In a cross-sectional design, this study examined the relationship between functional physical fitness and mild cognitive impairment (MCI) in older adults. A total of 306 older adults (91 men and 215 women) aged 65 years or older were recruited from our local community. A senior fitness test (SFT) was used to assess functional domains of physical fitness consisting of upper and lower body strength, endurance, upper and lower body flexibility, and agility/dynamic balance. Korean version of mini-mental state examine for dementia screening and short-form geriatric depression scale were used to assess global cognitive performance and depression, respectively. Age, sex, education, body mass index, percent body fat, blood lipids, glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed. A composite score of physical fitness was calculated as a sum of z scores for each domain of the SFT parameters. Based on the composited score of physical fitness, subjects were classified as low fit (lower 25 percentile), moderate fit (middle 50 percentile), and high fit (high 25 percentile). Linear contrast analysis using one-way analysis of variance showed significant linear trends for age (p<0.001), education (p<0.001), cognitive function (p<0.001), and depression scale (p=0.006) across incremental composite score of physical fitness. Functional physical fitness was positively associated with age, years of education and global cognitive performance and negatively with depression scale. Logistic regression analyses showed that compared to the low fit group, the moderate (p=0.004) and high fit (p=0.010) groups had significantly lower odds ratios for having MCI even after adjusted for age, sex, education, and body fatness parameters. However, the odds ratios of the moderate (p=0.101) and high fit (p=0.191) groups were not significant when additionally controlling for depression scale and HOMA-IR. The current findings suggest that physical fitness promotion along with treatments of depression and HOMA-IR should be key components of interventions to prevent and/or treat MCI with normal aging.
Adipose Tissue ; Adult* ; Aging ; Body Mass Index ; Dementia ; Depression ; Education ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Logistic Models ; Male ; Mass Screening ; Mild Cognitive Impairment* ; Odds Ratio ; Physical Fitness* ; Pliability

No abstract available.
Darier Disease*

Iron has a vital role in the human body, including the central nervous system. Increased deposition of iron in the brain has been reported in aging and important neurodegenerative diseases. Owing to the unique magnetic resonance properties of iron, MRI has great potential for in vivo assessment of iron deposition, distribution, and non-invasive quantification. In this paper, we will review the MRI methods for iron assessment and their changes in aging and neurodegenerative diseases, focusing on Alzheimer’s disease. In addition, we will summarize the limitations of current approaches and introduce new areas and MRI methods for iron imaging that are expected in the future.

PURPOSE: Mothers who give birth prematurely experience parenting stress after their babies are discharged and find it difficult to emotionally bond with them. Forming an emotional bond with a baby promotes the baby's growth and development, helps the mother cope with parenting stress after discharge, and is important for maintaining family functioning. This study aimed to identify the attachment experiences of mothers with low-birth-weight infants (LBWIs) in a follow-up program using early intervention. METHODS: A phenomenological perspective was used for this qualitative research. Data were collected from in-depth interviews with twelve mothers who participated in a follow-up program using early intervention for mothers with LBWIs from September 2017 to December 2017. Colaizzi's method was used to analyze the data. RESULTS: The experience of mothers' attachment was investigated on the basis of three categories: ‘beginning of changes in parenting methods,’ ‘forming an intimate mother–child bond,’ and ‘concerns and expectation about the child's development.’ CONCLUSION: The results indicate that the follow-up program using an early intervention designed to increase mothers' confidence in their parenting skills can promote mother' attachment and the quality of life of families with LBWIs.
Early Intervention (Education) ; Follow-Up Studies ; Growth and Development ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Methods ; Mothers ; Object Attachment ; Parenting ; Parents ; Parturition ; Qualitative Research ; Quality of Life

