The Association between Psychosocial Stress and Type of Physical Activity in Middle Aged Adult: A Community-based Cohort Study / 대한스포츠의학회지

Purpose@#The purpose of this study was to identify the associations between type of moderate-vigorous physical activities (MVPA) and psychological stress in South Korean, based on the Korean Genome and Epidemiology Study. The subjects of this study were 2,891 Korean men and women aged 40 to 69, who completed health examination from 2011 to 2012. @*Methods@#The type of MVPA was measured by using self-reported physical activity questionnaire. A high psychological stress was determined by scoring Psychological Well-being Index Short Form (≥ 27). Logistic regression analysis, adjusting other confounding factors, was conducted to identify the association of type of MVPA level with psychological stress (p＜ 0.05). @*Results@#Participants who leisure-related MVPA of ≥ 150 min/week was less likely have to high psychological stress than ＜ 150 min/week (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.57–0.92). From the analysis of gender, leisure-related (OR, 0.50; 95% CI, 0.35–0.72) and work-related (OR, 0.63; 95% CI, 0.41–0.97) MVPA of ≥ 150min/week were associated with low psychological stress in men, but women was not significantly associated. From the analysis of age, leisure-related MVPA of ≥ 150 min/week were associated with low psychological stress in middle age group (OR, 0.70; 95% CI, 0.53–0.92), but elderly group was not significantly associated. Differences inpsychological stress OR according to type of MVPA time were observed about classification of occupations. @*Conclusion@#High level of leisure related physical activity were independently associated with reducing risk for psychological stress. Also, encouraged MVPA by gender, age, classification of occupations could help to improve psychological stress levels in middle-aged or older adults.

A Validation of the Korean Version of Ultra-Short Suicidal Ideation Scale / 신경정신의학

Objectives@#An accurate and easy-to-identify form is needed for the early evaluation of suicidal ideation in high-risk patients. Therefore, this study examined the validity and reliability of a Korean version of the Ultra-Short Suicidal Ideation Scale (K-USSIS). @*Methods@#A total of 161 psychiatric university-affiliated general hospital patients completed the K-USSIS. The data were analyzed using correlation, internal consistency, and confirmatory factor analyses. @*Results@#First, the scale had good internal consistency with a Cronbach’s α of 0.94. Second, the confirmatory factor analysis demonstrated that the single-factor model had a reasonable fit (comparative fit index=0.99, Tucker–Lewis index=0.98, standardized root mean squared residual=0.01, and root mean square error of approximation=0.10). Finally, the convergent validity analysis revealed a significant positive correlation with depression, anxiety, and hopelessness. @*Conclusion@#The findings suggest that the K-USSIS has good psychometric properties and can serve as a valuable tool for screening for suicidal ideation to ensure early intervention in Korean psychiatric patients.

Association between Sedentary Behavior and General Anxiety Disorder by Change in Physical Activity after COVID-19 among Adolescents / 대한스포츠의학회지

Purpose@#This study aimed to investigate the association between sedentary behavior and generalized anxiety disorder (GAD) according to changes in physical activity after coronavirus disease 2019 (COVID-19) in Korean adolescents. @*Methods@#This study included 52,723 South Korean middle and high school students who had obtained a complete Korea youth risk behavior survey, 2021. To identify the association between sitting time and GAD (GAD-7 scale≥10), odds ratio (OR) and 95% confidence interval (CI) were calculated using complex sample logistic regression analysis (p＜0.05). @*Results@#After adjusting for confounding variables, higher sitting time was associated with higher GAD risk (OR [95% CI]: 5–10 hours, 1.15 [1.04–1.27]; 10–15 hours, 1.23 [1.12–1.35]; ≥15 hours, 1.28 [1.15–1.43]). In adolescents whose physical activity has not changed or has increased after COVID-19, as the sitting time increased, the OR (95% CI) of GAD increased (5–10 hours, 1.15 [1.02–1.31]; 10–15 hours, 1.20 [1.07–1.35]; ≥15 hours, 1.35 [1.17–1.54]). But, not in adolescents whose physical activity has decreased after COVID-19. @*Conclusion@#We observed the independent associations between sedentary behavior and GAD, and sedentary behavior and GAD are associated by change in physical activity after COVID-19 among adolescents. Therefore, in the pandemic era reducing sedentary behavior and increasing physical activity is necessary for adolescents to enhance mental health and decrease the case of GAD.

Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

Objective@#This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation. @*Materials and Methods@#Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. After three dimensional T1-based brain segmentation, the average MVF was analyzed at the bilateral cerebral white matter (WM), bilateral cerebral gray matter (GM), corpus callosum, and brainstem. The Mann–Whitney U-test was performed to compare MVF and myelin volume between patients with mTBI and controls. Myelin volume was correlated with neuropsychological test scores using the Spearman rank correlation test. @*Results@#The average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS (median [interquartile range], 25.2% [22.6%–26.4%]) than that in controls (26.8% [25.6%–27.8%]) (p = 0.004). The region-of-interest myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (1.87 cm3 [1.70–2.05 cm3 ] vs. 2.21 cm3 [1.86– 3.46 cm3 ]; p = 0.003) and brainstem (9.98 cm3 [9.45–11.00 cm3 ] vs. 11.05 cm3 [10.10–11.53 cm3 ]; p = 0.015). The total myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (0.45 cm3 [0.39–0.48 cm3 ] vs. 0.48 cm3 [0.45–0.54 cm3 ]; p = 0.004) and brainstem (1.45 cm3 [1.28–1.59 cm3 ] vs. 1.54 cm3 [1.42–1.67 cm3 ]; p = 0.042). No significant correlation was observed between myelin volume parameters and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall) (r = 0.425; p = 0.048). @*Conclusion@#MVF quantified from the MDME sequence was decreased at the bilateral cerebral WM in mTBI patients with PCS. The total myelin volumes at the corpus callosum and brainstem were decreased in mTBI patients with PCS due to atrophic changes.

The Moderating Effect of Reasons for Living on the Relationship Between Depression and Suicidal Ideation Among Psychiatric Patients / 정신신체의학

Objectives@#：This study aimed to examine the moderating effects of reasons for living on the relationship between depression and suicidal ideation among psychiatric patients. @*Methods@#：Patients were recruited from the department of psychiatry of university hospital. A total of 137 participants completed self-report questionnaires assessing depression (Beck Depression Inventory), suicidal ideation (Ultra-Short Suicidal Ideation Scale) and reasons for living (The Reasons for Living Inventory). @*Results@#：Among 4 sub-scales of the reasons for living inventory, survival and coping beliefs, fear of death and social disapproval, and future expectation moderated the relationship between depression and suicidal ideation. @*Conclusions@#：The results suggest that the reasons for living can work as a protective factor on the relationship between depression and suicidal ideation among psychiatric patients.

Comparison of the bovine blood gas parameters produced with three types of portable blood gas analyzers

Background@#A definite diagnosis should be made in the bovine practice field, however, it was difficult to perform laboratory analysis immediately. Currently, three types of portable blood gas analyzers are available in Korea. @*Objectives@#This study aimed to evaluate the correlations among these three analyzers. @*Methods@#Seventy-two plasma samples from Holstein-Friesian cows were used for blood gas analysis, and three instruments (EDAN i15 Vet, VETSCAN i-STAT, and EPOC) were operated simultaneously. Moreover, plasma calcium levels were compared between these portable analyzers and blood chemistry device, which is usually used in a laboratory environment.Pearson analysis was performed to confirm the correlation of each parameter produced with the three instruments and blood chemistry analyzer. @*Results@#As results, high correlation was observed in parameters of pH, pO2 , potassium ion, ionized calcium, and glucose (p 0.7). In addition, pCO 2 showed a moderate correlation among the three analyzers (p 0.5), and there was no correlation among all instruments for sodium ions. There was also a high correlation between ionized calcium from the three portable devices and total calcium from the biochemistry analyzer (p 0.9). @*Conclusions@#In conclusion, there was a high correlation between results from the three different blood gas analyzers used in the bovine clinical field in Korea. Thus, a consistent diagnosis can be made even with different equipment if the operator is aware of the strengths and weaknesses of each piece of equipment and operates it properly.

