BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

Objectives: The purpose of the study was to investigate the factors affecting unmet dental care needs among elderly living alone. Methods: The study subjects were 19,019 elderly living by themselves, who participated in the Korea Community Health Survey 2018 (KCHS, 2018). The data were analyzed using frequency analysis, Rao-Scott chi-square test, t-test, and binary logistic regression analysis, using the SAS 9.4 software. Results: Results from the multiple logistic regression analysis revealed a higher odds ratio (OR) for unmet dental care needs among those with a monthly household income below KRW 1,000,000 (OR=1.64, 95% confidence interval, 95%CI=1.39-1.92), compared to those with an income of above KRW 2,000,000. With regards to stress levels, unmet dental care needs were more prevalent among participants in the “stress moderate” (OR=1.19, 95% CI=1.06-1.33) and “stress” groups (OR=1.68 95% CI=1.48-1.92), compared to the “no stress” group. Furthermore, the OR for unmet dental care needs was significantly higher among participants in the “depression” group (OR=1.84, 95% CI=1.61-2.11) than the “no depression” group. Conclusions Higher unmet dental care needs were found among participants in the low monthly household income, stress, and depression groups. Further study is needed to analyze the association between factors and needs related to unmet dental care.

Objectives: The purpose of the study was to investigate the factors affecting unmet dental care needs among elderly living alone. Methods: The study subjects were 19,019 elderly living by themselves, who participated in the Korea Community Health Survey 2018 (KCHS, 2018). The data were analyzed using frequency analysis, Rao-Scott chi-square test, t-test, and binary logistic regression analysis, using the SAS 9.4 software. Results: Results from the multiple logistic regression analysis revealed a higher odds ratio (OR) for unmet dental care needs among those with a monthly household income below KRW 1,000,000 (OR=1.64, 95% confidence interval, 95%CI=1.39-1.92), compared to those with an income of above KRW 2,000,000. With regards to stress levels, unmet dental care needs were more prevalent among participants in the “stress moderate” (OR=1.19, 95% CI=1.06-1.33) and “stress” groups (OR=1.68 95% CI=1.48-1.92), compared to the “no stress” group. Furthermore, the OR for unmet dental care needs was significantly higher among participants in the “depression” group (OR=1.84, 95% CI=1.61-2.11) than the “no depression” group. Conclusions Higher unmet dental care needs were found among participants in the low monthly household income, stress, and depression groups. Further study is needed to analyze the association between factors and needs related to unmet dental care.

Bone marrow edema syndrome (BMES) is a rare condition which mainly affects the hip area. The etiology and pathogenesis of BMES is still unclear. Pain near the affected area, regional osteoporosis, bone marrow edema (identified using magnetic resonance imaging) and spontaneous regression within 6-12 months are the main characteristics of BMES. In this case, a 52-year-old male was diagnosed with BMES of the right hip followed by spontaneous subsiding of symptoms. After 3 years, and under nearly the same social and physical conditions, he was admitted again with newly developed left hip pain and again diagnosed with BMES. We report this rare case since a similar one has not been previously reported in the domestic literature and may be considered valuable for basic research relating to the pathogenesis of BMES.
Bone Marrow* ; Edema* ; Femur Head ; Head* ; Hip ; Humans ; Male ; Middle Aged ; Osteoporosis

The nutritional support of acutely ill patients is very important and early enteral nutrition is recommended. Feeding via the nasogastric route is used widely for its ease of access if the patient cannot maintain volitional food intake. If the position of the tip or side holes of the nasogastric tube (NGT) is above the gastroesophageal junction, there is the possibility of retention and solidification of the administered enteral feeding formula in the esophagus. Therefore, the tip of the NGT should be checked carefully; a chest radiograph to confirm its position can be considered, especially in patients with a higher risk of aspiration and gastroesophageal reflux. In addition, careful consideration of the risk factors that can trigger esophageal obstruction is required when feeding patients in the intensive care unit. This paper describes two unusual cases of esophageal obstruction caused by the solidification of residue of an enteral feeding formula.
Eating ; Enteral Nutrition* ; Esophagogastric Junction ; Esophagus ; Gastroesophageal Reflux ; Humans ; Intensive Care Units ; Nutritional Support ; Radiography, Thoracic ; Risk Factors

Delayed breast reconstruction is challenging because it requires a large volume and symmetry, and the dual-pedicled deep inferior epigastric perforator (DIEP) flap is used with microvascular augmentation. However, candidate recipient vessels in patients who have undergone radiation therapy may be damaged, with uncertain patency. This report suggests a novel method, the dual-pedicled conjoined abdominal flap, in which a free DIEP flap is combined with a pedicled transverse rectus abdominis muscle (TRAM) flap. A 57-year-old female patient who had undergone modified radical mastectomy and radiotherapy 25 years previously was referred for breast reconstruction. A whole abdominal flap was needed, but supercharged anastomosis was very risky due to calcification and scarring of the internal mammary vessel. Therefore, the thoracodorsal vessels were anastomosed with a free left DIEP flap, which was combined with a right-pedicled TRAM flap. The reconstructed volume was sufficient, and the blood flow was intact. The patient presented a symmetric contour without any complications after 4 months. The dual-pedicled conjoined abdominal flap is reliable for delayed breast reconstruction that requires a large volume and skin replacement, especially in patients with radiation-injured recipient vessels. Even if microscopic anastomosis failure occurs, secondary rescue is made possible by the pedicled TRAM flap.

