PURPOSE: The purpose of this study was to explore the experiences of family caregivers who care for the elderly under Long-term Care Insurance. METHODS: Data were collected using focus group interviews and analyzed using a phenomenological approach. The four focus groups consisted of eight caregivers, two social workers and three nurses in B city, Korea. RESULTS: Five themes were identified: 'Obtaining a care-helper certification for employment', 'Taking care of the elderly in their homes', 'Difficulties due to life changes', 'Difficulties due to reduced wages' and 'Dissatisfaction with the Long-term Care Insurance operating system'. CONCLUSION: The results of this study demonstrate that the long-term care system for family caregivers faces many systematic challenges in providing care for the elderly harmoniously in their home. To help them succeed in their tasks, Long-term Care Insurance system must offer respite and support programs to family caregivers.
Aged ; Caregivers ; Certification ; Focus Groups ; Humans ; Insurance ; Insurance, Long-Term Care ; Long-Term Care ; Qualitative Research ; Social Workers

PURPOSE: To understand the incidence of retinopathy of prematurity (ROP) in preterm infants with birth weights more than 1,500 g or gestational age 30 weeks, and/or unstable clinical course, we investigated the highest gestational age and birth weight of preterm infants who require ROP treatment and those who do not. METHODS: The subjects were preterm infants admitted in Samsung medical center between January 1, 2000 and December 31, 2013. We retrospectively reviewed the medical records of 847 premature infants whose birth weights were more than 1,000 g. RESULTS: Of the 847 infants, 105 (12.4%) had stage 1 ROP, 54 (6.4%) had stage 2, 31 (3.7%) had stage 3, 0 had stage 4, and 2 (0.2%) had stage 5 ROP. Thirty-three (3.9%) of the 847 infants developed stage 3-5 ROP. Twenty (2.4%) of these 33 (3.9%) stage 3-5 ROP infants required treatment. Among the stage 1-3 ROP infants who did not require treatment, the highest gestational age was 37(+1) weeks (stage 1) and birth weight was 2,362 g (stage 1). Among the stage 3-5 ROP infants who needed treatment, the highest gestational age was 32 weeks and birth weight was 1,495 g. CONCLUSIONS: Newborn infants with gestational age more than 38 weeks or birth weight more than 2,400 g did not develop ROP even if they had an unstable clinical course. In our study, no preterm infants with gestational age more than 33 weeks or birth weight more than 1,500 g required ROP treatment.
Birth Weight* ; Gestational Age ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Medical Records ; Retinopathy of Prematurity* ; Retrospective Studies

OBJECTIVES: The aim of this 7-year study was to examine regional differences in scaling experience rate. METHODS: This study used data on scaling experience rate from the Community Health Survey (CHS) obtained between 2008 and 2014. The standardized frequency of scaling experience rate was analyzed using the SPSS 20.0 program, and shown as a Box Plot. Using the Map Wizard for Excel 10.0, the scaling experience rate in each region was illustrated using Geographic Information System (GIS). RESULTS: The scaling experience rate in 2008 was 18.6% and in 2014, was 34.9%. From 2008 to 2014, the annual rate of scaling experience increased approximately 1.8 times. The scaling experience appeared to form clustering on GIS, and there were differences in scaling experience rate between cities, towns, and districts. Although the scaling experience rate increased, the gap between regions seems consistent. CONCLUSIONS: The Scaling Experience rate increased annually, but regional differences did not decrease. Therefore, oral health care professionals in each community should strive to improve the scaling experience rate.
Geographic Information Systems ; Health Surveys ; Oral Health

OBJECTIVE: The objective of this study was to determine the differences in urinary nephrin among controls, gravidas with preeclampsia (PE), and small-for-gestational age (SGA) infants. We also determined whether or not maternal urinary concentrations of nephrin are associated with the subsequent development of PE and SGA infants. METHODS: We analyzed maternal urinary levels of nephrin in women who were normal controls (n=50), women who were delivered SGA infants (n=40), and gravidas with PE (n=33) in the first, second and third trimesters. Urinary nephrin concentrations were measured with nephrin enzyme-linked immunosorbent assay kits. RESULTS: The levels of urinary nephrin were higher in gravida developing preeclampsia or SGA than in controls after adjusting serum creatinine (P<0.05 for both). Maternal urine concentrations of nephrin were higher in pregnancies complicated by SGA and PE in the third trimester (P<0.05), and also higher in pregnancies complicated by SGA in the first trimester (P<0.05). The sensitivity and specificity of nephrin in predicting SGA from normal pregnancies were 67% and 89% in the first trimester, 60% and 79% in the second trimester, and 80% and 84% in the third trimester, respectively. The sensitivity and specificity of nephrin in predicting PE from normal pregnancies were 67% and 83% in the first trimester and 73% and 79% in the third trimester, respectively. CONCLUSION: We suggest that urinary nephrin can be used as an early marker in pregnancies at risk for developing PE and SGA infants.
Creatinine ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Membrane Proteins ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Sensitivity and Specificity

