the correlation errors between the real-time positions of the acupuncture needles and the predicted coordinates. RESULTS: The maximum and the average translational movement of the liver tumor were measured 23.5 mm and 13.9+/-5.5 mm, respectively from the superior to the inferior direction, 3.9 mm and 1.9+/-0.9 mm, respectively from left to right, and 8.3 mm and 4.9+/-1.9 mm, respectively from the anterior to the posterior direction. The maximum and the average rotational movement of the liver tumor were measured to be 3.3degrees and 2.6+/-1.3degrees, respectively for X (Left-Right) axis rotation, 4.8degrees and 2.3+/-1.0degrees, respectively for Y (Cranio-Caudal) axis rotation, 3.9degrees and 2.8+/-1.1degrees, respectively for Z (Anterior-Posterior) axis rotation. In addition, the average correlation error, which represents the treatment's accuracy was 1.1+/-0.7 mm. CONCLUSION: In this study real-time movement of a liver tumor during the radiosurgery could be verified quantitatively and the accuracy of the radiosurgery with the Synchrony Respiratory motion tracking system of robot could be evaluated. On this basis, the decision of treatment volume in radiosurgery or conventional radiotherapy and useful information on the movement of liver tumor are supposed to be provided.

Heterotopic ossification (HO) is frequently seen on rehabilitation units after spinal cord injuries, fractures, brain injuries, and limb amputations. Currently, there is no effective treatment for HO other than prophylaxis with anti-inflammatory medications, irradiation, and bisphosphonate administration. These prophylactic treatments are not effective for managing ectopic bone once it has formed. Here we describe three cases of established neurogenic HO treated with radiation therapy (RT). All patients had decreased serum alkaline phosphatase (ALP) and bone-specific ALP levels with decreased pain but increased range of motion immediately after RT. Post-treatment X-rays revealed no further growth of the HO. All patients maintained clinical and laboratory improvements 4 or 6 months after the RT. Our results suggest that RT is safe and effective in decreasing pain and activity of neurogenic HO.
Alkaline Phosphatase ; Amputation ; Brain Injuries ; Extremities ; Humans ; Ossification, Heterotopic* ; Radiotherapy ; Range of Motion, Articular ; Rehabilitation ; Spinal Cord Injuries

PURPOSE: The pathologic mechanisms of central nervous system(CNS) injuries in human meningitis are not yet completely understood. Recent studies indicate that the host inflammatory responses are as important in brain damage as the infecting organisms and toxins. There have been some reports on the relationship of nitric oxide(NO), macrophage inflammatory protein-1 alpha (MIP-1 alpha ), and lactoferrin in bacterial meningitis, but few reports in aseptic meningitis. Thus, we investigated the concentrations of NO, MIP-1 alpha and lactoferrin in cerebrospinal fluid(CSF) and serum of patients with aseptic meningitis and control subjects and evaluated their relationship with other parameters of meningitis. METHODS: CSF and blood were obtained from 25 subjects with aseptic meningitis and 15 control subjects. After centrifugation, supernatants were stored at -70degrees C and we assayed the concentrations of NO, MIP-1 alpha and lactoferrin with the ELISA method. There were no patients with neurologic sequelae after being recovered from aseptic meningitis. RESULTS: Concentrations of CSF and serum NO, MIP-1 alpha were not increased in aseptic meningitis subjects compared to control subjects. Concentration of CSF lactoferrin was significantly elevated in patients with aseptic meningitis and concentration of serum lactoferrin was significantly decreased in patients with aseptic meningitis compared with those in control subjects(P<0.05). CSF lactoferrin level was positively correlated with CSF WBC counts(rs=0.449, P=0.007), especially with neutrophil counts(rs=0.574, P<0.001) and CSF protein level(rs=0.508, P=0.002). CONCLUSION: Lactoferrin plays an important role in aseptic meningitis and may be released from neutrophils recruited from blood to the CSF through breakdown of blood-brain barrier. NO and MIP-1 alpha may not be important factors in the pathogenesis of aseptic meningitis without neurologic sequelae.
Blood-Brain Barrier ; Brain ; Centrifugation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lactoferrin* ; Macrophage Inflammatory Proteins* ; Macrophages* ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Neutrophils ; Nitric Oxide*

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

Oral sodium phosphate is known to be safe and it is widely used as a colon cleansing agent for colonoscopy. Yet several complicated cases with the development of electrolyte imbalance have been reported. We report here on 2 interesting cases: after administration of oral sodium phosphate, one patient presented with hyponatremia (Na, 122 mEq/L) with seizure and the other patient presented with hyponatremia (Na, 120 mEq/L) with a confused mentality. Brain imaging and electroencephalography showed no evidence of other causes for the seizure and mental change. We report here on two cases of hyponatremia with neurologic side effects, and this was all caused by oral sodium phosphate. We also include a review of the relevant literature.
Colon ; Colonoscopy ; Detergents ; Electroencephalography ; Humans ; Hyponatremia ; Neuroimaging ; Phosphates ; Seizures ; Sodium