Oral mucositis continues to be a major complaint of patients who have chemotherapy for the acute leukemia. An innovative and inexpensive remedy which produces favorable results for those afficted is not yet introduced. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. The one is sodium bicarbonate-normal saline gargling, and the other consists of chlorhexidine gargling. This quasi-experimental study was performed to compare the efficacy of these two different oral care protocols. Twenty subjects were assigned to one of the two specific diagnosis of leukemia, aim of the chemotherapy. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort, WHO Grading system fot mucositis and the discomfort of oral gargling solution were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count(ANC) reached 1,000. It continued about 2-4 weeks. The data analyzed by Mann-Whittney U test and ANCOVA. The result was follows as: The patient who used sodium bicarbonate-normal saline gargling showed significantly higher mean score of the discomfort of oral gargling solution than chlorhexidine gargling. The other scores were not significantly different between two groups. However the subjects using the sodium bicarbonate-normal saline gargling showed a lower level of oral mucositis. We concluded that oral using sodium bicarbonate-normal saline gargling was between to reduce the level of oral mucositis during chemotherapy and nursing assessments of the oral cavity seemed to promote patient's compliance with the oral care regimen.
Chlorhexidine* ; Compliance ; Diagnosis ; Drug Therapy ; Humans ; Leukemia* ; Mouth ; Mucositis ; Neutrophils ; Nursing Assessment ; Sodium* ; Stomatitis*

PURPOSE: Retroperitoneal paraganglioma is a relatively uncommon neurogenic tumor, arising from paraganglial tissue. In our knowledge, there is few report about the radiologic findings of extraadrenal paraganglioma, therefore, here we document the adiologic findings of retroperitoneal paraganglioma with pathologic correlation. MATERIALS AND METHODS: In 5 patients with surgicopathologically confirmed extraadrenal paraganglioma and 1 clinjcolaboratorily confirmed case, we analyzed the ultrasonographic, computed tomographic and MRI findings, and correlated them with gross pathologic specimen. RESULTS: The location of the tumors was medial aspect of left kindey(n=2), superomedial aspect of right kidney hilum(n=2), and organ of Zuckerkandl area(n=2), UItrasonoram showed well-marginated mass(n=5), occasionally with irregular central necrosis with or without partially echogenic area suggesting hemorrhage(n=2). CT scan also showed well-marginated mass(n=6) with hemorrhagic necrosis(n--3) and contrast enhancement. One showed are shaped calcification along the capsule, and another case showed adhesion with aorta. In MRI, solid portion of the mass showed relatively low signal intensity on T1WI, increased signal on T2WI, and enhancement with gadolinium. Necrotic portion showed increased signal intensity on T1WI, and also showed increased signal intensity on T2WI, without contrast enhancement. Grossly the mass showed internal hemorrhagic necrosis of variable degree(n=6). CONCLUSION: If well-marginated mass is noted around the area of paraganglial distribution including organ of Zuckerkandl, especially with evidence of hemorrhagic necrosis and contrast enhancement, we must consider the possibility of paraganglioma despite no characteristic symptoms.
Aorta ; Gadolinium ; Humans ; Kidney ; Magnetic Resonance Imaging ; Necrosis ; Para-Aortic Bodies ; Paraganglioma* ; Tomography, X-Ray Computed

PURPOSE: Piccolo et al. advocated the usefulness of Tc-99m-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied Tc-99m-MDP uptake pattern and lesions/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of Tc-99m-MDP scan. MATERIALS AND METHODS: Total 34 patients were studied with physical examination, mammogram and Tc-99m-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq Tc-99m-MDP. Breast uptake pattern of Tc-99m-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammo-grain. RESULTS: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of Tc-99m-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 2/7, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. CONCLUSION: Tc-99m-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.
Biopsy ; Biopsy, Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Mammography ; Physical Examination ; Prospective Studies ; Technetium Tc 99m Medronate*

