Objectives: This study investigated sleep quality in female full-time homemakers and evaluated the relationship of sleep disturbance with psychological and socio-environmental factors. Methods: This cross-sectional study adopted a structured survey and sequential recruitment method for randomized participation of community-dwelling full-time female homemakers. Sleep quality and mental health were measured using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI), Korean version of the Beck Depression Inventory-II (K-BDI-II), Korean version of the Beck Anxiety Inventory (K-BAI), and Korean version of the Beck Hopelessness Scale (K-BHS). The willingness-to-pay (WTP) method was selected to measure the self-evaluated monetary value of household service work. The relationship among the main relevant factors was statistically analyzed through a mediation model. Results: A total of 166 participants were analyzed and classified having poor versus good sleep quality (poor : 24.1%, n = 40 ; good : 75.9%, n = 126 ; cut-off point = 9 on the K-PSQI). Significant between-group differences were observed in mental health status (K-BDI-II, p < 0.001 ; K-BAI, p < 0.001 ; K-BHS, p = 0.003). The moderated mediation model was verified, indicating that depression may mediate the association between nurturing burden and sleep disturbance. The path from nurturing burden to depression may be moderated by average monthly household income. Conclusion A relatively high portion of full-time female homemakers may suffer from sleep disturbance and interactions between psychological and socio-environmental factors might determine sleep quality, suggesting the need for public health policies targeting improvement of sleep quality and mental health among full-time homemakers.

Objectives: This study investigated sleep quality in female full-time homemakers and evaluated the relationship of sleep disturbance with psychological and socio-environmental factors. Methods: This cross-sectional study adopted a structured survey and sequential recruitment method for randomized participation of community-dwelling full-time female homemakers. Sleep quality and mental health were measured using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI), Korean version of the Beck Depression Inventory-II (K-BDI-II), Korean version of the Beck Anxiety Inventory (K-BAI), and Korean version of the Beck Hopelessness Scale (K-BHS). The willingness-to-pay (WTP) method was selected to measure the self-evaluated monetary value of household service work. The relationship among the main relevant factors was statistically analyzed through a mediation model. Results: A total of 166 participants were analyzed and classified having poor versus good sleep quality (poor : 24.1%, n = 40 ; good : 75.9%, n = 126 ; cut-off point = 9 on the K-PSQI). Significant between-group differences were observed in mental health status (K-BDI-II, p < 0.001 ; K-BAI, p < 0.001 ; K-BHS, p = 0.003). The moderated mediation model was verified, indicating that depression may mediate the association between nurturing burden and sleep disturbance. The path from nurturing burden to depression may be moderated by average monthly household income. Conclusion A relatively high portion of full-time female homemakers may suffer from sleep disturbance and interactions between psychological and socio-environmental factors might determine sleep quality, suggesting the need for public health policies targeting improvement of sleep quality and mental health among full-time homemakers.

Background/Aims: Postal distribution of a fecal immunochemical test (FIT) kit has been recommended as an effective method of increasing participation in colorectal cancer (CRC) screening. The present study was performed to assess the impact of the round-mailed FIT kit on screening participation in underserved regions of Korea and to identify factors related to nonparticipation. Methods: Residents were recruited from three rural regions of Korea that lack screening units for the National Cancer Screening Program. A package containing a FIT kit for stool self-sampling and a return envelope addressed to the local health center was postally distributed to each subject. Thirty days after the kits were mailed, nonresponders were reminded via telephone as the second intervention. The participation rates and odds ratios with 95% confidence intervals (CIs) for each intervention response were calculated to evaluate the effect of the interventions and factors related to screening participation in response to the interventions. Results: CRC screening participation rates increased from 24.5% (95% CI, 21.6% to 27.4%) to 42.6% (95% CI, 39.3% to 46.0%) as a result of postal screening and increased further to 51.4% (95% CI, 48.0% to 54.9%) after the telephone reminder. After controlling for the sex, age, and household type of each subject, factors associated with poor response to postal screening were identified as low educational attainment and poor previous participation in the National Cancer Screening Program. Conclusions Round-mailed FIT kits with phone call reminders were an effective intervention, nearly doubling the screening rate in underserved regions of Korea.

Polymyositis is one form of inflammatory myopathy. In some patients, this disease does not entirely respond to conventional initial therapy with glucocorticoid, methotrexate and azathioprine. Multiple options exist for treating these patients, but only intravenous immune globulin has been subjected to a randomized clinical trial. We report here on a case of polymyositis that did not respond to multiple drug therapy, but it did respond to tacrolimus. After treatment with tacrolimus, the patient's disease has been well controlled for many years.
Azathioprine ; Humans ; Immunoglobulins, Intravenous ; Methotrexate ; Myositis ; Polymyositis ; Tacrolimus

Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21–52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.

