Purpose: Diabetes Mellitus (DM) is a leading cause of death with a prevalence rate of 12.4% in South Korea. Self-management is crucial for patients with DM, because many studies have reported that self-management intervention based on the Health Belief Model (HBM) is effective. The purpose of this study was to investigate the current state of HBM based intervention studies and the components and effects of the theories used in the study for diabetes patients. Methods: A systematic review was conducted using the Pubmed, Cochrane Library and Embase databases from January 2009 to May 2019. We reviewed characteristics of intervention based on the HBM in randomized controlled clinical trials (RCTs), quasi-experimental study intervention. Results: Eight studies published in English between 2009 and 2019 were included in this review. The key components of the health behavior promotion program applied to the DM patients were perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy. The intervention based on these components has reported to significantly increase the health behavior change, likelihood of taking health action and improve physiological indicators (HbA1c, and fasting blood sugar etc.). Conclusion This study highlighted the importance of intervention programs based on the HBM for DM patients.

BACKGROUND: Irritable bowel syndrome (IBS) is a chronic recurrent gastrointestinal disorder that may deteriorate life quality significantly. There is no specific way of curing IBS but to rely on symptomatic and supportive treatment as well as changes in lifestyle. Previous studies have suggested that physical exercise might be effective for improving IBS symptoms. However, evidence does not exist for Korean population. This study was performed to evaluate the association of physical activity with IBS. METHODS: A total of 706 women nurses with shift work in a university affiliated tertiary hospital were surveyed with a self-administered questionnaire asking IBS symptoms (Rome III criteria), depression (Zung's Self-rating Depression Scale), anxiety (Goldberg's Short Screening Scale for Anxiety, GAS), stress (Brief Encounter Psychosocial Instrument), demographic characteristics, and health behavior. The association between IBS and physical activity was examined using chi-square test and multiple logistic regression analysis. RESULTS: Prevalence of IBS was 37.5% and the most common subtype of IBS was mixed constipation and diarrhea (70.6%). Neither physical activity nor regular exercise was not associated with IBS. IBS was independently associated with higher level of anxiety (GAS score > or = 5), tolerable dysmenorrhea, and troublesome dysmenorrhea with odds ratios (95% confidence intervals) of 2.10 (1.37-3.22), 2.83 (1.39-5.75), and 2.56 (1.21-5.40), respectively. CONCLUSION: In Korean women nurses with shift work, IBS was not associated with physical activity. However, the higher level of anxiety and dysmenorrhea were independently associated with increased risk of IBS.
Anxiety ; Constipation ; Depression ; Diarrhea ; Dysmenorrhea ; Exercise ; Female ; Health Behavior ; Humans ; Irritable Bowel Syndrome ; Life Style ; Logistic Models ; Mass Screening ; Motor Activity ; Odds Ratio ; Physical Exertion ; Prevalence ; Quality of Life ; Tertiary Care Centers ; Surveys and Questionnaires

The necessary role of genital infection by specific types of human papillomavirus (HPV) in cervical cancer development provides an opportunity to reduce the risk of cervical cancer, a second leading cancer in women, through prophylactic vaccination. Two types of vaccines targeting HPV 16 and 18 which are responsible for about 70% of all cervical cancer worldwide have been developed: a quadrivalent vaccine (Gardasil?) and a bivalent vaccine (Cervarix?). Gardasil also targets HPV 6 and 11 causing 90% of genital wart. Both two vaccines contain virus-like particles composed of L1 protein of viral capsid and do not exert infectivity. HPV vaccines were highly effective in preventing persistent infection by vaccine specific type HPV in young women who have not been previously exposed to them. Randomized double-blind placebo-controlled clinical trials have provided evidence that HPV vaccines have high efficacy against cervical precancerous lesion in young women irrespective of baseline HPV infection status. However, HPV vaccines neither treat existing HPV infections nor provide protection against all types of HPV related with cervical cancer. Therefore, even vaccinated females should take cervical cancer screening as recommended. Gardasil has been tested mainly in 9~26 years old females and Cervarix in 15~25 years old. Current recommendation for vaccination age is 9~26 years for Gardasil and 10~25 years for Cervarix, considering sexual debut and previous clinical trials. There are plenty of remaining issues regarding HPV vaccination such as vaccine efficacy in older women and in males, cost-effectiveness, duration of protection, cross-protection, potential replacement infection, and vaccine compatibility.
Cancer Vaccines ; Capsid ; Condylomata Acuminata ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Human papillomavirus 6 ; Humans ; Male ; Mass Screening ; Papillomavirus Vaccines ; Uterine Cervical Neoplasms ; Vaccination ; Vaccines ; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18

