Purpose: The purpose of this study was to identify the knowledge structure of health information (HI) for chronic obstructive pulmonary disease (COPD). Methods: Keywords or meaningful morphemes from HI presented on five health-related websites (HRWs) of one national HI institute and four hospitals, as well as HI needs among patients presented in nine literature, were reviewed, refined, and analyzed using text network analysis and their co-occurrence matrix was generated. Two networks of 61 and 35 keywords, respectively, were analyzed for degree, closeness, and betweenness centrality, as well as betweenness community analysis. Results: The most common keywords pertaining to HI on HRWs were lung, inhaler, smoking, dyspnea, and infection, focusing COPD treatment. In contrast, HI needs among patients were lung, medication, support, symptom, and smoking cessation, expanding to disease management. Two common sub-topic groups in HI on HRWs were COPD overview and medication administration, whereas three common sub-topic groups in HI needs among patients in the literature were COPD overview, self-management, and emotional management. Conclusion The knowledge structure of HI on HRWs is medically oriented, while patients need supportive information. Thus, the support system for self-management and emotional management on HRWs must be informed according to the structure of patients’ needs for HI. Healthcare providers should consider presenting COPD patient-centered information on HRWs.

The purpose of this study was to investigate the effect of isoflavone supplementation using soymilk on bone mineral density in underweight college women aged 19-22 years with lower than average bone mass. The bone mineral density (BMD) of the lumbar spine and femoral neck of a number of underweight (BMI<20) college women was measured. From this group, 33 subjects whose T-score value was below -1 were selected. Anthropometric measurements, dietary recall and BMD were measured before the study began and at the end of the 10th week. The 33 subjects were given 400 ml of soymilk containing 60 mg of isoflavones daily for 10 weeks. After 12 weeks at the end of 10 weeks treatment, the BMD of the subjects was reassessed. The average age of the subjects was 21.1 yrs. At the baseline, average height, weight, and BMI of the subjects were 161 cm, 49.1 kg, 18.8 kg/m2, respectively. Mean daily intake of energy and protein was 1637.2 kcal and 61.2 g, respectively. Mean dietary isoflavone intake was 17.4 mg. Despite the 400 ml soymilk supplementation, there was no significant change in nutrient intake after the 10-week treatment. However, there were significant increases in lumbar spine and femoral neck BMD. After the study, the BMD of the subjects' spine and femoral neck was lower than that before the study. In conclusion, soymilk intake was associated with a significant increase in the BMD of the lumbar spine and femoral neck in underweight college women with lower than average bone mass.
Bone Density* ; Female ; Femur Neck ; Humans ; Isoflavones ; Spine ; Thinness*

The purpose of this study is to compare the educational needs and perception of mothers of normal neonates and high risk infants. This research was designed as a descriptive study. Data were collected for two months from April 2002 to March 2002. Subjects were 41 mothers of high risk infants and 60 mothers of normal neonates in one general hospital in Seoul participated in the study. Measurement tools used in this study were the educational needs scale developed by Cho Kyoul Ja et al and the neonatal perceptive inventories scale developed by Broussard. They ask mothers to rate each item on a four point Likert type scale. The collected data were analyzed using SPSS 8.0 program. The variables were listed as frequency, mean, standard deviation, X2 test, t-test, ANOVA. The results were as follows: The educational needs of the mothers of primi pregnancy was higher than the mothers of multi pregnancy. The educational needs on management of diseases such as prevention of infection, symptoms of disease, mental development, attachment promotion, congenital metabolism test, management of convulsion, care of vomiting and fever were higher than general care of infants such as immunization, measurement of temperature, hiccough care, follow up care. The informations must be included in nursing intervention program to reduce the mothers' stress level. In conclusion, in order to promote positive mother infant relationship, nurse need to give information and educate the mothers of high risk infant and normal neonate.
Equipment and Supplies ; Fever ; Hiccup ; Hospitals, General ; Humans ; Immunization ; Infant* ; Infant, Newborn* ; Metabolism ; Mothers* ; Nursing ; Pregnancy ; Seizures ; Seoul ; Vomiting ; Child Health

