PURPOSE: Many family caregivers of people with early stages of dementia experience difficulty in obtaining information on dementia. In addition, adjusting to this new caregiving role is emotionally demanding, thus many family caregivers go thorough a lot of emotional stress. This study tested emotion-focused individual intervention as a way to help family caregivers of early-stage dementia patients obtain necessary information and emotional support related to caregiving. METHODS: To achieve this goal, a quasi-experimental study with a non-equivalent control group design was conducted. Emotion-focused individual intervention was administered to the experimental group (n=15), and no treatment was administered to the control group (n=21). Both groups completed a demographic profile, and also took pre- and post-test measuring their dementia-related knowledge, self-efficacy of care, preparedness of care, and coping strategies of care. Descriptive statistics were calculated, and t-test, and ANCOVA were performed to SPSS program. RESULTS: It was found that there was a statistically significant improvement in dementia-related knowledge (p<.001), self-efficacy of care (p=.030), preparedness of care (p<.001), and coping strategies of care (p<.001) after the intervention. CONCLUSION: The findings suggest that emotion-focused individual intervention was effective for family caregivers of patients with early dementia to adjust to the new caregiving role.
Caregivers* ; Dementia* ; Humans ; Non-Randomized Controlled Trials as Topic ; Stress, Psychological

Objectives: Gastric cancer (GC) demonstrates a sex disparity that may also be associated with body mass index (BMI). This study explored whether the effect of BMI on the risk of GC varies by sex. Methods: The study cohort included 341,999 Koreans aged 40 years or older from the National Health Insurance Service–Health Screening Cohort, with a median follow-up period of 10 years. Participants were categorized into five groups based on their BMI. The effect of BMI was evaluated using Cox proportional hazard regression. Additionally, stratification analysis was performed according to waist circumference. Results: An increased risk of developing GC was observed across the study population among those with obesity (BMI 25.0–29.9 kg/m2 ; hazard ratio [HR], 1.11; 95% CI , 1.03–1.20) and severe obesity (BMI ≥30.0 kg/m2 ; HR, 1.22; 95% CI, 1.01–1.47), considering a 2-year latency period. Notably, the rise in GC risk was particularly pronounced among women with obesity and men with severe obesity. In the age-stratified analysis, severe obesity (BMI ≥30.0 kg/m2 ) was associated with an increased risk of GC in men under 50 years old (HR, 1.83; 95% CI, 0.99–3.37). For individuals aged ≥50 years, obesity was linked to a heightened risk of GC in both sexes. Furthermore, normal BMI (18.5–22.9 kg/m2 ) was associated with an increased GC risk in women. Conclusion These findings indicate a positive association between excess body weight and the risk of GC in Koreans, particularly among men with severe obesity.

OBJECTIVES: While the Korean government’s response to the coronavirus disease 2019 (COVID-19) pandemic is considered effective given the relatively low mortality rate, issues of inequality have been insufficiently addressed. This study explored COVID-19-related health inequalities in Korea. METHODS: Age standardization for various health inequality indices was derived using data from the Korean National Health Insurance Service, the Korea Disease Control and Prevention Agency, and the Microdata Integrated Service of Statistics Korea. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for socioeconomic variables, while absolute difference (AD) and relative difference (RD) were used for gender and disability inequalities. RESULTS: We observed a number of COVID-19-related health outcome inequalities. Gender inequality was particularly noticeable in infection rates, with the rate of women 1.16 times higher than that of men. In contrast, socioeconomic inequality was evident in vaccination rates, with a 4.5-fold (SII, -4.519; 95% confidence interval, -7.403 to -1.634) difference between the highest and lowest household income groups. Regarding clinical progression post-infection, consistent findings indicated higher risk for men (RD for hospitalization, 0.90; severe cases, 0.54; and fatality, 0.65), individuals with disabilities (RD for hospitalization, 2.27; severe cases, 2.29; and fatality, 2.37), and those from lower socioeconomic groups (SII for hospitalization, 1.778; severe cases, 0.089; and fatality, 0.451). CONCLUSIONS While the infection risk was nearly ubiquitous, not everyone faced the same level of risk post-infection. To prevent further health inequalities, it is crucial to develop a thoughtful policy acknowledging individual health conditions and resources.

