OBJECTIVE: To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. METHODS: We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. RESULTS: Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (p<0.001), while the proportion of indoor fall accidents decreased from 38.12% to 23.16% (p<0.001). Females had more annual fall accidents than males (p<0.001). The major reason for fall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04–2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83–3.10). CONCLUSION: The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults.
Accidental Falls ; Adult* ; Depression ; Education ; Female ; Health Surveys* ; Humans ; Incidence ; Independent Living* ; Korea ; Life Style ; Logistic Models ; Male ; Osteoarthritis ; Osteoporosis

The Schedule of Fatigue and Anergy/General Physician (SOFA/GP) was developed to screen for prolonged fatigue in the primary care setting. We aimed to evaluate the reliability and validity of the Korean version of the SOFA/GP (SOFA/GP-K), which is adapted from the original English version. We performed translation and back translation, and after conducting a pilot study, we tested the final version of the questionnaire for its reliability and validity in a Korean primary care setting. Two hundred participants that visited a health examination center in a university hospital completed the survey between September and November 2012. A second survey was performed within 2 weeks of the primary survey to test for reliability. We evaluated concurrent validity between the SOFA/GP-K score, the Fatigue Severity Scale (FSS), and Brief Fatigue Index (BFI) scores. The Spearman correlation coefficient between SOFA/GP-K and FSS was 0.71 and 0.61 between SOFA/GP-K and BFI. Internal consistency of SOFA/GP-K was observed (Cronbach's alpha = 0.82) and construct validity was confirmed by factor analysis. The Kappa scores for test-retest reliability for each survey item were between 0.28 and 0.64. The SOFA/GP-K is a valid and reliable questionnaire for screening fatigue in a primary care setting.
Adult ; Aged ; Fatigue/metabolism/*pathology ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Practice Guidelines as Topic/*standards ; Republic of Korea ; Severity of Illness Index ; Surveys and Questionnaires ; Translating ; Young Adult

The Schedule of Fatigue and Anergy/General Physician (SOFA/GP) was developed to screen for prolonged fatigue in the primary care setting. We aimed to evaluate the reliability and validity of the Korean version of the SOFA/GP (SOFA/GP-K), which is adapted from the original English version. We performed translation and back translation, and after conducting a pilot study, we tested the final version of the questionnaire for its reliability and validity in a Korean primary care setting. Two hundred participants that visited a health examination center in a university hospital completed the survey between September and November 2012. A second survey was performed within 2 weeks of the primary survey to test for reliability. We evaluated concurrent validity between the SOFA/GP-K score, the Fatigue Severity Scale (FSS), and Brief Fatigue Index (BFI) scores. The Spearman correlation coefficient between SOFA/GP-K and FSS was 0.71 and 0.61 between SOFA/GP-K and BFI. Internal consistency of SOFA/GP-K was observed (Cronbach's alpha = 0.82) and construct validity was confirmed by factor analysis. The Kappa scores for test-retest reliability for each survey item were between 0.28 and 0.64. The SOFA/GP-K is a valid and reliable questionnaire for screening fatigue in a primary care setting.
Adult ; Aged ; Fatigue/metabolism/*pathology ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Practice Guidelines as Topic/*standards ; Republic of Korea ; Severity of Illness Index ; Surveys and Questionnaires ; Translating ; Young Adult

Background: The coronavirus disease pandemic is predicted to have adverse health effects on children and adolescents who are overweight or obese due to restricted school activity and stay-at-home orders. The purpose of this observational study was to determine the factors associated with weight gain in children and adolescents with overweight and obesity during coronavirus disease 2019 (COVID-19) lockdown. Methods: Ninety-seven participants (sex- and age-specific body mass index (BMI) ≥ 85th percentile) were included. A baseline examination was conducted pre-COVID-19 (August 2019 to January 2020), and re-examination was performed post-lockdown (June to September 2020) and the results were compared. Correlation and regression analyses were conducted to investigate the association among changes in cardiometabolic markers and lifestyle behaviors with changes in BMI z-score. Results: During the COVID-19 pandemic, an increase in BMI z-score (2.56 [2.01–2.94] to 2.62 [2.03–3.18]) was noticed in children and adolescents with obesity. Changes in cardiometabolic markers including liver enzymes, triglycerides (r = 0.398), leptin (r = 0.578), and adiponectin (r = −0.326), as well as muscular strength (r = −0.212), were correlated with the increase in BMI z-score. According to a multivariate regression analysis, changes in sedentary time (B = 0.016; 95% confidence interval [CI], 0.001–0.032) and fast-food consumption (B = 0.067; 95% CI, 0.013–0.122) were the lifestyle variables associated with BMI z-score increase. Conclusion Changes in lifestyle behaviors including fast-food consumption and sedentary time during the COVID-19 pandemic may be associated with weight gain. In order to prevent health-related risks in children and adolescents with obesity during the pandemic, it is important to maintain the level of physical activity and healthy dietary habits.

