PURPOSE: Loneliness may be a typical psychological consideration in chronically ill patients, linking with low life satisfaction. We aimed to determine if loneliness would be independently associated with life satisfaction in pneumoconiosis patients hospitalized in long-term care facilities. METHODS: We recruited 164 patients from 3 pneumoconiosis-specialized hospitals in M and S cities, South Korea, and measured loneliness and life satisfaction by using the University of California Los Angeles loneliness and life satisfaction index-Z scales. The Multiple regression analysis was performed to examine an independent association between loneliness and life satisfaction after adjustment for age, the levels of dyspnea and bronchitisemphysema symptom, length of institutionalization, marital status, previous coal work experience, perceived socioeconomic status, and presence of caregivers. RESULTS: The mean of loneliness was 46.4. We found a significant association between loneliness and life satisfaction (standardized beta=-0.16, p=0.049), independent of all the covariates. Conclusions: Loneliness was an independent associate of life satisfaction in patients with pneumoconiosis who were institutionalized in long-term care facilities. Thus, a nursing intervention strategy for relieving loneliness is needed to increase life satisfaction in these patients.
California ; Caregivers ; Chronic Disease ; Coal ; Dyspnea ; Humans ; Institutionalization ; Loneliness ; Long-Term Care ; Los Angeles ; Marital Status ; Pneumoconiosis ; Republic of Korea ; Social Class ; Weights and Measures

BACKGROUND: Pharmacy schools newly adopted a 6-year program strengthening clinical knowledge since 2011 in Korea. The clinical training under the guidance of preceptors at hospital sites is a requisite for pharmacy students during the last year of undergraduate course. It has been rarely studied on the hospital pharmacists' perspective regarding being a preceptor or teaching pharmacy students. OBJECTIVES: This study aimed to examine the hospital pharmacists' intention toward student training and to identify the relevant factors among the individual pharmacists' characteristics and working environment within the theoretical frame of the Theory of Planned Behavior (TPB). METHOD: A mail-survey was conducted for pharmacists working in tertiary hospitals in Seoul and Incheon. The survey questionnaire consisting of 131 questions with a 5-likert scale was developed for investigating pharmacists' attitude, subjective norm, perceived behavioral control and the intention to teach pharmacy students as well as other demographic variables. To estimate the construct validity of components, factor analysis was conducted and Cronbach's alpha was calculated to estimate the reliability of the observed variables. Statistical analyses of one-way variance analysis and multiple regression analysis were performed using SPSS 18.0. RESULTS: The survey response rate was 53% (116/210) and the three constructs of attitude (r = .519), subjective norm (r = .233) and perceived control (r = .392) have appropriate correlations with the intention, proving the appropriateness of using the TPB model. Pharmacists working in inpatient (mean = 3.45) and outpatient clinics (mean = 3.34) generally showed positive intention for teaching. The attitude (beta = .432, p < 0.01) and perceived control (beta = .270, p < .01) constructs were significant predictors of the intention. Both age (r = 0.246, p = 0.017) and length of career (r = 0.310, p = 0.002) were positively related with the perceived control. CONCLUSION: Hospital pharmacists showed generally positive intention to provide student training in spite of the concern on their limited perceived behavioral control. Future research to find the actual barriers pharmacists faced in educating students need to be conducted.
Ambulatory Care Facilities ; Education, Pharmacy ; Humans ; Incheon ; Inpatients ; Intention* ; Korea ; Pharmacists* ; Schools, Pharmacy ; Seoul ; Students, Pharmacy ; Tertiary Care Centers

PURPOSE: The purpose of this study was to develop and evaluate a school adaptation program (SAP) for school-age children with emotional and behavioral problems who attended public elementary schools. METHODS: SAP, developed by the authors, addresses school adaptation and academic efficacy and consists of 10 sessions based on five categories (i.e., school life, classroom activity, relationship with friends, relationship with teacher, and school environment). Sixteen children with emotional and behavior problems answered questionnaires before and after participation in the program. RESULTS: The results showed that there was a significant difference between pre and post-test on school adaptation (t=-2.78, p=.015) and academic efficacy (t=-4.62, p<.001) after the 10 sessions of SAP. CONCLUSION: The results indicate that SAP can could serve as a practical program for school nurses and teachers. Further studies based on SAP in various school settings are recommended.
Child* ; Friends ; Humans ; Program Development ; Program Evaluation ; Surveys and Questionnaires

OBJECTIVES: To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA). METHODS: We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors. RESULTS: Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90). CONCLUSIONS Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.

