No Abstract Available.
Calmodulin* ; Cell Death* ; Humans* ; Retinoblastoma*

Objective: Studies using simulation-based programs for empathy enhancement have been conducted mostly for health profession students and medical care providers in Western countries. No empirical research has been conducted for non-medical care providers of older adults in community settings in Asian countries. The purposes of this mixed-methods study were: to explore experiences and perceived usability of non-medical care providers of older adults in a simulation-based empathy enhancement program; and to examine if the program is effective in improving empathy and relevant outcomes. Methods: 104 non-medical care providers of older adults in South Korea participated in a simulation-based empathy enhancement program in 2018. Data were collected using self-reported questionnaires for effectiveness testing, a program evaluation questionnaire, and individual interviews and analyzed using statistical tests and thematic analysis. Results: Care providers showed higher levels of empathy and lower levels of stress and burnout after the program participation (p<0.05). Qualitative findings supported the improved attitude and care strategies, increased empathy towards older adults, preparing for their own aging, and restoration of emotional stability through the participation in the program. Conclusion This study suggests that the simulation-based program is useful in promoting empathic responses of non-medical care providers working with older adults.

It is acknowledged that there is a negative relationship between dementia and auditory function in older adults. This study conducted a systematic review and meta-analysis based on the data of audiologic testings from patients with neurodegenerative diseases in terms of auditory eventrelated potentials and central auditory processing tests, while focusing on Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD). A total of 34765 articles were retrieved from the seven electronic databases. After being screened by Participants, Index test, Control, Outcomes, Study design (PICOS) criteria, 129 articles for AD were included and then 72 articles were applied to the meta-analysis. However, five and six ar-ticles were systematically reviewed for the auditory functions of DLB and PDD, respectively,due to a small number of articles. The results of meta-analysis showed a significant difference between patients with AD and age-matched normal subjects, for N200 and P300 latency, P300 amplitude, and the behavioral central auditory processing tests, although there was a high heterogeneity. On the other hand, the systematic review indicated that the results of mismatch negativity test might distinguish auditory performance of DLB patients from that of PDD. Furthermore, for P300 amplitude, anterior to posterior distribution of brain resulted in meaningful difference of auditory function between AD and DLB patients. In sum, current review study suggests that lesion and degree of auditory (dys)function may be different depending on the type of dementia, although future research should be followed.

We report the case of a 78-year-old female patient with dementia with Lewy bodies accompanying severe psychotic and parkinso-nian symptoms. The patient's symptoms did not improved with various antipsychotics, and cardiac and pulmonary side effects pre-vented adequate doses of the drugs from being administered. As an alternative approach, we performed electroconvulsive therapy, which can be conducted relatively safely in elderly patients with underlying medical conditions. The patient received 10 sessions of electroconvulsive therapy across a 4-week period. Remarkable improvements in psychotic and parkinsonian symptoms proven with validated scales were observed following the repeating electroconvulsive therapy sessions. This is the first case report describing the use of electroconvulsive therapy in a patient with dementia with Lewy bodies in Korea. This case report may help to establish new guidelines for the treatment of patients with dementia with Lewy bodies, which is still considered a difficult disease to treat.

Aged ; Caregivers ; Dementia ; Depression ; Empathy ; Epidemiologic Studies ; Humans ; Korea ; Pilot Projects

