Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients’ prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients’ prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km2 area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients’ prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

Purpose: This study aimed to evaluate the effects of auricular acupressure on the severity of urinary incontinence, quality of life, and sleep quality in elderly women with stress urinary incontinence Methods: This single-blind, randomized, placebo-controlled study included 53 subjects. The participants were elderly women with stress urinary incontinence. The experimental period was a total of 6 weeks, and four different acupressure sites were applied for each group; the experimental group (n=27) received auricular acupressure on the kidney, bladder, central rim, anterior lobe, whereas the placebo-control group (n=26) received acupressure on the wrist, elbow, helix 2, and helix 3. In order to examine the effects of the auricular acupressure intervention, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), Incontinence Quality of Life (I-QOL) and Pittsburgh Sleep Quality Index (PSQI) were measured before and after the intervention. Results: The ICIQ-UI SF scores and the PSQI scores in the experimental group with auricular acupressure significantly decreased after 6 weeks (p<.001) compared with the scores of the placebo-control group. The I-QOL scores in the experimental group significantly increased after 6 weeks (p<.001) compared with the scores of the placebo-control group. Conclusion Auricular acupressure was effective for mitigating the severity of urinary incontinence and improving the quality of life and sleep after 6 weeks. Therefore, auricular acupressure can be used as a non-pharmacological nursing intervention for elderly women with stress urinary incontinence.

Silver nanoparticles (size: 7.9 +/- 0.95 nm, dosage: 250 mg/kg) were orally administered to pregnant rats. At 4 days after parturition, four pups were randomly selected (one pup from one dam) and silver level in liver, kidney, lung and brain was determined by ICP-MS and electron microscope. As results, silver nanoparticles highly accumulated in the tissues of the pups. Silver level in the treated group was 132.4 +/- 43.9 ng/g in the kidney (12.3 fold compared to control group), 37.3 +/- 11.3 ng/g in the liver (7.9 fold), 42.0 +/- 8.6 ng/g in the lung (5.9 fold), and 31.1 +/- 4.3 ng/g in the brain (5.4 fold). This result suggested that the possible transfer of silver nanoparticles from pregnant dams to the fetus through mainly placenta.
Animals ; Brain ; Electrons ; Fetus ; Kidney ; Liver ; Lung ; Nanoparticles ; Parturition ; Placenta ; Rats ; Silver

Since the year 2000, low birth rates have resulted in significant decreases to maternity care services throughout many Korean hospitals. However, there has been a concomitant increase in the number of high-risk pregnancies, due to growing trends in delayed marriages and subsequent pregnancies. Increased maternal age is a risk factor associated with complicated pregnancies and high-risk deliveries, both of which are strongly related to maternal death. With this in mind, the Ministry of Health and Welfare has supported the establishment of a regional perinatal center for high-risk pregnancies, estimated to be be fully completed by the year 2020. Despite this, maternity care services for high-risk pregnancies remain insufficient. According to previous reports, the total number of maternity care hospitals and beds available for high-risk pregnant women were 60 and 399, respectively. This is in stark contrast to previous bed estimates of 1,640. The establishment of a maternity care system for high-risk pregnant women is integral to ensuring optimal conditions for both pregnancy and childbirth. This review briefly evaluates the existing maternity care system for high-risk pregnancies, and proposes several new suggestions for improvements.
Birth Rate ; Female ; Humans ; Korea ; Marriage ; Maternal Age ; Maternal Death ; Parturition ; Pregnancy ; Pregnancy, High-Risk ; Pregnant Women ; Risk Factors

Systemic vasculitis is a rare disease, and the diagnosis is very difficult when patient shows atypical symptoms. We experienced an unusual case of dysphagia caused by Churg-Strauss syndrome with lower cranial nerve involvement. A 74-year-old man, with a past history of sinusitis, asthma, and hearing deficiency, was admitted to our department for evaluation of dysphagia. He also complained of recurrent bleeding of nasal cavities and esophagus. Brain magnetic resonance imaging did not show definite abnormality, and electrophysiologic findings were suggestive of mononeuritis multiplex. Dysphagia had not improved after conventional therapy. Biopsy of the nasal cavity showed extravascular eosinophilic infiltration. All these findings suggested a rare form of Churg-Strauss syndrome involving multiple lower cranial nerves. Dysphagia improved after steroid therapy.
Aged ; Asthma ; Biopsy ; Brain ; Churg-Strauss Syndrome* ; Cranial Nerve Diseases ; Cranial Nerves ; Deglutition Disorders* ; Diagnosis ; Eosinophils ; Esophagus ; Hearing ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Mononeuropathies ; Nasal Cavity ; Rare Diseases ; Sinusitis ; Systemic Vasculitis