PURPOSE: The purpose of this study was to categorize adult's subjectivity of their attitudes towards life sustaining treatment, and thereby understand the differences among these life sustaining treatment types using Q methodology. METHODS: Q-methodology, which provides a method of analyzing the subjectivity of each item, was used. Thirty selected Q-statements received from 52 adults were classified into a shape of normal distribution using a 7 point scale. The collected data was analyzed using a QUANL pc program. RESULT: Four types of attitudes toward life sustaining treatment were identified. Type I is called one's autonomy type. Type II is called potentiality of resuscitation type. Type III is called DNR (Do not resuscitation) type. Type IV is calledone's effort type. CONCLUSION: The results of the study indicate that different approaches of life support care programs are recommended based on the four types of life sustaining treatment attitudes among Korean adults.
Adult ; *Attitude to Death ; Humans ; *Life Support Care/psychology ; Middle Aged ; Q-Sort ; Terminal Care/psychology ; Withholding Treatment

PURPOSE: To determine risk factors contributing to the development of an epiretinal membrane after retinal detachment surgery. METHODS: The authors retrospectively reviewed the records of 294 eyes which underwent retinal detachment surgery between 2001 and 2004. Parameters including numbers and locations of retinal breaks, operation methods and associated abnormalities were compared between the eyes from which a postoperative epiretinal membrane was removed and the eyes from which the membrane was not removed. RESULTS: Fourteen eyes (4.8%) underwent epiretinal membrane removal during the follow-up period. The mean interval between the retinal reattachment surgery and the vitrectomy for epiretinal membrane was 184 days (range: 50~546 days). Retinal breaks were located superiorly in 12 eyes and inferiorly in 2 eyes. Regarding the number of breaks, 1 break was observed in 9 eyes, 2 breaks in 2 eyes, 3 breaks in 2 eyes and no breaks in 1 eye. Vitreous hemorrhages presented in 7 eyes (50%). Twelve eyes were phakic eyes and 2 were pseudophakic. The macula was detached in 9 eyes (64.3%). Procedures for retinal detachment were vitrectomy with gas tamponade in 8 eyes (57.1%) and scleral buckling with cryoretinopexy in 6 eyes (42.9%). CONCLUSIONS: Preoperative vitreous hemorrhage, superior location of retinal breaks, old age and scleral buckling with cryotherapy were determined to be significant factors for the postoperative development of an epiretinal membrane. Postoperative visual acuity increased in all cases. This study demonstrates that vitrectomy for epiretinal membrane results in an overall favorable functional outcome.
Cryotherapy ; Epiretinal Membrane ; Eye ; Follow-Up Studies ; Membranes ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Risk Factors ; Scleral Buckling ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

Inflammation is known to participate in the mediation of a growing number of acute and chronic neurological disorders. Even so, the involvement of inflammation in the pathogenesis of epilepsy and seizure-induced brain damage has only recently been appreciated. Inflammatory processes, including activation of microglia and astrocytes and production of proinflammatory cytokines and related molecules, have been described in human epilepsy patients as well as in experimental models of epilepsy. For many decades, a functional role for brain inflammation has been implied by the effective use of anti-inflammatory treatments, such as steroids, in treating intractable pediatric epilepsy of diverse causes. Conversely, common pediatric infectious or autoimmune diseases are often accompanied by seizures during the course of illness. In addition, genetic susceptibility to inflammation correlated with an increased risk of epilepsy. Mounting evidence thus supports the hypothesis that inflammation may contribute to epileptogenesis and cause neuronal injury in epilepsy. We provide an overview of the current knowledge that implicates brain inflammation as a common predisposing factor in epilepsy, particularly childhood epilepsy.
Animals ; Blood-Brain Barrier ; Chronic Disease ; Encephalitis/genetics/immunology/metabolism/*pathology ; Epilepsy/immunology/metabolism/*pathology/therapy ; Gene Expression Regulation ; Humans ; Nervous System Diseases/immunology/pathology