The lower elementary school grades are an important period in which eating habits are formed. We examined the relationship between eating habits and school meal intake in the lower grades of an elementary school in Seoul. The eating habits were investigated using the Nutrition Quotient (NQ) for children. The school meal intake rates and preferred menus were obtained by automatically scanning the plate before and after meals using an artificial intelligence food scanner. The average school meal intake rate for the 347 subjects was 68.5±12.2%, and the nutrient intakes through the school meals were 353.5±70.0 kcal of energy, 51.8±10.2 g of carbohydrates, 14.6±3.1 g of proteins, 10.3±2.3 g of fats, 87.0±20.0 mg of calcium, and 1.8±0.4 mg of iron. The preferred menus were rice, grilled food, and dairy products, and non-preferred menus were salad, beverages, and stewed food. The eating habits that showed a positive correlation with the school meal intake rate were ‘Diverse side dishes (r=0.332, P＜0.001)’, ‘Vegetable side dishes (r=0.166, P＜0.01)’, ‘Kimchi side dish (r=0.230, P＜0.001)’ and ‘Less TV watching and computer game time (r=0.105, P＜0.05)’. The NQ score also showed a positive correlation with the rate of school meal intake (r=0.216, P＜0.001). The balance score was positively correlated with fruit (r=0.192, P＜0.001), and the diversity score had the highest positive correlation with Kimchi (r=0.362, P＜0.001). The regularity score was positively correlated with fried food (r=0.114, P＜0.05). In conclusion, it was found that elementary school students in the lower grades had a higher school meal intake rate when their eating habits included eating side dishes evenly, and consuming vegetable side dishes and Kimchi.

Objective: Subjective cognitive decline (SCD) refers to self-reported memory loss despite normal cognitive function and is considered a preclinical stage of Alzheimer’s disease. This study aimed to examine the mediating effects of depression and Instrumental Activities of Daily Living (IADL) on the association between the scoring of Clinical Dementia Rating Scale-Sum of Boxes (CDR-SB) and Subjective Cognitive Decline Questionnaire (SCD-Q). Methods: A sample of 139 community-dwelling older adults aged 65–79 with normal cognitive function completed the SCD-Q, a comprehensive neuropsychological battery, and functional/psychiatric scales. We conducted 1) a correlation analysis between SCD-Q scores and other variables and 2) a path analysis to examine the mediating effects of depression and IADL on the relationship between CDR-SB and SCD-Q. Results: CDR-SB was found to be indirectly associated with SCD-Q, with depressive symptoms mediating this relationship. However, no direct association was observed between SCD-Q and CDR-SB. Additionally, IADL was not associated with SCD-Q and did not mediate the relationship between CDR-SB and SCD-Q. The model fit was acceptable (minimum discrepancy function by degrees of freedom divided [CMIN/DF]=1.585, root mean square error of approximation [RMSEA]=0.065, comparative fit index [CFI]=0.955, Tucker-Lewis index [TLI]=0.939). Conclusion Our results suggest that SCD-Q is influenced by depressive symptoms, but not by IADL. The role of depressive symptoms as a mediator between CDR-SB and SCD-Q indicates that psychological factors may contribute to the perception of SCD. Therefore, interventions targeting depression may mitigate the concerns associated with SCD and reduce feelings of worse performance compared to others of the same age group.

PURPOSE: Half of the world's gastric cancer cases and the highest gastric cancer mortality rates are observed in Eastern Asia. Although several genome-wide association studies (GWASs) have revealed susceptibility genes associated with gastric cancer, no GWASs have been conducted in the Korean population, which has the highest incidence of gastric cancer. MATERIALS AND METHODS: We performed genome scanning of 450 gastric cancer cases and 1,134 controls via Affymetrix Axiom Exome 319 arrays, followed by replication of 803 gastric cancer cases and 3,693 healthy controls. RESULTS: We showed that the rs2976394 in the prostate stem cell antigen (PSCA) gene is a gastriccancer-susceptibility gene in a Korean population, with genome-wide significance and an odds ratio (OR) of 0.70 (95% confidence interval [CI], 0.64 to 0.77). A strong linkage disequilibrium with rs2294008 was also found, indicating an association with susceptibility. Individuals with the CC genotype of the PSCA gene showed an approximately 2-fold lower risk of gastric cancer compared to those with the TT genotype (OR, 0.47; 95% CI, 0.39 to 0.57). The effect of the PSCA gene on gastric cancer was more prominent in the female population and for diffuse type gastric cancer. CONCLUSION: Our result confirmed that the PSCA gene may be the most important susceptibility gene for gastric cancer risk in a Korean population.
Exome ; Far East ; Female ; Genetic Variation ; Genome ; Genome-Wide Association Study ; Genotype ; Humans ; Incidence ; Linkage Disequilibrium ; Mortality ; Odds Ratio ; Prostate ; Stem Cells ; Stomach Neoplasms

