The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for ‘home-delivered meal and side dish services are effective for checking older adults’ conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.
Adult ; Community Health Centers ; Eating ; Humans ; Meals ; Seoul ; Social Work ; Social Workers ; Spouses ; Statistics as Topic ; Surveys and Questionnaires

The diagnosis of HELLP syndrome associated with preeclampsia-eclampsia during pregnancy uses three test results, including hemolysis, elevated liver enzyme, low platelets and their related clinical symptoms. Liver rupture is a life-threatening and rare complication related to HELLP syndrome. Early diagnosis and rapid treatment are very important for protecting the life of the patient and the fetus. We are reporting an anesthetic experience a sudden-onset suspicious HELLP syndrome with an intraperitoneal hemorrhage caused by a rapidly progressed liver rupture in a severe preeclampsia patient without any abnormalities during gestation.
Diagnosis ; Early Diagnosis ; Eclampsia ; Female ; Fetus ; HELLP Syndrome* ; Hemolysis ; Hemorrhage* ; Humans ; Liver* ; Pre-Eclampsia* ; Pregnancy ; Rupture*

PURPOSE: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. MATERIALS AND METHODS: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl 25 µg (up to 100 µg), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. RESULTS: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. CONCLUSION US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.

Glutathione (GSH) protects cells against oxidative stress by playing an antioxidant role. Protecting brain endothelial cells under oxidative stress is key to treating cerebrovascular diseases and neurodegenerative diseases including Alzheimer's disease and Huntington's disease. In present study, we investigated the protective effect of GSH on brain endothelial cells against hydrogen peroxide (H2O2). We showed that GSH attenuates H2O2-induced production of nitric oxide (NO), reactive oxygen species (ROS), and 8-Oxo-2'-deoxyguanosine (8-OHdG), an oxidized form of deoxiguanosine. GSH also prevents H2O2-induced reduction of tight junction proteins. Finally, GSH increases the level of nuclear factor erythroid 2-related factor 2 (Nrf2) and activates Nrf2-mediated signaling pathways. Thus, GSH is a promising target to protect brain endothelial cells in conditions of brain injury and disease.
Alzheimer Disease ; Apoptosis ; Brain Injuries ; Brain* ; Endothelial Cells* ; Glutathione* ; Huntington Disease ; Hydrogen Peroxide ; Hydrogen* ; Neurodegenerative Diseases ; Nitric Oxide ; Oxidative Stress* ; Reactive Oxygen Species ; Tight Junction Proteins

Postherpetic neuralgia (PHN) is a chronic and refractory pain disease. It requires longterm treatment and follow-up. Comorbid diseases can change or aggravate the pain condition and responsiveness of patients to PHN treatment. In such cases, the cause of pain should be identified through proper testing, and appropriate treatment should be administered. Herein, we report the case of a 67-year-old man with PHN in the maxillary nerve. As the pain was being controlled with medication and infraorbital nerve block, the patient experienced deterioration of pain caused by a newly worn upper complete denture. The patient's pain was relieved following correction of the upper complete denture.
Aged ; Denture, Complete* ; Follow-Up Studies ; Humans ; Maxillary Nerve ; Nerve Block ; Neuralgia, Postherpetic* ; Pain, Intractable ; Trigeminal Nerve

OBJECTIVES: This study examined the practices of a community meal program for older adults in rural areas during the agricultural off-season. METHODS: A survey was conducted from December 12 to December 22, 2016. Self-administered questionnaires were distributed to 150 cooking volunteers, who had participated in the community meal program in 50 villages. A total of 114 responses were returned from 44 villages and used for data analysis. In addition, in-depth interviews were conducted with the volunteers of eight villages. RESULTS: Most of the cooking volunteers were 50 years old or older and they participated in serving older adults meals for good will. The cooking volunteers perceived that the older adults in their community did not eat various foods, had difficulties in grocery shopping, and frequently consumed salty foods. During the agricultural off-season, 40.9% of villages served the older adults meals 6–7 days a week and 95.5% provided meals for lunch. An average of 21 to 40 older adults were served meals in each village. The cooking volunteers reported that the food preparation and meal service times were sufficient, recipes provided were useful, and menus met the preference of the older adults. At the end of the program, they felt proud of serving meals for older adults in the community. An increased awareness of healthy eating, interest in health, and consumption of nutritious meals, a decrease in loneliness among older adults, and the promotion of fellowship in the community were rated highly. The cooking volunteers expected additional support for cooking personnel and insisted that the program should be provided for the entire agricultural off-seasons. CONCLUSIONS: The community meal program during the agricultural off-season for the elderly in rural areas was effective in improving the dietary life of older adults, relieving their feelings of isolation, and promoting fellowship of the community. The volunteers felt workload due to a shortage of volunteers but answered that they were rewarded by helping older adults in their community.
Adult ; Aged ; Cooking ; Eating ; Fellowships and Scholarships ; Humans ; Loneliness ; Lunch ; Meals ; Reward ; Statistics as Topic ; Volunteers

Intercostal neuralgia is neuropathic pain that develops in the thorax and abdomen. It usually occurs as a result of injury or inflammation associated with the intercostal nerve triggered by trauma, surgery, or herpes zoster. Primary intercostal neuroma is a rare cause of intercostal neuralgia. A 69-year-old male patient without a history of thoracic trauma or surgery underwent repeated testing and intermittent treatment for refractory pain in the right chest and abdomen for several years. However, the treatment had limited effect. Abdominal computed tomography performed to diagnose recent pain aggravation revealed schwannoma of the 11th intercostal nerve. The patient's pain was relieved following surgical excision of the tumor.
Abdomen ; Aged ; Herpes Zoster ; Humans ; Inflammation ; Intercostal Nerves ; Male ; Neuralgia ; Neurilemmoma ; Neuroma ; Pain, Intractable ; Thorax

