BACKGROUND: Many factors affecting the spread of spinal anesthesia have been investigated. But L3-4 or L4-5 interspace was choosen which was known as the site of buffering, in their study. We investigated the effect of some of these factors on sensory blockade level by using L2-3 interspace. METHODS: Eightyfive patients, ASA physical status I - Il, were involved in our study. Sensory blockade level was checked with pinprick test at 10 minutes and 30 minutes. The effect of age, sex, height, weight, CSF pressure and pressure difference generated when full flexed and non-full flexed lateral position on sensory blockade level was studied whereas other factors such as puncture technique, dosage and concentration of drug and patients position after injection, were kept constant under the same condition. And also studied the effect of degree of flexion at injection on the sensory blockade level. RESULTS: Height and CSF pressure were correlated with sensory blockade level at 10 minutes after injection(R2=0.14, P<0.01). Only height was correlated with sensory blockade level at 30 minutes after injection(R2=0.09, P<0.0l). CONCLUSIONS: Only height was correlated with sensory blokade level at 30 minutes. So, height might be considered as the most impressive minor factor affecting the extent of sensory blockade level.
Anesthesia, Spinal* ; Humans ; Punctures

OBJECTIVE: To assess the effectiveness of Internet of Things (IoT)-based behavioral intervention for reducing depressive symptom of older adults with major depressive disorder. METHODS: A 12-week randomized cross-over controlled study was conducted at community mental health center. We recruited 39 participants with major depressive disorder aged 60 years or older. As a multidomain intervention, four evidence-based therapeutic factors (physical activity, healthy diet, social activity, and emotional regulation) were approached. To maintain motivation of participants, we applied contingency management using IoT device based on operant conditioning theory. RESULTS: The primary outcome was change of depressive symptom measured by Montgomery-Asberg Depression Rating Scale (MADRS). Mixed-effect model compared the effectiveness of intervention and usual care management (intervention by time and period interaction, p=0.017). And during the study period consisting of a total of visit 8, significant group difference was shown in post hoc test at visit 4 (MADRS score of intervention group : MADRS score of control group=7.7±3.4 : 21.1±11.5, p=0.008). CONCLUSION: Community-implementable IoT-based behavioral intervention resulted in greater reduction of depressive symptom of elderly with major depressive disorder.
Adult ; Aged ; Conditioning, Operant ; Depression ; Depressive Disorder, Major ; Diet ; Humans ; Internet ; Mental Health ; Motivation

BACKGROUND: Children today are exposed to various media devices, and their usage of these is increasing. Prior studies have outlined forms of harm this can potentially cause. However, there has been little empirical research on the use of media devices among preschool children in Asia. The aim of this study was to examine and analyze longitudinal trends in media device use among Korean preschool children, focusing on the frequency of engagement, time spent with, and ownership of media devices, delineated by sex. METHODS: Four hundred parents of children aged 2–5 years were invited to enroll. The baseline assessment, Wave 1, was conducted between December 2015 and June 2016, and follow-up assessments, Wave 2 and Wave 3, were conducted annually for the following 2 years. Time of media use, frequency of media use, and ownership of media devices (TV, tablet PCs, and smartphones) were investigated. RESULTS: Ownership of tablet PCs increased significantly between Wave 1 and Wave 3 for boys and girls (corrected P < 0.001). Frequency of media use increased significantly between Wave 1 and Wave 3 only in boys' use of tablet PCs (mean difference 0.8 day/wk). Time of media use increased significantly between Wave 1 and Wave 3 for both sexes in all devices, measured by mean difference on weekdays and weekends (TV by 0.6 and 0.7 hr/day, tablet PCs by 0.6 and 0.8 hr/day, and smartphones by 0.4 and 0.4 hr/day). Children spent more time using media devices during weekends than on weekdays. CONCLUSION: This study observed an increase in the tendency of media device use among preschool children in Korea. The patterns of use indicate that paying attention to the types of devices children use is needed, as well as vigilance on weekends.
Asia ; Child ; Child, Preschool ; Empirical Research ; Female ; Follow-Up Studies ; Humans ; Korea ; Ownership ; Parents ; Smartphone

