The Metaverse for Healthcare: Trends, Applications, and Future Directions of Digital Therapeutics for Urology / 대한배뇨장애요실금학회지

In recent years, the emergence of digital therapeutics as a novel approach to managing conditions has garnered significant attention. This approach involves using evidence-based therapeutic interventions that are facilitated by high-quality software programs to treat, manage, or prevent medical conditions. The incorporation of digital therapeutics into the Metaverse has increased the feasibility of their implementation and application in all areas of medical services. In urology, substantial digital therapeutics are being produced and researched, including mobile apps, bladder devices, pelvic floor muscle trainers, smart toilet systems, mixed reality-guided training and surgery, and training and telemedicine for urological consultations. The purpose of this review article is to provide a comprehensive overview of the current impact of the Metaverse on the field of digital therapeutics and identify its current trends, applications, and future perspectives in the field of urology.

Incidence of Extravasation in Acute Care Hospitals and Nurses’ Knowledge and Attitude toward Extravasation Prevention and Management / 임상간호연구

Purpose@#Extravasation of diagnostic and therapeutic materials might occur when the intravascular solution leaks into the surrounding tissues. Injury associated with extravasation depends on various factors. It may range from mild skin reaction to severe necrosis. However, the incidence rate for extravasation is largely unknown because of the limited reporting in Korea. Therefore, this study was conducted to identify the incidence of extravasation and nurses’ attitude and knowledge of extravasation for providing high-quality nursing care. @*Methods@#Three acute care hospitals were surveyed to estimate the occurrence of extravasation. Knowledge and attitude toward extravasation were investigated from 793 nurses working in six hospitals. @*Results@#The incidence rate of extravasation was 0.5%. Extravasation commonly occurred in elderly patients aged 66 or older (59.9%) and internal medicine (48.2%), and it happened 13.73±20.68 days after hospitalization on average.It mostly occurred in the forearm site (52.9%) and was mainly caused by parenteral nutrition (33.6%). The mean scores of nurses’ knowledge and attitude were 14.63±2.86 and 28.91±36.00, respectively. There was a significant negative correlation between the subjects' knowledge and attitude (r=-.11, p=.002). @*Conclusion@#It is necessary to have a reporting system that can accurately monitor the occurrence of extravasation for patient safety management. In addition, it is necessary to develop a protocol that can be applied to clinical practice and a nurse education program.

The Meanings of Hands among Clinical Nurses in a Tertiary Hospital / 중환자간호학회지

PURPOSE: The purpose of this study was to explore and describe the meanings of hands among clinical nurses.METHODS: A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis.RESULTS: A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included “meaning as an instrument,” “meaning of infection control,” and “meaning of caring.”CONCLUSION: Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.

Updates of Nursing Practice Guideline for Pressure Injury / 임상간호연구

PURPOSE: This study was conducted to update the existing evidence-based nursing clinical practice guideline in management of pressure injury in South Korea. METHODS: The update process underwent the 22 steps according to the update method based on the international standards. RESULTS: The updated nursing practice guideline for pressure injury consists of 4 domains and 436 recommendations. The numbers of recommendations in each domain were 25 for hospital policies, 51 for assessment, 350 for prevention and management, and 10 for education. There were 2.5% of A, 13.3% of B, 84.2% of C in terms of grading of recommendations. Among these, the major revision was done in 32 recommendations (7.4%). A total of 299 recommendations (68.6%) were added newly. Minor revisions, such as change or addition of some words, were also made in 25 recommendations(5.7%). No change was made in 80 recommendations (18.3%) compared to the previous ones. CONCLUSION: The nursing practice guideline for pressure injury has been updated. This updated guideline can be used as educational materials for both healthcare workers and patients with pressure injury.

