With the rapid spread of coronavirus disease 2019 (COVID-19), a particularly sharp increase in the number of confirmed cases in Daegu and Gyeongbuk regions at the end of February, Korea faced an unprecedented shortage of medical resources, including hospital beds. To cope with this shortage, the government introduced a severity scoring system for patients with COVID-19 and designed a new type of quarantine facility for treating and isolating patients with mild symptoms out of the hospital, namely, the Residential Treatment Center (RTC). A patient with mild symptoms was immediately isolated in the RTC and continuously monitored to detect changes in symptoms. If the symptoms aggravate, the patient was transferred to a hospital. RTCs were designed by creating a quarantine environment in existing lodging facilities capable of accommodating > 100 individuals. The facilities were entirely divided into a clean zone (working area) and contaminated zone (patient zone), separating the space, air, and movement routes, and the staff wore level D personal protective equipment (PPE) in the contaminated zone. The staffs consisted of medical personnel, police officers, soldiers, and operation personnel, and worked in two or three shifts per day.Their duty was mainly to monitor the health conditions of quarantined patients, provide accommodations, and regularly collect specimens to determine if they can be released.For the past two months, RTCs secured approximately 4,000 isolation rooms and treated approximately 3,000 patients with mild symptoms and operated stably without additional spread of the disease in and out of the centers. Based on these experience, we would like to suggest the utilization of RTCs as strategic quarantine facilities in pandemic situations.

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

Background/Aims: This study was performed to evaluate trends in antibiotic usage at a tertiary care hospital in Korea. Methods: This study collated antibiotic prescription data and total patient days for inpatients at a tertiary care hospital in Korea between 2004 and 2013. The consumption of each class of antibiotic was converted to defined daily dose (DDD)/1,000 patient-days. We defined 3rd generation cephalosporins, 4th generation cephalosporins, β-lactam/β-lactamase inhibitors, and fluoroquinolones as broad-spectrum antibiotics; carbapenems, tigecycline, glycopeptides, oxazolidinone, and polymyxin were defined as antibiotics against multidrug-resistant (MDR) pathogens. Other antibiotic classes were defined as nonbroad-spectrum antibiotics. Results: Mean antibiotic consumption was 920.69 DDD/1,000 patient-days. The proportions of broad-spectrum antibiotics, antibiotics against MDR pathogens, and nonbroad-spectrum antibiotics were 41.8% (384.48/920.69), 3.5% (32.24/920.69), and 54.7% (503.97/920.69), respectively. Consumption of broad-spectrum antibiotics (coefficient for time 0.141; p = 0.049) and antibiotics against MDR pathogens (coefficient for time 0.185; p < 0.001) showed a significant increasing trend over the study period. Nonbroad-spectrum antibiotic consumption showed a significant decreasing trend over the study period (coefficient for time –2.601; p < 0.001). Conclusions Over the 10-year period, a stepwise increase in the consumption of broad-spectrum antibiotics and antibiotics against MDR pathogens was observed at a tertiary care hospital in Korea. Conversely, during the same period, nonbroad-spectrum antibiotic consumption showed a significant decreasing trend.

Purpose: The purpose of this study was to determine whether the dietary quality of food consumed by the elderly is influenced by the consumption of healthy functional foods using Nutrition Quotients for the Elderly (NQ-E). Methods: The study subjects were 250 adults aged ≥ 65 living in Seoul or Gyeonggi-do. Those who had consumed healthy functional food for more than 2 weeks within the previous year were classified as healthy functional food consumers, and the quality of their meals was evaluated using the NQ-E. Statistical analysis was performed using SAS 9.4, and sex and age-associated differences were adjusted before comparing differences based on healthy functional food intake. Results: The average age of the study subjects was 70.8. The scores for each area and the Nutrition Quotient (NQ) score were as follows: balance 43.3 points, moderation 56.7 points, practice 65.7 points, and NQ 52.5 points. When comparing differences according to healthy functional food intake status, healthy functional food consumers had significantly higher balance and NQ scores than non-consumers. When considering each NQ item score, healthy functional food consumers had significantly higher scores than non-consumers for fruit, fish and seafood, eggs, nuts, and whole grain rice, and a higher score for effort to maintain a healthy diet. Conclusion Dietary quality as assessed by Nutrition Quotients for the Elderly was better for healthy functional food consumers than non-consumers.