Many young women suffer from premenstrual syndrome (PMS). The purpose of this study was to examine the effect of isoflavone on serum sex hormone and PMS during the luteal phase of the menstrual cycle. We investigated the incidence of PMS in 116 Korean female college students. The incidence of PMS was 19.8%. Among them, 9 PMS and 13 control were given 90 mg isoflavone per day during 2 menstrual cycles. The changes in anthropometric measurements, dietary intakes, serum parameters including sex hormones, and PMS symptoms were observed. Isoflavone supplementation did not affect anthropometric measurements. However, SBP and DBP were significantly decreased in control. Dietary intakes were not changed after supplementation of isoflavones. Serum SHBG was lower in PMS group than in control and significantly decreased in control with isoflavone supplementation. PMS symptoms such as backache, sweet, salty, and fatty food craving, coffee/tea drinking, and anxiety were significantly lessened. Based on these results, isoflavone supplementation may benefit young women by reducing some of PMS. Further studies of soy isoflavones effect on sex hormone and PMS may help to prepare for PMS management.
Anxiety ; Back Pain ; Drinking ; Female* ; Gonadal Steroid Hormones ; Humans ; Incidence ; Isoflavones ; Luteal Phase ; Menstrual Cycle ; Premenstrual Syndrome*

PURPOSE: Immunotherapy (IT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanism and prognostic index of IT are not completely understood. Generally allergen specific-IgE antibody significantly initially increases, then gradually declines, but there is no consistent data about the changes of allergen-specific IgE. Also there is some controversies for skin test reactivity and bronchial hyperreactivity after IT. To understand the mechanism and find the prognostic index after conventional IT, we compared the clinical and laboratory parameters before and after IT between patients with IT and patients without IT. METHODS: The IT group included 24 patients with D.f and D.p-sensitized asthmatic children who had received conventional IT. The control group included 22 D.f and D.p-sensitized asthmatic children who had not received IT. The symptom scores of asthma, methacholine challenge test (PC20), skin reactivity to D.f and D.p (allergen/histamine ratio), total eosinophil counts, the changes of D.f- and D.p-specific IgE, were compared before, 4 and 9 month after IT in two groups. RESULTS: The symptom scores and the skin reactivity to D.p were decreased significantly 9 month after IT. The eosinophil count in peripheral blood was decreased 9 month after IT. But D.p-specific IgE level was not changed 9 month after IT in either two groups. The bronchial hyperreactivity was not changed 9 month after IT. CONCLUSION: These findings suggest that the changes of effector cells such as skin mast cell may be induced after the result of IT regardless of the changes of serum IgE and bronchial hyperreactivity.
Asthma ; Bronchial Hyperreactivity ; Child* ; Dust* ; Eosinophils* ; Humans ; Immunoglobulin E* ; Immunotherapy* ; Mast Cells ; Methacholine Chloride ; Pyroglyphidae* ; Skin Tests* ; Skin*