Objectives: ：We aimed to explore weekend catch-up sleep (CUS) by age and to find out the association between CUS and depression by the age group and weekday sleep duration (SD). Methods: ：Using data from the 2016-2018 Korean National Health and Nutrition Examination Survey, the CUS by age of 16,174 subjects was investigated, and the depression data of 11,088 subjects were analyzed. CUS was calculated as the weekend sleep duration minus weekday sleep duration (SD). The mean of CUS and weekday SD in depression group and non-depression group was compared by early, middle, and late adulthood groups, and logistic regression analysis was performed to investigate the effect of CUS on the depression by age group when weekday SD was insufficient. Results: ：The CUS tended to decrease continuously with age, the mean of CUS in the late adult group was the shortest. However, the average SD, adjusted for weekend CUS, was the shortest in the middle adulthood group. Overall, the sleep durations were shorter in the depression group than in the non-depression group, but the CUS difference between the two groups was significantly only in the middle adulthood. The risk of depression was signifi-cantly higher when weekend CUS was less than 1hour with a short weekday SD of less than 6hours (OR 2.44, 95% CI: 1.78-3.35), and this finding was significant in all adult groups. Conclusions ：The findings of this study suggest that short weekday SD and inadequate weekend CUS are as-sociated with depression and that CUS is an option to compensate for sleep deprivation and prevent depression.

Purpose: This study aimed to analyze the clinical outcomes of venous thromboembolism (VTE) patients and identify the risk factors for VTE-related unfavorable outcomes, major bleeding, and 30-day all-cause mortality. Materials and Methods: From January 2016 to December 2020, 198 patients with confirmed VTE were enrolled. Potential risk factors for unfavorable outcomes, major bleeding, and all-cause mortality were analyzed. Results: VTE-related unfavorable outcomes developed in 13.1%, while 30-day all-cause mortality was 8.6%. In the multivariate analysis, a pulse ≥110/min and respiratory rate ≥30/min were statistically significant predictors for VTE-related unfavorable outcomes. Diabetes was a significant risk factor for major bleeding. In addition, a history of malignancy, no anticoagulation treatment, and need for mechanical ventilation were significant predictors of all-cause mortality. Conclusion VTE-related mortality and morbidity rates remained high. In cases of tachycardia and tachypnea, early aggressive treatment is needed to prevent unfavorable outcomes. Patients with risk factors should be closely monitored.

Apoptosis is a physiologic or programmed cell death process which is controlled by genes and it is essential for the function and the appropriate development of multicellular organism. Apoptosis is also thought to be one of the main mechanisms of cell death in ischemic tissues. The effect of prostaglandin E1(PGE1) is proven to be useful in the recovery of ischemic changes by inducing vasodilation of peripheral vessels and platelet disaggregation. Prostaglandin is also known to suppress apoptosis in a serum deprived cell. The purpose of this study is to evaluate the effects of PGE1 on the apoptosis in the ischemic skin island flap. Thirty Sprague-Dawley rats were used. In control group(n=15), 3x5cm sized skin island flap based on the superficial epigastric vessel was elevated and its pedicle was occluded for 14 hours. After removing the vessel clamp, skin flap was reperfused for 5 hours and harvested. In experimental group(n=15), a ischemic skin island flap was also made as in the control group except the interarterial administration of the PGE1 right after elevation of the flap and after removing the clamp. H&E, TUNEL and immunohistochemical stains for p53 and bax proteins were performed. There were ischemic changes in gross and microscopic findings in both groups. Immunohistochemical staining for p53 protein shows many positive cells with nuclear staining in squamous epithelium of the control group, but sparse positive cells in the experimental group. Immunohistochemical stainings for bax protein shows many positive cells with cytoplasmic staining in squamous epithelium of the control group, but sparse positive cells in the experimental group. The apoptotic index was significantly lower in the experimental group(2.39+/-1.76(p=0.0001)) than in the control group(7.53+/-2.05). These data indicate that PGE1 suppresses the apoptosis in the ischemic skin island flap.
Alprostadil* ; Animals ; Apoptosis ; bcl-2-Associated X Protein ; Blood Platelets ; Cell Death ; Coloring Agents ; Cytoplasm ; Epithelium ; In Situ Nick-End Labeling ; Prostaglandins I ; Rats* ; Rats, Sprague-Dawley ; Skin* ; Vasodilation