Acute fatty liver of pregnancy (AFLP) is unusual but can potentially progress to overwhelming liver failure, resulting in maternal and fetal death. AFLP is characterized by the accumulation of microvesicular fat within hepatocytes. We report the case of a 37-year-old woman at 36 weeks' gestation with a twin pregnancy who was admitted with the diagnosis of intrauterine fetal death of one baby. The patient showed profile of AFLP on her laboratory findings and underwent emergency cesarean section. Then she progressed to cryptogenic fulminant hepatic failure and underwent successful orthotopic liver transplantation on 9th day of admission. This case demonstrates that liver transplantation is a feasible therapeutic option for the treatment of patients with this condition.
Adult ; Anesthesia, General ; Cesarean Section ; Diagnosis ; Emergencies ; Fatty Liver ; Female ; Fetal Death ; Hepatocytes ; Humans ; Liver Failure ; Liver Failure, Acute ; Liver Transplantation ; Liver ; Pregnancy ; Pregnancy, Twin

PURPOSE: We investigated the outcome and the prognostic factors of patients with locally advanced esophageal cancer who were treated with concurrent chemo-radiotherapy. Materials and METHODS: Two hundred forty six patients with esophageal cancer that were treated by radiotherapy between January 1994 and July 2007. Of these, 78 patients who received radiotherapy of > or =45 Gy with concurrent chemotherapy were retrospectively enrolled in this study. We included patients stages IIA, IIB, III, IVA, and IVB with supraclavicular metastasis in the middle/lower esophageal cancer or celiac node metastasis in cervical or upper/middle thoracic esophageal cancer. The median radiation dose was 54 Gy and the combination chemotherapy with 5-FU and cisplatin (FP chemotherapy) was given concurrently with radiotherapy in most patients (88%). RESULTS: The follow-up period ranged from 2 to 117 months (median 14 months). The treatment response of the 54 patients could be evaluated by computerized tomography or endoscopy. A complete response (CR) was observed in 17 patients, whereas a partial response was observed in 18 patients. In patients with a CR, the median recurrence time was 20 months and the first relapse sites constituted a locoregional failure in 3 patients and a distant failure in 7 patients. The 1-, 2-, and 5-year overall survival (OS) rates were 58.9%, 21.7%, and 12.2%, respectively. The median survival period was 14 months. A univariate analysis indicated that the treatment response and cycles of FP chemotherapy were significant prognostic factors for OS. Daily or weekly administration of cisplatin as a radiosensitizer showed a better treatment response than FP chemotherapy. CONCLUSION: This study has shown that results of concurrent chemo-radiotherapy in patients with locally advanced esophageal cancer is comparable to those of other studies. Daily or weekly cisplatin administration may be considered as an alternative treatment in patients that are medically unfit for FP chemotherapy.
Cisplatin ; Drug Therapy, Combination ; Endoscopy ; Esophageal Neoplasms ; Fluorouracil ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies

Multinucleated cells resulted from mitosis defect have been noted in pathophysiological states of the cells such as inflammation, senescence and cancer. Since oxidative stress has been known to correlate with these pathophysiological conditions, we tested the effect of H2O2 on the cell cycle progression and formation of multinucleated cells. H2O2 induced a significant delay in cell cycle progression in Chang liver cells. Interestingly, H2O2 actively induced hyperamplification of centrosomes (> or =3) and multipolar spindle formation during mitosis and subsequently increased the generation of multinucleated cells. A significant increase of the phospho-ERK level was observed upon H2O2 treatment but PD98059, an MEK1/2 inhibitor, didn't reduce the frequency of cells with hyperamplified centrosomes. On the other hand, treatment of either H2O2 or adriamycin increased intracellular ROS levels and multinucleated cells, which were significantly suppressed by antioxidants, N-acetylcysteine and PDTC. Thus, our results suggest that oxidative stress can trigger centrosome hyperamplification and multinucleated cell formation, which may promote pathophysiological progression.
Cell Line ; Cell Nucleus/*drug effects/*metabolism ; Centrosome/*drug effects/*metabolism ; Gene Amplification ; Humans ; Hydrogen Peroxide/*pharmacology ; MAP Kinase Signaling System ; Mitotic Spindle Apparatus/drug effects ; Phenotype ; Reactive Oxygen Species/metabolism ; Research Support, Non-U.S. Gov't