PURPOSE: The purpose of this study was to investigate the factors associated with social isolation in older adults using a senior welfare center. METHODS: This study was a cross-sectional survey. Data was collected from June to August 2006 using a questionnaire. A total of 248 older adults responded. RESULTS: About one third (34.9%) of participants responded they felt socially isolated. There were statistically significant differences in living, religion, family and belongingness social support, loneliness, depression, family function, perceived health status, and number of chronic illnesses between socially isolated and non isolated groups. However, factors influencing social isolation were family function (OR=0.954, CI=0.926-0.982), loneliness (OR=1.042, CI=1.002-1.083), depression (OR=1.041, CI=1.002-1.081), and number of chronic illness (OR=1.657, CI=1.153-2.382). CONCLUSION: We found that some older adults were feeling socially isolated even though the senior welfare center was a good place to meet people. The findings of this study indicated that older adults suffering from social isolation need special attention and may benefit from interventions which promote health and social interactions. Further studies are needed to develop and evaluate an intervention program for this population.
Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Depression ; Family ; Female ; Health Status ; Humans ; Loneliness ; Male ; Middle Aged ; Predictive Value of Tests ; Questionnaires ; Social Isolation/*psychology ; Social Welfare ; Translating

Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2 cell monolayer, during the period of January-December, 1991. There were peaks of incidences in March-May and November-December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases(66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates(67%), segmental or subsegmental atelectasis(32%), and segmental or lobar consolidation(16%). In 15 cases(20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or hilar lymph node enlargement in all cases. By considerig clinical features(symptoms, age. Underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally though to represent bacterial pneumonia, is also observed not infrequently in respiratory syncytial virus infections.
Child* ; Humans ; Incidence ; Infant* ; Lymph Nodes ; Pleural Effusion ; Pneumonia, Bacterial ; Respiratory Syncytial Virus Infections ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections

BACKGROUND: The College of Medicine at Korea University has lunched the new curriculum which incorporated optional elective courses in 2000. Optional elective course is consisted of 10 subjects. 8 subjects are conducted in classroom lectures and 2 of them are active experiences in research or community service. The purpose of this study is to identify the level of achievement of its own educational goals and objectives. Also, we tried to explore the possibilities of improving this course for the maximum educational effectiveness.. MATERIAL AND METHOD: We conducted a survey and the subjects of this study were second, and third year medical students who finished this course. RESULTS: 84.8% of respondents were aware of the goals of the course. 91.1% of them agreed this course is needed to enhance the effectiveness in undergraduate medical education. Most students agreed the course provide an opportunity to broaden their perspectives of field of medicine(81.4% of respondents). Also, this course provided good informations for students' future career choice(78.6% of respondents). However, students wanted to have more in-depth learning experience. INTERPRETATION: The implementation of the optional elective course at the Korea University, Medical College was successful. Despite of its initial success, the course has to be revised to allow students to get more in - depth study according their own interests.
Curriculum ; Surveys and Questionnaires ; Education, Medical, Undergraduate ; Humans ; Korea ; Learning ; Lectures ; Lunch ; Social Welfare ; Students, Medical

Neurofibromatosis, first clearly described by von Recklinghausen in 1882, is a dominantly inherited mesodermal and ectodermal dysplasia with a broad spectrum of clinical findings. Most common is the classical neurofibromatosis, which has three major features: (1) multiple neural tumors dispersed anywhere on or in the body; (2) numerous pigmented skin lesions, some of which are "cafe au lait" spots; and (3) pigmented iris hamartomas also called Lisch nodules. Other lesions sometimes seen in patients with von Recklinghausen's disease include congenital malformations of various types, vascular lesions, neurilemoma meningioma and other intracranial neoplasms, pheochromocytoma, medullary carcinoma of thyroid gland, neuroblastoma, ganglioneuroma and Wilms' tumor. Approximately 10% of the patients with neurofibromatosis have the gastrointestinal tract tumors as neurofibroma, ganglioneuroma and leiomyoma. Some of them show evidence of malignancy. Increased activity of the protein "nerve growth factor" in the sera of the patients with disseminated neurofibromatosis has been reported. We would like to report here two cases of von Recklinghausen's neurofibromatosis with involvement of the gastrointestinal tract.
Hamartoma ; Meningioma

