OBJECTIVES: Sarcopenic obesity is closely related to aging and the prevalence of various chronic diseases and frailty. The purpose of this study was to analyze whether diet quality is related to obesity, sarcopenia, and sarcopenic obesity, and if so, to explore the difference in that relationship between urban and rural settings. METHODS: Using data from the Korea National Health and Nutrition Examination Survey of 2016-2018, a total of 7,151 participants aged 40 years or older were analyzed. Sarcopenia was diagnosed using handgrip strength. Diet quality was assessed using Korea Healthy Eating Index (KHEI) scores, and obesity was determined based on participants’ abdominal circumference. Multinomial logistic analysis was used for testing statistical significance. RESULTS: Rural participants had significantly lower KHEI scores and a higher prevalence of sarcopenic obesity than urban participants. The study findings demonstrate that participants without obesity, sarcopenia, or sarcopenic obesity had significantly higher KHEI scores in both rural and urban settings. Multinomial regression analysis further revealed that a higher KHEI score was associated with a lower risk of sarcopenia and sarcopenic obesity among urban residents, while only the risk of obesity was lower with higher diet quality scores among rural residents. CONCLUSIONS Since diet quality and health status were lower in rural areas, it is important to address this regional disparity with appropriate policy measures. To mitigate urban health disparities, urban residents in poor health with few resources should also be supported.

OBJECTIVES: This study was conducted to examine the differences in food literacy between adults and older adults and the association of food literacy with food group intake. METHODS: In total, 4,039 participants from the 2021 Survey for Food Consumption in Seoul were included in this study. The intake of whole grains, high-protein foods, total vegetables, vegetables excluding kimchi and pickles, fresh fruits, and milk and dairy products was assessed using a simple food frequency questionnaire. Food literacy was measured using a food literacy measurement questionnaire. RESULTS: With the exception of milk and dairy, adults had a significantly higher proportion of insufficient food intake than older adults (p<0.001). Both adults and older adults with sufficient food group consumption had higher food literacy scores. Notably, the difference in food literacy scores by level of food intake was highest for fresh fruits (p<0.001). After adjusting for confounding factors affecting food literacy scores, a higher score was associated with a lower probability of having insufficient food intake in all food groups for both adults and older adults. Specifically, those in the highest food literacy score quartile were less likely to have insufficient intake of vegetables (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.28 to 0.43) and fresh fruits (OR, 0.32; 95% CI, 0.24 to 0.43), compared to the lowest quartile. CONCLUSIONS Improving food literacy is an important factor for promoting healthy food intake in older adults as well as adults. Therefore, it is necessary to develop intervention programs to work toward this goal.

Purpose: This paper proposes a method to convert the measurement of the humerus from conventional two-dimensional (2D) to threedimensional (3D) measurements and apply it to clinical environments for diagnosis and surgery to improve results. Materials and Methods: In the developed software application, reflection and registration functions were implemented to quantify the difference between both sides of the humerus. Consistent measurements of the humerus were taken by defining the reference axis based on the Principal Component Analysis and aligning the humerus model with respect to the reference axis. Subsequently, the length, volume, the largest cross-sectional area in the head and condyle region, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, and length and angle measurement between markups determined in the head and condyle region were examined. In addition, the automatic extraction of the head and groove, landmarks of the humerus proximal, was implemented. This study applied 40 humerus models (20 males and 20 females) to evaluate the measurements and automatic landmarkdetermination methods for humerus. Results: The measurements by this software application could provide consistent measurements of the same humerus. In addition, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, proposed through this study, provides a similar ratio regardless of gender and side. Conclusion The software application developed in this study could measure the humerus and analyze its shape using an objective, reliable, and automatic method in a 3D environment. If the results of this study are applied to real clinical trials, diagnosis, and surgery could be conducted based on objective measurements, and improved results would be achieved. In addition, the study method could be expanded to other fields, such as orthopedics.