Reference Standards for Nerve Conduction Studies of Individual Nerves of Lower Extremity With Expanded Uncertainty in Healthy Korean Adults

Objective@#To develop a set of reference standards for tibial motor, common peroneal motor, sural sensory, and superficial peroneal sensory nerve conduction studies (NCSs) with expanded uncertainty in a healthy Korean population. @*Methods@#Standardized procedures were conducted for individual lower extremity NCSs of 199 healthy participants in their 20s (n=100) and 50s (n=99). Mean values and expanded uncertainties for parameters were analyzed with thorough consideration of multiple uncertainty factors under the International Guide to the Expression of Uncertainty in Measurement. In addition, side-to-side differences in onset latency, amplitude, and nerve conduction velocity (NCV) were analyzed. @*Results@#Mean (reference range) for distal onset latency, baseline to negative peak amplitude, NCV of tibial motor nerve in males in their 20s were 4.3 ms (3.1–5.4 ms), 7.1 mV (3.4–10.9 mV), and 50.7 m/s (42.2–59.3 m/s), respectively; sural sensory nerve baseline to negative peak amplitude in males in their 20s was 21.7 μV (8.3–35.2 μV). Including the aforementioned data, we present a vast dataset of normative mean values and expanded uncertainties for NCSs of the leg in a healthy Korean population. Furthermore, upper limits for normal side-to-side differences for onset latency, amplitude, and NCV of each nerve are suggested. @*Conclusion@#To our knowledge, this is the first study to present the reference standards of leg NCSs with consideration for multifactorial uncertainties in an Asian population. We expect these results to help practitioners make reliable and reproducible clinical decisions.

Blood-Brain Barrier Disruption in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Evaluation with Region-Based Quantification of Dynamic Contrast-Enhanced MR Imaging Parameters Using Automatic Whole-Brain Segmentation

Objective@#This study aimed to investigate the blood-brain barrier (BBB) disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and automatic whole brain segmentation. @*Materials and Methods@#Forty-two consecutive mTBI patients with PCS who had undergone post-traumatic MR imaging, including DCE MR imaging, between October 2016 and April 2018, and 29 controls with DCE MR imaging were included in this retrospective study. After performing three-dimensional T1-based brain segmentation with FreeSurfer software (Laboratory for Computational Neuroimaging), the mean Ktrans and vp from DCE MR imaging (derived using the Patlak model and extended Tofts and Kermode model) were analyzed in the bilateral cerebral/cerebellar cortex, bilateral cerebral/cerebellar white matter (WM), and brainstem. Ktrans values of the mTBI patients and controls were calculated using both models to identify the model that better reflected the increased permeability owing to mTBI (tendency toward higher Ktrans values in mTBI patients than in controls). The Mann-Whitney U test and Spearman rank correlation test were performed to compare the mean Ktrans and vp between the two groups and correlate Ktrans and vp with neuropsychological tests for mTBI patients. @*Results@#Increased permeability owing to mTBI was observed in the Patlak model but not in the extended Tofts and Kermode model. In the Patlak model, the mean Ktrans in the bilateral cerebral cortex was significantly higher in mTBI patients than in controls (p = 0.042). The mean vp values in the bilateral cerebellar WM and brainstem were significantly lower in mTBI patients than in controls (p = 0.009 and p = 0.011, respectively). The mean Ktrans of the bilateral cerebral cortex was significantly higher in patients with atypical performance in the auditory continuous performance test (commission errors) than in average or good performers (p = 0.041). @*Conclusion@#BBB disruption, as reflected by the increased Ktrans and decreased vp values from the Patlak model, was observed throughout the bilateral cerebral cortex, bilateral cerebellar WM, and brainstem in mTBI patients with PCS.

Clinical Characteristics of Formal Thought Disorder in Schizophrenia

Objectives@#Our study aimed to present the distinctive correlates of formal thought disorder in patients with schizophrenia, using the Clinical Language Disorder Rating Scale (CLANG). @*Methods@#We compared clinical characteristics between schizophrenia patients with (n = 84) and without (n = 82) formal thought disorder. Psychometric scales including the CLANG, the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS), the Calgery Depression Scale for Schizophrenia (CDSS) and the Word Fluency Test (WFT) were used. @*Results@#After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the abnormal syntax (p = 0.009), lack of semantic association (p = 0.005), discourse failure (p < 0.0001), pragmatics disorder (p = 0.001), dysarthria (p < 0.0001), and paraphasic error (p = 0.005) items than those without formal thought disorder. With defining the mentioned item scores as covariates, binary logistic regression model predicted that discourse failure (adjusted odds ratio [aOR] = 5.88, p < 0.0001) and pragmatics disorder (aOR = 2.17, p = 0.04) were distinctive correlates of formal thought disorder in patients with schizophrenia. @*Conclusions@#This study conducted Clinician Rated Dimensions of Psychosis Symptom Severity (CRDPSS) and CLANG scales on 166 hospitalized schizophrenia patients to explore the sub-items of the CLANG scale independently related to formal thought disorders in schizophrenia patients. Discourse failure and pragmatics disorder might be used as the distinctive indexes for formal thought disorder in patients with schizophrenia.

