Dietary therapy is a basic and emphasized treatment for diabetes. Several clinical studies have shown that diet can play a major role in preventing and managing diabetes. The purposes of this study were to evaluate the dietary behavior and to find solutions to barriers of diabetes mellitus patients. From February to July in 2007, questionnaires were distributed to one hundred and ten patients who were diagnosed DM by physicians and excluded first coming out-patients. One hundred and three data were used for statistical analysis using SPSS/Win 12.0. The main results of this study included the following: To measure dietary behaviors and barriers, a five point scale was used with the following labels: 'strongly yes', 'yes', 'fair', 'no', 'strongly no'. Thirteen dietary behaviors related to diabetes were grouped into the following 4 factors using factor analysis; 'taste control factor', 'blood glucose influence factor', 'practice volition factor', and 'exercise factor'. The mean scores of 4 factors were 3.88, 3.48, 3.55, 3.21, respectively. The 'taste control behaviors' score of subjects who had practiced diet therapy (4.00) was higher than those who had not practiced diet therapy (P < 0.05). The 'blood glucose influence behaviors' score of subjects who had nutrition education (3.59) was higher than those who had no nutrition education (P < 0.05) and subjects who had practiced diet therapy showed higher score (3.59) than those who had not practiced diet therapy (P < 0.05). 'Exercise behaviors score' of subjects who were over 60 (3.59) was the lowest (P < 0.05). Subjects who had nutrition education showed higher 'exercise behaviors' scores (3.38) than those who had no nutrition education (P < 0.05). Subjects who had practiced diet therapy showed higher 'practice volition behaviors' scores (3.72) than those who had not practiced diet therapy (P < 0.001). Subjects who were over weight showed the highest 'practice volition behaviors' scores (3.78) concerning BMI (P < 0.05). In conclusion, this study expected that Nutrition educators (Dietitian) applied to patient effective nutrition education and counseling through evaluation of Dietary behaviors and barriers considered management types and ecological factors of diabetes patients. Also diabetic patients were easy to change dietary habits because they formed behaviors through education and counsel and there were positive effects in their blood glucose control through removing barriers related to dietary therapy.
Blood Glucose ; Counseling ; Diabetes Mellitus ; Diet ; Food Habits ; Glucose ; Humans ; Life Style ; Outpatients ; Volition

OBJECTIVES: The aim of this study was to develop auditory-verbal and visual-spatial memory tasks using smart devices for children aged 8 to 10 years and examine their validity. METHODS: One-hundred and fourteen school-aged children were recruited through internet advertising. We developed memory tasks assessing auditory-verbal memory, visual-spatial memory, and working memory, and then examined their construct validity by examining the developmental trend of the children's mean scores with age. In order to examine the concurrent validity of the tasks, we conducted correlation analyses between the children's scores on the newly developed auditory-verbal, visual-spatial memory and working memory tasks and their scores on well-known standardized tests of memory and working memory, including the auditory-verbal memory subtests of the Korean Luria-Nebraska Neuropsychological Battery for Children, Korean Rey-Osterrieth Complex Figure Test, digit span and arithmetic subtest of Korean Educational Development Institute Wechsler Intelligence Scale for Children Revised, and Corsi block test. RESULTS: The memory and working memory scores measured by the newly developed tasks tended to increase with age. Further, there were significant correlations between the scores of the four cognitive tasks and the corresponding scores of the standardized assessment tools. CONCLUSION: This study revealed promising evidence for the validity of the memory tasks using smart devices, suggesting their utility for school-aged children in research and clinical settings.
Child* ; Humans ; Intelligence ; Internet ; Luria-Nebraska Neuropsychological Battery ; Memory* ; Memory, Short-Term

BACKGROUND AND OBJECTIVES: We sought to determine parameters to guide the decision of retreatment in patients with Kawasaki disease (KD) who remained febrile after initial intravenous immunoglobulin (IVIG). SUBJECTS AND METHODS: A total of 129 children with KD were studied prospectively. Patients were treated with IVIG 2 to 9 days after the onset of disease. Laboratory measures, such as white blood cell (WBC), percentage of neutrophils, C-reactive protein (CRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP), were determined before and 48 to 72 hours after IVIG treatment. Patients were classified into IVIG-responsive and IVIG-resistant groups, based on the response to IVIG. RESULTS: Of a total of 129 patients, 107 patients (83%) completely responded to a single IVIG therapy and only 22 patients (17%) required retreatment: 14 had persistent fever and 8 had recrudescent fever. There was no significant difference between the groups in age, gender distribution, and duration of fever to IVIG initiation, but coronary artery lesions developed significantly more often in the resistant group than in the responsive group (31.8% vs. 2.8%, p=0.000). Compared with pre-IVIG data, post-IVIG levels of WBC, percentage of neutrophils, CRP, and NT-proBNP decreased to within the normal range in the responsive group, whereas they remained high in the resistant group. Multivariate logistic regression indicated that neutrophil counts, CRP, and NT-proBNP were independent parameters of retreatment. CONCLUSION: Additional therapy at an early stage of the disease should be administered for febrile patients who have high values of CRP, NT-proBNP, and/or neutrophil counts after IVIG therapy.
C-Reactive Protein ; Child ; Coronary Vessels ; Fever ; Humans ; Immunization, Passive ; Immunoglobulins ; Immunoglobulins, Intravenous ; Leukocytes ; Logistic Models ; Mucocutaneous Lymph Node Syndrome ; Natriuretic Peptide, Brain ; Neutrophils ; Peptide Fragments ; Prospective Studies ; Reference Values ; Retreatment