Multiple simultaneous cranial neuropathies occur rarely in diabetes patients. In general, diabetic cranial neuropathy presents in an isolated form and frequently involves oculomotor or facial nerves. We report a 73-year-old man with known type 2 diabetes mellitus who presented with severe dizziness, diplopia and third, fourth and sixth nerve ophthalmoplegia of both eyes. Radiological, laboratory and ophthalmic work-up including magnetic resonance imaging and angiography (MRI and MRA) revealed no specific tumor, aneurysm, or inflammation findings, except for a previous cerebral infarction and atherosclerotic changes in the internal carotid and vertebral arteries. After strict blood glucose control, the multiple cranial nerve palsies spontaneously resolved in 12 weeks. We report the case with a review of the literature.
Abducens Nerve* ; Aged ; Aneurysm ; Angiography ; Blood Glucose ; Cerebral Infarction ; Cranial Nerve Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Neuropathies* ; Diplopia ; Dizziness ; Facial Nerve ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Vertebral Artery

OBJECTIVE: The object of this study was to compare the cure rate and confirm the clinical efficacy of three most frequent surgical procedures for stress urinary incontinence (Burch colposuspension, pubovaginal sling operation, tension-free vaginal tape). MATERIALS AND METHODS: We collected datas from the records of ninety-one patients who were diagnosed as stress urinary incontinence from Jan. 1999 to May 2001. Burch colposuspension was performed by department of gynecology, Severance hospital in thirty-three patients, pubovaginal sling operation was performed by department of urology in twenty-eight patients, and tension-free vaginal tape was performed by department of urology in thirty-one patients. We investigated the characteristics of patients, preoperative urodynamic study results, cure rates and complication rates for the result, and compared them by x2-test. RESULTS: There were statistically no significant differences between the cure rate of each operation after 3, 6 month of operation but after 12 months of follow up, the cure rate of pubovaginal sling operation was significantly higher than that of Burch operation and tension-free vaginal tape. CONCLUSION: The cure rate of pubovaginal sling operation was significantly higher after 12 months of follow up after surgery. There was no significant difference between cure rates of Burch operation and tension- free vaginal tape. We propose randomized prospective study with larger population in the future.
Female ; Follow-Up Studies ; Gynecology ; Humans ; Suburethral Slings* ; Urinary Incontinence* ; Urodynamics ; Urology

Stem cells can give rise to various cell types and are capable of regenerating themselves over multiple cell divisions. Pluripotency and self-renewal potential of stem cells have drawn vast interest from different disciplines, with studies on the molecular properties of stem cells being one example. Current investigations on the molecular basis of stem cells pluripotency and self-renewal entail traditional techniques from chemistry and molecular biology. In this mini review, we discuss progress in stem cell research that employs proteomics approaches. Specifically, we focus on studies on human stem cells from proteomics perspective. To our best knowledge, only the following types of human stem cells have been examined via proteomics analysis: human neuronal stem cells, human mesenchymal stem cells, and human embryonic stem cells. Protein expression serves as biomarkers of stem cells and identification and expression level of such biomarkers are usually determined using two-dimensional electrophoresis coupled mass spectrometry or non-gel based mass spectrometry.
*Electrophoresis, Gel, Two-Dimensional ; Genetic Techniques ; Humans ; Mass Spectrometry/*methods ; Neurons/*cytology/physiology ; Proteomics/*methods ; Stem Cells/*metabolism

OBJECTIVE: The objective of this study was to compare the effectiveness of usual care management (UCM) and a newly-developed lifestyle modification with contingency management (LMCM) for geriatric depressive symptoms in the community. METHODS: A randomized controlled trial was conducted in 93 older adults with major depressive disorder at community mental health centers. A 12 week multi-domain LMCM was developed by providing positive reinforcement using ‘gold medal stickers’ as a symbolic incentive to motivate their participation and adherence. Participants were allocated to LMCM (n=47) and UCM (n=46) groups. They were then subjected to the 12 week treatment. Effects of the two intervention methods on Geriatric Depression Scale were determined using mixed model analysis. RESULTS: Participants in the LMCM group had greater decline in GDS score per month than participants in the UCM group after adjusting for age, sex, years of education, living alone, and MMSE scores at baseline examination [coefficient for GDS score (95% CI): -1.08 (-1.51, -0.65), p < 0.001, reference: UCM group]. CONCLUSION: LMCM is safe and easy to use with a low cost. LMCM is suitable as psychosocial intervention for older adults with depressive symptoms in the community.
Adult* ; Aged ; Community Mental Health Centers ; Depression* ; Depressive Disorder, Major ; Education ; Humans ; Life Style* ; Motivation ; Numismatics ; Reinforcement (Psychology)

