Purpose: BRCA1/2 mutations are well-known risk factors for breast and ovarian cancers in women. Risk-reducing salpingo-oophorectomy (RRSO) is the standard treatment for preventing ovarian cancer with BRCA mutations. Postmenopausal syndrome (symptoms after RRSO can be alleviated by hormone replacement therapy (HRT); however, the use of HRT in carriers of BRCA mutations has been controversial because of the concern that HRT increases the risk of breast cancer. This study aimed to evaluate the effects of HRT in BRCA mutation carriers who underwent RRSO. Materials and Methods: A total of 151 carriers, who underwent RRSO between 2013 and 2020 after the diagnosis of BRCA1 or BRCA2 mutations were selected and followed up for a median of 3.03 years. Patients were divided into two groups: those who received HRT after RRSO (n=33) and those who did not (n=118). We compared the incidence of breast cancer over time between these two groups. Results: There was no significant difference in the incidence of breast cancer between women who received HRT and those who did not (p=0.229). Multivariate logistic regression analysis, adjusted for age and parity revealed no significant difference in the risk of breast cancer between these two groups (hazard ratio, 0.312; 95% confidence interval, 0.039 to 2.480; p=0.278). Conclusion In this study, we found no relationship between post-RRSO HRT and breast cancer in the population with BRCA mutations. Therefore, healthcare providers may consider the alleviation of symptoms of postmenopausal syndrome through HRT in patients who underwent RRSO.

Background: Coronary artery disease patients undergoing percutaneous coronary intervention (PCI) often exhibit reduced left ventricular ejection fraction (LVEF). However, the impact of LV dysfunction status in conjunction with platelet reactivity on clinical outcomes has not been previously investigated. Methods: From the multicenter PTRG-DES (Platelet function and genoType-Related long-term prognosis in DES-treated patients) consortium, the patients were classified as preserved-EF (PEF: LVEF ≥ 50%) and reduced-EF (REF: LVEF< 5 0%) group by echocardiography. Platelet reactivity was measured using VerifyNow P2Y 12 assay and high platelet reactivity (HPR) was defined as PRU ≥ 252. The major adverse cardiac and cerebrovascular events (MACCEs) were a composite of death, myocardial infarction, stent thrombosis and stroke at 5 years after PCI. Major bleeding was defined as Bleeding Academic Research Consortium bleeding types 3–5. Results: A total of 13,160 patients from PTRG-DES, 9,319 (79.6%) patients with the results of both PRU and LVEF were analyzed. The incidence of MACCE and major bleeding was higher in REF group as compared with PEF group (MACCEs: hazard ratio [HR] 2.17, P < 0.001, 95% confidence interval [CI] 1.85–2.55; major bleeding: HR 1.78, P < 0.001, 95% CI 1.39–2.78).The highest rate of MACCEs was found in patients with REF and HPR, and the difference between the groups was statistically significant (HR 3.14 in REF(+)/HPR(+) vs. PEF(+)/HPR(-) group,P <0.01, 95% CI 2.51–3.91). The frequency of major bleeding was not associated with the HPR in either group. Conclusion LV dysfunction was associated with an increased incidence of MACCEs and major bleeding in patients who underwent PCI. The HPR status further exhibited significant increase of MACCEs in patients with LV dysfunction in a large, real-world registry.Trial Registration: ClinicalTrials.gov Identifier: NCT04734028

BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*

Because of various current problems and issues which are low health insurance medical fee of National Health Insurance Corporation, extreme competition with very large general hospitals, new supply of more than of 3,000 new doctors, many medical practitioner's offices who are suffering management difficulties are increasing. In order to investigate their current overall management situations, we made this study through statistical extraction procedures with the sample population of the medical practitioners which are registered in Korean Medical Association and subsequently we made the study with 1,031 selected cases. The average number of patients is 53.6 patients per day. 44.4% of the medical practitioners' offices are working at night and legal holidays and 8.5% are working at Sunday. Average working hours is 50.1 hours per week, which greatly exceeds 40 hours per week that is regulated in the Labor Standards Act. According to the management performance analysis of those medical clinics through profit and loss statements, average total annual sales revenue in 2010 fiscal year was 444,167,867 KRW, the expenses were 314,217,081 KRW and the earnings before taxes was 129,940,786 KRW. The average net profit (earnings before taxes) of the director of the medical practitioners' offices was 122,337,868 KRW per year and 10,194,822 KRW per month. According to the study results, we have found that we need to increase doctor's bill for outpatient, and establishment and its improvement of medical service delivery systems and classification standards of medical services for first and succeeding outpatients. Considering overall results of the study, readjustment of outpatients' treatment fees and reestablishment of more efficient medical service delivery systems which require the first medical service is to be provided properly should be realized in order to improve the management performance of the medical practitioners' offices.
Commerce ; Fees and Charges ; Fees, Medical ; Holidays ; Hospitals, General ; Humans ; Insurance, Health ; Korea ; National Health Programs ; Outpatients ; Stress, Psychological ; Taxes

PURPOSE: This study was performed to identify the relationship between belief, knowledge, and practice about oral health care of middle-aged women, and to prepare baseline data for developing a dental health education and promotion program. METHOD: For the survey, 120 individuals(middle-aged women) were chosen by convenience sampling and agreed to participate in the study. Their belief, knowledge, and practice about oral health care were measured. For descriptive statistics, t-test, ANOVA, Tukey and Pearson's correlation coefficient were used with SPSS Win 14.0. RESULT: The level of belief and practice about oral health care was middle for the subjects. However, the level of knowledge about oral health care was relatively high. The level of practice about oral health care related to characteristics of subjects showed significant differences according to level of education and oral health status. There was no significant correlation between the level of practice and the belief about oral health care. The practice about oral health care showed a significant positive correlation with knowledge. CONCLUSION: These findings demonstrate a need for the development of oral health care programs that is effective in improving belief, knowledge, and practice about oral health care reported by middle-aged women.
Female ; Health Education, Dental ; Humans ; Oral Health

PURPOSE: This study was to suggest the direction to the exercise intervention development for the stroke survivors. METHOD: 12 domestic and 54 foreign research papers about the exercise intervention for the stroke patients published during 1998~2007 were analyzed. RESULT: Among the papers, quasi-experimental design(75.8%) and multidisciplinary approach(60.6%) were the most frequent ones. The mean age of the respondents was 63.3 and the intervention was supplied for 7.14 weeks. The frequency of exercise was 3.87 per week and the exercise time was 1.88 hours. And physical research variables - such as ambulation, muscle strength, activities of daily living and balance - were more than psychosocial variables. This study suggested that the exercise intervention for the stroke survivors need to include aerobic exercise, muscle strengthening exercise, flexible exercise, body coordination, balance exercise. In addition we confirmed that the exercise intervention was revealed as an effective physiological parameters; such as maximum oxygen uptake quantity, blood pressure. CONCLUSION: We suggest that the further researchs are needed which include the intensity of exercise into the quantity of the exercise. Also researchers need to extend the motion intervention time for an effective sociopsychological variable and to try the meta analysis for the effective exercise intervention for the stroke survivors.
Activities of Daily Living ; Blood Pressure ; Surveys and Questionnaires ; Exercise ; Humans ; Muscle Strength ; Oxygen ; Stroke* ; Survivors* ; Walking

PURPOSE: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. METHOD: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. RESULT: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. CONCLUSION: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.

PURPOSE: This study was done to investigate sleep patterns and utilization of the charcoal eyepatch in high school students through a survey research. METHOD: The participants in this study were 80 students in a high school in Seoul. The period of data collection was from July 1, 2002 to 15, 2002. The research instruments used in this study were the measures of sleep and SPSSWIN 10.0 Program was used for data analysis. RESULT: The students went to bed after 12 p.m., but many of them easily fell asleep within 5 minutes. They woke up quite early at around 4 to 6 o'clock in the morning but remained in bed 1 hour. Satisfaction with their sleep was the response for 38.8% of the students. While 77% napped, they generally did so in the afternoon and 38.8% napped for half an hour. As for quality of sleep, 2.5% of the students could not sleep deeply, and 21.7% woke frequently during sleep. Their sleep environments were calm and comfortable, and they turned off the light when sleeping. The utilization of the charcoal eyepatch was effective for sleep, fatigue and powerlessness in high school students. CONCLUSION: Utilization of the charcoal eyepatch was effective for sleep in high school students and while the utilization of charcoal is recommended in life, the effect of charcoal must be testified through research.
Charcoal* ; Data Collection ; Fatigue ; Humans ; Seoul ; Statistics as Topic

