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

The purposes of this study were to measure the resting metabolic rate(RMR) of 30-40 year old women and to compare it with values predicted using published equations. Body weight, height and body fat of subjects were measured. RMR was measured by two indirect calorimeter(method 1 and method 2). RMR was predicted using various equations. Average height, weight and body fat(%) of subjects were 158.6cm, 59.1kg and 30.9%, respectively. The RMR(1621.2+/-301.5 kcal/day) measured by portable indirect calorimeter(method 2) was significantly higher than RMR(1447.4+/-223.6 kcal/day) measured by typical indirect calorimeter(method 1). Comparison of measured RMR with predicted RMRs suggested that there was a least difference in RMR predicted by equation of Cunningham. According to RMSPEs(Root Mean Squared Prediction Errors), equations of Cunningham and body surface area were found to predict measured RMR(by method 1) most accurately (within 239.1kcal/day and 232.9kcal/day, respectively). The fat free mass and fat mass - adjusted correlation showed that measured RMR(by method 1) had negative relationships with muscle mass(r = -0.873) and fat free mass(r = -0.866). The equations of Cunningham and body surface area provide relatively accurate estimates of RMR when determining energy needs of 30-40 aged women. There are needs for development of RMR predicted equations that are derived from large samples of Korean.
Adipose Tissue ; Body Surface Area ; Body Weight ; Female ; Humans

The purpose of this study is to analyze the accuracy of predictive equations for resting metabolic rate (RMR) in Korean college students. Subjects were 60 healthy Korean college students (30 males, 30 females) aged 18-25 years. RMR was measured by indirect calorimetry. Predicted RMRs were calculated using the Harris-Benedict, Schofield (W)/(WH), FAO/ WHO/UNU(W)/(WH), Owen, Mifflin, Cunningham, Liu, IMNA and Henry (W)/(WH) equations. The accuracy of the equations was evaluated on basis of accurate prediction (the percentage of subjects whose RMR was predicted within90% to 110% of the RMR measured), mean difference, RMSPE, mean % difference, limits of agreement of Bland- Altman method between predicted and measured RMR. Measured RMR of male and female students were 1833.4 +/- 307.4 kcal/day and 1454.3 +/- 208.0 kcal/day, respectively. All predictive equations underestimated measured RMR. Of the predictive equations tested, the Harris-Benedict equation (mean difference: -80.4 kcal/day, RMSPE: 236 kcal/day, mean % difference: -3.1%) was the most accurate and precise, but accurate prediction of the equation was only 42%. Thus, this study suggests that the ethnicity-specific predictive equation from Korean people should be developed to improve the accuracy of predicted RMR for Koreans.
Aged ; Calorimetry, Indirect ; Female ; Humans ; Male

Clear cell acanthoma is a rare benign tumor, which usually presents as a solitary erythematous to brown colored papule or nodule, with a predilection for the lower leg of t hemiddle-aged and older individuals. An 11-year-old male presented with a 1-month history of bilateral brownish colored and exudative plaques on the both areolae.Histopathologic examination showed psoriasiform proliferation of pale keratinocytes and neutrophil exocytosis. Therefore, the patient was diagnosed with clear cell acanthoma. Typically, clear cell acanthoma occurs as a unilateral lesion on the leg in an adult. However, our case shows a bilateral lesion as well as the uncommon age and site.To our knowledge, this case of bilateral clear cell acanthoma has been rarely reported in Korea. Herein, we report a case of clear cell acanthoma that occurred on both areolae in a child.

Necrotizing fasciitis (NF) is a severe soft tissue infection, characterized by rapid and fulminant progression. Thus, early suspicion, and prompt medical and aggressive surgical management are important for the clinical outcomes of NF. Despite the rarity of NF in infants and group B streptococcus as its cause, a 2-month-old preterm girl presented with NF involving the suprapubic, inguinal, and lower lateral abdominal regions caused by group B streptococcus. The girl recovered after early medical and surgical management.

