PURPOSE: This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients. METHODS: A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group). RESULTS: The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical antipsychotics, and effectively increased a sense of efficacy for control of dietary behavior. CONCLUSION: Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.
Adult ; Cognitive Therapy ; Diet Therapy ; Exercise ; Female ; Health Behavior ; Hospitals, Psychiatric ; Humans ; Inpatients/psychology ; Mentally Ill Persons/*psychology ; Middle Aged ; Patient Education as Topic ; Psychiatric Nursing ; *Weight Loss

We investigated dietary effects of prickly pear cactus (Opuntina ficus-indica) on plasma lipids, platelet aggregation (PA), hemolysis, plasma TBARS and liver enzymes. Twenty eight volunteer diving women in Jeju island had daily 20 g cactus tea containing 27% prickly pear cactus (PPC) powder for 4 weeks, and data for the study subjects were analyzed, on the basis of diagnostic criteria for blood pressure (BP)(> or = 140/90 mmHg), plasma cholesterol (> or = 200 mg/dL) and triglyceride (> or = 150 mg/dL). The subjects with higher BP had higher plasma total cholesterol (TC) and triglyceride (TG) concentrations than those with normal BP. Those with higher TC also had higher TG. Subjects with normal BP or normal TC had higher initial slope of PA than their higher counterpart in BP and TC. PPC intake decreased plasma TG in those with higher BP. PPC intake significantly decreased the elevated initial slope in groups with normal BP, TC, and TG. Hemolysis after PPC intake decreased significantly in all the subjects and plasma TBARS decreased in the subjects with higher plasma TC and higher TG. Glutamic-oxaloacetic transaminase (GOT) significantly increased and total bilirubin significantly decreased in all the subjects after PPC intake. The present study with diving women showed that beneficial effects of short term intake of prickly pear cactus might differ depending on the subject conditions in term of blood pressure, and plasma lipids. However, long term usage of prickly pear cactus may provide preventive effects of cardiovascular diseases to all the population, presumably by hypolipidemic, antithrombotic, and antioxidant actions of its bioactive flavonoids and soluble fiber.
Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Blood Pressure ; Cactaceae ; Cardiovascular Diseases ; Cholesterol ; Diving ; Female ; Flavonoids ; Hemolysis ; Humans ; Liver ; Opuntia ; Plasma ; Platelet Aggregation ; Tea ; Thiobarbituric Acid Reactive Substances

PURPOSE: Recent research has shown that there is a relationship between the level of preoperative serum TSH and a papillary thyroid carcinoma. Therefore, this study examined the correlation between the serum TSH and papillary thyroid carcinoma. METHODS: The preoperative serum TSH level of papillary thyroid carcinoma and nodular hyperplasia of 418 patients from 2009 Jan. to 2011 Dec. was examined. The patients were divided into 3 groups, nodular hyperplasia, less than 1 cm micropapillary carcinoma and more than 1 cm papillary carcinoma, and their TSH levels were compared. RESULTS: Nodular hyperplasia and total papillary carcinoma was found in 98 (23.0%) and 322 (77.0%) patients, respectively. After dividing the patients according to the size of the mass, there were 224 (53.6%) patients with a mass less than 1 cm in size and 98 (23.4%) patients with a mass more than 1 cm in size. The preoperative serum TSH level of the 3 groups showed a significant difference, which was 1.180±1.168 μIU/ml in the nodular hyperplasia group, 1.670±1.224 μIU/ml in the micropapillary carcinoma group and 2.279±2.837 μIU/ml in the papillary carcinoma group (P<0.001). On the other hand, there were no significant correlations between the preoperative serum TSH level and gender, age, metastasis to lymph node, number of masses and extrathyroidal extensions. CONCLUSION: The larger size of the papillary thyroid carcinoma, the higher the preoperative high serum TSH level. Therefore, the stimulation of TSH can affect the progression of papillary thyroid carcinoma but more study will be needed.
Carcinoma, Papillary ; Hand ; Humans ; Hyperplasia ; Lymph Nodes ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: The purpose of this study was to investigate health management state during pregnancy, childbirth, and postpartum of immigrant women. METHODS: A descriptive research design was employed. Data were collected from 182 immigrant women who lived in four provinces and D city. Subjects were completed the following questionnaires: demographic, medical service use, pregnancy and childbirth, and health management during the ante-postpartum. RESULTS: The average age of subjects was 28.96 and 83 subjects (45.6%) were coming from Vietnam. 55 Subjects (30.2%) were within the low-income group with less than 4 million won per month. So, 62 subjects were uninsured women because of the expensive costs. Subjects mainly visited a health care center with their husband. On the using a health care center, subjects complained about communication difficulties and transportation problems. 42 Subjects were pregnant but 21.4% of pregnant subjects did not receive antenatal care. Subjects got information about pregnancy and childbirth through their husbands and husband's family. CONCLUSION: Nursing intervention to manage the pregnancy, childbirth, and the postpartum of immigrant women need to be developed and should include strategies to take care of themselves after delivery and provide knowledge and information about ante-postpartum.
Cultural Diversity ; Delivery of Health Care ; Delivery, Obstetric ; Emigrants and Immigrants ; Female ; Humans ; Medically Uninsured ; Parturition ; Postpartum Period ; Pregnancy ; Research Design ; Spouses ; Transportation ; Vietnam