OBJECTIVES: The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases. METHODS: We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model. RESULTS: Compared to normal levels (SBP < 120 or DBP < 90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85- 89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ≥160 mmHg) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ≥160 mmHg) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively). CONCLUSIONS: An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.
Adult* ; Blood Pressure* ; Cardiovascular Diseases ; Cohort Studies* ; Diabetes Mellitus ; Humans ; Hypertension ; Ischemia ; Liver Cirrhosis ; Liver Diseases, Alcoholic ; Pneumonia ; Proportional Hazards Models ; Renal Insufficiency

Background: Although group B Streptococcus (GBS) colonization rate among pregnant Korean women is lower than that among women from many Western countries, recent data show an upward trend. We investigated recent epidemiological changes in GBS among pregnant Korean women in terms of colonization rate, antimicrobial susceptibility, serotype, and resistance genotype. Methods: Vaginal and anorectal swab specimens from 379 pregnant Korean women were cultured on Strep B Carrot Broth with GBS Detect (Hardy Diagnostics, USA), selective Todd-Hewitt broth (Becton Dickinson, USA), and Granada agar plate medium (Becton Dickinson). The antimicrobial susceptibility, serotypes, and macrolide-lincosamide-streptogramin B (MLS B) resistance genes of the GBS isolates were tested. Results: The GBS colonization rate among pregnant Korean women was 19.8% (75/379).Colonization rates using Strep B Carrot Broth with GBS Detect, selective Todd-Hewitt broth, and Granada agar plate medium cultures were 19.5%, 19.3%, and 15.0%, respectively.Six pregnant women were colonized by non-beta-hemolytic GBS and were detected only in Strep B Carrot Broth with GBS Detect. Resistance rates of GBS to clindamycin, erythromycin, and tetracycline were 16.0%, 28.0%, and 42.7%, respectively. The most common GBS serotypes were V (22.7%), VIII (20.0%), and III (20.0%). The frequency of MLS B resistance genes erm(B) and erm(TR) were 63.6% and 36.4%, respectively. Conclusions The GBS colonization rate among pregnant Korean women has risen to levels observed in Western countries. To accurately evaluate GBS epidemiology among pregnant Korean women, periodic studies in multiple centers, including primary clinics, are necessary.

Human immunodeficiency virus (HIV) is one of the less common triggers of secondary hemophagocytic lymphohistiocytosis (HLH) in which coagulation disorder is a frequent manifestation. Here, we present a case of HIV-triggered secondary HLH presenting with severe bleeding tendency and fever. Despite high-dose dexamethasone infusion (10 mg/body surface area/day), progressive disseminated intravascular coagulation and thrombocytopenia resulted in massive hemathochezia: the bleeding episode ceased after endoscopic hemoclipping. After then, he took a highly-active antiretroviral therapy (HAART). Eventually, body temperature and overall laboratory findings normalized in response to HAART.Clinicians should not overlook HIV infection as a possible trigger of secondary HLH. In such cases, HAART is the core treatment.

The purpose of this study was to investigate the consumption status and perception of soy meat among university students and to compare their sensory evaluations of commercial meatballs and soy meatballs. The subjects were students at a university who were grouped into those majoring in food and nutrition and those not majoring in the subject. The results of the two groups were compared. The main sources through which the students became aware of meat analogs were examined. The food and nutrition major students were about three times more likely to learn about meat analogs through ‘education’, and those not majoring in the subject were about four times more likely to learn about them from the social media (P＜0.01). The most common reason for having tried soy meat was 'curiosity' and that for not eating it was ‘no opportunity’. Without significant differences between groups, the most common answer for questions relating to the product that they had eaten was ‘Ramen flakes’ (30.5%) and the most common answer for the routes for eating the product was in the order of: ‘restaurants’ (36.6%)＞school lunches (24.9%)＞large and medium-sized supermarkets (22.8%). The most common answer to the question inviting suggestions on ‘improvement points to promote the consumption of soy meat’ was ‘taste’(19.2%), followed by ‘product promotion’ and ‘reasonable price’. About half of the subjects failed to differentiate the soy meatballs from regular meatballs before the sensory test and 21.3% after that. The difference in the sensory test scores of the two types of meatballs with respect to ‘texture’ was significantly higher for the major students than for the non-major students (P＜0.05). These results could provide basic information that could enable the promotion of soy meat.