The epithelial-mesenchymal transition (EMT) is important for embryonic development and the formation of various tissues or organs. However, EMT dysfunction in normal cells leads to diseases, such as cancer or fibrosis. During the EMT, epithelial cells are converted into more invasive and active mesenchymal cells. E-box-binding proteins, including Snail, ZEB and helix-loop-helix family members, serve as EMT-activating transcription factors. These transcription factors repress the expression of epithelial markers, for example, E-cadherin, rearrange the cytoskeleton and promote the expression of mesenchymal markers, such as vimentin, fibronectin and other EMT-activating transcription factors. Signaling pathways that induce EMT, including transforming growth factor-beta, Wnt/glycogen synthase kinase-3beta, Notch and receptor tyrosine kinase signaling pathways, interact with each other for the regulation of this process. Although the mechanism(s) underlying EMT in cancer or embryonic development have been identified, the mechanism(s) in embryonic stem cells (ESCs) remain unclear. In this review, we describe the underlying mechanisms of important EMT factors, indicating a precise role for EMT in ESCs, and characterize the relationship between EMT and ESCs.
Animals ; Cadherins/metabolism ; Embryonic Stem Cells/*cytology/metabolism ; *Epithelial-Mesenchymal Transition ; Humans ; Signal Transduction ; Transcription Factors/metabolism

Clinical therapy that combines full-mouth rehabilitation with immediate implantation and orthognathic surgery poses a challenge to prosthodontists. This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient presenting with skeletal discrepancy and rampant caries. The results thus achieved indicate that full-mouth rehabilitation by fixed immediate and early loading implantation accompanied by orthognathic surgery can be a predictable and effective treatment procedure.
Diagnosis ; Humans ; Orthognathic Surgery* ; Rehabilitation*

PURPOSE: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy. Some aspects of POPF management remain controversial. Therefore, the aim of this study was to determine the natural course of POPF and fluid collection after distal pancreatectomy and to reappraise the necessity of intraoperative abdominal drainage insertion. METHODS: For recent 10 years, 264 distal pancreatectomies were performed at Seoul National University Hospital. Clinicopathologic data including POPF and postoperative fluid collection (POFC), and its treatment modality were reviewed retrospectively. During follow-up, the location, size, and clinical impact of the POFC were determined on the basis of CT images. RESULTS: Clinically relevant POPFs were identified in 72 patients (27.3%). Therapeutic interventions were performed in 40 patients (55.6%), and conservative management was successful in 32 patients (44.4%). POFC was detected in 191 cases (72.3%) on the first postoperative CT. During follow-up, spontaneous regressions were observed in 119 cases (93.0%). Only thick pancreatic stump increased the risk of clinically relevant POPF (≥17.3 mm, P = 0.002) and the occurrence of POFC (≥16.0 mm, P < 0.001) in multivariate analysis. CONCLUSION: Intraoperative abdominal drainage insertion could be selectively indwelled in patients with a thickness of pancreas ≥17.3 mm. Since radiologically-proven POFC after distal pancreatecomy showed a 93.0 rate of spontaneous regression, POFC without signs of infection can be safely monitored.
Drainage ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Pancreas ; Pancreatectomy* ; Pancreatic Fistula* ; Retrospective Studies ; Seoul

BACKGROUND: The purpose of this study was to assess the role of hypophosphatemia in major clinical outcomes of patients treated with low- or high-intensity continuous renal replacement therapy (CRRT). METHODS: We performed a retrospective analysis of data collected from 492 patients. We divided patients into two CRRT groups based on treatment intensity (greater than or equal to or less than 40 mL/kg/hour of effluent generation) and measured serum phosphate level daily during CRRT. RESULTS: We obtained a total of 1,440 phosphate measurements on days 0, 1, and 2 and identified 39 patients (7.9%), 74 patients (15.0%), and 114 patients (23.1%) with hypophosphatemia on each of these respective days. In patients treated with low-intensity CRRT, there were 23 episodes of hypophosphatemia/1,000 patient days, compared with 83 episodes/1,000 patient days in patients who received high-intensity CRRT (P < 0.01). Multiple Cox proportional hazards analysis showed that Acute Physiology and Chronic Health Evaluation (APACHE) III score, utilization of vasoactive drugs, and arterial pH on the second day of CRRT were significant predictors of mortality, while serum phosphate level was not a significant contributor to mortality. CONCLUSION: APACHE score, use of vasoactive drugs, and arterial pH on the second CRRT day were identified as significant predictors of mortality. Hypophosphatemia might not be a major risk factor of increased mortality in patients treated with CRRT.
Acute Kidney Injury* ; APACHE ; Critical Illness* ; Humans ; Hydrogen-Ion Concentration ; Hypophosphatemia* ; Mortality ; Renal Replacement Therapy* ; Retrospective Studies ; Risk Factors