Primary cutaneous B-cell lymphomas are rare diseases comprising nodular to diffuse lymphoid cell infiltration with an overlying grenz zone and no epidermal involvement upon histological analysis. Diagnostics can become challenging when lymphomas exhibit the characteristics of both B and T-cells. Differential diagnoses may include reactive proliferations, cutaneous composite lymphomas, and transformed mycosis fungoides. Immunohistochemistry and gene arrangement tests may be beneficial to clarify the diagnosis. Herein, we report a rare case of epidermotropic EBV-positive cutaneous B-cell lymphoma along with a literature review.

Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status. Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels. Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms.The comparison of area under the curve showed that individual factors had a greater influence than regional factors. Conclusion This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

BACKGROUND: Beta₂-adrenergic receptor (ADRβ2) gene variations seem to be correlated with disease progression, prognosis, and drug response to β-blockers in cardiovascular events. In this study, we investigated the genotypes and haplotypes of ADRβ2 in Korean patients and analysed their association with coronary artery disease (CAD). METHODS: One hundred five patients diagnosed with stable angina (SA), 109 patients with acute coronary syndrome (ACS), and 88 controls were enrolled. Five single nucleotide polymorphisms (SNPs) were determined at positions 46, 79, 252, 491, and 523 nucleotides, using the polymerase chain reaction and direct sequencing analysis. The haplotype reconstruction was carried out using genotype data, and analyses of the association between the genetic variation and CAD were performed. RESULTS: There were significant differences in the allele frequencies for the 79CG SNPs among the three groups. Relative to the control group, the distribution of 79CG genotypes was significantly different in both the SA group (P=0.0003) and the ACS group (P=0.0056). Compared with the CC genotype of 79CG, subjects with CG or GG had a higher risk of CAD (adjusted odds ratio [OR], 12.851; P=0.014). The frequencies of specific ACGCA, GCACC, and GGGCC haplotypes were 6.4% vs. 0%, 8.3% vs. 0%, and 6.9% vs. 0.6%, respectively, in the ACS group and controls. The GGGCC haplotype was significantly associated with CAD (adjusted OR, 12.266; P=0.016). CONCLUSIONS: Although there are large ethnic differences in the distribution of ADRβ2 SNPs and their association with CAD, the 79G polymorphism and GGGCC haplotype in ADRβ2 might specifically contribute to CAD pathogenesis in Korean patients.
Acute Coronary Syndrome ; Angina, Stable ; Coronary Artery Disease* ; Coronary Vessels* ; Disease Progression ; Gene Frequency ; Genetic Variation ; Genotype ; Haplotypes* ; Humans ; Nucleotides ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prognosis

OBJECTIVES: The aim of this study was to investigate the impact of clinical and psychological factors on the quality of life of children and adolescents with epilepsy and their families.METHODS: Children and adolescents with epilepsy and their families (n = 63, age range = 6–17 years) completed questionnaires on epilepsy-related variables, quality of life, children's depressive symptoms, children's anxiety, children's behavioral problems, children's attention problems, parental stress, and parental anxiety. Stepwise regression analysis was performed to determine the significant predictive variables that affect quality of life.RESULTS: In the correlational analysis, children's attention problems (r = 0.363, p = 0.004), parental anxiety (r = 0.377, p = 0.003), parental stress (r = 0.564, p < 0.001), and children's behavioral problems (r = 0.503, p < 0.001) showed a significant correlation with quality of life. Parental stress (β = 0.415, p = 0.001, adjusted R² = 0.345) and children's behavioral problems (β = 0.285, p = 0.02, adjusted R² = 0.345) were significantly related to the quality of life.CONCLUSIONS: Clinicians should pay attention to parental stress and children's behavioral problems, which affect quality of life in families with pediatric epilepsy.
Adolescent ; Anxiety ; Child ; Depression ; Epilepsy ; Humans ; Parents ; Problem Behavior ; Psychology ; Quality of Life