PURPOSE: This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. METHODS: The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. RESULTS: The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. CONCLUSION: These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.
Accidental Falls/*prevention & control ; Aged ; Aged, 80 and over ; Depression ; Exercise ; Female ; Frail Elderly/*psychology ; Health Education ; Humans ; Male ; Massage ; Muscle Strength ; *Program Evaluation ; Risk Factors ; Rural Population ; Self Care ; Self Efficacy

BACKGROUND: Explicit recall in a cesarean section under general anaesthesia can be a terrifying experience and may cause psychological sequelae. Administering low doses of midazolam, we investigated the changes of the bispectral index (BIS) and the occurrence of explicit recall of specific events after fetal expulsion in a cesarean section under general anesthesia. METHODS: The investigation was carried out on 30 ASA 1 or 2 parturients who underwent a cesarean section under general anesthesia. Anesthesia was maintained with 50% N2O in oxygen and 0.75% of isflurane. We randomly allocated parturients into a control group (n = 10), group A (n = 10), and B (n = 10). Neither midazolam nor any other drugs except oxytocin were administered in the control group. In the group A and B, midazolam 0.02 and 0.03 mg/kg respectively, were injected immediately after umbilical cord clamping. An isolated forearm test were done to all the parturients at 5, 10, and 20 minutes after fetal expulsion. We assessed the changes of the BIS at 1, 2, 3, 4, 5, 10, 15, and 20 minutes after fetal expulsion, at discontinuance of isoflurane administration and extubation. The wav file, "clench your left or right hand" was binaurally played, simultaneously with the isolated forearm test. The wav file, "one, two, three, four, five" was also binaurally played 15 minutes after fetal expulsion. We interviewed all the parturients the next day and assessed the occurrence of explicit recall. RESULTS: The BIS values after fetal expulsion in the control group and group A was maintanied above 60 and group B, below 60 (P < 0.05). The lowest median BIS value was 54.5 in the group A, 36.4 in the group B (P < 0.05). There were two parturients in the control group and in the group A, respectively, who showed explicit recall. The results of the isolated forearm test were negative for all groups. The extubation times and PAR scores failed to show significant differences among the three groups. CONCLUSIONS: The authors confirmed the occurrence of explicit recall for specific events after fetal expulsion. The BIS values after fetal expulsion could be maintained below 60 until the end of surgery,and explicit recall could be prevented when we injected midazolam 0.03 mg/kg immediately after fetal expulsion.
Anesthesia ; Anesthesia, General* ; Cesarean Section* ; Constriction ; Female ; Forearm ; Isoflurane ; Midazolam* ; Oxygen ; Oxytocin ; Pregnancy ; Umbilical Cord

BACKGROUND: In some cases of one-lung ventilation (OLV), hypoxemia may occur secondarily to the obligatory right to left transpulmonary shunt through the collapsed lung. We investigated the efficacy of high frequency jet ventilation (HFJV) to the non-dependent lung which rendered to be manually collapsed by surgeon and not to be reinflated, in improving systemic oxygenation and ventilation during OLV while ventilating the dependent lung with intermittent positive pressure ventilation. METHODS: Investigation was carried out on 20 ASA 2 or 3 patients who underwent thoracotomy in lateral decubitus position. The patients were randomly allocated into HFJV group (n = 11) or CPAP group (n = 9). In HFJV group, 20 minutes after OLV began, HFJV with driving pressure 1.0 bar, Ti 30%, and frequency 150 cycles/min, was applied to the non-dependent lung. In CPAP group, 5 cmH2O of CPAP was applied to the non-dependent lung without re-inflation. We compared the changes of PaO2, PaCO2, AaDO2 and pulmonary shunt, before and after HFJV or CPAP was applied to the non-dependent lung during OLV. RESULTS: AaDO2 and pulmonary shunt were decreased significantly and therefore, PaO2 was increased significantly when HFJV was applied to the non-dependent lung (P < 0.05, respectively). PaO2, AaDO2 and pulmonary shunt were not improved after 5 cmH2O of CPAP was applied to the non-dependent lung without re-inflation. In HFJV group, PaCO2 measured after HFJV was not decreased significantly compared with that before HFJV. CONCLUSIONS: HFJV to the non-dependent lung during OLV improved systemic oxygenation, even after the non-dependent lung collapsed completely but did not enhance CO2 elimination. 5 cmH2O of CPAP to the non-dependent lung, which was completely collapsed and not re-inflated, did not improve systemic oxygenation.
Anoxia ; High-Frequency Jet Ventilation* ; Humans ; Intermittent Positive-Pressure Ventilation ; Lung* ; One-Lung Ventilation* ; Oxygen* ; Thoracotomy ; Ventilation

