Purpose: The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. Methods: Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. Results: The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%).The average score for family caregivers’ performance of caregiving for delirium was 2.60 ±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96± 0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. Conclusion Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

Purpose: The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. Methods: Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. Results: The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%).The average score for family caregivers’ performance of caregiving for delirium was 2.60 ±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96± 0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. Conclusion Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

Purpose: The aim of this study was to investigate the outcomes of endodontic treatment of mandibular second molar with C-shaped canal in elderly patients and related factors affecting the survival of the tooth. Materials and Methods: From 2010 to 2015, the survival rate following endodontic treatment was evaluated in elderly patients over 60 years who visited the Veterans Health Service Medical Center for endodontic treatment. The presence of C-shaped canals was confirmed using clinical records and radiographic features. Patientʼs age, sex, systemic diseases, tooth location, vitality, signs and symptoms, fractures, caries, apical radiolucency, canal shaping methods, sealer leakage, filling voids, and restoration of prosthesis were included in the analyses as confounding variables. The survival rate of teeth was analyzed using Kaplan–Meire analysis and the relationship between the survival rate and variables was analyzed using Simple and Multiple Cox regression analysis.Result: In total, 107 teeth in elderly patients had C-shaped canal. The survival rate of teeth that received endodontic treatment was 63.70%. None of the factors investigated significantly influenced the survival rate (P>0.05). Conclusion In elderly patients with C-shaped canal, the survival rate after root canal treatment was not significantly different from that of other mandibular molars.

Psoriasis is one of the most common inflammatory skin disorders, with a global prevalence of 2% – 3%. It is an autoimmune skin disorder characterized by excessive generation of plaques on the skin with typical long-lasting red, itchy, and scaly lesions. In this study, we aimed to elucidate the anti-psoriatic effect of the methanolic extract of Persicaria senticosa (PS), a bioactive edible plant extract used in traditional medicine, using a mouse model of imiquimod (IMQ)-induced psoriasis. The daily topical application of IMQ could induce human psoriasis-like lesion. The extract ameliorated IMQ-induced psoriasis. Furthermore, hematoxylin and eosin staining and the Psoriasis Area and Severity Index (PASI) scores indicated that topical application of PS led to an improvement in erythema, scaling, and thickness scores of the mouse dorsal skin and a considerable decrease in the epidermal thickness of the ear and dorsal skin in the IMQ-induced psoriatic mouse model. We also studied the effect of PS on the proliferation of keratinocytes using HaCaT cells. The extract inhibited cell proliferation and IL-6 and pSTAT3 expression induced by M5 cocktail (comprising interleukin [IL]-1α, IL-17A, IL-22, oncostatin M, and tumor necrosis factor-α) in HaCaT cells. Thus, PS might serve as a potential therapeutic agent for the treatment of psoriasis.

PURPOSE: This study was to identify the health status and reported resilience according to acculturation type among Chinese students in Korea. METHODS: The subjects were 386 Chinese students studying in three universities in Chungnam province. The data were collected by standardized questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, Chi-square, t-test, and ANOVA. RESULTS: Subjects reported the following Acculturation type: integration (26.7%), assimilation (28.5%), separation (32.4%), and marginalization (12.4%). The reported resilience was significantly different according to economic status. The health status was significantly different according to religion and economic status. Acculturation type was significantly different according to age, educational level, length of stay, type of residency and economic status working style. The health status and resilience were significantly different according to acculturation type. CONCLUSION: The findings suggest that integration of acculturation type is most useful to health status and resilience among Chinese students in Korea. Future studies need to examine acculturation type as coping strategy for foreign students' adaptation.
Acculturation ; Asian Continental Ancestry Group ; Humans ; Internship and Residency ; Korea ; Length of Stay ; Surveys and Questionnaires

We report a 55-year-old female patient who presented with no P waves but with a wide QRS complex escape rhythm at 44 beats/min and prolonged QTc of 0.55 seconds on ECG. The patient had recurrence of ventricular fibrillations and loss of consciousness, and underwent defibrillation and cardiopulmonary resuscitation (CPR) several times because of cardiac arrest. The transthoracic echocardiography showed dilated cardiomyopathy and enlargement of both atria. The Doppler echocardiography documented the absence of A wave in the tricuspid and mitral valve flow. An electrophysiologic study demonstrated electrical inactivity in the right and left atria. Atrial pacing with maximum output did not capture the atria. These findings together with her electrocardiographic finding indicated atrial standstill. Sudden cardiac death was her first clinical manifestation of ventricular arrhythmia. The patient remained asymptomatic after receiving a single chamber implantable cardioverter-defibrillator (ICD) with VVI pacemaker function.
Bradycardia/*diagnosis/*therapy ; Cardiomyopathy, Dilated/*therapy ; Death, Sudden, Cardiac ; *Defibrillators, Implantable ; Electrocardiography ; Female ; Heart Atria ; Humans ; Middle Aged ; Ventricular Fibrillation/diagnosis/therapy