BACKGROUND: Sputum decontamination with NALC-NaOH (N-acetyl-L-cysteine-sodium hydroxide) is known to better detect Mycobacterium tuberculosis (M. tb) by culture than that with using NaOH, which is widely used in Korean hospitals. In this report, sputum samples collected from pulmonary tuberculosis (TB) patients were treated with either NaOH or NALC-NaOH, and we compared the results of smear and culture positivity to determine whether the NALC-NaOH treatment method improves culture positivity in the sputum samples, and especially for those sputum samples that are smear negative and scanty. METHODS: For each decontamination method, 436 sputum samples from pulmonary TB patients in the National Masan Tuberculosis Hospital were collected for this study. Sputum from a patient was collected two times for the first and second day of sampling time, and these samples were employed for the decontamination process by performing the 4% NaOH and NALC-2% NaOH treatment methods, respectively, for detecting M. tb by an AFB (Acid Fast Bacilli) smear and also by culture in solid Ogawa medium. RESULTS: The NaOH and NALC-NaOH treatment methods did not significantly affect the AFB smear positivity of the sputum samples (33.0% vs 39.0%, respectively, p=0.078). However, the culture positive percents of M. tb in the Ogawa medium treated with NALC-NaOH and NaOH were 39.7% and 28.0%, respectively, which was a significantly different (p=0.0003). This difference in culture was more prominent in the sputum samples that were smear negative (the positive percents with NALC-NaOH and NaOH were 15.8% and 7.2%, respectively, p=0.0017) and scanty (NALC-NaOH and NaOH were 60.8% and 42.9%, respectively, p=0.036), but not for a smear that was 1+ or higher (p>0.05). CONCLUSION: NALC-NaOH treatment is better than NaOH treatment for the detection of M. tb by culture, but not by smear, and especially when the AFB smear is negative and scanty.
Decontamination ; Hospitals, Chronic Disease ; Humans ; Mycobacterium tuberculosis ; Nitroimidazoles ; Sputum ; Sulfonamides ; Tuberculosis ; Tuberculosis, Pulmonary

The healthy cities approach emphasizes the role of the leadership of local governments in promoting the health of the population in city settings. The concept emerged from public health strategies declared in the Ottawa Charter for Health Promotion, and reflects the characteristics of the third public health revolution. The Korean healthy cities movement, characterized by voluntary participation of local governments in the Alliance for Healthy Cities, has grown rapidly in recent years. A strong push of the healthy cities movement by a local government without a profound commitment to the vision may hinder the effective and sustainable development of the movement. By reviewing the historical background and significance of the healthy cities movement and its underlying concepts, and illustrating the main strategies and goals of the movement, that is, the development of partnerships, community participation and empowerment, and working in networks for stimulating change, this article argues that the healthy cities movement is a potent vehicle for implementing the new paradigm of public health introduced to local governments. We also argue that the Korean healthy cities movement needs more active participants and more support of the central government and other related stakeholders.
Consumer Participation ; Health Promotion ; Korea ; Local Government ; Natural Resources ; Power (Psychology) ; Public Health ; Vision, Ocular

Rhythm control therapy is the main strategy for restoring and maintaining sinus rhythm in patients with non-valvular atrial fibrillation (NVAF). Sinus rhythm is better restored and maintained with antiarrhythmic drugs than with placebo treatment. In addition, catheter ablation or combination therapy is more effective than antiarrhythmic drugs for treating NVAF. However, in most clinical trials to date, rhythm control therapy has resulted in neutral clinical outcomes compared with rate control therapy. The decision to undergo rhythm control therapy should be based on age, atrial fibrillation (AF)-related symptoms, type of AF, structural heart disease, and underlying comorbidities. For now, rhythm control therapy is indicated to improve symptoms in patients with NVAF who have refractory symptoms after adequate rate control therapy. The Korean Heart Rhythm Society organized the Korean AF Management Guideline Committee and analyzed all available data, including South Korean patients with NVAF. This review article provides general principles and detailed methodology for rhythm control therapy in South Korean patients with NVAF.
Anti-Arrhythmia Agents ; Atrial Fibrillation* ; Catheter Ablation ; Comorbidity ; Drug Therapy* ; Heart Diseases ; Heart* ; Humans