OBJECTIVES: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. MATERIALS AND METHODS: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. RESULTS: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and ‘responder group’ and ‘non-responder group,’ but there was no significant difference with the ‘worsened group.’ In addition, the age of the patients was a relative factor with BRONJ stage. CONCLUSION: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.
Bisphosphonate-Associated Osteonecrosis of the Jaw* ; Busan ; Creatinine ; Diphosphonates ; Filtration ; Holidays ; Human Body ; Humans ; Kidney ; Oral and Maxillofacial Surgeons ; Osteomyelitis ; Renal Insufficiency, Chronic

Uterine sacculation is a very rare complication associated with pregnancy in which a part of the uterine wall balloons, and it is difficult to diagnose because it is usually asymptomatic. It frequently contains the placenta and sometimes may be involved with the trapped placenta after delivery due to its structural characteristic. It is impossible to remove the retained placenta in the sac by using usual methods such as manual delivery or curettage so most of patients with it end up with having a laparotomy. Especially, if the placenta in it is accompanied by abnormal adherence of the placenta or serious hemorrhage, hysterectomy should be considered. Currently several conservative methods for the retained placenta including selective uterine artery embolization and administration of methotrexate have been introduced and these may be tried to treat the retained placenta in the uterine sacculation for avoiding operation and preserving future reproductive potential in selective cases. We experienced a case of placenta increta in the uterine sacculation that was diagnosed first during cesarian section and was treated with selective uterine artery embolization followed by methotrexate administration. This case is reported with a brief review of the literatures.
Curettage ; Hemorrhage ; Humans ; Hysterectomy ; Laparotomy ; Methotrexate ; Placenta Accreta* ; Placenta* ; Placenta, Retained ; Pregnancy ; Uterine Artery Embolization

Uterine sacculation is a very rare complication associated with pregnancy in which a part of the uterine wall balloons, and it is difficult to diagnose because it is usually asymptomatic. It frequently contains the placenta and sometimes may be involved with the trapped placenta after delivery due to its structural characteristic. It is impossible to remove the retained placenta in the sac by using usual methods such as manual delivery or curettage so most of patients with it end up with having a laparotomy. Especially, if the placenta in it is accompanied by abnormal adherence of the placenta or serious hemorrhage, hysterectomy should be considered. Currently several conservative methods for the retained placenta including selective uterine artery embolization and administration of methotrexate have been introduced and these may be tried to treat the retained placenta in the uterine sacculation for avoiding operation and preserving future reproductive potential in selective cases. We experienced a case of placenta increta in the uterine sacculation that was diagnosed first during cesarian section and was treated with selective uterine artery embolization followed by methotrexate administration. This case is reported with a brief review of the literatures.
Curettage ; Hemorrhage ; Humans ; Hysterectomy ; Laparotomy ; Methotrexate ; Placenta Accreta* ; Placenta* ; Placenta, Retained ; Pregnancy ; Uterine Artery Embolization

OBJECTIVE: The object of this study was to evaluate the indications, effectiveness and complications associated with arterial embolization as a safe and effective alternative treatment of obstetrical hemorrhage. METHODS: From September 1998 to October 2005, 42 patients who had a pregnancy related hemorrhage which did not respond to treatment using obstetric maneuvers and uterotonic drugs were included in our study. The patients underwent angiographic embolization for the management of intractable obstetrical hemorrhage at Department of Obstetrics and Gynecology, Yonsei University Medical Center. All available medical records and telephone interviews were reviewed and detailed to collect adequate clinical data such as clinical status, underlying conditions, amount of transfusion, embolization sites, materials of embolization, hospital stay, the success rate and the complications. RESULTS: We have experienced clinically successful embolization in 40 (95.2%) of 42 patients of obstetrical hemorrhage resulting from various causes. After embolization, the patient's vital sign was stabilized. The causes of hemorrhage were atony of uterus (n=17), cervical pregnancy (n=5), abnormal placentation (n=5), laceration of uterine cervix and vagina (n=6). The average amount of blood transfusion was 10.3 unit (range; 0-63 unit). The average duration of hospitalization was 7.4 days (range; 4-18 days). We were able to follow up on 32 patients. The main complications after embolization were hypomenorrhea (n=6), numbness of lower extremities (n=3). In all cases menses resumed spontaneously after procedures. CONCLUSION: The arterial embolization is one of the safe and the effective procedures and offers patients a fertility-preserving alternative to hysterectomy for treatment of intractable postpartum hemorrhage.
Academic Medical Centers ; Blood Transfusion ; Cervix Uteri ; Female ; Follow-Up Studies ; Gynecology ; Hemorrhage* ; Hospitalization ; Humans ; Hypesthesia ; Hysterectomy ; Interviews as Topic ; Lacerations ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation Disturbances ; Obstetrics ; Placentation ; Postpartum Hemorrhage ; Pregnancy ; Uterus ; Vagina ; Vital Signs

Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. The purpose of this study was to investigate the changes in serum ADA activity throughout normal pregnancy. We measured the catalytic values of serum ADA from 202 normal pregnant women using a commercial kit. Subjects were divided into four groups according to the gestational age in weeks (Gwks) (Group I: 5-9 Gwks [n=58]; Group II: 15-20 Gwks [n= 63]; Group III: 24-30 Gwks [n=34]; Group IV: 30-39 Gwks [n=47]). The serum ADA levels for the Groups I, II, III, and IV were as follows: 20.1+/-6.9 IU/L, 20.0+/-7.6 IU/L, 37.9+/-19.9 IU/L, and 24.5+/-8.6 IU/L, respectively. The serum ADA activity of group III was significantly higher than the other groups (p<0.05). However, there was no significant correlation between the Gwks and the serum ADA activity. Furthermore, other parameters, such as maternal age (p=0.29), gestational age at delivery (p=0.07), delivery mode (p=0.39), and birth weight (p=0.59) had no correlation with ADA activity. Reference values of serum ADA in normal pregnancy may provide important database for making clinical decisions in pregnancies complicated by conditions where cellular immunity has been altered.
Adenosine/metabolism ; Adenosine Deaminase/*blood/*metabolism ; Adult ; Analysis of Variance ; Birth Weight ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Inosine/metabolism ; Logistic Models ; Maternal Age ; Pregnancy ; Substrate Specificity