Recently, the number of Korean travelers and workers to malaria-endemic regions has increased, and the number of patients with imported malaria cases has increased as well. In Korea, most cases of imported malaria infections are caused by Plasmodium falciparum and P. vivax. Only one report of imported P. malariae infection has been published thus far. Here, we describe a case of imported P. malariae infection that was confirmed by peripheral blood smear and nested PCR targeting the small subunit ribosomal RNA (SSU rRNA) gene. A 53-yr-old man, who had stayed in the Republic of Guinea in tropical West Africa for about 40 days, experienced fever and headache for 3 days before admission. The results of rapid malaria test using the SD Malaria Antigen/Antibody Kit (Standard Diagnostics, Korea) were negative, but Wright-Giemsa stained peripheral blood smear revealed Plasmodium. To identify the Plasmodium species and to examine if the patient had a mixed infection, we performed nested PCR targeting the SSU rRNA gene. P. malariae single infection was confirmed by nested PCR. Sequence analysis of the SSU rRNA gene of P. malariae showed that the isolated P. malariae was P. malariae type 2. Thus, our findings suggest that when cases of imported malaria infection are suspected, infection with P. malariae as well as P. falciparum and P. vivax should be considered. For the accurate diagnosis and treatment of imported malaria cases, we should confirm infection with Plasmodium species by PCR as well as peripheral blood smear and rapid malaria antigen test.
Africa, Western ; Coinfection ; Diagnosis ; Fever ; Genes, rRNA ; Guinea* ; Headache ; Humans ; Korea ; Malaria ; Plasmodium ; Plasmodium falciparum ; Plasmodium malariae* ; Polymerase Chain Reaction ; RNA, Ribosomal ; Sequence Analysis

PURPOSE: The aim of this study is to evaluate the value of lung biopsies for the management of children with lung disease. METHODS: We retrospectively reviewed 19 lung biopsies done at Asan Medical Center, Seoul between 1993 and 2001. Data gathered included demographic information, underlying conditions, diagnosis before biopsy, final diagnosis, change in therapy, morbidity and mortality. RESULTS: Nineteen patients underwent lung biopsy. Among them, 13 patients were male and six patients were female; the median age was 3.6 years(0.8 to 8.6 years). Twelve patients underwent open lung biopsies and seven patients had thoracoscopic biopsies. The overall diagnosis rate was 95 %. The most common diagnosis was interstitial lung disease(12 patients, 64%) and infection was detected in four patients(21%). The biopsy-proven bronchiolitis obliterance was confirmed in two of seven patients suspected by CT findings. Specific treatment was changed after biopsy in 16 patients (85%). The morbidity & overall mortality rates of the patients were 5%(one patient) and 21%(four patients) respectively. Only one complication was seen: empyema. The causes of death were acute respiratory distress syndrome(one patient), respiratory failure(two patients), and septicemia(one patient). CONCLUSIONS: The lung biopsy is a safe procedure and it contributes to more accurate diagnosis and proper management of pediatric lung diseases. We recommend lung biopsies should be considered more positively in the diagnosis of pediatric lung diseases.
Biopsy* ; Bronchiolitis ; Cause of Death ; Child ; Chungcheongnam-do ; Diagnosis ; Empyema ; Female ; Humans ; Lung Diseases* ; Lung* ; Male ; Mortality ; Retrospective Studies ; Seoul

PURPOSE: Atopy and specific immunogloguline (Ig) E to individual aeroallergen are considered a hallmark of allergic diseases, including asthma. However, the association between these parameters and lung function or bronchial hyperresponsiveness (BHR) is still controversial in previous studies. METHODS: A total of 234 atopic asthmatic children was recruited in this study. The amounts of total IgE and specific IgE were determined by employing the CAP system FEIA (Pharmacia Diagnostics, Uppsala, Sweden). Specific IgE was focused on two major inhalant allergens in Korea, Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To evaluate BHR, methacholine and exercise challenge tests were performed. RESULTS: In the atopic asthmatic group, total IgE correlated negatively with methacholine PC20 and positively with a maximum percentage fall in FEV1 after exercise. Specific IgE to Der f strongly correlated with a maximum percentage fall in FEV1 after exercise in atopic asthmatics, particularly exercise-induced asthma (EIA) (r=0.176, P=0.007 and r=0.199, P=0.011, respectively) and specific IgE to Der p weakly correlated with a maximum percentage fall in FEV1 after exercise only in EIA-positive children with atopic asthma (r=0.140, P=0.073), while neither of them correlated with methacholine PC20 (P> 0.05). However FEV1, FVC, and FEF25-75% were not associated with total IgE and specific IgE to Der p or Der f regardless of positivity of EIA in atopic asthmatic children. CONCLUSION: The severity of atopy and sensitization to house dust mites are significantly correlated with BHR, especially challenged by exercise but not pulmonary function in atopic asthmatic children.
Allergens ; Asthma ; Asthma, Exercise-Induced ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin E ; Korea ; Lung ; Methacholine Chloride ; Pyroglyphidae