BACKGROUND: The definition of sarcopenia focuses on muscle mass and function. Sarcopenic obesity is the relative excess of fat tissue with decreased muscle mass. We examined the association between cigarette smoking and sarcopenia according to obesity in middle-aged and elderly Koreans. METHODS: We conducted a cross-sectional study of 9,385 subjects (age ≥50 years) based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (2008–2011). Smoking groups were categorized by smoking status and the number of cigarettes smoked daily. Sarcopenia was defined as weight-adjusted appendicular skeletal muscle mass of 2 standard deviations below the sex-specific mean for young adults. Obesity was defined as fat mass ≥30% for men and ≥40% for women. Subjects were categorized into three groups: sarcopenic obese (SO), sarcopenic non-obese (SNO), and normal. Multiple logistic regression analysis was performed to assess the association between smoking and SNO and SO. RESULTS: Among men, current smokers were more associated with SNO than never-smokers (adjusted odds ratio [OR], 3.34; 95% confidence interval [CI], 1.09–10.26). However, there was no significant association between smoking status and SNO in women or SO in either sex. Among current smokers, moderate smokers (11–20 cigarettes/d) were more likely to be SNO (adjusted OR, 5.81; 95% CI, 1.12–30.31) and heavy smokers (>20 cigarettes/d) were more likely to be SO (adjusted OR, 9.53; 95% CI, 1.65–55.01) than light smokers (<11 cigarettes/d). CONCLUSION: In men, smoking was positively associated with SNO, and heavy smokers were more likely to be SO than light smokers.
Aged ; Cross-Sectional Studies ; Female ; Humans ; Korea ; Logistic Models ; Male ; Muscle, Skeletal ; Nutrition Surveys ; Obesity ; Odds Ratio ; Sarcopenia ; Smoke ; Smoking ; Tobacco Products ; Young Adult

Background: Depression is a global mental health concern that negatively affects individuals’ health and increases medical costs. This study aimed to assess whether early depression management is cost-beneficial and effective from the perspective of quality indicators. Methods: Data of patients newly diagnosed with depressive disorder between 2012 and 2014 as well as follow-up data until 2020 were extracted from the National Health Insurance Service database. Hospitalization, emergency room visits, and annual medical expenses were set as dependent variables to estimate the effect of depression and information on medical expenditures. Six quality indicators developed by the Health Insurance Review and Assessment Service comprised independent variables. Results: In total, 465,766 patients were included in this study. Patients who met the quality indicators were more likely to be hospitalized with a psychiatric diagnosis. Furthermore, patients who met the quality indicator of revisiting within 3 weeks of their first visit had greater psychiatric and overall expenses during the early treatment phase; however, the overall expenses gradually decreased over time. Conclusion High-quality initial treatment for depression can be cost-effective in the long term; however, further studies are needed to discern its immediate clinical effects.

BACKGROUND: Self-monitoring of blood glucose is an important component of therapy for diabetes mellitus. The aim of this study was to evaluate the analytic performance evaluation of blood monitoring system G400 according to ISO 15197:2013. METHODS: We evaluated the G400 according to the ISO 15197:2013 guideline, we measured precision, accuracy, interference of hematocrit and interfering substances, user performance. RESULTS: Repeatability and intermediate precision of G400 showed standard deviation 2.7–3.8 mg/dL, 2.4–3.6 mg/dL and coefficient of variation 1.9-2.9% and 1.7–3.7%, respectively. Accuracy measured 98–98.5%, satisfied acceptable criteria. Error grid analysis showed that all results of this study were in zone A. Hematocrit between 20% to 60% did not cause interference. Three of 24 interfering substances were not acceptable criteria, and dose-response evaluation was needed. CONCLUSIONS: This study showed that G400 was considered reliable results satisfying the ISO 15197:2013 criteria
Blood Glucose ; Blood Glucose Self-Monitoring ; Diabetes Mellitus ; Hematocrit

