PURPOSE: This study was done to identify the risk factors influencing suicidal ideation in Korean elders. METHODS: Data from the Korean national health & nutrition examination survey 2007 collected by the Korean Center for Disease Control were analyzed using chi2 test and t-test. RESULTS: Differences in suicidal ideation according to individual factors were as follows: gender, education status, recognition of stress, experience of depression, and smoking. Differences in suicidal ideation according to health related factors were as follows: subjective health status, EQ-5D (EuroQoL-5 Dimensions), and restriction of activity. Differences in suicidal ideation according to family related factors were as follows: spouse, and status of dietary life. CONCLUSION: The findings suggest that board intervention programs should be provided to prevent problems of suicidal ideation. It is also recommended that programs be developed that can help control the variables identified in this study along with follow up study to verify the model.
Centers for Disease Control and Prevention (U.S.) ; Depression ; Education ; Humans ; Risk Factors ; Smoke ; Smoking ; Spouses ; Suicidal Ideation ; Suicide ; Thinking

In breast cancer, the treatment volume presents a relatively complex three dimensional structure. Effective radiation therapy requires the delivery of adequate dose to a large target volume using complex beam arrangements. The technique proposed here is our department's method using asymmetric jaw with appropriate couch, collimator and gantry rotation. This technique has the following advantages: 1) all treatments are given in a single clinical set up 2) it dose not require half beam blocks 3) it produces exact geometric match 4) it is very convenient and easy to use 5) it has daily reproducibility.
Breast Neoplasms* ; Breast* ; Jaw

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.
Area Under Curve ; Critical Care* ; Electronic Health Records ; Humans ; Hygiene ; Incidence ; Intensive Care Units ; Nursing Assessment ; Pressure Ulcer* ; Retrospective Studies ; Risk Assessment* ; Sensitivity and Specificity ; Tertiary Healthcare

Oxidative stress in eye lens is one of the main causes of the cataract. Dietary antioxidants including vitamin A and C are therefore known to be associated with the risk of the disease. However, evidences are still lacking in Koreans. This study aimed to examine whether dietary vitamin A and C levels are associated with the cataract, using data of Korea National Health and Nutrition Examination Survey 2012. A total of 3,344 individuals (599 cases and 2,745 controls) were analyzed in the study. Dietary data was classified into 3 groups following Dietary Reference Intakes for Koreans 2015: 1) ≤ estimated average requirements (EAR), 2) EAR-recommended nutrient intake (RNI), and 3) ≥ RNI. Findings suggested normal subjects (controls) had better vitamin A and C nutritional status. Vitamin A and C intakes of normal subjects were significantly higher than those of cataract cases (p < 0.001, respectively). Ratio of subjects who consumed vitamin A and C lower than EAR was higher in cataract cases compared to normal subjects (p < 0.001, respectively). These antioxidant intake levels predicted that having lower level of vitamins lower than EAR increased the odd ratios (ORs) for cataract [for vitamin A: OR, 1.89; 95% confidence interval (CI), 1.55–2.31 and for vitamin C: OR, 2.06; 95% CI, 1.69–2.51]. However, such associations were not retained, when the subjects’ demographic and lifestyle factor were adjusted. In conclusion, vitamin A and C showed a protective effect against cataract. However, subjects' life style and demographic factors nullified the association. More studies are required to verify the true association between dietary antioxidants and risk of cataract in Koreans.

Oxidative stress in eye lens is one of the main causes of the cataract. Dietary antioxidants including vitamin A and C are therefore known to be associated with the risk of the disease. However, evidences are still lacking in Koreans. This study aimed to examine whether dietary vitamin A and C levels are associated with the cataract, using data of Korea National Health and Nutrition Examination Survey 2012. A total of 3,344 individuals (599 cases and 2,745 controls) were analyzed in the study. Dietary data was classified into 3 groups following Dietary Reference Intakes for Koreans 2015: 1) ≤ estimated average requirements (EAR), 2) EAR-recommended nutrient intake (RNI), and 3) ≥ RNI. Findings suggested normal subjects (controls) had better vitamin A and C nutritional status. Vitamin A and C intakes of normal subjects were significantly higher than those of cataract cases (p < 0.001, respectively). Ratio of subjects who consumed vitamin A and C lower than EAR was higher in cataract cases compared to normal subjects (p < 0.001, respectively). These antioxidant intake levels predicted that having lower level of vitamins lower than EAR increased the odd ratios (ORs) for cataract [for vitamin A: OR, 1.89; 95% confidence interval (CI), 1.55–2.31 and for vitamin C: OR, 2.06; 95% CI, 1.69–2.51]. However, such associations were not retained, when the subjects’ demographic and lifestyle factor were adjusted. In conclusion, vitamin A and C showed a protective effect against cataract. However, subjects' life style and demographic factors nullified the association. More studies are required to verify the true association between dietary antioxidants and risk of cataract in Koreans.