Purpose: This paper proposes a method to convert the measurement of the humerus from conventional two-dimensional (2D) to threedimensional (3D) measurements and apply it to clinical environments for diagnosis and surgery to improve results. Materials and Methods: In the developed software application, reflection and registration functions were implemented to quantify the difference between both sides of the humerus. Consistent measurements of the humerus were taken by defining the reference axis based on the Principal Component Analysis and aligning the humerus model with respect to the reference axis. Subsequently, the length, volume, the largest cross-sectional area in the head and condyle region, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, and length and angle measurement between markups determined in the head and condyle region were examined. In addition, the automatic extraction of the head and groove, landmarks of the humerus proximal, was implemented. This study applied 40 humerus models (20 males and 20 females) to evaluate the measurements and automatic landmarkdetermination methods for humerus. Results: The measurements by this software application could provide consistent measurements of the same humerus. In addition, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, proposed through this study, provides a similar ratio regardless of gender and side. Conclusion The software application developed in this study could measure the humerus and analyze its shape using an objective, reliable, and automatic method in a 3D environment. If the results of this study are applied to real clinical trials, diagnosis, and surgery could be conducted based on objective measurements, and improved results would be achieved. In addition, the study method could be expanded to other fields, such as orthopedics.

Purpose: This paper proposes a method to convert the measurement of the humerus from conventional two-dimensional (2D) to threedimensional (3D) measurements and apply it to clinical environments for diagnosis and surgery to improve results. Materials and Methods: In the developed software application, reflection and registration functions were implemented to quantify the difference between both sides of the humerus. Consistent measurements of the humerus were taken by defining the reference axis based on the Principal Component Analysis and aligning the humerus model with respect to the reference axis. Subsequently, the length, volume, the largest cross-sectional area in the head and condyle region, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, and length and angle measurement between markups determined in the head and condyle region were examined. In addition, the automatic extraction of the head and groove, landmarks of the humerus proximal, was implemented. This study applied 40 humerus models (20 males and 20 females) to evaluate the measurements and automatic landmarkdetermination methods for humerus. Results: The measurements by this software application could provide consistent measurements of the same humerus. In addition, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, proposed through this study, provides a similar ratio regardless of gender and side. Conclusion The software application developed in this study could measure the humerus and analyze its shape using an objective, reliable, and automatic method in a 3D environment. If the results of this study are applied to real clinical trials, diagnosis, and surgery could be conducted based on objective measurements, and improved results would be achieved. In addition, the study method could be expanded to other fields, such as orthopedics.

Purpose: This paper proposes a method to convert the measurement of the humerus from conventional two-dimensional (2D) to threedimensional (3D) measurements and apply it to clinical environments for diagnosis and surgery to improve results. Materials and Methods: In the developed software application, reflection and registration functions were implemented to quantify the difference between both sides of the humerus. Consistent measurements of the humerus were taken by defining the reference axis based on the Principal Component Analysis and aligning the humerus model with respect to the reference axis. Subsequently, the length, volume, the largest cross-sectional area in the head and condyle region, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, and length and angle measurement between markups determined in the head and condyle region were examined. In addition, the automatic extraction of the head and groove, landmarks of the humerus proximal, was implemented. This study applied 40 humerus models (20 males and 20 females) to evaluate the measurements and automatic landmarkdetermination methods for humerus. Results: The measurements by this software application could provide consistent measurements of the same humerus. In addition, the position ratio of the largest cross-sectional area compared to the longitudinal length in the head and condyle region, proposed through this study, provides a similar ratio regardless of gender and side. Conclusion The software application developed in this study could measure the humerus and analyze its shape using an objective, reliable, and automatic method in a 3D environment. If the results of this study are applied to real clinical trials, diagnosis, and surgery could be conducted based on objective measurements, and improved results would be achieved. In addition, the study method could be expanded to other fields, such as orthopedics.

The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multiple-trauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and anti-thrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC.
Abdominal Pain ; Aged ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Brain ; Coma ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Drainage ; Emergencies ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Iliac Artery ; Multiple Trauma ; Shock ; Sleep Stages ; Subarachnoid Hemorrhage, Traumatic* ; Tomography, X-Ray Computed ; Vital Signs