No abstract available.
Meconium*

Minimal residual disease (MRD) following B-lymphoblastic leukemia (B-ALL) treatment has gained prognostic importance. Clonal immunoglobulin heavy chain (IGH) gene rearrangement is a useful follow-up marker in B-ALL owing to its high positivity rate. We evaluated the performance and clinical applicability of a next-generation sequencing (NGS) assay for IGH rearrangement in B-ALL MRD monitoring. IGH rearrangement was tested by using fluorescence PCR-fragment analysis and the NGS assay in eight B-ALL patients. The NGS assay was run on two platforms: the Ion Torrent PGM (Thermo Fisher Scientific, USA) (18 samples from 1st to 7th patients) and the MiSeq system (Illumina, USA) (four samples from 8th patient). All initial diagnostic samples and four follow-up samples were positive for clonal IGH rearrangement with fluorescence PCR-fragment analysis and the NGS assay, and six follow-up samples were positive only with NGS. In one case with BCR-ABL1 translocation, BCR-ABL1 quantitative PCR was negative but the NGS IGH assay was positive just prior to full-blown relapse, suggesting the high sensitivity and clinical utility of the NGS assay. The NGS assay is proposed for MRD monitoring in B-ALL Additional studies are needed to confirm the clinical implications of cases showing positive results only in NGS.
Fluorescence ; Follow-Up Studies ; Gene Rearrangement ; Humans ; Immunoglobulin Heavy Chains* ; Immunoglobulins* ; Leukemia* ; Neoplasm, Residual* ; Polymerase Chain Reaction ; Recurrence

Anaplastic thyroid cancer (ATC) belongs to the most malignant and rapidly progressive human thyroid cancers and its prognosis is very poor. Also, it shows high resistance to cancer treatments, so that effective treatment for ATC has not been found to date, and virtually all patients terminate their life rapidly after diagnosis. Although targeted treatment of genetic alterations has emerged as an extremely promising approach to human cancers, such as BRAF in metastatic melanoma, it remains unclear that how commonly genomic alterations are influenced in ATC tumorigenesis. In recent years, genome wide approaches have been exploited to find genetic alterations associated with complex diseases, including cancer. Here, we reviewed the comprehensive genetic alterations in ATC and recent approaches in the context of identifying genomic alterations associated with ATC. Since surprisingly few reports have been published on the genome wide study of ATC, this review puts emphasis on the urgent needs of genomic research for the prevention and treatment of ATC.
Cell Transformation, Neoplastic ; Genetic Variation ; Genome ; Humans ; Melanoma ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

No abstract available.
Analgesia* ; Cesarean Section* ; Emergencies* ; Female ; Pregnancy ; Spinal Cord Injuries* ; Spinal Cord*

BACKGROUND/OBJECTIVES: This study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients.MATERIALS/METHODS: Thirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 cm 3 ) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations. RESULTS: Compared to the commercial snacks, the developed high-protein snacks had belowaverage calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P< 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the highprotein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion. CONCLUSIONS The results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.

Purpose: In Cambodia, noncommunicable diseases (NCDs) account for 64% of all deaths. A lack of risk perception of NCDs leads to poor measures of their prevention and management. This study aimed to investigate Cambodians’ risk perceptions of NCDs based on the health belief model. Methods: A cross-sectional design was used, and using convenience sampling, participants included 200 Cambodians aged 40 years or older. A face-to-face administered structured questionnaire was used to assess demographic characteristics, health behaviors, and risk perceptions of NCDs. Results: Of the constructs of NCD risk perception, perceived severity (88.2%) and benefits (86.3%) were high, but relative to these, perceived cues to action (64.1%), barriers (63.5%), and self-efficacy (58.1%) were low. Conclusion It is important to improve perceived self-efficacy in government health promotion, outreach, and improvement programs and to reduce perceived barriers through medical tests either by facility-based delivery or via outreach health services in Cambodia.