PURPOSE: The aim of this retrospective study was to investigate whether there are prognostically different subgroups among patients with pathologic N3 (pN3) breast cancer. METHODS: The records of 220 patients who underwent surgery for pN3 breast cancer from January 2006 to September 2012 were reviewed. All patients received adjuvant therapy according to standard protocols. The primary outcome was disease-free survival (DFS). RESULTS: Patients were followed for a median time of 68.3 months after their primary surgery (range, 10-122 months), during which time 75 patients (34.1%) had developed disease recurrence and 48 patients (21.8%) had died. The DFS and overall survival were 67.8% and 86.1%, respectively, at 5 years. Multiple logistic regression analysis showed that young age (<35 years, p=0.009), high serum neutrophil/lymphocyte ratio (>3.0) (p=0.020), high nodal ratio (number of metastatic lymph nodes divided by number of removed nodes) (>0.65) (p=0.062), and molecular phenotype (p=0.012) were significantly associated with tumor recurrence. Tumor biological subtype was the most significant predictor of recurrence. The 5-year DFS rates in patients with hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER2) negative, HR+HER2+, HR-HER2+, and triple negative subtypes were 82%, 63%, 58%, and 37%, respectively. CONCLUSION: Clinical outcomes of patients with extensive nodal metastasis were heterogeneous in terms of prognosis. Tumor biological subtype was the most important prognostic factor for pN3 disease. The prognosis of patients with HR+HER2- subtype in pN3 breast cancer was similar to that of patients with stage II breast cancer.
Biology ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Logistic Models ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Phenotype ; Prognosis ; Receptor, Epidermal Growth Factor ; Recurrence ; Retrospective Studies

PURPOSE: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. METHODS: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. RESULTS: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. CONCLUSION: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.
Delirium* ; Education ; Hospitals, General ; Humans ; Nursing ; Surveys and Questionnaires

PURPOSE: Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. METHODS: This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. RESULTS: Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was .88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. CONCLUSIONS: The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.
Aged ; Aged, 80 and over ; *Ego ; Female ; Humans ; Korea ; Male ; Questionnaires ; Self Concept

BACKGROUND: This study was aimed to investigate the diagnosis-related characteristics of the microvascular complications among patients with type 2 diabetes mellitus and to identify the relationship ship between regular check-up and detection of complications of diabetes. METHODS: The study subjects were 63 patients with diabetic microvascular complications. The data were collected with self-administered questionnaire and analyzed with descriptive statistics. RESULTS: The main motive to identify retinopathy was through 'visiting hospital after having symptoms (58.9%)', and not through regular checkup. The most common symptom of retinopathy was dim dye (84.3%) and the mean duration after diabetes mellitus diagnosis was 6.8 years. The main motive to identify renal complications was through 'visiting hospital after having symptoms and checking for other complications (28.0%)'. The most common symptom of renal complications was edema of face and hands (72.0%) and the mean duration following diabetes mellitus diagnosis was 8.4 years. The main motive to identify neuropathy was through 'visiting hospital after having symptoms (34.8%)', and not regular checkup. The most common symptom of neuropathy was tingling sensation of feet (100.0%) and the mean duration following diabetes mellitus diagnosis was 7.4 years. CONCLUSION: Based on the results, we suggest that diabetes complications check-up should be performed simultaneously to make the diagnosis of diabetes mellitus, and that the health care providers could provide them with more opportunities to have such check-ups with standardized complications care guidelines.
Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diagnosis ; Edema ; Foot ; Hand ; Health Personnel ; Humans ; Sensation ; Ships ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify the current attitudes and knowledge toward Koryo Hand Therapy(KHT) by the experienced people. METHOD: The Subjects for this study included 3,351 people living in Korea who experienced KHT. The data were collected from April 6 to November 25, 2004 using a structured questionnaire. The data were analyzed through the SAS 8.1 Windows Program using frequency, percentage, t-test, ANOVA and Pearson's correlation coefficient. RESULTS: The results of the study are as follows: 1) Families and relatives were a main source of information about Koryo Hand Therapy. The subjects were very satisfied with therapeutic and preventive effects of the therapy. Sujichim was the most preferable choice in the KHT. Most of the subjects thought that KHT could be applied to modern medicine. 2) Those who experienced KHT had a high level of knowledge and very positive attitudes toward KHT. 3) There were statistically significant differences in the attitude toward KHT according to age, gender, educational level, religion, income, place of residence, marital status and experience which studied KHT. 4) There were significant differences in the knowledge of KHT according to age, educational level, income, marital status and experience which studied KHT. 5) The data showed positive correlation between attitude and knowledge. CONCLUSION: According to the above findings, it can be concluded that KHT needs to be actively informed and more easily approached by general peoples. Nursing protocols of KHT needed to be developed.
Hand* ; History, Modern 1601- ; Humans ; Korea ; Marital Status ; Nursing Assessment ; Surveys and Questionnaires