The cytogenetic analysis of mesenchymal stromal cells (MSCs) is essential for verifying the safety and stability of MSCs. An in situ technique, which uses cells grown on coverslips for karyotyping and minimizes cell manipulation, is the standard protocol for the chromosome analysis of amniotic fluids. Therefore, we applied the in situ karyotyping technique in MSCs and compared the quality of metaphases and karyotyping results with classical G-banding and chromosomal abnormalities with fluorescence in situ hybridization (FISH). Human adipose- and umbilical cord-derived MSC cell lines (American Type Culture Collection PCS-500-011, PCS-500-010) were used for evaluation. The quality of metaphases was assessed by analyzing the chromosome numbers in each metaphase, the overlaps of chromosomes and the mean length of chromosome 1. FISH was performed in the interphase nuclei of MSCs for 6q, 7q and 17q abnormalities and for the enumeration of chromosomes via oligo-FISH in adipose-derived MSCs. The number of chromosomes in each metaphase was more variable in classical G-banding. The overlap of chromosomes and the mean length of chromosome 1 as observed via in situ karyotyping were comparable to those of classical G-banding (P=0.218 and 0.674, respectively). Classical G-banding and in situ karyotyping by two personnel showed normal karyotypes for both cell lines in five passages. No numerical or structural chromosomal abnormalities were found by the interphase-FISH. In situ karyotyping showed equivalent karyotype results, and the quality of the metaphases was not inferior to classical G-banding. Thus, in situ karyotyping with minimized cell manipulation and the use of less cells would be useful for karyotyping MSCs.
Azure Stains ; Chromosome Banding/*methods ; Humans ; In Situ Hybridization, Fluorescence/*methods ; Karyotyping/*methods ; Mesenchymal Stromal Cells/*cytology

OBJECTIVES: Alcohol problems of parents have an influence on not only their psychological problems but also on their children's psychosocial adaptation. The purpose of this study was to compare the emotional and behavioral problems, including school bullying and social skills, between children of alcoholics (COAs) and children of non-alcoholics (non-COAs). METHODS: We recruited 4th grade children (n=741) from 7 primary schools in Seoul and their parents as subjects. The self-rated psychiatric symptoms were assessed with the Korean version of the Children of Alcoholics Screening Test (CAST-K), the Children's Depression Inventory (CDI), the Rosenberg's Self-esteem Scale (RSES), the School Bullying Scale, the Social Skill Rating Scale and the Korean version of Alcohol Expectancy Questionnaire-Adolescent (AEQ-A). The Attention-deficit Hyperactivity Disorder Rating Scale-IV (ARS) was completed by the parents. RESULTS: 518 children were non-COAs and 223 were COAs. The COAs showed higher CDI and ARS-IV scores and lower RSES scores than the non-COAs. Especially, the COAs also showed higher school bullying scale scores and lower cooperative scale scores on the social skill rating scales. But there was no difference of alcohol expectancy between the COAs and non-COAs. CONCLUSION: It was plausible that the COAs had more behavioral & psychosocial problems than the non-COAs among the school aged children. It is important to identify and intervene to solve the problems of peer relationships of school age COAs in order to prevent victimization by bullying and to improve psychosocial adaptation.
Aged ; Alcoholics ; Bullying ; Child ; Crime Victims ; Depression ; Humans ; Mass Screening ; Parents ; Weights and Measures

Background: Human papillomavirus (HPV) infection is a major global disease burden and the main cause of cervical cancer. Certain HPV genotypes, with are the most common etiologic pathogens and cause a significant disease burden, are being targeted for vaccine development. However, few studies have focused on the comparative effectiveness of the bivalent HPV (2v-HPV), quadrivalent HPV (4v-HPV), and nonavalent HPV (9v-HPV) vaccines against HPV strain-specific infection. This study investigated the comparative effects of these vaccines against genotype-specific infection. Materials and Methods: We conducted a pairwise and network meta-analysis of published randomized clinical trials of HPV vaccines according to sex and HPV infection status for nine HPV genotypes (HPV 6/11/16/18/31/33/45/52/58). Results: Overall, 10 randomized controlled trials (12 articles) were included in this study. In the network metaanalysis, no statistically significant differences were observed in the prevention of carcinogenic HPV strains (16/18/31/33/45/52/58) between the 2v-HPV and 4v-HPV vaccines in female HPV infection–naïve populations. However, the 9v-HPV vaccine showed a significantly superior effect compared with 2v-HPV and 4v-HPV vaccines in preventing HPV 31/33/45/52/58 infections. Although 2v-HPV and 4v-HPV vaccines provided some cross-protection against HPV 31/33/45/52/58 infections, the effect was significant only on HPV 31 infection. For HPV 16 and 18, neither statistically significant nor small differences were found in the prevention of HPV infection among the 2v-HPV, 4v-HPV, and 9v-HPV vaccines. Conclusion Our study complements previous understanding of how the effect of HPV vaccines differs according to the HPV genotype. This is important because HPV genotype prevalence varies among countries. We advocate for continued efforts in vaccinating against HPV, while public health agencies should consider the difference in the vaccine effect and HPV genotype prevalence when implementing HPV vaccination in public vaccination programs.