Oligomeric Procyanidins (OPCs) Inhibit Procollagen Type I Secretion of Fibroblasts

Wound healing is composed of a complex process that requires harmonies of various cell populations where fibroblasts play the main role. Oligomeric procyanidins (OPC) are main components of grape (Vitis vinifera) seed extracts, and recent studies showed OPC's effects on inflammation, cell migration, and proliferation. We investigated the effect of OPC on fibroblasts to regulate wound healing process. Human dermal fibroblast known as Hs27 cells were treated with various concentrations of OPC (0, 2.5, 5, 10, and 20 µg/µl). Cell cytotoxicity was evaluated by the Cell Counting Kit assay, and the expression levels of secreted procollagen were analyzed. Procollagen levels in OPC treated cells exposed to transforming growth factor beta 1 (TGF-β1) or ascorbic acid were evaluated using Western blot and immunocytochemistry. Relative mRNA expressions of procollagen, molecular chaperone such as HSP47, P4H were determined by real-time PCR in OPC treated cells. OPC showed no cytotoxicity on Hs27 cells at every concentration but inhibited procollagen secretion in a dose-dependent manner. The inhibitory effect also appeared under TGF-β1 induced collagen overproduction. Immunocytochemistry showed that higher levels of intracytoplasmic procollagen were accumulated in TGF-β1 treatment group, whereas ascorbic acid induced a release of accumulated procollagen under OPC treatment. The mRNA expressions of procollagen, molecular chaperone were not affected by OPC, but procollagen level was increased when exposed to TGF-β1. OPC inhibits procollagen secretion from fibroblasts with no effects on cell proliferations even under the environment of TGF-b1-induced collagen overproduction. OPC could regulate the diseases and symptoms of abnormal overabundant collagen production.

Changes in Strain Pattern and Exercise Capacity after Transcatheter Closure of Atrial Septal Defects

BACKGROUND AND OBJECTIVES: Assessment of left ventricle (LV) function by using strain and strain rate is popular in the clinical setting. However, the use of these echocardiographic tools in assessing right ventricle (RV) failure, and the manner in which they both reflect the functional capacity of the patient, remains poorly understood. This study aimed to investigate the change in exercise capacity and strain between before and (1 month) after the transcatheter closure of atrial septal defects (ASDs). SUBJECTS AND METHODS: Thirty patients who underwent transcatheter closure of ASD between May 2014 and June 2015 at the Division of Pediatric Cardiology, Severance Cardiovascular Hospital, were enrolled. We compared and analyzed the results of the following examinations, before and (1 month) after the procedure: echocardiography, cardiopulmonary exercise test (CPET), and N-terminal pro-brain natriuretic peptide level. RESULTS: There were no mortalities, and the male-to-female ratio was 1:2. The mean defect size was 22.3±4.9 mm; the mean Qp/Qs ratio, 2.1±0.5; and the mean device size, 22.3±4.9 mm. Changes in global RV longitudinal (GRVL) strain and LV torsion were measured echocardiographically. Exercise capacity improved from 7.7±1.2 to 8.7±1.8 metabolic equivalents (p=0.001). These findings correlated to the change in GRVL strain (p=0.03). CONCLUSION: The average exercise capacity increased after device closure of ASD. The change in strain was evident on echocardiography, especially for GRVL strain and LV torsion. Further studies comparing CPET and strain in various patients may show increased exercise capacity in patients with improved RV function.

Clinical implication of exhaled breath temperature measurement in pediatric asthma

PURPOSE: Exhaled breath temperature (EBT) has been suggested as a noninvasive marker of airway inflammation in asthma. The aim of this study was to determine its clinical implication in children with asthma. METHODS: A total of 233 children were enrolled in this study. Among them, 116 were asthmatic children and 117 were healthy children. Spirometry, bronchodilator response (BDR) test, methacholine challenge test, and skin prick test were performed. EBT, fractional exhaled nitric oxide (FeNO), blood eosinophils, and total IgE levels were measured. EBT was measured by using X-halo. RESULTS: EBT was significantly higher in the asthma group than in the control group (median [interquartile range], 32.1℃ [30.0℃–33.9℃] vs. 29.7℃ [29.0℃–31.3℃], P<0.001). EBT was significantly higher in poorly or partly controlled asthmatic children than well-controlled asthmatic children (33.5℃ [31.0℃–34.4℃] vs. 30.3℃ [29.3℃–32.9℃], P<0.0001). Among total subjects, EBT was significantly higher in the atopic group than in the nonatopic group (32.4℃ [30.3℃–34.0℃] vs. 29.8℃ [29.0℃–30.3℃], P<0.001). There were neither significant associations between EBT and BDR (r=0.109, P=0.241) nor between EBT and PC20 (provocation concentration causing a 20% fall in FEV1) in total subjects (r=0.127, P=0.316). EBT did not show any association with FeNO (r=0.353, P=0.071). CONCLUSION: Our study suggests that EBT might play a role as an ancillary marker for allergic airway inflammation and the degree of control in pediatric asthma patients. Additional studies are required to explore the value of EBT in detail.