BACKGROUND: Cord blood (CB) is a reliable source of hematopoietic stem cells, and its utilization in stem cell transplantation is increasing continuously. The CD34+ cell count is arguably one of the most important parameters for evaluating the quality of a cord blood unit (CBU), but there is little evidence on the post-genetic modifications that can affect the CD34+ cell counts. In this study, the difference in the miRNA expression profiles between low and high CD34+ CBU was evaluated. METHODS: Paired CB and maternal samples with low (<0.06%) and high CD34+ cell counts (>0.9%) were selected for analysis. MicroRNA profiling was performed, and differentially expressed miRNA were identified. In addition, gene ontology analysis was conducted on the miRNA to elucidate the genes that could potentially affect the CD34+ cell count. RESULTS: Ten miRNA were identified to show significantly different expression between the low and high CD34+ groups. Four of the 10 miRNA were hematopoiesis-related (miR-199a-5p, miR-22-5p, miR-140-5p, and miR-181b-5p). From a total of 119 associated genes, nine (CALCA, FARP2, FSHR, ITGAM, MELK, MLF1, PRG4, TREM2 and VCAM1) were associated with two or more of the aforementioned miRNA. CONCLUSION: This is the first study that examined the difference in the miRNA expression profiles between high and low CD34+ CB cells and revealed the relevant genes associated with hematopoiesis. These results provide basic insight into the genetic processes involving hematopoietic stem cell proliferation.
Cell Count ; Fetal Blood ; Gene Ontology ; Genetic Processes ; Hematopoiesis ; Hematopoietic Stem Cells ; MicroRNAs ; Stem Cell Transplantation ; Stem Cells

OBJECTIVE: This study aims to examine association of temporal discounting with well-being of Korean community-dwelling elderly. METHODS: The subjects of this research were 4,373 community-dwelling older persons without dementia. Each subject was administered the questionnaires regarding the socio-demographic characteristics, temporal discounting which was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Outcome variable is Korean version of the World Health Organization Five Well-Being Index (WHO-5). Statistical analyses including the Pearson's correlation test and logistic regression were performed in this study. RESULTS: At baseline, temporal discounting was negatively associated with WHO-5 in the Pearson's correlation test (r=-0.04, p=0.006). In a adjusted model for confounding variables, temporal discounting was negatively associated with WHO-5 [odd ratio (95% confidence interval)=0.57 (0.35–0.92), p=0.021]. CONCLUSION: Elderly individual with a higher temporal discounting (which indicates impulsivity) may have a lower quality of life.
Aged* ; Confounding Factors (Epidemiology) ; Dementia ; Humans ; Logistic Models ; Quality of Life ; World Health Organization

OBJECTIVE: This study aims to investigate the association between alcohol use disorder and cognition in Korean community-dwelling elderly, especially the gender-specific difference. METHODS: Data obtained from 1,141 subjects (976 men and 165 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study. All subjects completed the study questionnaire including demographic characteristics, history of current and past illnesses, drug history, Korean Mini-Mental State Examination (K-MMSE), and cut down, annoyed, guilty feelings, eye-opener (CAGE), Short Form of Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: Of the 1,141 subjects (mean age 72.17±6.20, mean educational level 6.50±4.48), 267 demonstrated alcohol use disorder (23.40%) and 874 were non-alcohol use disorder (76.60%). The mean of K-MMSE for alcohol use disorder group was 23.23±4.99, and for non-alcohol use disorder group was 23.70±3.94. When alcohol use disorder is accompanying, the decrement of K-MMSE score was 3.07 for female, and 0.35 for male. And we confirmed the interactive effect on K-MMSE score between sex and alcohol use disorder after adjusting for age, education level, depression (F=5.798, p=0.016). CONCLUSION: In conclusion, our study demonstrates an association between alcohol use disorder and cognitive impairment by gender in the elderly.
Aged* ; Alcohols ; Cognition ; Dementia ; Depression ; Education ; Female ; Gwangju ; Humans ; Male ; Mild Cognitive Impairment