BACKGROUND: Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)'s own PHR system and to analyze consumer's use pattern after providing PHR service. METHODS: Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. RESULTS: The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. CONCLUSION: For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR.
Advisory Committees ; Electronic Health Records ; Health Records, Personal* ; Humans ; Internet ; Mobile Applications ; Patient-Centered Care ; Seoul

PURPOSE: The current study investigated whether the combined effects of soy intake and genetic polymorphisms of interleukin (IL) genes modify gastric cancer risk. MATERIALS AND METHODS: A total of 377 cases and 754 controls of Korean origin were included in the analysis. Soy consumption was assessed using a semi-quantitative food frequency questionnaire. Seven variants of IL10 (rs1800871), IL2 (rs2069763 and rs2069762), IL13 (rs6596090 and rs20541), and IL4R (rs7205663 and rs1805010) were genetically analyzed. To analyze the combined effect of soy intake and genetic polymorphisms, a low-intake group and high-intake group of each type of soy were categorized based on the intake level of the control group. Interactions between soy products and these genetic variants were analyzed by a likelihood ratio test, in which a multiplicative interaction term was added to the logistic regression model. RESULTS: A higher intake of nonfermented soy products was associated with a reduced cancer risk (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.43 to 0.90), and the reduced risk was only apparent in males (OR, 0.44; 95% CI, 0.27 to 0.71). None of the IL genetic polymorphisms examined were independently associated with gastric cancer risk. Individuals with a minor allele of IL2 rs2069762 and a higher intake of nonfermented soy food had a decreased risk of gastric cancer (OR, 0.46; 95% CI, 0.31 to 0.68) compared to those with a lower intake (p(interaction)=0.039). CONCLUSION: Based on the genetic characteristics of the studied individuals, the interaction between IL2 rs2069762 and nonfermented soy intake may modify the risk of gastric cancer.
Alleles ; Case-Control Studies* ; Gene-Environment Interaction ; Humans ; Interleukin-10 ; Interleukin-13 ; Interleukin-2 ; Interleukins* ; Korea* ; Logistic Models ; Male ; Polymorphism, Genetic* ; Soy Foods ; Stomach Neoplasms*

In brain tissue, astrocytes play defensive roles in central nervous system integrity by mediating immune responses against pathological conditions. Type I phosphatidylinositol 4-phosphate 5-kinase alpha (PIP5Kalpha) that is responsible for production of phosphatidylinositol 4,5-bisphosphate (PI[4,5]P2) regulates many important cell functions at the cell surface. Here, we have examined whether PIP5Kalpha is associated with astrocyte inflammatory responses. Gangliosides are releasable from damaged cell membranes of neurons and capable of inducing inflammatory responses. We found that treatment of primary cultured astrocytes with gangliosides significantly enhanced PIP5Kalpha mRNA and protein expression levels. PI(4,5)P2 imaging using a fluorescent tubby (R332H) expression as a PI(4,5)P2-specific probe showed that ganglioside treatment increased PI(4,5)P2 level. Interestingly, microRNA-based PIP5Kalpha knockdown strongly reduced ganglioside-induced transcription of proinflammatory cytokines IL-1beta and TNFalpha. PIP5Kalpha knockdown also suppressed ganglioside-induced phosphorylation and nuclear translocation of NF-kappaB and the degradation of IkappaB-alpha, indicating that PIP5Kalpha knockdown interfered with the ganglioside-activated NF-kappaB signaling. Together, these results suggest that PIP5Kalpha is a novel inflammatory mediator that undergoes upregulation and contributes to immune responses by facilitating NF-kappaB activation in ganglioside-stimulated astrocytes.
Animals ; Astrocytes/*metabolism ; Cells, Cultured ; Gangliosides/*metabolism ; Gene Knockdown Techniques ; Inflammation/*metabolism ; Interleukin-1/metabolism ; NF-kappa B/metabolism ; Phosphotransferases (Alcohol Group Acceptor)/*metabolism ; RNA, Messenger/*genetics/metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Tumor Necrosis Factor-alpha/metabolism ; Up-Regulation