BACKGROUND: Hypopituitarism is associated with osteoporosis and osteopenia especially when hypogonadotropic hypogonadism is present. Despite hypopituitarism being an important cause of secondary osteoporosis, osteoporosis in patients receiving surgery for pituitary tumors in Korea has not been studied. In this study, we evaluated the effects of testosterone replacement therapy (TRT) on bone mineral density (BMD) in postoperative hypogonadal patients with pituitary tumors. METHODS: To examine the effect of TRT on BMD, we performed a retrospective observational study in 21 postoperative male patients who underwent pituitary tumor surgery between 2003 and 2012 at the Ajou University Hospital. Testosterone was replaced in postoperative hypogonadal patients by regular intramuscular injection, daily oral medication, or application of transdermal gel. BMD (g/cm2) measurements of central skeletal sites (lumbar spine, femoral neck, and total femur) were obtained using dual-energy X-ray absorptiometry (GE Lunar). For lumbar spine BMD, L1 to L4 values were chosen for analysis. Femur neck and total femur were also analyzed. RESULTS: During the follow-up period (mean, 56 months; range, 12 to 99 months) serum testosterone levels increased with the administration of TRT (P=0.007). There was significant improvement (4.56%+/-9.81%) in the lumbar spine BMD compared to baseline BMD. There were no significant changes in the femur neck BMD or total femur BMD. We did not find any statistically significant relationships between changes in testosterone levels and BMD using Spearman correlation analysis. CONCLUSION: Our results indicated that TRT used in the postoperative period for hypogonadal pituitary tumor surgery patients may have beneficial effects on the BMD of the spine.
Absorptiometry, Photon ; Bone Density* ; Bone Diseases, Metabolic ; Femur ; Femur Neck ; Follow-Up Studies ; Humans ; Hypogonadism ; Hypopituitarism ; Injections, Intramuscular ; Korea ; Male* ; Observational Study ; Osteoporosis ; Pituitary Neoplasms* ; Postoperative Period ; Retrospective Studies ; Spine ; Testosterone*

We report an autopsy case of congenital monoblastic leukemia that developed in monozygotic twins. The twin presented with progressive hepatosplenomegaly at 4 weeks after birth. One twin died of massive bleeding and hypovolemic shock before the treatment started. At autopsy, the liver was diffusely enlarged and showed a diffuse whitish discoloration except for the subcapsular and perivenular areas. Microscopic examination disclosed infiltration of histiocyte-like atypical cells along the sinusoids and portal areas of the liver. Spleen, lymph nodes and choroid plexus were also infiltrated by the tumor cells. However, bone marrow involvement of the tumor was minimal although multifocal. On immunohistochemical staining, these atypical cells were reactive for CD68 (PGM-1) and lysozyme, suggesting that the tumor cells might have been derived from mono- histiocyte. Cytogenetic study revealed 9;11 translocation, which is frequently associated with acute monoblastic leukemia. To the best of our knowledge, this is the first report of congenital monoblastic leukemia of monozygotic twins in Korea.
*Chromosomes, Human, Pair 11 ; *Chromosomes, Human, Pair 9 ; *Diseases in Twins/genetics ; Fatal Outcome ; Female ; Hepatomegaly/complications/genetics/pathology ; Human ; Infant, Newborn ; Leukemia, Monocytic, Acute/complications/*congenital/genetics/pathology ; Liver/pathology ; Splenomegaly/complications/genetics/pathology ; *Translocation (Genetics) ; *Twins, Monozygotic/genetics