Effects of Career Management and Organizational Justice on Job Rotation Attitude among Hospital Nurses / 간호행정학회지

Purpose@#The purpose of this study was to identify the relationship between career management, organizational justice, and job rotation attitude among tertiary hospital nurses. @*Methods@#A cross-sectional descriptive design was used. The participants were 195 nurses with more than one year of experience working at tertiary care hospitals.Data was collected with self-reported questionnaires from April to May 2018. Data was analyzed using SPSS Statistics version 25.0 for windows including descriptive statistics, bivariate analysis, and multiple regression analysis. @*Results@#The mean score of career management of participants was 3.14±0.49 (range 1~5), organizational justice was 2.95±0.53 (range 1~5), and job rotation attitude was 4.02±0.97 (range 1~7). There were significant positive correlations among the participants' career management, organizational justice, and job rotation attitude. 37% of job rotation attitude was explained by position, organizational justice, career management, and the frequency of job rotation experience in the regression model. @*Conclusion@#This study provided the empirical evidence that it is necessary to improve the perception of organizational justice, and to establish a systematic job rotation in order for nurses to positively recognize job rotation.

Relationship between Arterial Stiffness and Physical Activity Level Assessed by International Physical Activity Questionnaireshort form (IPAQSF) in the Elderly / 대한지역사회영양학회지

Objectives@#Cardiovascular disease is a major cause of death in the elderly in Korea. Increased arterial stiffness is linked to risk of cardiovascular disease and mortality. The purpose of this study was to investigate the relationship between arterial stiffness and physical activity in the elderly. @*Methods@#A total of 209 older adults (110 men and 99 women) participated in this study. Arterial stiffness of subjects such as brachial–ankle pulse wave velocity (baPWV) and ankle brachial pressure index (ABI) was measured using a non-invasive vascular screening device (VP-1000 Plus, Omron, Kyoto, Japan). The interviewed Korean version of the international physical activity questionnaire short form (IPAQ-SF) was used to evaluate subject’s physical activity level and classify subjects as active or inactive group based on the time spent doing moderate to vigorous physical activity (MVPA). @*Results@#The mean age of total subjects was 75.3 ± 5.6 years. There was no significant difference in sex distribution between the active group (39.7%) and inactive group (60.3%). The baPWV (1,758.1 ± 375.2cm /sec) of the active group was significantly lower than that (1,969.7 ± 372.3 cm/sec) of the inactive group (P < 0.05). There was a significant inverse association between time spent in MVPA and baPWV (r = -0.245, P < 0.01). @*Conclusions@#This study suggests that physical activity programs for older adults are needed to prevent arteriosclerosis.

Factorial Validity of the Korean Version of the Illness Intrusive Rating Scale among Psychiatric Outpatients Mainly Diagnosed with Anxiety or Depressive Disorders / 정신신체의학

OBJECTIVES@#The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients.@*METHODS@#Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale.@*RESULTS@#76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales.@*CONCLUSIONS@#The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients / 정신신체의학

OBJECTIVES: Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. METHODS: Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's α for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). RESULTS: Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's α=0.94) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. CONCLUSIONS: Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study TSCdemonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

Resin bonded fixed prosthesis for single tooth restoration: A case report / 대한치과보철학회지

In the case of single tooth replacement, a fixed prosthesis or a dental implant is the treatment option commonly selected as first choice. However, any amount of sound tooth structure should be removed to prepare the abutment teeth for full coverage retainer. The adjacent tooth damage can be avoided placing a dental implant. However, depending on the patient's oral condition and any other circumstances, it may be impossible or delayed. In this case resin bonded fixed partial denture was selected as an alternative that can restore single tooth loss without much tooth structure removal to the young patients and the patients with gingival recession. We report these patients were satisfied with esthetic and function.