Association between the serum 25-hydroxyvitamin D level and allergic rhinitis in Korean children

PURPOSE: Vitamin D is known to play an important role in the regulation of the immune system and in the prevention of allergic disease. Herein, we examined the association between vitamin D and allergic rhinitis (AR) in children. METHODS: A total of 72 aeroallergen-proven AR and 57 healthy control subjects who visited Severance Children's Hospital between 2012 and 2014 were evaluated. The mean serum 25-hydroxyvitamin D (25(OH)D) level was measured in all subjects to evaluate their vitamin D status. RESULTS: The mean serum 25(OH)D levels was significantly lower in patients with AR than in controls (19.5±6.4 ng/mL vs. 22.3±5.8 ng/mL, P=0.013). The incidence of AR is higher in the 25(OH)D-insufficient group (15–20 ng/mL) and in the 25(OH)D-deficient group (≤15 ng/mL) compared with the 25(OH)D-sufficient group (>20 ng/mL) (40.3% vs. 84.4% vs. 22.2%, P<0.001). There was no significant difference in the serum 25(OH)D level between subgroups with mild and moderate-to-severe AR symptoms (19.8±6.5 vs. 19.0±6.3, P=0.596). After adjusting for confounding factors, the lower serum vitamin D level groups had increased odds of AR compared with the 25(OH)D-sufficient group (odds ration [95% confidence interval]; 3.67 [1.29–10.38] in the 25(OH)D-insufficient group; P=0.014 and 6.04 [1.49–24.51] in the 25(OH)D-deficient group; P=0.012). CONCLUSION: The serum vitamin D levels were significantly lower in children with AR compared with healthy controls. Therefore, lower serum level of 25(OH)D may be associated with the development of AR.

The Effects of a Self-care Management Program for Patients with Diabetic Foot Ulcers

PURPOSE: Diabetic foot ulcers are significant problems in diabetes mellitus and often result in lower extremity amputation. This study was conducted to evaluate the effects of a self-care management program on Korean patient's self-efficacy, self-care behavior, size of the wound, and wound related pain. METHODS: This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The intervention strategies of the self-care management program consisted of individual intervention (education, practice and demonstration), computer animation, and face-to-face counseling. There were thirty seven patients, and 20 were assigned to the experimental group while the other 17 were assigned to the control group. The experimental group was given a self-care management program. The control group received information on diabetic mellitus care by means of a leaflet. The data was analyzed using descriptive statistics, a chi-square test, an independent t-test, and a Mann-Whitney test. RESULTS: There were significant differences in self-care behavior and wound related pain. CONCLUSION: A Self-care program is an effective way to increase patient's self-care ability. This program is highly applicable to diabetic foot ulcer patients in various settings.

Molecular Neuroimaging in Posttraumatic Stress Disorder

Over the past decade, an increasing number of neuroimaging studies have provided insight into the neurobiological mechanisms of posttraumatic stress disorder (PSTD). In particular, molecular neuroimaging techniques have been employed in examining metabolic and neurochemical processes in PTSD. This article reviews molecular neuroimaging studies in PTSD and focuses on findings using three imaging modalities including positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance spectroscopy (MRS). Although there were some inconsistences in the findings, patients with PTSD showed altered cerebral metabolism and perfusion, receptor bindings, and metabolite profiles in the limbic regions, medial prefrontal cortex, and temporal cortex. Studies that have investigated brain correlates of treatment response are also reviewed. Lastly, the limitations of the molecular neuroimaging studies and potential future research directions are discussed.