BACKGROUND: Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications; however, peripheral fat mass (PFM) is associated with insulin sensitivity. The aim of this study was to investigate the relation of absolute and relative regional adiposity to insulin resistance index and adipokines in type 2 diabetes. METHODS: Total of 83 overweighted-Korean women with type 2 diabetes were enrolled, and rate constants for plasma glucose disappearance (KITT) and serum adipokines, such as retinol binding protein-4 (RBP4), leptin, and adiponectin, were measured. Using dual X-ray absorptiometry, trunk fat mass (in kilograms) was defined as CFM, sum of fat mass on the lower extremities (in kilograms) as PFM, and sum of CFM and PFM as total fat mass (TFM). PFM/TFM ratio, CFM/TFM ratio, and PFM/CFM ratio were defined as relative adiposity. RESULTS: Median age was 55.9 years, mean body mass index 27.2 kg/m2, and mean HbA1c level 7.12+/-0.84%. KITT was positively associated with PMF/TFM ratio, PMF/CFM ratio, and negatively with CFM/TFM ratio, but was not associated with TFM, PFM, or CFM. RBP4 levels also had a significant relationship with PMF/TFM ratio and PMF/CFM ratio. Adiponectin, leptin, and apolipoprotein A levels were related to absolute adiposity, while only adiponectin to relative adiposity. In correlation analysis, KITT in type 2 diabetes was positively related with HbA1c, fasting glucose, RBP4, and free fatty acid. CONCLUSION: These results suggest that increased relative amount of peripheral fat mass may aggravate insulin resistance in type 2 diabetes.
Absorptiometry, Photon ; Adipokines ; Adiponectin ; Adiposity ; Apolipoproteins ; Body Mass Index ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Leptin ; Lower Extremity ; Plasma ; Vitamin A

OBJECTIVE: To evaluate the relationship between depression and cognitive-behavioral characteristics of caregivers using social problem solving inventory (SPSI), social support or conflict scale (SSS or SCS) and somatic symptoms (SS). METHOD: Fifty five couples of brain-injured patients and caregivers participated in this study. We conducted a questionnaire survey of caregivers with Beck depression index (BDI), SPSI, SSS, SCS and SS for cognitive-behavioral characteristics. And also we studied demographic factors of patients and caregivers, clinical features of brain-injured patients, care- giving duration and time per day through interview and review of medical records. The statistical analyses were performed by independent t-test, one-way ANOVA, Pearson correlation test and linear regression analysis-stepwise method. RESULTS: BDI of the caregivers showed a negative correlation with SPSI, SSS, patients' MMSE and caregivers' education level, also a positive correlation with SCS, SS and patients' GDS (p<0.05). And married caregivers showed more depressive mood (p<0.05). Of these factors, the most influencing factors on BDI were GDS and SCS through linear regression analysis (p<0.01). CONCLUSION: MMSE, GDS and education level as cognitive- mental factors rather than physical and economic strain had a statistical correlation with depression of caregivers. Especially, SPSI, SSS and SCS as cognitive-behavioral characteristics should be considered on evaluation of depression of caregivers and will be helpful for successful rehabilitation for patients and caregivers.
Caregivers ; Demography ; Depression ; Family Characteristics ; Humans ; Linear Models ; Medical Records ; Surveys and Questionnaires ; Social Problems ; Sprains and Strains

About 40% of pregnant women are exposed to one or more kinds of medications including multivitamins during their early pregnancy period. And some of those medications are essential for the mother's health throughout full time of pregnancy. But most of clinical trial for the medicine cannot include the pregnant women because of its uncertain effect on fetus. In this circumstances, the medication can be researched by retrospective study through establishing pregnancy exposure registries. In this study, we aimed to make evidence of fetal safety and risk of many biopharmaceutical products that can help clinician & pregnant women. It is important to enroll the pregnant women who had medication exposure in her early pregnancy without any selective biases. And It should include enough population size and proper data. In addition, pregnancy outcome including the major & minor anomalies of fetus following the exposure of medications in pregnancy must be evaluated by regulated standard guideline. USA & European Union had already published the registry of pregnant women and it really helpful for safe prescription in pregnant women. So It is strongly suggested that this registry will have a great influence on determining the safety and risk of many medications in Korean pregnant women.
Bias (Epidemiology) ; European Union ; Female ; Fetus ; Humans ; Population Density ; Pregnancy Outcome ; Pregnancy ; Pregnant Women ; Prescriptions ; Registries ; Retrospective Studies