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

BACKGROUND/AIMS: It remains unclear whether atrophic gastritis can affect dyspeptic symptoms. We aimed to investigate whether the extent of atrophic gastritis is associated with specific dyspeptic symptoms. METHODS: Consecutive adults in a routine health-checkup program were enrolled in the study. The extent of atrophic gastritis was classified into 3 groups based on the Kimura-Takemoto criteria; the gastritis with no or little atrophy (group A: C0), the gastritis with atrophy mainly in the antrum (group B: C1 and C2), and the gastritis with atrophy in the large area of the corpus (group C: C3 and O). Upper gastrointestinal symptoms were categorized into "typical reflux symptoms," "epigastric pain syndrome (EPS)-related symptoms," and "postprandial distress syndrome (PDS)-related symptoms." RESULTS: A total of 1827 patients (1009 males, mean age 45.1 years) were included in the analysis. The subgroups of atrophic gastritis were as follows: group A (n = 1218, 66.7%), group B (n = 392, 21.4%), and group C (n = 217, 11.9%). Typical reflux, EPS-related, and PDS-related symptoms were present in 10.5%, 19.8%, and 16.2% of the subjects, respectively. PDS-related and EPS-related symptoms were significantly more prevalent in the group C of male patients and the group B of female patients, respectively, compared with other groups. PDS-related and EPS-related symptoms were independently associated with the group C in males (OR, 2.123; 95% CI, 1.090-4.136) and the group B in females (OR, 2.571; 95% CI, 1.319-5.025), respectively. CONCLUSIONS: The extent of atrophic gastritis appears to affect the generation of specific dyspeptic symptoms in a gender-dependent manner.

Achalasia in Korea: An Epidemiologic Study Using a National Healthcare Database

Owing to the rarity of the disease, epidemiologic information on achalasia is limited. This study aimed to investigate the epidemiology and treatment patterns of achalasia in the population of Korea using a national healthcare database. The diagnostic code K22.0 of the International Classification of Diseases was used to identify cases of achalasia between 2007 and 2011. Treatment modalities for achalasia were identified using the electronic data interchange codes Q7642 or Q7641 for balloon dilation and QA421 or QA422 for esophago-cardiomyotomy. A total of 3,105 patients with achalasia (1,447 men; mean age, 52.5 yr) were identified between 2007 and 2011, indicating a prevalence of 6.29/100,000 (95% confidence interval [CI], 4.94-7.66) during this 5-yr period. A total of 191 incident cases of achalasia (82 men; mean age, 49.5 yr), which were not diagnosed as achalasia in the previous 4 yr, were detected in 2011, indicating an incidence of 0.39/100,000 (95% CI, 0.15-0.63) for that year. During the study period, balloon dilation therapy was performed a total of 975 times in 719 patients, and surgical esophago-cardiomyotomy was performed once per patient in 17 patients. This is the first population-based epidemiologic study of achalasia in Korea.

Estimating free-living human energy expenditure: Practical aspects of the doubly labeled water method and its applications

The accuracy and noninvasive nature of the doubly labeled water (DLW) method makes it ideal for the study of human energy metabolism in free-living conditions. However, the DLW method is not always practical in many developing and Asian countries because of the high costs of isotopes and equipment for isotope analysis as well as the expertise required for analysis. This review provides information about the theoretical background and practical aspects of the DLW method, including optimal dose, basic protocols of two- and multiple-point approaches, experimental procedures, and isotopic analysis. We also introduce applications of DLW data, such as determining the equations of estimated energy requirement and validation studies of energy intake.