BACKGROUND: As the clinical-end point is not clear-cut in conscious sedation, there are no objective and feedback-providing methods to assess the depth of sedation within the levels appropriate for conscious sedation. METHODS: The investigation was carried out on 19 ASA PS 1 patients. The authors developed a system to measure the reaction time to visual (red colored flash, 40 lux for 30 msec) and auditory (beep, 1,000 Hz, 67.5 dB for 30 msec) stimulations. The authors confirmed the beeps to be audible to all the patients before the test began. When they perceived a visual or auditory stimulation, the authors instructed the patients to signal by pushing a button as soon as possible. The reaction time was defined as the time from the beginning of stimulation to the push of a button. The patients were gradually sedated with propofol TCI. The authors measured the visual and auditory reaction time and BIS after every 0.1 microgram/ml increment of the effect site concentration of propofol. RESULTS: As the effect site concentration of propofol increased, the reaction time to visual and auditory stimulations tended to be prolonged (P < 0.0001, respectively). The estimate was 409 and 498, respectively, which means the slope a in y = ax; x means unit change of the effect site concentration of propofol; y means the estimated values of the reaction time. The BIS values at loss of response to visual and auditory stimulations were 86 +/- 7 and 78 +/- 7 (mean +/- SD). CONCLUSIONS: The responses to visual and auditory stimulations were prolonged and ultimately abolished as the effect site concentration of propofol increased. The loss of response to visual stimulations preceded the loss of response to auditory stimulations. The BIS values at loss of responses to visual and auditory stimulations suggested light and moderate sedation, respectively.
Acoustic Stimulation ; Conscious Sedation* ; Humans ; Photic Stimulation ; Propofol* ; Reaction Time*

OBJECTIVES: The purpose of this study was to investigate changes in public recognition of parabens on Twitter and the research status of parabens related to toothpaste. METHODS: Tweet information between 2010 and October 2016 was collected by an automatic web crawler and examined according to tweet frequency, key words (2012-October 2016), and issue tweet detection analyses to reveal changes in public recognition of parabens on Twitter. To investigate the research status of parabens related to toothpaste, queries such as “paraben,”“paraben and toxicity,”“paraben and (toothpastes or dentifrices),” and “paraben and (toothpastes or dentifrices) and toxicity” were used. RESULTS: The number of tweets concerning parabens sharply increased when parabens in toothpaste emerged as a social issue (October 2014), and decreased from 2015 onward. However, toothpaste and its related terms were continuously included in the core key words extracted from tweets from 2015. They were not included in key words before 2014, indicating that the emergence of parabens in toothpaste as a social issue plays an important role in public recognition of parabens in toothpaste. The issue tweet analysis also confirmed the change in public recognition of parabens in toothpaste. Despite the expansion of public recognition of parabens in toothpaste, there are only seven research articles on the topic in PubMed. CONCLUSIONS: The general public clearly recognized parabens in toothpaste after emergence of parabens in toothpaste as a social issue. Nevertheless, the scientific information on parabens in toothpaste is very limited, suggesting that the efforts of dental scientists are required to expand scientific knowledge related to parabens in oral hygiene measures.
Oral Hygiene ; Parabens* ; Toothpastes*

Objectives: The purpose of this study was to examine the association between oral health-related quality of life and adult attachment type among college students. Methods: A total of 557 self-administered questionnaires were collected from undergraduates in Jeonbuk. Data were analyzed using SPSS 22.0. The results were analyzed using t-tests, analyses of variance, Duncan’s multiple range tests, correlation analyses, and multiple regression analyses. Results: The results of this study showed that sex and age were significant factors according to the analysis of the oral health-related quality of life in terms of general characteristics. The variable that had the greatest effect on the oral health-related quality of life was attachment anxiety, followed by age, sex, and attachment avoidance. Conclusions Education and counseling to promote safety of adult attachment will improve the oral health-related quality of life for college students.