Family History and Functional Outcome in Korean Stroke Patients: A Preliminary Study

OBJECTIVE: To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. METHODS: A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage. Stroke severity as assessed with the National Institutes of Health Stroke Scale (NIHSS), functional outcomes using the Korean version of the Modified Barthel index (K-MBI), Functional Independence Measurement (FIM), and cognitive function using the Korean version of Mini-Mental State Examination (K-MMSE) were assessed at admission and discharge. RESULTS: Subjects with a family history of stroke were more likely to have an ischemic stroke (90.7%) than were those without a family history (70.9%). The K-MBI, FIM, NIHSS, and K-MMSE scores did not show significant differences between patients with or without family history. CONCLUSION: Family history of stroke was significantly associated with ischemic stroke, but not with functional outcomes. Other prognostic factors of stroke were not distributed differently between patients included in this study with or without a family history of stroke.

The Prediction of Clinical Outcome Using HbA1c in Acute Ischemic Stroke of the Deep Branch of Middle Cerebral Artery

OBJECTIVE: To elucidate the association between glycemic control status and clinical outcomes in patients with acute ischemic stroke limited to the deep branch of the middle cerebral artery (MCA). METHODS: We evaluated 65 subjects with first-ever ischemic stroke of the deep branches of the MCA, which was confirmed by magnetic resonance angiography. All subjects had blood hemoglobin A1c (HbA1c) measured at admission. They were classified into two groups according to the level of HbA1c (low or =7.0%). Neurological impairment and functional status were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), Korean version of Modified Barthel Index (K-MBI), Korean version of Mini-Mental State Examination (MMSE-K), and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) at admission and discharge. Body mass index, serum glucose, homocysteine and cholesterol levels were also measured at admission. RESULTS: The two groups did not show any difference in the NIHSS, FIM, K-MBI, MMSE-K, and LOTCA scores at any time point. Body mass index and levels of blood homocysteine and cholesterol were not different between the two groups. The serum blood glucose level at admission was negatively correlated with all outcome measures. CONCLUSION: We found that HbA1c cannot be used for predication of clinical outcome in patients with ischemic stroke of the deep branch of the middle cerebral artery.

Effects of Polydeoxyribonucleotide in the Treatment of Pressure Ulcers

This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial, the effects of PDRN were compared over time between an experimental group (n=11) and a control group (n=12). The former was administered the same dose of PDRN intramuscularly (1 ampule, 3 mL, 5.625 mg, for 5 days) for 2 weeks and perilesionally (1 ampule, 3 mL, 5.625 mg, twice a week) for 4 weeks. The primary endpoint for determining efficacy was wound healing in the pressure ulcers, which was reflected by the wound surface area determined using VISITRAK Digital (Smith & Nephew, Largo, FL). The secondary endpoint was the pressure ulcer scale for healing score, determined using pressure ulcer scale for healing (PUSH Tool 3.0 developed by the National Pressure Ulcer Advisory Panel). After the 4-week treatment period, PDRN therapy was found to significantly reduce the wound size and PUSH score, without adverse effect during the treatment. The findings indicate that PDRN can positively modify the wound healing process in pressure ulcers, and its use could improve the clinical outcomes of patients and lower the need for additional therapies or hospital stay.

Radiologic Assessment of Forward Head Posture and Its Relation to Myofascial Pain Syndrome

OBJECTIVE: To assess head posture using cervical spine X-rays to find out whether forward head posture is related to myofascial pain syndrome (MPS) in neck and shoulder. METHODS: Eighty-eight participants who were diagnosed with MPS in neck and shoulder were evaluated in this study. Four parameters (distance among head, cervical spines, and shoulder, and cervical angle) were measured from lateral view of cervical spine X-ray. The location and number of trigger points in the neck and shoulder and symptom duration were evaluated for each patient. RESULTS: Both horizontal distances between C1 vertebral body and C7 spinous process and between the earhole and C7 vertebral body were negatively correlated with cervical angle reflecting cervical lordosis (p<0.05). Younger patients had significantly (p<0.05) less cervical angle with more forward head posture. There was no relationship between MPS (presence, location, and number of trigger points) and radiologic assessments (distance parameters and the cervical angle). CONCLUSION: Forward head posture and reduced cervical lordosis were seen more in younger patients with spontaneous neck pain. However, these abnormalities did not correlate with the location or the number of MPS. Further studies are needed to delineate the mechanism of neck pain in patients with forward head posture.