PURPOSE: This study aimed to analyze physical activity as measured by the International Physical Activity Questionnaire (IPAQ) and an actigraph in breast cancer survivors, as well as to identify their intention to participate in a physical activity program. METHODS: Breast cancer patients who had been diagnosed for more than six months (N=135) at a university hospital participated from June 2012 to May 2013. Physical activity was measured using the Korean version of the IPAQ-Short Form and Actigraph GT3X plus an accelerator for seven consecutive days. Data analyses were conducted using the SPSS WIN 19.0 program. RESULTS: Mean total physical activity was 2298.21 metabolic equivalent task (MET)-min/week as assessed by IPAQ and 150,140.57 counts/day as measured by an actigraph. There were statistically significant correlations between moderate physical activity from IPAQ and light intensity of physical activity from the actigraph (r=.735, p<.001), vigorous physical activity from IPAQ and vigorous intensity of physical activity from the actigraph (r=.871, p<.001), total physical activity from IPAQ and light intensity of physical activity from the actigraph (r=.825, p<.001), respectively. Most (80.7%) cancer survivors reported a positive attitude toward physical activity and 57.8% expressed a willingness to participate in a physical activity program. More than half (60%) of the subjects preferred walking, 80.6% preferred more than 30 minutes of exercise, and 57.1% wanted to engage in physical activity three times a week and preferred home-based activities. Perceived barriers included fatigue, lack of strength and pain. CONCLUSION: It is necessary to consider intensity, personal preferences, and patient-perceived barriers when developing physical activity programs for breast cancer survivors.
Breast Neoplasms* ; Breast* ; Fatigue ; Humans ; Intention* ; Metabolic Equivalent ; Motor Activity* ; Statistics as Topic ; Survivors* ; Walking

This study investigated dieting behavior, awareness of body shapes, and eating disorders in female adolescents according to age and BMI. The Eating Attitude Test for Korean Adolescents (EAT-26KA) and sociocultural standards were used to measure eating disorders and sociocultural attitudes related to appearance, respectively. In addition, the BDI (Beck Depression Inventory) scale was used to measure the correlation between disordered eating and depression. The data were collected from 390 female adolescents living in Seoul and were analyzed using SPSS15.0. The results indicated that subjects wanted to be thinner despite having a normal body weight (BMI 19.35+/-2.73). They also thought of themselves as fat and with desires to be slimmer, and viewed "diet and exercise" as the best way to lose weight. About 67.4% of the respondents had tried a diet and had experienced dizziness, anorexia, and general exhaustion while dieting. Also, 5.1% of the subjects were classified as eating disorder and suffered from stress to be thin. In addition, 85.0% of the subjects with eating disorder had tried a diet due to "appearance". They thought that "being underweight" was an ideal body image and considered themselves fat, although their BMIs were in the normal range (19.94+/-2.02). In terms of symptoms during dieting, many of the subjects dealing with an eating disorder felt dizzy, had low energy, and were depressed. In conclusion, we must educate young females about healthy eating and positive body image to prevent the development of adolescent eating disorders.
Adolescent ; Anorexia ; Body Image ; Surveys and Questionnaires ; Depression ; Diet ; Dizziness ; Eating ; Eating Disorders ; Female ; Humans ; Ideal Body Weight ; Reference Values ; Weights and Measures

BACKGROUND: There have been few reports suggesting involvement of mast cell and neutrophil to induce bronchoconstriction in aspirin-sensitive asthrna. OBJECTIVE: To evaluate mast cell and neutrophil activation in pathogenesis of aspirin-sensitive asthma. MATERIAL AND METHOD: We observed changes of serum NCA and MPO levels during L-ASA bronchoprovocation test in 14 subjects with aspirin-sensitive asthma. RESULTS: Serum NCA was significantly increased at 30 min(p=0.01) after the inhalation of L-ASA and then, no significant changes were noted at 240 min (p=0.14). NCA was significantly higher in subjects with late asthmatic responses than in those without it (p=0.04). Serum MPO level tended to increase at 30 min with no statistical significance (p=0.08), and then it significantly decreased at 240 min (p=0.05). There was no significant correlation between serum NCA and MPO level (r=0.22, p=0.58). CONCLUSION: These results support the view that NCA derived from mast cell may contribute to neutrophil recruitment into the airway in aspirin-sensitive asthmatic patients.
Asthma ; Bronchoconstriction ; Humans ; Inhalation ; Mast Cells ; Neutrophil Activation ; Neutrophil Infiltration ; Neutrophils*