Background: and Purpose Subjective cognitive complaints (SCCs) are gaining attention as a self-perceived symptom for cognitive impairment in patients with Parkinson’s disease (PD), but there are few suitable tools for assessing SCCs in PD. This study aimed to develop and validate a questionnaire for assessing SCCs in PD, called the Subjective Cognitive Complaints Questionnaire for Parkinson’s Disease (SCCQ-PD). Methods: The SCCQ-PD consists of 12 yeso questions on subjective cognitive function, and the questionnaire was completed by patients with PD (score-P) and their caregivers (score-C). The cognitive function of patients was examined using comprehensive neuropsychological tests. Results: This study included 73 patients (38 cognitively normal, 25 with mild cognitive impairment [MCI], and 10 demented) and their caregivers. Score-P and score-C had excellent reliability (Kuder-Richardson formula 20 coefficients of 0.893 and 0.931, respectively), and the scores exhibited a strong intercorrelation. Both score-P and score-C were negatively correlated with cognitive performance, and both were excellent in discriminating demented patients from those with normal cognition or MCI (areas under the receiver operating characteristic curve of 0.83 and 0.88, respectively). Conclusions The SCCQ-PD is a reliable tool for assessing SCCs in patients with PD. SCCs measured using the SCCQ-PD are correlated with objective cognitive decline and useful for discriminating demented patients from nondemented patients.

BACKGROUND: It is important to know and decide when to end regimen for the quality of life of the patients. However, there is currently no clear agreement on when to terminate palliative chemotherapy. We investigated the duration between the last chemotherapy and death, and associated factors affecting patients receiving palliative care after the last chemotherapy. METHODS: We studied 242 patients who were put into palliative care ward after receiving chemotherapy and died during hospitalization from 2008 to 2009. Electronic medical records were used to gather information on demographic characteristics, types of primary cancer, and palliative chemotherapy. Then we analyzed the relationship between the clinical characteristics of patients and interval between last chemotherapy and death. RESULTS: The average survival time of patients after referral to palliative care was 17.5 days; survival time after discontinuation of chemotherapy was 103 days. Also, 104 (43.0%) patients died within 3 months and 14 (5.8%) patients died within 1 month of persistent palliative chemotherapy. Chemotherapy on patients within 3 months from their death was not associated with the social characteristics of the population. CONCLUSION: The patients who were referred to palliative care were found to have continued to receive chemotherapy within 3 months before death. However, only a small number of patients received chemotherapy within 1 month before death, which confirms that futile chemotherapy that extends to the end of life was less frequent. Doctors should be able to recognize the implications of excessive and aggressive use of chemotherapy and should actively communicate with patients about therapeutic choices.
Electronic Health Records ; Hospitalization ; Humans ; Palliative Care ; Quality of Life ; Referral and Consultation ; Sociology

OBJECTIVE: The purpose of this study was to analyze the characteristics and factors of voluntary discharged patients after suicide attempt and analyze the effectiveness of follow-up measures. METHODS: Total 504 adult patients aged 14 years and over, who visited a local emergency medical center from September 1, 2013 to December 31, 2015 were enrolled and retrospectively reviewed. We analyzed the relationship with voluntary discharge group (VDG) among basic characteristics, suicidal attempt variables, outcome variables related to suicide attempts, and treatment related variables comparing with normal discharge group (NDG). RESULTS: Of the total 504 suicide attempts, three hundred eleven (61.7%) patients were VDG and 193 (38.2%) were NDG. The proportion of patients who completed the community service linkage were 18.7% (36/193) in NDG, compared with 7.7% (24/311) in VDG (p < 0.05). In addition, the ratio of the patients who visited psychiatric outpatient department in NDG were 57.0% (110/193), more than four times as likely as 14.5% (45/311) in VDG (p < 0.05). CONCLUSION: Over sixty percent of suicide attempters discharged against medical advice. Further various aspects of national supportive measures including strengthening case management service should be considered.
Adult ; Case Management ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies ; Humans ; Linear Energy Transfer* ; Outpatients ; Retrospective Studies ; Social Welfare ; Suicide ; Suicide, Attempted*

PURPOSE: People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression. METHOD: Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report. RESULTS: Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history. CONCLUSION: Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Anxiety ; Comorbidity ; Depression ; Depressive Disorder, Major ; Humans ; Mood Disorders ; Suicide ; Suicide, Attempted

On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl’s node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.

To investigate the population densities of potential malaria vectors, Anopheles species were collected by light traps in malaria endemic areas, Paju and Gimpo, Gyeonggi-do of Korea. Five Anopheles Hyrcanus sibling species (An. sinensis, An. pullus, An. lesteri, An. kleini, and An. belenrae) were identified by PCR. The predominant species, An. pullus was collected during the late spring and mid-summer, while higher population consists of An. sinensis were collected from late summer to early autumn. These 2 species accounted for 92.1% of all Anopheles mosquitoes collected, while the other 3 species accounted for 7.9%. Taking into account of these population densities, late seasonal prevalence, and long-term incubation period (9-13 months) of the Korean Plasmodium vivax strain, An. sinensis s.s is thought to play an important role in the transmission of vivax malaria in the study areas.
Animals ; Anopheles/*classification/genetics/*growth & development ; Humans ; Malaria, Vivax/transmission ; Polymerase Chain Reaction/methods ; Population Dynamics ; Republic of Korea ; Seasons

BACKGROUND: Many epidemiological studies suggest the pathogenic role of serum uric acid level in development of hypertension. Several cross-sectional studies have shown the relationship between uric acid and development of hypertension in Korea. We investigated whether uric acid associates with the development of hypertension in a retrospective cohort study. METHODS: We included 2,353 people who did not have hypertension initially and underwent general medical examination between 1997 and 1998 and were re-examined after 10 years later. Study people divided into three groups according to serum uric acid level tertiles. RESULTS: The incidences of hypertension in tertile groups were 14.1% (108/764), 22.0% (175/769), and 24.3% (193/793) and they showed statistically significant difference. We performed multivariable logistic regression with serum uric acid and other risk factors of hypertension. The incidence of hypertension in second and third tertile group were significantly higher than first tertile group (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.11 to 2.10; P = 0.009 in second tertile group and OR, 1.66; 95% CI, 1.17 to 2.37; P = 0.005 in third tertile group). CONCLUSION: Serum uric acid level is associated with the development of hypertension.
Cohort Studies ; Epidemiologic Studies ; Hypertension ; Incidence ; Korea ; Logistic Models ; Retrospective Studies ; Risk Factors ; Uric Acid

PURPOSE: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. METHODS: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. RESULTS: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). CONCLUSION: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.
Surveys and Questionnaires ; Hospice Care ; Hospices ; Humans ; Palliative Care ; Referral and Consultation ; Specialization

PURPOSE: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). METHODS: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2–4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. RESULTS: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. CONCLUSIONS: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.
Anti-Bacterial Agents ; Bone Regeneration ; Chlorhexidine ; Dental Implants ; Hemorrhage ; Humans ; Minocycline ; Peri-Implantitis ; Shoulder

Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky–Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; TxMod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; TxMod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky–Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky–Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001).However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky–Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.