BACKGROUND: The drug resistance rate in tuberculosis patients with history of chemotherapy is an important indicator of for evaluation of appropriateness of treatment regimens and compliance of patients. This study examined the long-term changes in the drug resistance rates among TB patients failed in treatment or reactivated. METHODS: The results of drug susceptibility testing data from patients registered in health centers from 1981 to 2004 were analyzed. RESULTS: The rate of resistance to isoniazid decreased from 90% to 20%, and the resistance to ethambutol decreased from 45% to 6%. The rate of resistance to rifampicin varied from 13% to 28% and the resistance to pyrazinamide was 5% to 10%. Multidrug resistance was about 2-3% lower than any rifampicin resistance rates. The second-line drug resistance was ranged from 1% to 3%. There was no difference between patients' genders. Patient numbers per 100,000 population increased with age. The regional distribution was even at 4-6 patients per 100,000 population, and drug resistance rates were significantly lower in big city areas than in small towns and rural areas. CONCLUSION: The rates of resistance of Mycobacterium tuberculosis isolated from TB patients with history of chemotherapy to isoniazid, rifampin, ethambutol, and isoniazid plus rifampin were significantly decreased during over two decades.
Compliance ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Ethambutol ; Humans ; Isoniazid ; Mycobacterium tuberculosis ; Pyrazinamide ; Rifampin ; Tuberculosis*

PURPOSE: Ego-integrity in Erikson's stage theory is used frequently among health team members related to the care of the elderly and has specific meanings within the context of quality of life in later life. However, the concept of ego-integrity in the elderly has not been well articulated in the literature. This study was conducted clarify and conceptualize the phenomena of ego-integrity in the elderly. METHOD: A Hybrid Model of concept development was applied to develop a concept of ego-integrity, which included a field study carried out in Seoul, South Korea using in-depth interviews with old adults who were admitted as a right person for research subject according to attributes of ego-integrity analysed in the theoretical phase. RESULTS: The concept of ego-integrity emerged as a complex phenomenon having meanings in several different dimensions which encompassed several attributes. CONCLUSIONS: Ego-integrity is a concept having needs that should be treated in a specific way and it is possible to enrich the meaning and methods to manage ego-integrity in nursing interventions for promoting quality of life so that its application may have effects that have positive impacts on the elderly's well being.
Adaptation, Psychological ; Aged/*psychology ; Aging/psychology ; *Ego ; Female ; Geriatric Nursing ; Humans ; Korea ; Male ; Superego

We investigated to see whether an altered role of nitric oxide (NO) system is involved in erythropoietin (EPO)-induced hypertension in chronic renal failure (CRF). Male Sprague-Dawley rats were five-sixths nephrectomized to induce CRF. Six weeks after the operation, EPO or vehicle was injected for another 6 weeks. Plasma and urine nitrite/nitrate (NOx) levels were determined. Expression of NO synthase (NOS) proteins in the aortae and kidneys were also determined. In addition, the isometric tension of isolated aorta in response to acetylcholine and nitroprusside was examined. Blood pressure progressively rose in CRF groups, the degree of which was augmented by EPO treatment. Plasma NOx levels did not differ among the groups, while urine NOx levels were lower in CRF groups. Endothelial NOS expression was lower in the kidney and aorta in CRF rats, which was not further affected by EPO-treatment. The inducible NOS expression in the kidney and aorta was not different among the groups. Acetylcholine and sodium nitroprusside caused dose-dependent relaxations of aortic rings, the degree of which was not altered by EPO-treatment. Taken together, EPO-treatment aggravates hypertension in CRF, but altered role of NO system may not be involved.
Acetylcholine/pharmacology ; Anemia/metabolism ; Anemia/etiology ; Anemia/drug therapy* ; Animal ; Aorta, Thoracic/physiology ; Body Weight ; Erythropoietin/pharmacology* ; Hypertension, Renal/metabolism ; Hypertension, Renal/drug therapy ; Isometric Contraction/drug effects ; Kidney/enzymology ; Kidney Failure, Chronic/metabolism* ; Kidney Failure, Chronic/complications ; Male ; Nitrates/urine ; Nitrates/blood ; Nitric Oxide/metabolism* ; Nitric-Oxide Synthase/metabolism ; Nitrites/urine ; Nitrites/blood ; Nitroprusside/pharmacology ; Rats ; Rats, Sprague-Dawley ; Vasoconstriction/drug effects ; Vasoconstrictor Agents/pharmacology ; Vasodilator Agents/pharmacology

PURPOSE: To find the anthropometric characteristics of newborn in women with gestational diabetes mellitus(GDM), and the relationship between the birth weight and anthropometric measurements of newborn, maternal body habitus and glycemic control in GDM group. METHODS: Maternal weight, height, and obstetric history of 82 women with GDM and 93 women with normal glucose tolerance were recorded at the time of screening test and delivery. Within 2 days after birth, the birth weight and anthropometric measurements were obtained, and maternal glycohemoglobin concentrations were measured and umbilical cord blood samples for C-peptide were collected in GDM group at delivery. RESULTS: There were no differences in the birth weight and frequency of LGA newborn between GDM and control group, although the primary C-section of GDM group was significantly higher compared with the control group. The abdominal circumference(AC) and triceps, subscapular, and thigh skinfold thickness(SFT) of newborn in GDM group were significantly increased compared with the control group. Maternal glycohemoglobin concentration was correlated with birth weight, but not with AC and three SFTs in GDM group. Umbilical cord blood C-peptide level had a correlation with birth weight and three SFTs in GDM group. Newborn's AC had a correlation with maternal weight and weight gain in GDM group, but not in control group. CONCLUSION: Although the birth weight and frequency of LGA did not differ, AC and triceps, subscapular, and thigh SFT were increased in GDM group. These increases of anthropometric measurements were observed in AGA newborn, and were greater in LGA newborn.
Birth Weight ; C-Peptide ; Diabetes, Gestational* ; Female ; Fetal Blood ; Glucose ; Humans ; Hyperinsulinism ; Infant, Newborn* ; Mass Screening ; Parturition ; Pregnancy ; Thigh ; Weight Gain

No abstract available.
Carps* ; Killer Cells, Natural