Purpose: This study was performed to identify the factors influencing the fear of dementia in middle-aged and older adults. Methods: Data on the characteristics, dementia knowledge, dementia attitude, dementia health beliefs, and fear of dementia of 156 participants were collected from January 20 to March 22, 2018, using a structured questionnaire. The data were analyzed with the SPSS/WIN 21.0 program for descriptive statistics, using an independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and stepwise multiple regression. Results: Significant factors associated with fear of dementia among middle-aged and older adults were subjective life satisfaction (F=3.72, p=.006) and regular exercise (t=6.05, p=.015). Fear of dementia has positive correlations with dementia attitude, perceived susceptibility, perceived severity, and perceived barrier. The determining factors affecting fear of dementia in middle-aged and older adults were perceived severity (β=.46, p<.001), followed by a perceived barrier (β=.20, p=.004) and perceived susceptibility (β=.17, p=.023), and the explanation power was about 47.8%. Conclusion The results suggest that perceived severity, perceived barrier, and perceived susceptibility be considered in developing the nursing interventions to increase perceived severity, perceived susceptibility, and to decrease perceived barrier to dementia by evaluating dementia health beliefs to manage the fear of dementia among middle-aged and older adults.

No abstract available.
Dose-Response Relationship, Radiation ; Glaucoma, Neovascular/*etiology ; Glioma/*surgery ; Humans ; Optic Nerve Neoplasms/*surgery ; Radiosurgery/*adverse effects

Purpose: To investigate the prognostic value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT). Methods: The medical records of HCC patients treated with SBRT between 2008 and 2019 were reviewed retrospectively. The NLR and PLR were calculated from the serum complete blood count before and after SBRT, and the prognostic values of the NLR and PLR for the treatment outcomes were evaluated. Results: Thirty-nine patients with 49 HCC lesions were included. After a median follow-up of 26.8 months (range, 8.4-80.0 months), three-year local control, overall survival (OS), and progression-free survival (PFS) rate were 97.4%, 78.3%, and 35.2%, respectively.Both NLR and PLR increased significantly after SBRT and decreased slowly to the pre-SBRT value at 6 months. Univariable analysis showed that gross tumor volume (GTV) >14 cc, post-SBRT PLR >90, and PLR change >30 were associated with a poorer OS (p=0.002, p=0.011, and p=0.001, respectively), and the PLR change was significant in multivariable analysis (hazard ratio [HR], 10.09; 95% CI, 1.15-88.40; p=0.037). For PFS, GTV >14 cc, post-SBRT NLR >2.5 and post-SBRT PLR >90 were predictive of a poorer PFS in univariable analysis (p=0.011, p=0.004 and p=0.041, respectively) and only post-SBRT NLR >2.5 remained significant in multivariable analysis (HR, 2.44; 95% CI, 1.03-5.76; p=0.042, respectively). Conclusions The NLR and PLR increased transiently after SBRT, and the post-SBRT NLR and PLR were associated with the clinical outcomes of HCC patients.

Objectives: The prevalence of psychiatric disorders among young adults is different from that among younger or older age groups because of biological and environmental changes. The purpose of this study was to analyze the diagnostic distribution of psychiatric disorders in 19–30-year-old Koreans based on their age and gender using data from the Korean National Health Insurance Service (NHIS). Methods: From the 2011 medical claims sample data of NHIS of 1,375,842 people, we extracted the data of 221,038 people aged 19–30 years, including 106,232 (48.1%) men and 114,806 (51.9%) women. We evaluated the overall changes in the diagnostic distribution of psychiatric disorders over a 3-year period. Results: The diagnostic frequency in women was 13,627 (59.0%), which was significantly higher than that in men. “Other anxiety disorders” was the most common psychiatric disorder in both genders, followed by depressive episodes, somatoform disorders, “other neurotic disorders,” and nonorganic sleep disorders. In men, attention-deficit/hyperactivity disorder or intellectual disabilities were not among the top 10 disorders. In women, no significant changes in major psychiatric disorders were seen over the 3-year period. Conclusion These results reveal the trends of diagnostic distribution of mental illnesses depending on the development, particularly in young adulthood. It is necessary to identify whether such trends are due to biological or environmental factors, aging processes, or complex influences.

Objectives: The prevalence of psychiatric disorders among young adults is different from that among younger or older age groups because of biological and environmental changes. The purpose of this study was to analyze the diagnostic distribution of psychiatric disorders in 19–30-year-old Koreans based on their age and gender using data from the Korean National Health Insurance Service (NHIS). Methods: From the 2011 medical claims sample data of NHIS of 1,375,842 people, we extracted the data of 221,038 people aged 19–30 years, including 106,232 (48.1%) men and 114,806 (51.9%) women. We evaluated the overall changes in the diagnostic distribution of psychiatric disorders over a 3-year period. Results: The diagnostic frequency in women was 13,627 (59.0%), which was significantly higher than that in men. “Other anxiety disorders” was the most common psychiatric disorder in both genders, followed by depressive episodes, somatoform disorders, “other neurotic disorders,” and nonorganic sleep disorders. In men, attention-deficit/hyperactivity disorder or intellectual disabilities were not among the top 10 disorders. In women, no significant changes in major psychiatric disorders were seen over the 3-year period. Conclusion These results reveal the trends of diagnostic distribution of mental illnesses depending on the development, particularly in young adulthood. It is necessary to identify whether such trends are due to biological or environmental factors, aging processes, or complex influences.

