PURPOSE: The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. METHODS: A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. RESULTS: Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. CONCLUSION: Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.
Adult ; Aged ; Antineoplastic Agents/therapeutic use ; *Fatigue ; Female ; Genital Neoplasms, Female/drug therapy/*psychology ; Health Behavior ; Health Education ; Humans ; *Life Style ; Middle Aged ; *Nutritional Status ; Proportional Hazards Models ; *Quality of Life ; Surveys and Questionnaires

Background: Subclinical thyroid disease is characterized by abnormal thyroid stimulating hormone (TSH) levels with normal free thyroxine (T4) levels. This study aimed to verify the association between subclinical hypothyroidism and depression measured using the Patient Health Questionnaire-9 (PHQ-9) score in the Korean population. Methods: This cross-sectional study included 1,786 adults aged ≥19 years with normal free T4 levels and serum TSH levels ≥0.45 mIU/L who had participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2014. The PHQ-9 was first introduced in the KNHANES to detect depression (PHQ score of ≥10). Serum TSH level of 0.45–4.49 mIU/L was defined as the reference range. The association between subclinical hypothyroidism and depression according to gender and age was evaluated using the binary logistic regression analysis after adjusting for age, education, and body mass index. Results: There was no association between subclinical hypothyroidism and depression according to gender. The odds ratio for depression was 2.498 (95% confidence interval [CI], 0.905–6.895; P=0.077) in men and 0.727 (95% CI, 0.352–1.503; P=0.390) in women. Additionally, there was no association between subclinical hypothyroidism and depression according to age. Conclusion These results suggest that subclinical hypothyroidism was not associated with depression in Korean adults.

Rheumatoid arthritis (RA) is an autoimmune disease that starts with decreased tolerance to modified self-antigens and eventually leads to synovitis and destruction of bone and cartilage. Age is a risk factor for developing RA. Major changes in the immune system come with age due to chronic oxidative stress on the deoxyribonucleic acid (DNA) damage pathway, somatic mutation, modifications of auto-antigens, T cell tolerance and activation of fibroblast-like synoviocytes (FLS). Reactive oxygen species (ROS) generated by nicotinamide adenine dinucleotide phosphate oxidase 2 (NADPH oxidase 2) suppress T cell receptor signaling. Sirtuin 1 (SIRT1) is a critical immune suppressor of T cell activation and a key regulator of oxidative stress. When oxidative stress reduces activity of SIRT1, the breakdown of tolerance to modified self-antigens is expected. Generation of ROS can be perpetuated by enhanced DNA damage and dysfunctional mitochondria in a feedback loop during the development of RA. Through major T cell loss and selective proliferation of peripheral T cells, pro-inflammatory T cell pools with abnormal features are established in the T cell compartment. Hypoxic and inflammatory condition in synovium perpetuates ROS generation, which leads to the activation of FLS. In both T cell and synovium compartment, oxidative stress reshapes the immune system into the development of pre-clinical RA.
Arthritis, Rheumatoid* ; Autoantigens ; Autoimmune Diseases ; Cartilage ; DNA ; DNA Damage ; Immune System ; Mitochondria ; NADP ; NADPH Oxidase ; Oxidative Stress ; Oxidoreductases ; Reactive Oxygen Species* ; Receptors, Antigen, T-Cell ; Risk Factors ; Sirtuin 1 ; Synovial Membrane ; Synovitis ; T-Lymphocytes

Fecal samples obtained from wild boar habitats are useful for the surveillance of diseases in wild boar populations; however, it is difficult to determine the species of origin of feces collected in natural habitats. In this study, a fecal IgA ELISA was evaluated as a method for identifying the porcine species from fecal samples. Both domestic pigs (Sus scrofa domestica) and wild boars (Sus scrofa coreanus) showed significantly higher levels of fecal IgA than other animal species. Additionally, age dependent changes in the level of Ig A in wild boars and domestic pigs were identified; Titers of Ig A were highest in suckling period and lowest in weanling period.
Animals* ; Antibodies* ; Ecosystem ; Enzyme-Linked Immunosorbent Assay ; Feces ; Immunoglobulin A* ; Immunoglobulins* ; Methods ; Sus scrofa*

OBJECTIVES : This case-based, small scale study was undertaken to identify the characteristics clinical features of children who exhbiit rare prepubertal onset bipolar disorder. METHODS : We analyzed the clinical records of 13 children who had been hospitalized and diagnosed with bipolar disorder. Clinical characteristics and cognitive function of these patients was based on psychiatrists' medical records and psychologists' evaluation reports. RESULTS : Eleven (84.6%) subjects exhibited clinical features of mixed mania and had a chronic clinicalcourse. They never fulfilled the full criteria of the Diagnostic Statistical Manual of Mental disorders- Fourth Edition (DSM-IV) for manic or hypomanic episodes. Mean age at onset of typical symptoms of bipolar disorder was 9.38 (SD=1.80) and mean age at admission was 12.00 (SD=2.45). Twelve (92.3%) had psychiatric comorbidity. Attention-deficit/hyperactivity disorder was the most prevalent comorbid disease and mean age of onset of it was 6.23 (SD=2.17). CONCLUSION : Subjects with prepubertal onset bipolar disorder showed atypical clinical features. These results suggest that most prepubertal onset bipolar disorder patients fail to meet the DSM-IV criteria for typical bipolar I disorder and therefore, we need to develop alternative diagnostic criteria for pediatric bipolar disorder.
Age of Onset ; Bipolar Disorder ; Child ; Comorbidity ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Medical Records ; Pilot Projects

