BACKGROUND: In Korea, the breastfeeding (BF) rate of infants aged 6 months or more is drastically decreasing, and this phenomenon is particularly worrisome for the future health of the population. The present study aimed to identify an antenatal strategy for initiation and continuation of human BF, and to identify how Baby-Friendly Hospitals (BFHs) may positively influence the intention to breastfeed. METHODS: A total of 414 pregnant Korean antenatal women were surveyed using questionnaires to determine current knowledge of the benefits of human breast milk, whether they planned to breastfeed after delivery, to continue BF after reinstatement in the workforce, are willing to abide by rooming-in care for infants, and plan to give birth at BFHs. RESULTS: We found that planning room-in care, greater awareness of BF benefits for infant and mother, participation in antenatal education programs, and provision of BF facilities in the workplace were positively associated with plans for exclusive breastfeeding (EBF) and longer BF duration. The mothers who planned to give birth at BFHs also desired to breastfeed immediately after birth, implement in-room care, continue BF at their workplace, participate in antenatal BF educational programs, and were more aware of the benefits of BF. CONCLUSION: If the beneficial effects of BFHs were well known to individuals, these would enhance the success rate of BF in Korea. Antenatal education and consequent acquisition of better knowledge of the benefits of BF are important for increasing the rate of BF practices.
Breast Feeding* ; Female ; Humans ; Infant ; Intention* ; Korea* ; Milk, Human ; Mothers ; Parturition ; Prenatal Education ; Rooming-in Care

PURPOSE: The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. METHODS: We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. RESULTS: There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. CONCLUSION: It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.
Cough ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lung ; Medical Records ; Mycobacterium ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Recurrence ; Retrospective Studies ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

In this study, new real-time PCR method based on the groEL gene was developed and investigated. Four spotted fever group (SFG) strains, four typhus group (TG) strains, and four scrub typhus group (STG) strains were easily differentiated as a distinct entity. This PCR assay was applied to detect Rickettsia DNA from 100 ticks. Twelve Haemaphysalis longicornis ticks were found positive and identified as spotted fever group Rickettsia. This real-time PCR method could simultaneously perform the rapid identification of rickettsiae and the differential diagnosis of SFG, TG, and STG in a single reaction.
Diagnosis, Differential ; DNA ; Fever ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Rickettsia ; Scrub Typhus ; Ticks ; Typhus, Epidemic Louse-Borne

A total of 190 ticks collected from the Chungju area of Korea was examined for the presence of Spotted Fever Group(SFG) Rickettsia using a PCR assay. Twenty-five (13.2%) Haemaphysalis ticks were found positive of the groEL gene of SFG Rickettsia. The prevalence rate of R. japonica in these 25 Haemaphysalis ticks was 72% (18 out of 25 SFG Rickettsia). The prevalence rate of R. conorii and new SFG rickettsia in these 25 Haemaphysalis ticks was 4% (1 out of 25 SFG Rickettsia) and 24% (6 out of 25 SFG Rickettsia), respectively. These results suggest that R. japonica was the highest infection frequency among in Haemaphysalis ticks SFG Rickettsia, and that R. conorii and new SFG Rickettsia are also present in the Chungju area.
Chungcheongbuk-do* ; Fever* ; Korea ; Polymerase Chain Reaction ; Prevalence* ; Rickettsia* ; Ticks*

Eleven Borrelia afzelii strains, isolated from Ixodes nipponensis and Apodemus agrarius in Korea, were characterized by groEL gene analysis. Results from previous studies suggested that the groEL gene, which encodes the 60-kDa heat shock protein GroEL, was useful for the differentiation of B. burgdorferi sensu lato. The B. afzelii isolates could be divided into two groups by the phylogenetic tree constructed by UPGMA method and Tsp509 I PCR-RFLP analysis. The result suggested that the groEL gene is useful for identification and characterization of B. burgdorferi sensu lato though a short DNA fragment (310 bp) of the gene was sequenced and compared each other, and that Korean B. afzelii strains are heterogeneous genotypically.
Animals ; Borrelia burgdorferi Group* ; Borrelia* ; DNA ; Heat-Shock Proteins ; Ixodes ; Korea* ; Murinae ; Population Characteristics

Eleven Borrelia afzelii strains, isolated from Ixodes nipponensis and Apodemus agrarius in Korea, were characterized by groEL gene analysis. Results from previous studies suggested that the groEL gene, which encodes the 60-kDa heat shock protein GroEL, was useful for the differentiation of B. burgdorferi sensu lato. The B. afzelii isolates could be divided into two groups by the phylogenetic tree constructed by UPGMA method and Tsp509 I PCR-RFLP analysis. The result suggested that the groEL gene is useful for identification and characterization of B. burgdorferi sensu lato though a short DNA fragment (310 bp) of the gene was sequenced and compared each other, and that Korean B. afzelii strains are heterogeneous genotypically.
Animals ; Borrelia burgdorferi Group* ; Borrelia* ; DNA ; Heat-Shock Proteins ; Ixodes ; Korea* ; Murinae ; Population Characteristics