PURPOSE: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. MATERIALS AND METHODS: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. RESULTS: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1- and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2- and 3-year overall survival rates were 31.6% and 15.8%, respectively. CONCLUSION: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.
Axis, Cervical Vertebra ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Recurrence ; Retrospective Studies ; Spine ; Survival Rate

BACKGROUND: Based on scientific evidence, the Korean National Health Examination recommends age 40 as an appropriate time for screening. However, awareness of the health examination itself or of the appropriate age for screening has not been discussed extensively with examinees. This study aims to evaluate the perception about age at the start and end of periodic health examinations (PHE). METHODS: A self-administered survey was completed by 887 subjects who visited either the health promotion center or the outpatient clinic at a university hospital in Korea between February 15 and May 18, 2016. Participants were divided into two groups: 587 were periodic health examinees, and 300 were visitors to the family medicine clinic. Their awareness of PHE was compared using the Chi-square test and multiple logistic regression. RESULTS: Both groups had similar (P>0.05) perceptions regarding the awareness, knowledge and usefulness of the PHE. Both groups preferred to continue taking a PHE with no upper limit on the age when it could be taken. This tendency was more prominent among subjects with higher levels of education and household income. In both groups with individuals under age 50 said that the appropriate age to begin screening is 40 or younger. CONCLUSIONS: The perception regarding the ages at which to start and end the PHE was confirmed according to the subject of visit; a wider range of appropriate ages was preferred than is included in the current recommendations.
Age Factors ; Ambulatory Care Facilities ; Education ; Family Characteristics ; Health Promotion ; Health Services ; Humans ; Korea* ; Logistic Models ; Mass Screening ; Socioeconomic Factors

BACKGROUND: The early and accurate diagnosis of leptomeningeal metastasis (LM) has become important because of introduction of new therapeutic strategies for LM and increasing incidence of LM along with longer survival of cancer patients. We aimed to evaluate the role of cerebrospinal fluid (CSF) CYFRA 21-1 as a diagnostic indicator for LM in patients with cancer. METHODS: CSF CYFRA 21-1 level was analyzed using electro-chemiluminescent immunoassay. The difference in concentration of CSF CYFRA 21-1 between 91 patients with LM and 339 control groups (patients with other neurological disease or healthy controls) was investigated. The cut-off value of CSF CYFRA 21-1 as a diagnostic indicator for LM and its diagnostic performance were evaluated. RESULTS: The CSF CYFRA 21-1 was significantly higher in LM patients than control groups (p<0.001). A cut-off value of diagnosis for LM in patients with cancer was 1.59 ng/mL. The sensitivity, specificity, accuracy, and positive and negative predictive values of CSF CYFRA 21-1 were 80.2%, 96.2%, 92.8%, 84.9%, 94.8% for diagnosis of LM. CONCLUSIONS: These results suggested that CSF CYFRA 21-1 can be an additional diagnostic indicator for cancer patients with LM.
Cerebrospinal Fluid ; Diagnosis ; Humans ; Immunoassay ; Incidence ; Neoplasm Metastasis ; Sensitivity and Specificity

Fanconi anemia is an autosomal recessive disease that's characterized by congenital anomalies, defective hematopoiesis and a high risk of developing acute myeloid leukemia and certain solid tumors. The clinical phenotype is extremely variable; therefore, the diagnosis is frequently delayed until the pancytopenia appears. Chromosomal instability, especially on exposure to an alkylating agent, may be seen in affected patients and it is the basis for a diagnostic test. This cellular phenotype can be demonstrated in cultured T cells, B cells, fibroblasts and fetal cells cultured from both amniotic fluid and chorionic villi. But somatic mosaicism may make the diagnosis of Fanconi anemia difficult because of inconclusive chromosome breakage studies. If the test is negative in lymphocytes and yet the clinical setting is highly suspicious, then the skin fibroblasts must be assessed. Because skin fibroblasts are somatic cells, a definitive test can be performed on primary skin fibroblasts. In this report we describe a case of Fanconi anemia that was diagnosed with the use of cultured skin fibroblasts, and this was despite the normal breakage studies in the peripheral blood.
Amniotic Fluid ; B-Lymphocytes ; Chorionic Villi ; Chromosomal Instability ; Chromosome Breakage ; Diagnostic Tests, Routine ; Fanconi Anemia ; Female ; Fibroblasts ; Hematopoiesis ; Humans ; Leukemia, Myeloid, Acute ; Lymphocytes ; Mosaicism ; Pancytopenia ; Phenotype ; Skin ; T-Lymphocytes