The importance of opiate dependence or abuse is increasing in the context of the increasing number of cancer survivors and patients with chronic cancer pain. Cancer patients are likely to have psychological disorders such as depression, anxiety, and sleep disturbances. It is important to distinguish these psychological disorders from opiate dependence or abuse. We report a case of a cancer patient with major depressive disorder who was initially suspected of opiate dependence or abuse.
Anxiety ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Humans ; Opioid-Related Disorders ; Survivors

We investigated serotype distribution and antimicrobial resistance of pneumococcal carriage isolates from children after optional immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) in Korea. From June 2009 to June 2010, 205 (16.5%) pneumococcal isolates were obtained from 1,243 nasopharyngeal aspirates of infants and children at Seoul National University Children's Hospital, Korea. Serotype was determined by Quellung reaction and antibiotic susceptibility was tested by E-test. The results were compared to previous studies done in the pre-PCV7 period. In this study, the most common serotypes were 6A (15.3%), 19A (14.7%), 19F (10.2%), 35B (7.3%), and 6D (5.6%). The proportion of PCV7 serotypes decreased from 61.9% to 23.8% (P < 0.001). The overall penicillin nonsusceptibility rate increased from 83.5% to 95.4% (P = 0.001). This study demonstrates the impact of optional PCV7 vaccination in Korea; the proportion of all PCV7 serotypes except 19F decreased while antimicrobial resistant serotypes 6A and 19A further increased.
Anti-Bacterial Agents/pharmacology ; Child, Preschool ; Drug Resistance, Bacterial/drug effects ; Humans ; Infant ; Microbial Sensitivity Tests ; Nasopharynx/*microbiology ; Pneumococcal Infections/immunology/prevention & control ; Republic of Korea ; Serotyping ; Streptococcus pneumoniae/classification/*isolation & purification ; Vaccination ; Vaccines, Conjugate/*immunology

PURPOSE: To evaluate the usefulness of pulmonary function test for the prediction of successful weaning and extubation from the ventilator in very low birth weight(VLBW) infants with chronic lung disease. METHODS: This study included 15 VLBW infants(<1,500 g) with chronic lung disease who were admitted to Neonatal Intensive Care Unit of Samsung Medical Center from July, 1995 to June, 1996. They had extubation failure more than one time. This study was performed by reviewing of patients records retrospectively. The extubation criteria were based on clinical status, ABGA profiles and ventilatory parameters. At the time of last extubation failure and final success, we analyzed the distribution of age and weight of infants, ventilator profiles, ABGA profiles, dynamic and static pulmonary function test profiles measured by Bicore CP-100R from the infant with ventilator assistance daily in line monitoring. The paired T-test and linear logistic regression analysis were used to compare the variables between the evets of extubation failure and success. RESULTS: At the time of successful extubation, expiratory airway resistance was significantly lower and minute volume was significantly higher in dynamic pulmonary function test and respiratory system resistance was significantly lower in static pulmonary function test(P<0.05). In ventilator parameter, Fi02 and respiratory rate were lower at successful extubation(P<0.05). No statistically significant differences in ABGA profiles were seen between unsuccessful and successful extubation. CONCLUSION: The pulmonary function test is a useful predictor for successful weaning and extubation in VLBW infants with chronic lung disease. Among various parameters of pulmonary function test, expiratory airway resistance, minute ventilation and respiratory system resistance are suggested as successful weaning parameters.
Airway Resistance ; Bronchopulmonary Dysplasia ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Logistic Models ; Lung Diseases* ; Lung* ; Parturition ; Respiratory Function Tests* ; Respiratory Rate ; Respiratory System ; Retrospective Studies ; Ventilation ; Ventilators, Mechanical ; Weaning*