Clinical Nurses' Knowledge and Visual Differentiation Ability in Pressure Ulcer Classification System and Incontinence-associated Dermatitis

PURPOSE: This study was done to compare clinical nurses' knowledge and visual differentiation diagnostic ability for the pressure ulcer classification system (PUCS) and incontinence-associated dermatitis (IAD). METHODS: A convenience sample of 602 nurses took the pressure ulcer classification system and incontinence-associated dermatitis knowledge test (PUCS & IAD KT) and completed the visual differentiation tool (VDT), consisting of 21 photographs with clinical information. RESULTS: The overall mean score for correct answers was 14.5 (+/-3.2) in PUCS & IAD KT and 11.15 (+/-4.9) in PUCS & IAD VDT. Incorrect responses were most common for statements related to stage III, IAD for PUCS & IAD KT, and suspected deep tissue injury (SDTI), unstageable, and stage III for PUCS & IAD VDT. Significant correlations were found between PUCS & IAD KT and VDT (r=.48, p<.001). Factors affecting scores for PUCS & IAD VDT were PUCS & IAD KT, frequency of pressure ulcer, IAD management and participation in wound care education programs. CONCLUSION: Results indicate that nurses have an overall understanding of PUCS & IAD, but low visual differentiation ability regarding stage III, SDTI, and unstageable ulcers. Continuing education is needed to further improve knowledge and visual differentiation ability for PUCS & IAD.

Spinal Cord Atrophy and Early Motor Recovery following Transverse Myelitis in Pediatric Patients

OBJECTIVE: To compare the motor recovery following transverse myelitis in pediatric patients with and without spinal cord atrophy. METHOD: From January 1995 through December 2009, twenty children (8 boys and 12 girls with an onset at 5.7+/-3.8 years) that were diagnosed with transverse myelitis at a Children's Hospital in Korea, and undertaken an initial and follow-up spine magnetic resonance image (MRI) were included. Medical records and spine MRI scans were reviewed retrospectively. An initial MRI was taken 5.1+/-8.7 days after the onset. The interval between an initial and follow-up MRIs was 33.4+/-23.0 days. The motor recovery differences between subjects with and without spinal cord atrophy on follow-up MRIs were determined. Motor recovery was defined as the elevation of one or more grades of manual muscle tests of the Medical Research Council. RESULTS: Eight patients had developed spinal cord atrophies and 12 patients had not. Of the 8 patients with spinal cord atrophy, 7 showed no motor improvement. Among the 12 patients without atrophy, 11 had motor improvement. Spinal cord atrophy on follow-up MRIs were related to the risk of no motor improvement (odds ratio=77.0, 95% confidence interval [4.114-1441.049], p-value=0.001). CONCLUSION: Children with transverse myelitis who had developed spinal cord atrophy on follow-up MRIs had poor motor recovery than those who had not. The appearance of spinal cord atrophy on follow-up MRI could be an indicator of poor prognosis in pediatric transverse myelitis.

The Correlation Analysis of Functional Factors and Age with Duchenne Muscular Dystrophy