The rpoB gene based sequencing analysis enabled not only the detection of rifampin resistant Mycobacterium tuberculosis, but also the differentiation of species in the genus Mycobacterium. In the present study, we applied the method to 68 isolates of M. tuberculosis (29 from initial treatment cases and 39 from recurrent cases) and 11 clinical isolates of nontuberculous mycobacteia (NTM) isolated from patients in Jeju island. Among rifampin resistant M. tuberculosis, two of 29 strains isolated from patients of initial cases (6.9%) and five of 39 strains isolated from patients of recurrent cases (12.8%) were confirmed to have rifampin resistant genotypes harboring mutations in rif r region of the rpoB gene. In NTM strains, M. fortuitum complex was the most frequently isolated species at the frequency of 54.5% (6/11).
Genotype ; Humans ; Mycobacterium ; Mycobacterium tuberculosis ; Rifampin ; Tuberculosis

OBJECTIVE: To evaluate pathological complete remission rate (pCR), survival rate, recurrence rate, 91 patients who had clinical complete remission with epithelial ovarian cancer were studied. METHODS: From 1983 to 2002, 91 consecutive patients with epithelial ovarian cancer underwent surgical cytoreduction followed by platinum-based chemotherapy at the Department of Obstetrics and Gynecology, Hanyang University Hospital. At the conclusion of chemotherapy, all patients who were clinically disease free and whose CA 125 was < 35 were offered a second-look operation that obtained over 20 specimens. Of 91 patients who qualified for second-look, 57 underwent the procedure and 34 did not undergo the laparotomy. RESULTS: Among 57 patients who had been performed second-look laparotomy, 40 patients (70%) had negative pathology, 9 (16%) were microscopically positive, and 8 (14%) had gross disease. Patients with positive findings received individualized salvage therapy (14/17). FIGO stage (p<0.01), initial CA 125 level (p=0.07) and residual tumor at primary surgery (p=0.01) correlated with second-look results. Eight (20%: 8/40) of the patients with negative pathology have recurred. Five year survival rate was 95% in patients refusing second look (n=34) was similar to 77% in patients who had been performed second-look operation (n=57). Five-year and ten-year survival rates were 77% and 68% in patients who had performed second-look laparotomy. And 5-year and 10-year survival rates were 84%, 84% in 40 patients with negative pathology, however, 53%, 34% of 17 patients with positive result. Stepwise logistic regression selected two covariates significantly affecting survival: the stage and residual tumor. CONCLUSION: Using the protocol described in a population of optimally resected patients with advanced stage ovarian cancer, second-look laparotomy can impact positively on survival. Patients with residual tumor > 2 cm with advanced stage at primary surgery and negative second-look findings should be the focus of future protocols for consolidation chemotherapy.
Consolidation Chemotherapy ; Drug Therapy ; Gynecology ; Humans ; Laparotomy* ; Logistic Models ; Neoplasm, Residual ; Obstetrics ; Ovarian Neoplasms* ; Pathology ; Recurrence ; Salvage Therapy ; Survival Rate

To detect Rickettsia, we have developed a nested PCR method amplifying the groEL gene. Rickettsia strains were successfully amplified by this PCR method but the microorganisms causing other febrile diseases, such as Orientia tsutsugamushi, Coxiella burnetii, Ehrlichia sennetsu, Borrelia burgdorferi sensu lato, Borrelia hermsii, and Leptospira interrogans were not amplified. This PCR assay was applied to detect Rickettsia DNA from 100 ticks. Sixteen Haemaphysalis longicornis ticks were positive by this PCR assay. These results suggest that the new nested PCR method might be sensitive and useful for discrimination between Rickettsia and other febrile disease-causing microorganisms.
Borrelia ; Borrelia burgdorferi Group ; Coxiella burnetii ; Discrimination (Psychology) ; DNA ; Leptospira interrogans ; Neorickettsia sennetsu ; Orientia tsutsugamushi ; Polymerase Chain Reaction* ; Rickettsia* ; Ticks

Mycobacterium fortuitum causes a wide spectrum of cutaneous and extracutaneous diseases. Trauma may precede the primary cutaneous disease. Granulomatous nodules, ulcers, scrofuloderma, abscess, and sporotrichoid lesions have been described. Extracutaneous manifestations include postoperative vasculitis, endocarditis, pericarditis, mediastinitis, osteomyelitis, and disseminated disease. However, there have been few reports of scrofuloderma caused by M. fortuitum in the literature. We report a case of scrofuloderma due to M. fortuitum, which developed on the right inguinal area in a 8-year old boy. He had received a tearing injury to his gluteal region in a swimming pool. M. fortuitum was isolated by culture of skin specimen on Lowenstein- Jensen medium and subsequently identified by selected biochemical tests and comparative sequence analysis of rpoB gene (306 bp). Eight-week treatment with tetracycline after incision and drainage along with infrared irradiation resulted in complete resolution of the lesion.
Abscess ; Buttocks ; Child ; Drainage ; Endocarditis ; Humans ; Male ; Mediastinitis ; Mycobacterium fortuitum* ; Mycobacterium* ; Osteomyelitis ; Pericarditis ; Sequence Analysis ; Skin ; Swimming Pools ; Tetracycline ; Tuberculosis, Cutaneous* ; Ulcer ; Vasculitis