Classic causes of fever of unknown origin (FUO) are infections, neoplasms, collagen vascular diseases and drugs. However, large studies of FUO have consistently reported that a considerable proportion of patients with FUO remain undiagnosed. We report a patient with a prolonged course of FUO and progressive pulmonary nodules in whom extensive clinical and laboratory evaluation did not reveal specific diagnosis. The patient had recurrent episodes of fever for more than three years, and the pulmonary nodules gradually progressed in size and number despite administration of antibiotics including antifungal and antituberculosis agents. Several pathologic examinations demonstrated an organizing pneumonia or non-neoplastic lung parenchyma with lymphoplasmacytic infiltration only. After a protracted course of disease, we thought that this patient might have lymphoproliferative disorder, possibly EBV-associated, and started anti-cancer chemotherapy. He was successfully treated with eight cycles of chemotherapy including cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP).
Anti-Bacterial Agents ; Collagen ; Cyclophosphamide ; Diagnosis ; Doxorubicin ; Drug Therapy* ; Fever of Unknown Origin* ; Fever* ; Humans ; Lung ; Lymphoproliferative Disorders ; Pneumonia ; Prednisolone ; Vascular Diseases ; Vincristine

Human norovirus are major causative agent of nonbacterial acute gastroenteritis. In general, genogroup (G) II.4 is the most prominent major genotype that circulate in human population and the environment. However, a shift in genotypic trends was observed in Korea in December 2014. In this study, we investigated the trend of norovirus genotype in detail using the database of Acute Diarrhea Laboratory Surveillance (K-EnterNet) in Korea. GII.17 has since become a major contributor to outbreaks of norovirus-related infections and sporadic cases in Korea, although the reason for this shift remain unknown.
Diarrhea ; Disease Outbreaks ; Gastroenteritis ; Genotype ; Humans ; Korea* ; Norovirus*

OBJECTIVE: To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS: A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). RESULTS: Participants who were younger, male, highly educated, living with family members, having high body mass index, having high appendicular lean mass index, and having no irritative lower urinary tract syndrome were more likely to have higher FRA scores. SPPB (β=1.012), BBS (β=0.481), and TUG (β=-0.831) were significantly associated with FRA score after adjusting for the variables (all p < 0.001). CONCLUSION: FRA composite score was closely correlated with SPPB, BBS, and TUG, suggesting that FRA is a promising candidate as a screening tool to predict falls among community-dwelling elderly people.
Accidental Falls ; Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Humans ; Male ; Mass Screening ; Risk Assessment ; Urinary Tract

The concept of cognitive frailty has recently been proposed by an International Consensus Group as the presence of physical frailty and cognitive impairment [defined using the Clinical Dementia Ratings (CDR)=0.5], without concurrent dementia. However, CDR is difficult to implement and not often available in epidemiologic studies or busy clinical settings, and an alternative to CDR is required. We suggest an alternative definition of cognitive frailty as: 1) physical frailty, 2) more than 1.5 standard deviation below the mean for age-, gender-, and education-adjusted norms on any cognitive function test (e.g., the Montreal Cognitive assessment test, the Alzheimer’s disease assessment scale-cognitive subscale, verbal learning test, Digit Span, Boston Naming Test, Trail Making Test, and Frontal Assessment Battery), and 3) no dependency in instrumental activities of daily living. The redefined criteria for cognitive frailty would be more feasible to implement and thus more applicable in epidemiologic studies and busy clinical settings.
Activities of Daily Living ; Cognition ; Cognition Disorders ; Consensus ; Dementia ; Epidemiologic Studies ; Mild Cognitive Impairment ; Trail Making Test ; Verbal Learning

BACKGROUND: The early and accurate diagnosis of leptomeningeal metastasis (LM) has become important because of introduction of new therapeutic strategies for LM and increasing incidence of LM along with longer survival of cancer patients. We aimed to evaluate the role of cerebrospinal fluid (CSF) CYFRA 21-1 as a diagnostic indicator for LM in patients with cancer. METHODS: CSF CYFRA 21-1 level was analyzed using electro-chemiluminescent immunoassay. The difference in concentration of CSF CYFRA 21-1 between 91 patients with LM and 339 control groups (patients with other neurological disease or healthy controls) was investigated. The cut-off value of CSF CYFRA 21-1 as a diagnostic indicator for LM and its diagnostic performance were evaluated. RESULTS: The CSF CYFRA 21-1 was significantly higher in LM patients than control groups (p<0.001). A cut-off value of diagnosis for LM in patients with cancer was 1.59 ng/mL. The sensitivity, specificity, accuracy, and positive and negative predictive values of CSF CYFRA 21-1 were 80.2%, 96.2%, 92.8%, 84.9%, 94.8% for diagnosis of LM. CONCLUSIONS: These results suggested that CSF CYFRA 21-1 can be an additional diagnostic indicator for cancer patients with LM.
Cerebrospinal Fluid ; Diagnosis ; Humans ; Immunoassay ; Incidence ; Neoplasm Metastasis ; Sensitivity and Specificity