OBJECTIVE: Our purpose was to investigate women's perception and satisfaction before and after hysterectomy comparing urinary, lower gastrointestinal, and sexual function. METHODS: It was a prospective study of 89 women ages 31-65 years undergoing total abdominal hysterectomy for nonmalignant conditions. These women were interviewed before surgery and 1, 3 and 6 months later. Patients-reported symptoms of urinary, lower gastrointestinal, and sexual function and woman's satisfaction of hysterectomy were assessed. Only P< or =0.001 was considered statistically significant. RESULTS: The most common reason of patients for hysterectomy was abnormal uterine bleeding. Secondary complication after hysterectomy was negligible. Hysterectomy has got lead to the improvements in pelvic/abdominal pain, gastrointestinal symptoms, and urinary symptoms. The frequency of orgasm was reduced, but other sexual variables were not changed significantly. The level of satisfaction after hysterectomy was very high. CONCLUSION: Abdominal hysterectomy for benign conditions improves urinary and lower gastrointestinal function with no consistent changes in sexual function. Hysterectomy gives patients high degree of satisfaction as well as marked improvement of quality of life.
Female ; Humans ; Hysterectomy* ; Orgasm ; Prospective Studies ; Quality of Life ; Uterine Hemorrhage

From January 1998 to December 2002, 3,259 cases of uterine myoma were treated at the department of Obstetrics and Gynecology, Chunbuk National University Hospital. A clinico-stastical study of uterine myoma was perfomed to analyse the clinical characteristics. The results were as follows. 1. The incidence of uterine myoma was 9.8%. 2. The most frequent age group was 40 to 49 years, and the mean age was 44.6 years. 3. The average parity was 2.29, the infertility was 163 cases (5.0%), while the primary infertility, 2.4%, the secondary, 2.6% respectively. 4. The most frequent chief complaint was pain which was observed in 2,648 cases (81.2%), abnormal bleeding in 1,775 cases (53.8%). dizziness in 270 cases (8.3%). 5. The corporeal myomas were observed in 2,879 cases (95.9%). Intramural type was observed in 1,687 cases (58.2%), subserous in 529 cases (18.2%), submucous in 191 cases (6.5%), mixed type in 483 cases (17.0%). 6. The mean value of preoperative hemoglobin was 11.1 gm/dL, and the anemia (Hb<10.0 gm/dL) was observed in 481 cases (11.7%). Transfusion was necessary in 215 cases (6.5%). 7. The mean weight of the uterine myoma operated was 335.0 gm. 8. The secondary change of myoma was found in 54 cases (1.7%) and hyaline degeneration was the most common (0.7%). 9. The most common associated condition was chronic cervicitis, which was observed in 784 cases (24.1%). 10. The gynecologic surgery were performed in 1,456 cases (44.7%), medical therapy in 25 cases (0.8%), observation in 1,792 cases (55.0%). 11. Total abdominal hysterectomy was performed in 607 cases (41.7%), total abdominal hysterectomy with unilateral adnexectomy in 115 cases (7.9%), total abdominal hysterectomy with both adnexectomy in 164 cases (11.3%), subtotal hysterectomy in 304 cases (20.9%), myomectomy in 153 cases (10.5%), total laparoscopic hysterectomy in 103 cases (7.0%), laparoscopy assisted vaginal hysterectomy in 8 cases (0.5%), diagnostic laparoscopy in 2 cases (0.1%) respectively. 12. The postoperative complication were found in 113 cases (3.5%) and the wound infection was the most common (1.6%). 13. The mean period of hospitalization was 8 days, and the period less than 10 days in 1,177 cases (80.9%).
Anemia ; Dizziness ; Female ; Gynecologic Surgical Procedures ; Gynecology ; Hemorrhage ; Hospitalization ; Humans ; Hyalin ; Hysterectomy ; Hysterectomy, Vaginal ; Incidence ; Infertility ; Laparoscopy ; Leiomyoma* ; Myoma ; Obstetrics ; Parity ; Postoperative Complications ; Uterine Cervicitis ; Wound Infection

Objective: The purposes of this study were to analyze the radiation doses for pediatric abdominopelvic and chest CT examinations from university hospitals in Korea and to establish the local diagnostic reference levels (DRLs) based on the body weight and size. Materials and Methods: At seven university hospitals in Korea, 2494 CT examinations of patients aged 15 years or younger (1625 abdominopelvic and 869 chest CT examinations) between January and December 2017 were analyzed in this study. CT scans were transferred to commercial automated dose management software for the analysis after being de-identified. DRLs were calculated after grouping the patients according to the body weight and effective diameter. DRLs were set at the 75th percentile of the distribution of each institution’s typical values. Results: For body weights of 5, 15, 30, 50, and 80 kg, DRLs (volume CT dose index [CTDIvol]) were 1.4, 2.2, 2.7, 4.0, and 4.7 mGy, respectively, for abdominopelvic CT and 1.2, 1.5, 2.3, 3.7, and 5.8 mGy, respectively, for chest CT. For effective diameters of < 13 cm, 14–16 cm, 17–20 cm, 21–24 cm, and > 24 cm, DRLs (size-specific dose estimates [SSDE]) were 4.1, 5.0, 5.7, 7.1, and 7.2 mGy, respectively, for abdominopelvic CT and 2.8, 4.6, 4.3, 5.3, and 7.5 mGy, respectively, for chest CT.SSDE was greater than CTDIvol in all age groups. Overall, the local DRL was lower than DRLs in previously conducted dose surveys and other countries. Conclusion Our study set local DRLs in pediatric abdominopelvic and chest CT examinations for the body weight and size.Further research involving more facilities and CT examinations is required to develop national DRLs and update the current DRLs.