Reusability of EMR Data for Applying Cubbin and Jackson Pressure Ulcer Risk Assessment Scale in Critical Care Patients / 대한의료정보학회지

OBJECTIVES: The purposes of this study were to examine the predictive validity of the Cubbin and Jackson pressure ulcer risk assessment scale for the development of pressure ulcers in intensive care unit (ICU) patients retrospectively and to evaluate the reusability of Electronic Medical Records (EMR) data. METHODS: A retrospective design was used to examine 829 cases admitted to four ICUs in a tertiary care hospital from May 2010 to April 2011. Patients who were without pressure ulcers at admission to ICU, 18 years or older, and had stayed in ICU for 24 hours or longer were included. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) were calculated. RESULTS: The reported incidence rate of pressure ulcers among the study subjects was 14.2%. At the cut-off score of 24 of the Cubbin and Jackson scale, the sensitivity, specificity, positive predictive value, negative predictive value, and AUC were 72.0%, 68.8%, 27.7%, 93.7%, and 0.76, respectively. Eight items out 10 of the Cubbin and Jackson scale were readily available in the EMR data. CONCLUSIONS: The Cubbin and Jackson scale performed slightly better than the Braden scale to predict pressure ulcer development. Eight items of the Cubbin and Jackson scale except mobility and hygiene can be extracted from the EMR, which initially demonstrated the reusability of EMR data for pressure ulcer risk assessment. If the Cubbin and Jackson scale is a part of the EMR assessment form, it would help nurses perform tasks to effectively prevent pressure ulcers with an EMR alert for high-risk patients.

Simultaneous Neuroendocrine Carcinoma and Adenocarcinoma of the Colon

Neuroendocrine carcinoma of colon is a rare disease entity that is histologically poorly differentiated and immunochemically synaptophysin positive, enabling it to be confirmed by an immunohistochemical stain. Neuroendocrine carcinomas, in almost all cases, have poor prognosis due to a tendency of early metastasis and lack of standardized treatment. The concurrent diagnosis of neuroendocrine carcinoma and adenocarcinoma is extremely rare. The relation of these two disease entities is not understood. We experienced a patient with a colonic neuroendocrine carcinoma concurrent with adenocarcinoma. A 65-year-old male presented with abdominal pain. Emergent computed tomography suggested a malignant tumor of the ascending colon. Colonoscopy showed an infiltrative lesion in the ascending colon with a luminal narrowing, a large pedunculated lesion at the splenic flexure, and multiple small polyps in the descending colon. The patient underwent a right hemicolectomy including the pedunculated lesion. The pathology confirmed advanced neuroendocrine carcinoma in the ascending colon, adenocarcinoma in proximal descending colon, and multiple metastatic lymph nodes of neuroendocrine carcinomas on abdomen. The patient underwent the postoperative chemotherapy but did not tolerate it well and expired a year after diagnosis. We report this rare case with a review of the literature.

The Related Factors Influencing on Self-rated Health Level of Middle-aged Women / 대한지역사회영양학회지

This survey of 836 midlife women (51.0 +/- 4.0 yrs) was undertaken by exclusively a face to face interview by well-trained interviewers guarantying data collection of higher quality. This survey data was analyzed using the SPSS program. The main purpose of this study was to describe the factors affecting self-rated health status, including dietary habits and physical . mental . social factors. In the self-rated health status of a 'good' group, age was lower (p < 0.05), monthly income was higher (p < 0.01), dietary habits score (p < 0.001) and appetite (p < 0.001) and the degree of movement (p < 0.001) and life satisfaction (p < 0.001), marital intimacy (p < 0.001) and relationship satisfaction with their children (p < 0.001) were significantly higher than the 'bad' group. The level of depression (p < 0.001) and severe feeling of menopausal symptoms (p < 0.001) were significantly higher in the 'poor' group. The results of correlation analysis demonstrated that educational level (r = 0.069, p < 0.05),income (r = 0.157, p < 0.001), eating habits (r = 0.235, p < 0.001), appetite (r = 0.263, p < 0.001), life satisfaction (r = 0.197, p < 0.001), marital intimacy (r = 0.167, p < 0.001), child relationship satisfaction (r = 0.149, p < 0.001), positive attitude toward menopause (r = 0.070, p < 0.05) showed a positive correlation, but depression (r = -0.122, p < 0.001) and menopausal symptoms (r = -0.292, p < 0.001) showed a negative association with self-rated health status. The predictable factors affecting the self-rated health status of middle-aged women were examined by multiple regression analysis. The 'menopausal symptoms - physical discomfort' was the most important variables followed by the 'appetite', 'eating habits', 'menopause symptoms - sensory problems', 'BMI', 'positive attitude toward menopause' and 'high marital intimacy'. These results showed that the 'appetite' and 'eating habits' are important factors affecting the self-rated health status. Therefore, a program of dietary education must be considered for the effective health education and counseling of middle-aged women.