The food and nutrient intakes on weekdays and weekends was examined with 196 high school girls residing in Seoul using the 3-day food record. Frequency for skipping breakfast was higher than that for lunch and dinner. Frequencies for skipping breakfast and lunch were significantly higher on weekends than on weekdays (p < 0.05). The daily average food, vegetable food, and animal food intakes were 1,074.8 g, 680.0 g, and 317.3 g, respectively. The total food and vegetable food intakes on weekdays were significantly higher than on weekends (p < 0.05). The daily average dietary variety score (DVS) was 20.5, and was significantly higher on weekdays (23.3) than on weekends (15.1)(p < 0.05). The daily averages of energy, protein, fat and carbohydrate intake were 1,732.9 kcal, 68 g, 56.2 g, and 240.9 g, respectively. Energy, protein, carbohydrate, phosphate, iron, sodium, potassium, thiamin, niacin, folate and vitamin C intakes were significantly higher on weekdays than on weekends (p < 0.05). Fat intake was significantly lower on weekdays than on weekends (p < 0.05). The daily average percentages of energy intake from carbohydrate, protein, and fat were 55.4%, 15.6%, and 29.0%: 56.1%, 15.8%, and 28.2% on weekdays and 54.7%, 15.3%, and 30.1% on weekends, respectively. The percentages of energy intake from carbohydrate on weekdays and weekends were below 60%, and that from fat was above 28% on weekdays and weekends. The daily averages of energy, vitamin A, riboflavin, niacin and phosphate intake were above 80% as compared with the estimated energy requirement (EER) or the recommended intake (RI). The intakes of calcium, potassium and folate were below 50% as compared with the adequate intake (AI) or (RI). The daily average mean adequacy ratio (MAR), an index of overall dietary quality, was 0.77, and significantly high school girls was worse on weekends than on weekdays.
Animals ; Ascorbic Acid ; Breakfast ; Calcium ; Eating ; Energy Intake ; Folic Acid ; Humans ; Iron ; Lunch ; Meals ; Niacin ; Potassium ; Riboflavin ; Sodium ; Vegetables ; Vitamin A

Background/Aims: The aim of this study was to compare antimicrobial resistance, clinical features, and outcomes of community-onset Escherichia coli (COEC) and Klebsiella pneumoniae (COKP) bacteremia. Methods: The medical records of patients diagnosed with E. coli or K. pneumoniae bacteremia in the emergency department of a 750-bed secondary care hospital in Daegu, Korea from January 2010 to December 2016 were retrospectively reviewed. Results: A total of 866 patients with COEC bacteremia and 299 with COKP bacteremia were enrolled. COEC bacteremia, compared to COKP bacteremia, had higher rates of 3rd generation cephalosporin (3GC) (18.8% vs. 8.4%, p < 0.001) and f luoroquinolone (FQ) (30.4% vs. 8.0%, p < 0.001) resistance. The patients with COKP bacteremia had higher Charlson comorbidity indices (CCI) (1.8 ± 2.0 vs. 1.5 ± 1.8, p = 0.035), Pittsburgh bacteremia scores (PBS) (2.0 ± 2.6 vs. 1.3 ± 1.8, p < 0.001), and 30-day mortality (14.44% vs. 8.8%, p = 0.008) than the patients with COEC bacteremia. Age younger than 70 years, male sex, polymicrobial infections, pneumonia, intra-abdominal infection, PBS ≥ 2, and Foley catheter insertion were independent predictive factors for COKP bacteremia compared to COEC bacteremia in the multivariate analysis. CCI, PBS, and intensive care unit admission were independent risk factors for 30-day mortality in the multivariate analysis. Conclusions 3GCs and FQs are still useful for the empirical treatment of patients with probable COKP bacteremia. The patients with COKP bacteremia had worse outcomes because of its greater severity and more frequent underlying comorbidities.

OBJECTIVES: Chrono-nutrition emphasizes meal timing in preventing obesity and metabolic disorders. This study explores the impact of temporal dietary patterns (TDPs) on obesity and metabolic syndrome (MetS) in Korean adults aged 20 years to 65 years. METHODS: We utilized dynamic time warping method and Kernel k-means clustering to investigate diet quality and the odds ratios (ORs) of obesity and MetS with different TDPs using data from the 7th Korea National Health and Nutrition Examination Survey. RESULTS: Participants were divided into three groups based on relative energy intake over 24 hours. After adjusting for age and gender, Cluster 3 (with the highest proportion of energy intake in the evening) had the lowest Healthy Eating Index scores compared to other clusters. Following adjustment for key covariates, Cluster 3 showed the highest values for body mass index, waist circumference, blood pressure, total cholesterol, and triglycerides. Compared to Cluster 1 (with a lower proportion of energy intake in the evening), Cluster 2 and Cluster 3 had ORs for obesity of 1.12 (95% confidence interval [CI], 0.97 to 1.30) and 1.19 (95% CI, 1.03 to 1.37), respectively. For MetS, the ORs were 1.26 (95% CI, 1.08 to 1.48) and 1.37 (95% CI, 1.17 to 1.61) when comparing Cluster 2 and Cluster 3 to Cluster 1. CONCLUSIONS This study reveals that individuals with higher energy intake in the evening have increased odds of obesity and MetS, even after adjusting for major covariates, including age and total energy intake.