Choanal atresia is a rare congenital anomaly involving unilateral or bilateral posterior nasal choanal obstruction. Multiple associated anomalies have been described. We describe the case of a 1-month-old boy with bilateral choanal atresia, misdiagnosed after CT as a midline meningocele because the floor of the midline anterior cranial fossa was not ossified and secretion had accumulated in the obstructed posterior nasal choana.
Choanal Atresia* ; Cranial Fossa, Anterior ; Diagnosis* ; Humans ; Infant, Newborn ; Male ; Meningocele

OBJECTIVES: To evaluate the Community-Based Participatory Research (CBPR) professional periodontal care program model for patients with hypertension and diabetes. METHODS: This descriptive case study included 151 participants of the professional periodontal care program. The CBPR-based professional periodontal care program consists of 5-steps: ‘Issue identification and prioritization’ (Step 1), ‘Strategy development’ (Step 2), ‘Entry into community’ (Step 3), ‘Implementation’ (Step 4), and ‘Transition’ (Step 5). Quantitative data were analyzed using frequency analysis, and descriptive data with PASW 23.0 (SPSS Inc., Chicago, IL, USA). The results of the Focus group interview (FGI) were classified as ‘general opinions regarding the program planning and operation receptiveness’, ‘sustainability’, ‘potential spread of the program’, and ‘improvement of program’. The interviews were qualitative research involving seven people. RESULTS: 1. Participants increased their interest in health and oral health by managing their hypertension, diabetes, and periodontal disease using community resources. Through this, healthy practices and improved awareness helped to prevent complications and manage periodontal diseases. 2. Community organizations actively cooperated, resulting in positive changes in oral health practices (increased registration of patients in education centers for hypertension and diabetes, and increased number of patients visiting the local dental clinic). In the future, it was positive to participate in the program continuously. CONCLUSIONS: The most important step is ‘Entry into community’, which has led to active participation and cooperation of community organizations and participants. Therefore, community organizations and strategy development should be discussed, and the role of community leaders should be emphasized to build cooperative relationships. In addition, participation in and collaboration with health-based projects should be achieved through a search of various community organizations.
Chronic Disease ; Community-Based Participatory Research ; Consumer Participation ; Cooperative Behavior ; Education ; Focus Groups ; Humans ; Hypertension* ; Oral Health ; Periodontal Diseases ; Qualitative Research

Aminophylline can elicit thermogenesis in rats or increase metabolic rate during cold stress in lambs. We tested the hypothesis that aminophylline would reduce the change in core body temperature during laparoscopic abdominal surgery requiring pneumoperitoneum. Fifty patients were randomly divided into an aminophylline group (n=25) and a saline control group (n=25). Esophageal temperature, index finger temperature, and hemodynamic variables, such as mean blood pressure and heart rate, were measured every 15 min during sevoflurane anesthesia. In the aminophylline group, esophageal temperatures at T45 (36.1+/-0.38 vs. 35.7+/-0.29, P=0.024), T60 (36.0+/-0.39 vs. 35.6+/-0.28, P=0.053), T75 (35.9+/-0.34 vs. 35.5+/-0.28, P=0.025), T90 (35.8+/-0.35 vs. 35.3+/-0.33, P=0.011), and T105 (35.8+/-0.36 vs. 35.1+/-0.53, P=0.017) and index finger temperatures at T15 (35.8+/-0.46 vs. 34.9+/-0.33, P<0.001), T30 (35.7+/-0.36 vs. 35.0+/-0.58, P=0.029), T45 (35.8+/-0.34 vs. 35.2+/-0.42, P=0.020), T60 (35.7+/-0.33 vs. 34.9+/-0.47, P=0.010), T75 (35.6+/-0.36 vs. 34.8+/-0.67, P=0.028), T90 (35.4+/-0.55 vs. 34.4+/-0.89, P=0.042), and T105 (34.9+/-0.53 vs. 33.9+/-0.85, P=0.024) were significantly higher than in the saline control group. Aminophylline is effective in maintaining the core temperature through a thermogenic effect, despite reduced peripheral thermoregulatory vasoconstriction.
Abdomen/surgery ; Aminophylline/*administration & dosage ; Body Temperature/*drug effects ; Female ; Humans ; Hypothermia/*etiology/physiopathology/*prevention & control ; Laparoscopy/*adverse effects ; Male ; Middle Aged ; Pneumoperitoneum, Artificial/*adverse effects ; Single-Blind Method ; Treatment Outcome

