The aim of this study was to investigate comorbidities in patients with end-stage renal disease, and to compare health-related quality of life (HRQOL) according to the type, and number of comorbidities.

PURPOSE: The purpose of this study was to identify the correlation among hope, physical symptoms, depressive mood, and quality of life and to examine the influence of hope on quality of life in young adults and patients in their prime who are on hemodialysis. METHODS: A secondary analysis using survey data was performed for 100 patients from 20-55 years of age treated in 10 local hemodialysis clinics. To measure hope, physical symptoms, depressive mood, and quality of life, Herth Hope Index, revised symptom scale, Hospital Anxiety and Depression Scale, and Satisfaction with Life Scale were utilized. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficient, and multiple regression. RESULTS: There were differences in the scores for hope according to income, job, and religion. Statistically significant relationships were found between hope and depressive mood, and between hope and quality of life. Hope predicted quality of life with the explanatory power of 43.4%. CONCLUSION: Results indicate that hope is a protective factor which has the potential to provide a clinically useful approach to helping patients with hemodialysis, especially, in young adults and patients in their prime. Interventions that support and facilitate hope need to be developed and tested.
Anxiety ; Depression* ; Hope* ; Humans ; Quality of Life* ; Renal Dialysis* ; Young Adult*

BACKGROUND: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. METHODS: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged > or =40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. RESULTS: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. CONCLUSIONS: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.
Arthrography ; Arthroscopy ; California ; Elbow ; Follow-Up Studies ; Humans ; Patient Selection ; Range of Motion, Articular ; Shoulder ; Visual Analog Scale

PURPOSE: The purpose of this study was to investigate the effects of oral health education on oral health knowledge, oral health behavior, and oral hygiene status of children from North Korea. METHODS: Participants were 32 North Korean children defectors (15 in the education group, 17 in the control group). The oral health education program, including theoretical training and toothbrush training, was done once a week for 4 weeks. Effects of the education program were assessed for oral health knowledge, oral health behavior, and oral hygiene status at pretest, 0, and 4 weeks after the intervention. Data were analyzed using repeated measures ANCOVA with the SAS program. RESULTS: Children in the education group showed increased oral health knowledge and behavior over time compared to the control group and an improvement in oral hygiene status including significantly decreased S-PHP and Snyder test for oral micro-organism. CONCLUSION: Results indicate that oral health education is effective in improving oral health knowledge, oral health behavior and oral hygiene status. These improvements could lead to a better quality of life for North Korean children defectors.
Child* ; Democratic People's Republic of Korea* ; Education* ; Health Behavior ; Health Education ; Humans ; Oral Health* ; Oral Hygiene* ; Quality of Life

In addition to cognitive and functional decline, various behavioral and psychological symptoms in dementia (BPSD) are manifested in the patients with Alzheimer's dementia (AD). Some of BPSD, especially psychosis, agitation, and aggression could be challenges to caregivers and clinicians. Atypical antipsychotic drugs (risperidone, olanzapine, quetiapine, and aripiprazole) are widely prescribed to manage complicated neuropsychiatric symptoms associated with AD. It is known that atypical antipsychotics (AAP) have modest and significant beneficial effects in the short term treatment of BPSD. However their safety of AAP has been concerned with potentially increased adverse events. This article reviewed the treatment outcomes and adverse effects of AAP when managing BPSD in the patients with AD. The effects of risperidone and aripiprazole are obvious on psychosis and aggression, but with small effect size. AAP could exacerbate cognitive decline, and it could increase the rate of cerebrovascular accidents and mortality rate in the patients with AD.
Aggression ; Alzheimer Disease ; Antipsychotic Agents* ; Behavioral Symptoms ; Caregivers ; Dementia* ; Dihydroergotamine ; Humans ; Mortality ; Psychotic Disorders ; Risperidone ; Stroke ; Aripiprazole ; Quetiapine Fumarate