Transpupillary argon laser cyclophotocoagulation has been proposed as an alternative to conventional glaucoma surgery. The procedure involves phoptocoagulation of cilliary process to decrease intraocular pressure by reducing aqueous production. We report our experience with 3 advanced glaucoma patients, who received transpuillary cyclophotocoagulation. Their ciliary process was well visualized by gonioscopy. All visible process were treated up to a maximum of 1800 at one setting and treated again a few weeks later, so total transpupiJIary argon laser cyclophotocoagulation were performed 3 or 4 times. After surgery, each patient was maintained on preoperative glaucoma medication. As a result of this study, one of these patients was sucessfully controled and other one of them had effect of 20mmHg Intraocular pressure reduction.
Argon* ; Glaucoma ; Gonioscopy ; Humans ; Intraocular Pressure

There are a few case reports describing prolonged myoclonus following propofol. A previously fit 26 year old woman presented for a left knee lateral impingement under general anesthesia as a day case. She had no personal or family history of epilepsy. Induction was smooth and anesthesia was maintained with propofol TCI, nitrous oxide 65% and oxygen 35%. 30 minutes after stopping of the propofol infusion, the patient developed involuntary movement and shivering that recurred intermittently. After drug therapy and psychotic therapy the patient was progressively stabilized. However 4 hours later the patient developed involuntary movement and myoclonus. She was admitted to the department of neurology under the diagnosis of propriospinal myoclonus. Forty days later she was discharged without long term sequelae.
Adult ; Anesthesia* ; Anesthesia, General ; Diagnosis ; Drug Therapy ; Dyskinesias ; Epilepsy ; Female ; Humans ; Knee ; Myoclonus* ; Neurology ; Nitrous Oxide ; Oxygen ; Propofol* ; Shivering

Non-alcoholic fatty liver disease (NAFLD) is emerging as a world-wide health problem and is currently recognized as a hepatic manifestation of metabolic syndrome. It is an umbrella term to describe a wide range of diseases from simple steatosis to non-alcoholic hepatosteatosis (NASH) and NSAH-related liver cirrhosis. NAFLD is mainly associated with insulin resistance which allows increased free fatty acid (FFA) flux to the liver by increasing lipolysis from adipose tissue, triggering macrophage/immune activation, decreasing skeletal muscle glucose uptake, and increasing de novo lipogenesis. Increased FFA pool in the liver, in turn, increases lipotoxic intermediates, such as ceramides, diacylglycerols, and lysophosphatidylcholines, which are responsible for mitochondrial dysfunction and endoplasmic reticulum stress, resulting in inflammation of the liver. When inflammation is severe enough to affect stellate cells, hepatic fibrosis can be induced.
Adipose Tissue ; Ceramides ; Diglycerides ; Endoplasmic Reticulum Stress ; Fatty Liver* ; Fibrosis ; Glucose ; Hepatic Stellate Cells ; Inflammation ; Insulin Resistance ; Lipogenesis ; Lipolysis ; Liver ; Liver Cirrhosis ; Lysophosphatidylcholines ; Muscle, Skeletal ; Obesity

OBJECTIVES: The purpose of this study was to investigate changes in the composition of artificial cariogenic biofilms using a Streptococcus mutans biofilm model over a period of time. METHODS: We analyzed the dry weight, colony forming unit (CFU) number, extracellular polysaccharide (EPS) biovolume, and acid production rate of S. mutans biofilms formed on saliva-coated hydroxyapatite discs after 26 h, 50 h, 74 h, 98 h, 171 h, and 195 h. In addition, we performed a laser scanning confocal fluorescence microscopy to determine the bacterial volume, EPS biovolume, and biofilm thickness. We calculated the biofilm density using dry weight and EPS biovolume. RESULTS: Over a period of time, there was no change in the CFU number and acid production rate of S. mutans biofilms, but there was an increase in the dry weight and EPS biovolume of S. mutans biofilms. The bacterial volume, EPS biovolume, and biofilm thickness only increased in the 50-h-old biofilm; however, no change was observed in 50-195-h-old biofilms. In addition, an increase in the biofilm density was observed over time. CONCLUSIONS: These results suggest that the acid production ability of cariogenic biofilms does not change, but the biofilm density increases over time. However, due to scientific information, further research needs to be conducted in the field of dentistry to get further insights on the progression of cariogenic biofilms over time.
Biofilms ; Dentistry ; Durapatite ; Microscopy, Fluorescence ; Stem Cells ; Streptococcus mutans