OBJECTIVE: The purpose of this case series was to retrospectively examine records of cases with uterine rupture in pregnancies following myomectomy and to describe the clinical features and pregnancy outcomes. METHODS: This study was conducted as a multicenter case series. The patient databases at 7 tertiary hospitals were queried. Records of patients with a diagnosis of uterine rupture in the pregnancy following myomectomy between January 2012 and December 2014 were retrospectively collected. The uterine rupture cases enrolled in this study were defined as follows: through-and-through uterine rupture or tear of the uterine muscle and serosa, occurrence from 24+0 to 41+6 weeks' gestation, singleton pregnancy, and previous laparoscopic myomectomy (LSM) or laparotomic myomectomy (LTM) status. RESULTS: Fourteen pregnant women experienced uterine rupture during their pregnancy after LSM or LTM. Preterm delivery of less than 34 weeks' gestation occurred in 5 cases, while intrauterine fetal death occurred in 3, and 3 cases had fetal distress. Of the 14 uterine rupture cases, none occurred during labor. All mothers survived and had no sequelae, unlike the perinatal outcomes, although they were receiving blood transfusion or treatment for uterine artery embolization because of uterine atony or massive hemorrhage. CONCLUSION: In women of childbearing age who are scheduled to undergo LTM or LSM, the potential risk of uterine rupture on subsequent pregnancy should be explained before surgery. Pregnancy in women after myomectomy should be carefully observed, and they should be adequately counseled during this period.
Animals ; Blood Transfusion ; Diagnosis ; Female ; Fetal Death ; Fetal Distress ; Hemorrhage ; Humans ; Mice ; Mothers ; Myometrium ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Serous Membrane ; Tears ; Tertiary Care Centers ; Uterine Artery Embolization ; Uterine Inertia ; Uterine Rupture*

BACKGROUND/AIMS: Radiofrequency ablation (RFA) is one of the most frequently applied curative treatments in patients with a single small hepatocellular carcinoma (HCC). However, the clinical significance of and risk factors for early massive recurrence after RFA—a dreadful event limiting further curative treatment—have not been fully evaluated. METHODS: In total, 438 patients with a single HCC of size ≤3 cm who underwent percutaneous RFA as an initial treatment between 2006 and 2009 were included. Baseline patient characteristics, overall survival, predictive factors, and recurrence after RFA were evaluated. In addition, the incidence, impact on survival, and predictive factors of early massive recurrence, and initial recurrence beyond the Milan criteria within 2 years were also investigated. RESULTS: During the median follow-up of 68.4 months, recurrent HCC was confirmed in 302 (68.9%) patients, with early massive recurrence in 27 patients (6.2%). The 1-, 3-, and 5-year overall survival rates were 95.4%, 84.7%, and 81.8%, respectively, in patients with no recurrence, 99.6%, 86.4%, and 70.1% in patients with recurrence within the Milan criteria or late recurrence, and 92.6%, 46.5%, and 0.05% in patients with early massive recurrence. Multivariable analysis identified older age, Child-Pugh score B or C, and early massive recurrence as predictive of poor overall survival. A tumor size of ≥2 cm and tumor location adjacent to the colon were independent risk factors predictive of early massive recurrence. CONCLUSIONS: Early massive recurrence is independently predictive of poor overall survival after RFA in patients with a single small HCC. Tumors sized ≥2 cm and located adjacent to the colon appear to be independent risk factors for early massive recurrence.
Aged ; Carcinoma, Hepatocellular/mortality/pathology/*surgery ; Catheter Ablation ; Female ; Hepatitis B/complications ; Hepatitis C/complications ; Humans ; Liver Neoplasms/mortality/pathology/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome

BACKGROUND/AIMS: Serum alpha-fetoprotein (AFP) measurement is commonly included in a health check-up program in Korea. However, its benefits remain uncertain. We analyzed whether AFP measurement should be included in a general health check-up program to screen for hepatocellular carcinoma (HCC). METHODS: A total of 36,552 adults aged 18 years or older—who participated in a routine health examination including AFP determination between January 2009 and December 2009 at the Health Promotion Center, Samsung Medical Center, South Korea—were analyzed. High risk of HCC was defined as positivity for hepatitis B surface antigen, anti-hepatitis C virus antibody or having liver cirrhosis. RESULTS: AFP level >10 ng/mL was observed in 27 participants (0.1%) and primary liver cancer was diagnosed in 9 patients (6 HCC and 3 cholangiocarcinoma). Among 1,619 participants with high risk factors of HCC, AFP level >10 ng/mL was observed in 16 participants, of which, 4 diagnoses were made. Sensitivity, specificity, positive predictive value, and negative predictive value of AFP for HCC was 0.66, 0.99, 0.25 and 0.99, respectively, for high risk participants. Among 34,933 participants without risk factors for HCC, 11 patients (<0.1%) showed elevated AFP levels above 10 ng/mL, and no case was diagnosed with primary liver cancer during a median follow-up period of 36 months (range: 0-48 months). CONCLUSIONS: AFP elevation was rare in participants without risk factors for HCC, and was unable to screen for HCC in this population. We discourage routine AFP measurements for asymptomatic adults without risk factors of HCC.
Adult ; alpha-Fetoproteins* ; Carcinoma, Hepatocellular* ; Diagnosis ; Follow-Up Studies ; Health Promotion ; Hepatitis B Surface Antigens ; Humans ; Korea ; Liver Cirrhosis ; Liver Neoplasms ; Mass Screening* ; Risk Factors ; Sensitivity and Specificity