PURPOSE: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. MATERIALS AND METHODS: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. RESULTS: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24–39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. CONCLUSION: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.
Dose Fractionation ; Humans ; Korea* ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms* ; Radiotherapy* ; Recurrence ; Seminal Vesicles

OBJECTIVES: As a preliminary study on the prevalence of mental disorders in Korean children and adolescents, we investigated the diagnosis distribution of mental disorders in people under 19 years of age using the health insurance data. METHODS: From the 2011 health insurance data of 1,375,842 people, the data of 286,465 people under 19 years old were extracted. Among them, we selected 10,778 with psychiatric diagnoses; male 6,453 (59.9%) and female 4,325 (40.1%). The frequency of psychiatric diagnoses in the males was 10,140 (62.7%) cases, which was significantly higher than that (6,031; 37.3%) in the females. We categorized the groups into 3 year intervals. RESULTS: In the males under 3 years old, F80 was the most prevalent diagnosis, followed by F98. F90 and F41 were the most prevalent in the 4-15 and above 16 years old groups, respectively. In the females, F98 was the most prevalent in the children up to 3 years old, while F80 was the second most prevalent. In the 4-6 years of age group, F98 was the most prevalent, followed by F93. F90 and F41 were predominant in the 7-12 and above 12 years old groups, respectively. CONCLUSION: In the analysis of the frequency of diagnosis of mental disorders in the population under 19 years old, there were significant differences in the distribution based on age and gender.
Adolescent ; Child ; Diagnosis ; Female ; Humans ; Insurance* ; Insurance, Health ; Male ; Mental Disorders ; Prevalence

OBJECTIVE: To evaluate the prevalence and risk factors of clopidogrel resistance, and association between thromboembolic complications and clopidogrel resistance in patient with stent-assisted angioplasty for atherosclerotic cerebrovascular disease. METHODS: Between September 2006 and June 2008, clopidogrel resistance test was performed on 41 patients who underwent stent-assisted angioplasty for atherosclerotic cerebrovascular disease. It was performed before drug administration and about 12 hours after drug administration (loading dose : 300 mg, maintain dose : 75 mg). Two patients were excluded, and 41 patients were included (mean : 67.59+/-7.10 years, age range : 41-79). Among 41 patients, 18 patients had intracranial lesions, and 23 had extracranial lesions. We evaluated the prevalence, risk factors and complications related to clopidogrel resistance. RESULTS: Twenty-one patients (51.2%) showed clopidogrel resistance [intracranial : 10 patients (55.6%), extracranial : 11 patients (47.8%)] and no clopidogrel resistance was seen in 20 patients. Hypercholesterolemia was an indepedent risk factor of clopidogrel resistance. Stent-assisted angioplasty was technically successful in all patients, but acute in-stent thrombosis occurred in 5 patients with intracranial lesions (4 patients with clopidogrel resistance and 1 without clopidogrel resistance). Acute thrombi were completely lysed after intra-arterial infusion of abciximab. CONCLUSION: There was relatively high prevalence of clopidogrel resistance in patients with atherosclerotic cerebrovascular disease. Hypercholesterolemia was an independent predictive factor of clopidogrel resistance. Acute in-stent thrombosis was more frequently seen in the clopidogrel resistant group. Therefore, clopidogrel resistance test should be performed to avoid thromboembolic complications related to stent-assisted angioplasty for atherosclerotic cerebrovascular disease, especially patients with hypercholeterolemia and intracranial lesion.
Angioplasty ; Humans ; Hypercholesterolemia ; Infusions, Intra-Arterial ; Prevalence ; Risk Factors ; Stents ; Thrombosis ; Ticlopidine

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.
Cerebrospinal Fluid ; Debridement ; Ear Canal ; Free Tissue Flaps* ; Fungi ; Humans ; Meningitis ; Otitis ; Parotid Gland ; Rectus Abdominis* ; Skin ; Temporal Bone ; Tissue Donors

PURPOSE: We compared the results of arthroscopic Bankart repair using metal and biodegradable anchor fixation. MATERIALS & METHODS: We reviewed 26 patients with anterior shoulder instability treated by arthroscopic Bankart repair from October, 2006, to March, 2007, 15 patients with metal anchors and 11 patients with biodegradable anchors. The average age was 27.4 years old (range: 17~55) and mean follow-up was 14 months (range: 12~17 months). Functional outcome was evaluated using the Korean Shoulder Score for Instability (KSSI), Rowe's Bankart Grading scale (RBGS), ASES score, and UCLA scores. RESULTS: In the metal-anchor group, the improvements of mean KSSI, ASES, UCLA score, and RBGS were 20.6, 24.0, 4.0, and 45.5, respectively. In the biodegradable anchor group, improvements of mean KSSI, ASES, UCLA score, and RBGS were 21.0, 23.6, 4.6, and 48.9. The improvements in final outcomes were not significantly different (p>.05). One metal problem and one traumatic redislocation occurred in the metal group. CONCLUSION: Both techniques produced satisfactory outcomes in the treatment of traumatic anterior instability. The biodegradable anchor group could also avoid problems with metal anchors.
Follow-Up Studies ; Humans ; Shoulder