BACKGROUND: Although many single nucleotide polymorphisms (SNPs) of mtDNA have been found to be associated with type 2 diabetes mellitus, the results of studies using different population samples and different methods are mixed. Therefore, we conducted a genetic association study of mtDNA SNPs and type 2 diabetes mellitus in a Korean sample and compared our results with those of studies conducted in other human populations. METHODS: A total of 298 blood samples from 147 type 2 diabetic patients and 151 normal controls were surveyed for SNPs via PCR directed sequencing. Sequencing analyses were performed using the SeqMan module of the DNASTAR program. The identified SNPs were compared to previously reported SNP lists on NCBI and V-mitoSNP. RESULTS: A total of 24 SNPs were identified in the MT-RNR2, MR-TL1 and MT-ND1 mtDNA genes in Korean type 2 diabetes mellitus patients and normal controls. The SNPs identified in the Korean sample were not closely associated with the type 2 diabetes mellitus phenotype, a significantly different result from those previously observed in European, Chinese and Japanese samples. Additionally, a haplotype and prevalence analysis could not detect any differences between the type 2 diabetes mellitus patients and normal controls. CONCLUSION: The 24 mtDNA SNPs were not associated with type 2 diabetes mellitus risk in our Korean sample. The results of the present study support the possibility that mtDNA SNPs have a differential effect on the risk of type 2 diabetes mellitus according to geographical origin.
Asian Continental Ancestry Group ; Diabetes Mellitus, Type 2 ; DNA, Mitochondrial ; Genetic Association Studies ; Haplotypes ; Humans ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prevalence

Objective: This study aims to evaluate the change in serum metalloproteinase-3 (MMP-3) following the management of active rheumatoid arthritis (RA) and define the relationships between MMP-3 and disease activity indices. Methods: Data from a previously reported a 24-week, randomized controlled trial to investigate efficacy of tocilizumab in active RA refractory to methotrexate were analyzed. The serum level of MMP-3 were measured at week 0, 12, 20, and 24. The changes in MMP-3, and the relationship between MMP-3 and clinical parameters was assessed based on treatment group, methotrexate with or without tocilizumab. Results: A total of 95 patients were included in this study. The serum MMP-3 significantly decreased and showed similar pattern with other disease activity indices during treatment period in both treatment groups (p<0.001). The MMP-3 was positively correlated with ESR, CRP, DAS28, SDAI, and CDAI for 302 visits throughout 24 weeks (p<0.001). In another correlation analysis to evaluate the treatment effect at 24 week time point, methotrexate group showed significant correlation between serum markers: MMP-3 (r=0.321, p=0.043); ESR (r=0.450, p=0.002); and CRP (r=0.536, p<0.001), with DAS28, but tocilizumab group didn’t show meaningful correlation between serum markers and DAS28 (p>0.05). Conclusion Serum MMP-3 showed positive correlation with disease activity indices in active RA patients. Furthermore, serum MMP-3 significantly decreased from baseline to week 20. As there is no single serum marker that can represent the disease activity particularly in tocilizumab treatment, MMP-3 might be a useful adjunct indicator to evaluate the treatment response in active RA patients.

Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune disorder associated with fibroinflammatory conditions that can affect multiple organs. Hallmark histopathological findings of IgG4-RD include lymphocytic infiltration of IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. However, little is known about central nervous system involvement of IgG4-RD.Hypertrophic pachymeningitis (HP) has recently been reported as a manifestation of IgG4-RD, which may have previously been demonstrated in a significant percentage of idiopathic cases. Herein, we report a rare case of a 63-year-old male who presented with a scalp mass that mimicked a brain tumor. He was diagnosed with IgG4-related HP (IgG4-RP) after surgery. This case suggests that awareness of a possibility of IgG4-RP in patients with isolated scalp masses, even in the absence of systemic symptoms, is crucial. A combination of careful history taking, evaluation of serum IgG4-levels and imaging as an initial work-up, followed by tissue biopsy, is important for the differential diagnosis of IgG4-RP, malignancy, and other infectious diseases.