In order to develop questionnaire estimating vinyl chloride monomer(VCM) exposure levels, to reset selection criteria for detailed tests, to measure current VCM exposure levels, to evaluate the mutagenic effects of VCM exposures and to develop multiphasic screening method of PVC- or VCM-handling workers, VCM concentrations of work environments were measured and tentative self-administrative questionnaire, physical examination, sister chromatid exchange(SCE) test and some clinical chemical test were applied to 195 men who had been handling VCM or PVC(Exposed Group) and 37, in the same factories without exposure to VCM or in polyethylene- or polypropylene-related factories(Control Group). Mean VCM concentrations of work environments were 0.268+/-0.183 ppm under PVC synthesis processes, 0.160+/-0.200 ppm under VCM synthesis process, 0.076+/-0.111 ppm under PVC pipe producing processes, 0.090+/-0.108 ppm under PVC wall paper, sheet, or film producing processes, 0.071+/-0.051 ppm under PVC floor producing processes, 0.243+/-0.250 ppm under PVC sash producing processes, and 0.020+/-0.031 ppm under triming process. VCM levels of work environments under manual resin mixing processes (0.209+/-0.168 ppm)were higher than those of the others (0.209+/-0.168 ppm) (p-value<0.05). There was no VCM-related symptoms, the positive response rates of which were higher in the Exposed Group. Overall abnormal rate in clinical chemistry test of the Exposed Group was higher than that of the Control Group, but due to extermely low exposure level of exposure group and to small sample size of the Control Group, no statistical significance was found(p-value>0.05). SCE frequencies of the Exposed Group were significantly higher than those of Contorl Group(p-value<0.05) and those of test-abnormal persons were higher than those of test-normal persons. SCE frequencies linearly increased with not only current but also cumulative VCM exposure levels(p-value<0.05). These results suggest that adverse health effect may ensue from VCM exposure to as low as 1 ppm. But SCE frequencies had no statistically significant correlation with drinking amounts, smoking amoutns, or radiation dose equivalents. Questionnaire was revised by referring to these results and formula estimating cumulative VCM exposure levels based on occupational history in questionnaire were made. In addition, were presented methods evaluating work environments and multiphasic screening test for PVC workers.
Chromatids ; Clinical Chemistry Tests ; Drinking ; Humans ; Male ; Multiphasic Screening* ; Patient Selection ; Physical Examination ; Polyvinyl Chloride* ; Polyvinyls* ; Questionnaires ; Sample Size ; Siblings ; Sister Chromatid Exchange ; Smoke ; Smoking ; Vinyl Chloride*

PURPOSE: For several decades, open reduction has been a controversial issue in mandibular condyle fracture. The authors have successfully used the open reduction and internal fixation with retromandibular approach and have found it to be satisfactory for mandibular condyle fracture. METHODS: A total of 10 patients with mandibular condyle fracture underwent open surgical treatment using retromandibular approach. The incision for the retromandibular approach was carried below the ear lobe and the facial nerve branches were identified. Dissection was continued until the fracture site was exposed and internal fixation was performed with miniplate following intermaxillary fixation. The average period of joint immobilization was 1 weeks and the arch bars were removed in 3 weeks on average. The preoperative and postoperative panoramic view and three-dimensional computed tomography were compared. During the follow up period, we evaluated the presence of malocclusion, chin deviation, trismus, pain, click sound, facial nerve palsy, hypertrophic scar and skin fistula. RESULTS: According to the radiographic findings, the fractured condyle was reducted satisfactorily in all patients without any symptoms of facial palsy. During the follow up period ranged form 6 to 12 months, all clinical symptoms were improved except in one case with chin deviation and malocclusion. CONCLUSION: Using open reduction and internal fixation of mandibular condyle fracture with retromandibular approach, all results were satisfactory with good functional outcomes and minimal complication. We concluded that the open surgical treatment should be considered as the first choice for mandibular condyle fracture management.
Chin ; Cicatrix, Hypertrophic ; Ear ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Malocclusion ; Mandibular Condyle ; Paralysis ; Skin ; Trismus