The purpose of this study was to identify the need for sex education in middle school students. Research subjects were 194 students who attended at 1 seminary in B city. The period of data collection was from July to August, 2001. Research instrument was composed of 61 structured items : 17 items related to demographics and sex, 44 items related to the need of sex education. Data were collected through the self-report method by the researcher and one trained assistant. The instrument developed by the researchers was employed to measure the need of sex education and it's Cronbach's alpha = 0.9349 in this research. Data were analyzed by frequency, percentage factor analysis and t-test using SPSS WIN Program. The findings of this study are summarized as follows: 1. The highest score among characteristics of sex was 'less interest about sex(42.6%)', 39.0% of subjects got information about sex from friends or elders. 52.3% of subjects consulted friends or elders about sex problems. The number of sex education lessons was 1-2 times in school during last semester(61.0%). Education by the school nurse was 35.9% to students. 43.1% of subjects announced moderate satisfaction on sex education. 2. The mean score of the need for sex education was 2.88+/-0.47(lowest value 1, highest 4). The most wanted sex education factor was 'chastity and sexual responsibility(3.33+/-0.67)' and followed by 'family and marriage(3.26+/-0.62)' and 'considerations of sex(3.07+/-0.69)'. Meanwhile, the lowest wanted sex education factor is 'physiological characteristics of male (2.47+/-0. 72)', followed by 'sexual behavior (2.49+/-0.75)'. The most wanted sex education item was 'the meaning of family(3.54+/-0.75)' and followed by 'the cautions to prevention from sexual abuse (3.49+/-0.78)' and sexual activity and responsibility(3.43+/-0.77)'. Meanwhile, the lowest wanted sex education item is 'masturbation(2.16+/-0.97)', followed by 'circumcision(2.32+/-0.97)'. 3. There is no significant difference between boys and girls in mean score about the need for sex education(t=- .715, p= .476). Sex education factor that girl-students wanted was 'physiological caracteristics of female'. Sex education factor that boy-students wanted was 'family and marriage'. Sex education items that girl-students wanted were 'cautions during menstruation', 'the relation of ovulation and pregnancy', 'caution to prevention from sexual abuse' and 'sexual behavior and responsibility'. Sex education items that boy-students wanted were 'the meaning of family', 'the importance of marriage', 'male's sex organs', 'a wet dream', 'the method to resolve sexual curiosity', 'sexual intercourse' and 'the connection with the other sex'. In conclusion, the mean score of the need for sex education is medium. The route to attain knowledge about sex and sexual problem is through consulting friends and elders. Therefore, it is necessary to give sex education that is suitable to the subject's needs and methods. Also, it is necessary to give differently strong point about sex education between female and male students.
Data Collection ; Demography ; Education ; Female ; Fibrinogen ; Friends ; Humans ; Male ; Ovulation ; Research Subjects ; Sex Education* ; Sex Offenses ; Sexual Behavior

Sustemic arterialization of the lung without sequestration is the rarest from of congenital anomalous systemic arterial supply to the lung, where an anomalous systemic artery arising from aorta supplies a normal unsequestrated segment of the lung. The non-sequestrated lung parenchyma which is supplied by an aberrant artery, has no parenchyma or bronchial abnormalities, and there is a normal connection with the bronchial trees. The symptoms of this disease varies. In most patients, it is often asymptomatic, but symptoms including dyspnea, hemoptysis, and central nervous system complications are possible. Here, we report a case of systemic arterialization of the lung without sequestration, which confirmed by angiography, with a review of the literature.
Angiography ; Aorta ; Arteries ; Central Nervous System ; Dyspnea ; Equipment and Supplies ; Hemoptysis ; Humans ; Lung* ; Trees