Purpose: In February 2020, the first outbreak of coronavirus disease 2019 (COVID-19) occurred in Daegu, South Korea, and confirmed cases increased sharply, sparking intense anxiety among residents. This study analyzed the data of a mental health survey on students enrolled at a medical school located in Daegu in 2020. Methods: An online survey was administered to 654 medical school students (pre-medical course: 220 students, medical course: 434 students) from August to October 2020, with 61.16% (n=400) valid responses. The questionnaire included items about COVID-19-related experiences, stress, stress resilience, anxiety, and depression. Results: Of the survey participants, 15.5% had experienced unbearable stress, with the most significant stress factors (in descending order) being limited leisure activities, unusual experiences related to COVID-19, and limited social activities. Approximately 28.8% reported psychological distress, and their most experienced negative emotions were helplessness, depression, and anxiety (in descending order). The mean Beck Anxiety Inventory and Beck Depression Inventory-II scores were 2.44 and 6.08, respectively, both within normal ranges. Approximately 8.3% had mild or greater anxiety, and 15% had mild or greater depression. For students under psychological distress, the experience of unbearable stress before COVID-19 affected anxiety (odds ratio [OR], 0.198; p<0.05), and having an underlying condition affected depression (OR, 0.190; p<0.05). With respect to their psychological distress during August–October 2020 compared with that during February–March 2020 (2 months from the initial outbreak), anxiety stayed the same while depression increased and resilience decreased at a statistically significant level. Conclusion It was found that some medical students were suffering from psychological difficulties related to COVID-19, and there were several risk factors for them. This finding suggests that medical schools need to not only develop academic management systems but also provide programs that can help students manage their mental health and emotions in preparation for an infectious disease pandemic.

Oseltamivir is an antiviral medication prescribed to prevent and treat influenza A and B. A case from a community pharmacy in Korea was reported for an adverse event associated with oseltamivir administration. A 20-month-old boy had psychiatric symptoms after receiving 2 doses of oseltamivir. Therefore, an evaluation of whether the psychiatric symptoms were caused by oseltamivir was required. To determine whether the adverse event resulted from the administrated medication or other factors, three tools were used: the Naranjo scale, the Korean causality assessment algorithm (Ver.2), and the World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria. The psychiatric symptoms occurred after oseltamivir administration, and were attenuated after oseltamivir termination. A possible cause of the psychiatric symptoms is high fever, but information on the body temperature of the patient was not sufficient. Therefore, it was unclear whether there were other nonpharmacological causes of adverse drug reaction. For these reasons, in terms of causality, the results evaluated by the three tools represented, “possible”, “probable”, and “probable/likely”, respectively.
Body Temperature ; Child ; Drug-Related Side Effects and Adverse Reactions ; Fever ; Global Health ; Humans ; Infant ; Influenza, Human ; Korea ; Male ; Oseltamivir ; Pharmacies

OBJECTIVE: To investigate how differences in oxygen saturation between non-REM (NREM) and REM sleep in patients according to the severity of sleep apnea. METHODS: We studied 396 male patients diagnosed with simple snoring or obstructive sleep apnea syndrome (OSAS) on nocturnal polysomnography. Patients were divided into groups by the OSAS severity. We compared the average oxygen saturation between REM and NREM sleep in each group. RESULTS: In the simple snoring group, average oxygen saturation was significantly greater during REM than during NREM sleep. In the severe OSA group alone, average oxygen saturation was greater in NREM than in REM sleep. The difference of NREM-REM average oxygen saturation correlated significantly with AHI in the severe OSA group. CONCLUSION: More severe hypoxemia was seen in REM than NREM sleep in the severe OSAS group. The differential oxygen decrease between REM and NREM sleep is likely due to the differentially occurring sleep breathing events in each sleep stage according to the SDB severity. The more AHI increases in the severe OSAS patients, the more prominent the hypoxemia of REM sleep compared with NREM sleep is likely to appear. This suggests that the pressure of continuous positive airway pressure should be increased to control the hypoxemia of REM sleep in extremely severe OSAS.
Anoxia ; Continuous Positive Airway Pressure ; Eye Movements* ; Humans ; Male ; Oxygen* ; Polysomnography ; Respiration ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep Stages ; Sleep, REM* ; Snoring