Background: Ogden type IV tibial tuberosity fractures, defined as a type of fracture with posterior–inferior metaphyseal extension (Salter-Harris type II variant), are uncommon but challenging pediatric fractures. The purpose of this study was to investigate the clinical and radiological presentation and associated surgical outcomes. Methods: Ten previously healthy patients who had been surgically treated at the authors’ institution between 2015 and 2018 with at least 2 years of postoperative follow-up were included. Demographic, clinical, and radiological characteristics and treatment/ follow-up data were investigated. Results: All included patients were male. All injuries resulted from jump-landings. Unacceptable remaining angular deformity after closed reduction, particularly increased posterior tibial slope angle, was the leading cause of surgery. All preoperative magnetic resonance images (MRIs) showed entrapped periosteum on the anteromedial side of the proximal tibial physis. Surgical removal of the entrapped periosteum achieved successful reduction. Metaphyseal fracture angles between the fracture plane of the metaphyseal beak and the posterior tibial condyle on the axial image of MRI were relatively constant, with an average of 24.3° ± 6.0°. Mean bone age at the time of trauma was older than mean chronological age (16.4 ± 1.0 years vs. 14.6 ± 1.1 years, respectively; p = 0.005).All patients reached skeletal maturity within 2 postoperative years, with little posttraumatic residual height growth (mean, 1.6 ± 0.7 cm from injury to skeletal maturity). At final follow-up, no patients showed significant angular deformity, tibial length discrepancy, or functional deficit. Conclusions In healthy adolescents, Ogden type IV tibial tuberosity fractures typically occur by jump-landing injuries, when they have little residual growth remaining. Therefore, accurate fracture reduction was required because of limited remodeling potential.Patients with unacceptable reduction should be investigated for entrapped periosteum on the anteromedial side of the physis because it was the primary obstacle in achieving adequate reduction.

Background: Many studies have reported injury characteristics of individual traumatic situations. However, a comparative analysis of specific risks is meaningful to better understand injury characteristics and help establish injury-prevention measures. This study was conducted to investigate and compare injury characteristics in children and adolescents by various outdoor traumatic situations. Methods: Outdoor traumatic situations were determined and classified into physical activity-related injury (n = 3,983) and pedestrian (n = 784) and passenger (n = 1,757) injuries in traffic accidents. Home injury (n = 16,121) was used as the control group. Then, the characteristics of each outdoor trauma were compared with 1:1 matched indoor trauma (among home injuries); each outdoor traumatic situation’s predisposing risk for the injured body part, injury type, and injury severity were analyzed; and changes by age of frequency ranking among physical activity-related injuries were investigated. Results: Outdoor trauma showed higher risks for limb injuries (injured body part), fracture and muscle/tendon injuries (injury type), and severe injuries (severity) than indoor trauma. Various outdoor traumatic situations presented different predisposing effects on injury characteristics. Among physical activity-related injuries, bicycle injury was commonest across all ages, and playing activities were common causes for injury for individuals of age < 9 years, whereas sports activities overwhelmed the common causes thereafter. Conclusions The findings would help to better understand the specific injury risk of various outdoor traumatic situations and may potentially facilitate the establishment of more effective injury-prevention measures.

Background: In the Korean medical system, the severity classification for a specific disease depends primarily on its nationwide admission rate in tertiary hospitals. Inversely, one of the important designation criteria for a tertiary hospital is the hospital's treatment ratio of patients classified as having a specific severe disease. Most diseases requiring pediatric orthopaedic surgery (POS) are not currently classified as high severity in terms of disease severity. We investigated the admission rates for the representative POS diseases in tertiary hospitals and compared these rates with those for adult orthopaedic surgery (AOS) diseases. Methods: Seven POS diagnoses and three AOS diagnoses were selected based on frequency of admission. Nationwide sample data were used to investigate the admission rates for these representative diagnoses from 2008 to 2017. Results: Six of the seven frequent POS diagnoses presented high admission rates in tertiary hospitals (62.5–92.3%). In contrast, all frequent AOS diagnoses presented low admission rates in tertiary hospitals. Conclusion The admission rates of frequent POS diagnoses in tertiary hospitals are high.Considering that these rates are the most important factors for the classification of disease severity, POS diseases seem to be underestimated in terms of severity. This may lead to a tendency for tertiary hospitals to intentionally reduce the admission of children with POS diseases. As a result, these children may not receive appropriate professional care. Therefore, for the disease severity, POS diseases should be classified differently from general AOS diseases by using different criteria reflecting the patient's age.