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

OBJECTIVE: The UE Video Stylet VL400-S2 (UE Medical Devices, Newton, MA, USA) and Ambu aScope (Ambu, Copenhagen, Denmark) were recently introduced rigid video stylets and single-use fiberoptic bronchoscopes, respectively. To compare the utility of the two sets of equipment, this study conducted a randomized cross-over study using a manikin. METHODS: Twenty-eight novice doctors performed tracheal intubation on an airway trainer manikin (Laerdal, Stavanger, Norway). The sequence of intubation devices was randomized. The following data were measured and recorded: time to complete tracheal intubation (primary end point), overall success rate, time to see the glottis, and time to tube passage. RESULTS: The video stylet (24 seconds; interquartile range [IQR] 18–36) showed a significantly shorter completion time of the tracheal intubation than the fiberoptic bronchoscope (43 seconds; IQR, 32–84) (P<0.001). The overall success rate of tracheal intubation was 96.4% (27/28) in the video stylet and 82.1% (23/28) in the fiberoptic bronchoscope, and the cumulative success rate over time to complete intubation was significantly higher in the video stylet (P<0.001). CONCLUSION: The video stylet was superior to the fiberoptic bronchoscope in terms of the time to complete and the cumulative success rate of intubation for novice operators in manikin model. Further research will be needed to determine the degree of education required to use fiberoptic bronchoscopy.
Bronchoscopes ; Bronchoscopy ; Cross-Over Studies ; Education ; Glottis ; Intubation ; Intubation, Intratracheal ; Manikins ; Microscopy, Video

Sarcopenic dysphagia is a complication of coronavirus disease 2019 (COVID-19). This report describes the approach to rehabilitation in a 65-year-old man with sarcopenic dysphagia who contracted severe COVID-19 and underwent awake venovenous extracorporeal membrane oxygenation (vv-ECMO). He started active rehabilitation while receiving vv-ECMO and underwent a course of comprehensive inpatient rehabilitation lasting 115 days. The sarcopenic dysphagia improved, and he regained physical functional independence without any complications at hospital discharge.

With focused ultrasound (FUS) and microbubbles, BBB can be transiently disrupted with a localized and non-invasive approach. BBB disruption induced by FUS has made progressions to move forward on delivery of therapeutic agents into a brain in a specific area of brain for better treatment of neurological diseases. In addition to be used as an improvement of drug delivery, BBB disruption has been found to induce biological effects such as a clearance of protein aggregation which cause Alzheimer's disease, regulation of proteins which facilitate drug uptake, and modulation of neuronal function and neurogenesis. In this review, we discuss overview about the principles of BBB opening with FUS and milestones in these biological effects of FUS-induced BBB disruption.
Alzheimer Disease ; Brain ; Microbubbles ; Neurogenesis ; Neurons ; Ultrasonography*

Background: Polypharmacy, the use of multiple drugs, is a growing concern in older adults. It has been reported that the prevalence of polypharmacy in elderly patients is higher in Korea than in other countries. The objective of this study was to investigate the prevalence and associated factors of polypharmacy in elderly outpatients who visited a Seoul Medical Center. Methods: We retrospectively reviewed medical records of 12,551 elderly patients aged ≥65 years who visited outpatient clinics in a public hospital in Seoul between January 1, 2018 and December 31, 2018. We defined “polypharmacy” as the use of ≥6 medications per person; “major polypharmacy,” ≥11 medications per person; and “excessive polypharmacy,” ≥21 medications per person. Multivariate logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to investigate the risk factors for polypharmacy. Results: Among the elderly outpatients studied, 40.7% had polypharmacy, 11.9% major polypharmacy, and 0.8% excessive polypharmacy. The lowerincome medical aid population is associated with polypharmacy (OR, 1.70; 95% CI, 1.47–1.97). Conclusion We observed a high prevalence of polypharmacy in elderly outpatients, especially the medical aid population, who visited a Korean public hospital. Nationwide vigorous efforts to assess and reduce the prevalence of polypharmacy are urgently required for the Korean older population.