OBJECTIVE: To correlate existing evaluation tools with clinical information on Duchenne muscular dystrophy (DMD) patients following age and to investigate genetic mutation and its relationship with clinical function. METHOD: The medical records of 121 children with DMD who had visited the pediatric rehabilitation clinic from 2006 to 2009 were reviewed. The mean patient age was 9.9+/-3.4 years and all subjects were male. Collected data included Brooke scale, Vignos scale, bilateral shoulder abductor and knee extensor muscles power, passive range of motion (PROM) of ankle dorsi-flexion, angle of scoliosis, peak cough flow (PCF), fractional shortening (FS), genetic abnormalities, and use of steroid. RESULTS: The Brooke and Vignos scales were linearly increased with age (Brooke (y1), Vignos (y2), age (x), y1=0.345x-1.221, RBrooke2=0.435, y2=0.813x-3.079, RVignos2=0.558, p<0.001). In relation to the PROM of ankle dorsi-flexion, there was a linear decrease in both ankles (right and left R2=0.364, 0.372, p<0.001). Muscle power, Cobb angle, PCF, and FS showed diversity in their degrees, irrespective of age. The genetic test for dystrophin identified exon deletions in 58.0% (69/119), duplications in 9.2% (11/119), and no deletions or duplications in 32.8% (39/119). Statistically, the genetic abnormalities and use of steroid were not definitely associated with functional scale. CONCLUSION: The Brooke scale, Vignos scale and PROM of ankle dorsi-flexion were partially available to assess DMD patients. However, this study demonstrates the limitations of preexisting scales and clinical parameters incomprehensively reflecting functional changes of DMD patients.

Correlation between Severe ALS Patient-Caregiver Couples' Characteristics and Caregivers' Health Related Quality of Life

PURPOSE: The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers. METHODS: The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis. RESULTS: The physical component summary and mental component summary of the HRQoL score for family caregivers were 147.49+/-31.63 and 129.09+/-35.83, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient's gender, caregiver's age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers. CONCLUSION: The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.

The Diagnostic Usefulness of the Fiberoptic Endoscopic Evaluation of Swallowing

OBJECTIVE: To investigate if adding fiberoptic endoscopic evaluation of swallowing (FEES) to the videofluoroscopic swallowing study (VFSS) will improve the detection of abnormalities related to swallowing and pharyngolaryngeal structures. METHOD: Sixty-nine subjects (47 men, aged 64.8+/-12.0 years) with dysphagia were evaluated using VFSS and FEES simultaneously. VFSS and FEES were independently interpreted by two different examiners, who were blinded to the results of the other study. The foods that were examined were a 5-ml semi-blended diet (SBD), plain yogurt, boiled rice (NRD), and 2-ml (small fluid, SF) and 5-ml (large fluid, LF) diluted liquid barium. The detection rates of penetration or aspiration and of the pharyngeal residues in VFSS and FEES were compared. RESULTS: Combining FEES with VFSS raised the detection rates of penetration (p=0.008 for SF and LF; p<0.001 for SBD, yogurt, and NRD) and of the pharyngeal residues (p<0.001 for SF, SBD, yogurt, and NRD; p=0.001 and 0.002 for LF in the vallecula and pyriform sinus, respectively) in all the food types. Adding FEES also improved the detection of fluid aspiration (p=0.03 and 0.02 for SF and LF, respectively). Oral and pharyngeal lesions such as candidiasis, and other mucosal abnormalities, were also detected by FEES. CONCLUSION: Combining FEES with VFSS raised the diagnostic sensitivities of penetration, aspiration, and pharyngeal residues compared to the evaluation using VFSS alone. It also enabled the visualization of the abnormal structural changes in the pharyngolarynx. FEES can be performed safely by physiatrists.

A Study on the Dietary Habits and Health Consciousness of High School Students in Seoul

This study was conducted to examine the dietary behaviors with 510 high school students (260 males and 250 females) residing in Seoul. The average age of male and female students were 16.3 and 16.4 years old, respectively. Mean height and weight of male students were 174.1 cm and 65.9 kg and those of female students were 161.6 cm and 52.5 kg. The body mass index (BMI) of male and female students were 21.7 kg/m2 and 20.1 kg/m2, respectively, which were within the normal range. Students skipped breakfast more than once a week were 41.1% of males and 44.4% of females. More than 40% of the male and female students skipped breakfast frequently. The mean mini dietary assessment index score of male and female students were 30.6 and 29.6 out of total 50 index scores, respectively. Female students perceived significantly less healthy and fatter than male students. Furthermore, body image satisfaction of the female students was lower than that of male students. Female students were more significantly concerned with body image and desired a thin body shape. Only 22.7% of male students and 6.4% of female students exercised regularly, and the frequency, time, and intensity of exercise in the male students were significantly higher than those of female students.