PURPOSE: The purpose of this study was to identify the predictors of acculturative stress among Chinese students in Korea. METHODS: Between October and December 2009, two hundred one Chinese students from three universities located in Cungnam province, were included in the current study using a questionnaire survey. Data analysis was done using SPSS/WIN 17.0 program. RESULTS: The average score of acculturative stress was 38.50+/-6.97. There were significant differences in acculturative stress according to educational level, economic status, type of residence, speaking skill in Korean, listening skill in Korean, grade point average, satisfaction for studying abroad, and perceived health status. The acculturative stress was significantly correlated with depression, resilience and social support. The strongest predictor of acculturative stress among Chinese students was depression. CONCLUSIONS: The findings suggest that developing programs to improve psychological health may provide a buffer against acculturative stress experienced by migrating Chinese students. Furthermore, more studies are needed to explore variables that influence on the international students' acculturation in Korea.
Acculturation ; Asian Continental Ancestry Group ; Depression ; Humans ; Korea ; Statistics as Topic

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly. Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis usually presents after menarche with progressive abdominal pain during menses secondary to hematocolpos. The method of choice for diagnosis is magnetic resonance imaging (MRI). MRI can do much for the early diagnosis and the prevention against further complications of this condition because it can demonstrate the mullerian duct anomaly complicated with obstructed hemivagina in detail and even ipsilateral renal agenesis. A greater awareness of the syndrome of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis should lead to its prompt diagnosis, allowing for early and appropriate surgical intervention as well as decreased long-term morbidity. Early accurate diagnosis after menarche followed by excision and marsupialization of the blind hemivagina offers complete relief of symptoms and preserves reproductive potential. We report a case of uterine didelphys with obstructed hemivagina and ipsilateral renal agensis with a brief review of the literature.
Abdominal Pain ; Diagnosis ; Early Diagnosis ; Female ; Hematocolpos ; Magnetic Resonance Imaging* ; Menarche ; Uterus*

BACKGROUND: Acute adaptive vascular remodeling occurs in active and unstable inflammatory plaques. It has been suggested that the adaptive coronary vascular remodeling, in patients with acute coronary syndrome (ACS), may be systemic and may show similar vascular remodeling in the carotid arteries. We investigated the ultrasonographic features of the common carotid artery (CCA) to determine whether the arterial expansive remodeling found in the coronary artery occurs in the carotid arteries of patients with ACS. METHODS: We measured lumen diameter (LD), interadventitial diameter (IAD) and intima media thickness (IMT) using a B-mode ultrasound in both common carotid arteries in patients with ACS (N=74) and chronic stable angina (CSA) (N=31). Positive remodeling was arbitrarily defined as an IMTmax >1 mm and IAD >8 mm and negative remodeling as an IMTmax >1 mm and IAD <7 mm. Other values were defined as "no remodeling" RESULTS: There were no significant differences in LD IAD and maximal IMT of the right CCA and the left CCA in comparisons between the ACS and the CSA patient groups. There were no differences for number of cases with no remodeling or differences in positive and negative remodeling in the right common carotid artery and left common carotid artery in comparisons between the ACS and CSA patient groups. . Presence of plaque in both common carotid arteries showed similar frequency in the ACS and CSA patient groups. The characteristics of carotid artery plaques were not different in the two groups. The remodeling index (IAD/LD) was correlated with IMTmax (right CCA r=0.797, p<0.001; left CCA r=0.860, p<0.001). CONCLUSIONS: The common carotid arterial structure of ACS patients was not different from that of CSA patients. Therefore, these results suggest that the expansive arterial remodeling, due to coronary inflammatory plaques, appears to take place locally rather than systemically.
Acute Coronary Syndrome* ; Angina, Stable* ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Stenosis ; Coronary Vessels ; Humans ; Ultrasonography

PURPOSE: Pulmonary hypertension (PH) is known as a major risk factor for preterm infants deaths, and associated with low gestational age, low birth weight, longer duration of oxygen therapy, low Apgar scores, and oligohydramnios. The aim of this study was to determine the risk factors for PH in preterm infants with chronic lung disease. METHODS: A retrospective review was performed of data from 86 infants (<32 weeks of gestation) who diagnosed with chronic lung disease at Severance Children's Hospital from July 2006 to June 2011. PH was diagnosed on the basis of echocardiogram demonstrating elevated right ventricle pressure. The infants were divided into two groups: PH group (n=18) or control group (n=67). RESULTS: PH group showed lower gestational age and underwent longer duration of oxygen therapy, mechanical ventilation, and hospitalization compared with control group. PH group received more surfactant therapy, and the frequency of the development of intraventricular hemorrhage (IVH) (> or =G3) and severe chronic lung disease was higher in PH group than control group. According to multivariate analysis, IVH (> or =G3) (OR=5.00, 95% CI=1.10-22.63, P=0.037) and severe BPD (OR=2.43, 95% CI=1.03-15.41, P=0.045) were found to be significant risk factors for PH in preterm infants with chronic lung disease. CONCLUSION: Pulmonary hypertension was significantly increased in preterm infants with chronic lung disease when associated with IVH (> or =G3). We suggest that effort for early diagnosis and management for PH would be helpful in preterm infants with chronic lung disease when severe IVH was combined.
Bronchopulmonary Dysplasia ; Early Diagnosis ; Female ; Gestational Age ; Heart Ventricles ; Hemorrhage ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Lung ; Lung Diseases ; Multivariate Analysis ; Oligohydramnios ; Oxygen ; Pregnancy ; Respiration, Artificial ; Retrospective Studies ; Risk Factors