Aminophylline can elicit thermogenesis in rats or increase metabolic rate during cold stress in lambs. We tested the hypothesis that aminophylline would reduce the change in core body temperature during laparoscopic abdominal surgery requiring pneumoperitoneum. Fifty patients were randomly divided into an aminophylline group (n=25) and a saline control group (n=25). Esophageal temperature, index finger temperature, and hemodynamic variables, such as mean blood pressure and heart rate, were measured every 15 min during sevoflurane anesthesia. In the aminophylline group, esophageal temperatures at T45 (36.1+/-0.38 vs. 35.7+/-0.29, P=0.024), T60 (36.0+/-0.39 vs. 35.6+/-0.28, P=0.053), T75 (35.9+/-0.34 vs. 35.5+/-0.28, P=0.025), T90 (35.8+/-0.35 vs. 35.3+/-0.33, P=0.011), and T105 (35.8+/-0.36 vs. 35.1+/-0.53, P=0.017) and index finger temperatures at T15 (35.8+/-0.46 vs. 34.9+/-0.33, P<0.001), T30 (35.7+/-0.36 vs. 35.0+/-0.58, P=0.029), T45 (35.8+/-0.34 vs. 35.2+/-0.42, P=0.020), T60 (35.7+/-0.33 vs. 34.9+/-0.47, P=0.010), T75 (35.6+/-0.36 vs. 34.8+/-0.67, P=0.028), T90 (35.4+/-0.55 vs. 34.4+/-0.89, P=0.042), and T105 (34.9+/-0.53 vs. 33.9+/-0.85, P=0.024) were significantly higher than in the saline control group. Aminophylline is effective in maintaining the core temperature through a thermogenic effect, despite reduced peripheral thermoregulatory vasoconstriction.
Abdomen/surgery ; Aminophylline/*administration & dosage ; Body Temperature/*drug effects ; Female ; Humans ; Hypothermia/*etiology/physiopathology/*prevention & control ; Laparoscopy/*adverse effects ; Male ; Middle Aged ; Pneumoperitoneum, Artificial/*adverse effects ; Single-Blind Method ; Treatment Outcome

Prophylactic surfactant is known to be effective to reduce chronic lung disease in preterm infants compared with rescue surfactant treatment. In Korea, early prophylactic surfactant therapy was introduced in 2011. However, recently, the increased utilization of antenatal steroids and early stabilization through continuous positive airway pressure (CPAP) in the delivery room may have changed the risks and benefits of prophylactic surfactant therapy of infants at high risk of respiratory distress syndrome (RDS). We compared the effects and safety of prophylactic surfactant therapy (within 30 minutes after birth) and early selective surfactant therapy (within 3 hours after birth) in preterm infants born at < 30 weeks gestation or with birth weight ≤ 1,250 g. The clinical data of 193 infants in period 1 (from 2008 to 2010, early selective surfactant therapy group) were collected retrospectively; those of 191 infants in period 2 (from 2012 to 2014, prophylactic surfactant therapy group) were collected prospectively. Compared to period 1, the rate of intubation and surfactant use were significantly increased in period 2. The use of multiple doses of surfactant in period 2 was significantly increased compared with period 1. Despite more invasive and aggressive management in period 2, there was no difference in the duration of mechanical ventilation, the incidence of bronchopulmonary dysplasia (BPD) or death, and the risk of other adverse neonatal outcomes between the 2 groups. In conclusion, the benefit of prophylactic surfactant therapy in infants treated under current practices is no longer clear compared to early selective surfactant therapy.
Birth Weight* ; Bronchopulmonary Dysplasia ; Continuous Positive Airway Pressure ; Delivery Rooms ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intubation ; Korea ; Lung Diseases ; Parturition* ; Pregnancy* ; Prospective Studies ; Respiration, Artificial ; Retrospective Studies ; Risk Assessment ; Steroids