PURPOSE: The purpose of the present study was to assess the biological effects of TNF-alpha in Caco-2 well-differentiated colon adenocarcinoma cells and to determine radiation sensitivity in order to develop TNF-alpha into a cancer therapeutic agent. MATERIALS AND METHODS: A cell viability test was conducted via a colorimetric and colony forming assay after 1 day and 3 days of incubation with TNF-alpha. Western blotting analysis and immunofluorescence staining were conducted to explore TNF-alpha-induced morphological and molecular changes in the adhesion molecules, E-cadherin and claudin-4. The effects of gamma-irradiation at a dose of 2 Gy on cell survival were evaluated by a clonogenic assay. The molecular changes in apoptosis-regulatory proteins were assessed by Western blotting. RESULTS: Caco-2 cells were highly resistant to TNF alpha-induced cell death and 2 Gy of gamma-irradiation. However, we observed the downregulation of the adherens junctional protein, E-cadherin and translocation of tight junctional protein, claudin-4 from the membrane to the cytosol induced by TNF-alpha treatment which would indicate cell-cell junction disruptions. These alterations of junctional proteins influenced the regulation of cell death in response to 2 Gy of gamma-irradiation. The combined treatment of TNF-alpha with 2 Gy of gamma-irradiation reduced the survival of Caco-2 cells by down-regulating bcl-xl and activating JNK pathways. CONCLUSION: These results suggest that TNF-alpha might be potentially applied as a therapeutic agent in order to enhance sensitivity to 2 Gy of gamma-irradiation administered in radiotherapy for the treatment of human colon cancer.
Adenocarcinoma ; Blotting, Western ; Caco-2 Cells ; Cadherins ; Cell Death ; Cell Survival ; Claudin-4 ; Colon ; Colonic Neoplasms ; Cytosol ; Down-Regulation ; Fluorescent Antibody Technique ; Humans ; MAP Kinase Signaling System ; Membranes ; Proteins ; Radiation Tolerance ; Tumor Necrosis Factor-alpha

OBJECTIVES: Despite increasing use of antipsychotic polypharmacy (APP), few studies have investigated APP for Korean patients with schizophrenia. The aim of this study was to identify the sociodemographic and clinical correlates and recent prescription profiles of APP in schizophrenia patients. METHODS: A total of 297 schizophrenia patients were recruited and interviewed using standardized assessment instruments in Seoul National Hospital. Differences in demographic and clinical characteristics between APP and antipsychotic monopharmacy (APM) groups were analyzed. The prescriptions of psychotropic drugs were collected by a review of medical records. RESULTS: In comparison with the APM group, the APP group showed association with earlier onset, lower employment rate, and higher scores for Clinical Global Impression-Severity and Brief Psychiatric Rating Scale (BPRS) (p<0.001). In particular, the BPRS positive (p<0.001) and affective symptom scores (p<0.001) of the APP group were higher those of the APM group. The most frequent combination pattern of APP was second generation antipsychotics (SGA)+SGA, followed by SGA+first generation antipsychotics (FGA), and SGA+SGA+FGA. For antipsychotics, it was risperidone+quetiapine, followed by clozapine+risperidone, risperidone+sulpiride, and risperidone+haloperidol. CONCLUSION: The current study suggests that the usage of APP for schizophrenia could be related to symptom severity affected by positive and affective symptoms. The prescription profile reflects that the proportion of atypical antipsychotics on APP has increased.
Affective Symptoms ; Antipsychotic Agents ; Brief Psychiatric Rating Scale ; Employment ; Humans ; Medical Records ; Polypharmacy* ; Prescriptions ; Psychotropic Drugs ; Schizophrenia* ; Seoul