Objectives: This study aimed to investigate the risk of osteoarthritis associated with menopausal hormone therapy (MHT). Methods: This population-based retrospective cohort study used a database of Korean health insurance claims (2007–2020). Females aged ≥ 40 who initiated menopause-related healthcare visits between 2011 and 2014 were identified. The MHT group comprised females aged ≥ 40 who initiated MHT for ≥ 6 months during this period. The non-MHT group comprised females aged ≥ 40 who attended menopause-related healthcare visits but did not receive MHT. To account for potential confounding factors, the two groups were matched at a 1:1 ratio using propensity score matching. Results: A cohort of 453,040 postmenopausal females aged ≥ 40 years was identified, with 26,354 assigned to either the MHT or nonMHT group after propensity matching. The median age was 49 years, and the median follow-up was 8.2 years. The Cox proportional hazards model demonstrated an elevated risk of osteoarthritis with MHT (hazard ratio [HR], 1.154; 95% confidence interval [CI], 1.117–1.193) for knee (HR, 1.148; 95% CI, 1.102–1.195) and other arthritis (HR, 1.205; 95% CI, 1.151–1.261), although not statistically significant for hip arthritis. Tibolone (HR, 1.211; 95% CI, 1.161–1.263), estrogen–progestogen therapy (EPT) (HR, 1.092; 95% CI, 1.048– 1.137), and estrogen therapy (ET) (HR, 1.235; 95% CI, 1.148–1.329) were associated with a higher risk of osteoarthritis compared to nonMHT users. Conclusions MHT was associated with an increased risk of osteoarthritis, consistently observed across tibolone, EPT, and ET, particularly affecting joints other than the hip, with a trend toward an elevated risk of hip osteoarthritis.

Objectives: The purpose of this study was to identify any difference in user experience between tablet- and augmented reality (AR) glasses-based tele-exercise programs in elderly women. Methods: Participants in the AR group (n = 14) connected Nreal glasses with smartphones to display a pre-recorded exercise program, while each member of the tablet group (n = 13) participated in the same exercise program using an all-in-one personal computer. The program included sitting or standing on a chair, bare-handed calisthenics, and muscle strengthening using an elastic band. The exercise movements were presented first for the upper and then the lower extremities, and the total exercise time was 40 minutes (5 minutes of warm-up exercises, 30 minutes of main exercises, and 5 minutes of cool-down exercises). To evaluate the user experience, a questionnaire consisting of a 7-point Likert scale was used as a measurement tool. In addition, the Wilcoxon rank-sum test was used to assess differences between the two groups. Results: Of the six user experience scales, attractiveness (p = 0.114), stimulation (p = 0.534), and novelty (p = 0.916) did not differ significantly between the groups. However, efficiency (p = 0.006), perspicuity (p = 0.008), and dependability (p = 0.049) did vary significantly between groups. Conclusions When developing an AR glasses-based exercise program for the elderly, the efficiency, clarity, and stability of the program must be considered to meet the participants’ needs.

Objectives: This study aimed to investigate the risk of osteoarthritis associated with menopausal hormone therapy (MHT). Methods: This population-based retrospective cohort study used a database of Korean health insurance claims (2007–2020). Females aged ≥ 40 who initiated menopause-related healthcare visits between 2011 and 2014 were identified. The MHT group comprised females aged ≥ 40 who initiated MHT for ≥ 6 months during this period. The non-MHT group comprised females aged ≥ 40 who attended menopause-related healthcare visits but did not receive MHT. To account for potential confounding factors, the two groups were matched at a 1:1 ratio using propensity score matching. Results: A cohort of 453,040 postmenopausal females aged ≥ 40 years was identified, with 26,354 assigned to either the MHT or nonMHT group after propensity matching. The median age was 49 years, and the median follow-up was 8.2 years. The Cox proportional hazards model demonstrated an elevated risk of osteoarthritis with MHT (hazard ratio [HR], 1.154; 95% confidence interval [CI], 1.117–1.193) for knee (HR, 1.148; 95% CI, 1.102–1.195) and other arthritis (HR, 1.205; 95% CI, 1.151–1.261), although not statistically significant for hip arthritis. Tibolone (HR, 1.211; 95% CI, 1.161–1.263), estrogen–progestogen therapy (EPT) (HR, 1.092; 95% CI, 1.048– 1.137), and estrogen therapy (ET) (HR, 1.235; 95% CI, 1.148–1.329) were associated with a higher risk of osteoarthritis compared to nonMHT users. Conclusions MHT was associated with an increased risk of osteoarthritis, consistently observed across tibolone, EPT, and ET, particularly affecting joints other than the hip, with a trend toward an elevated risk of hip osteoarthritis.

Objectives: This study aimed to investigate the risk of osteoarthritis associated with menopausal hormone therapy (MHT). Methods: This population-based retrospective cohort study used a database of Korean health insurance claims (2007–2020). Females aged ≥ 40 who initiated menopause-related healthcare visits between 2011 and 2014 were identified. The MHT group comprised females aged ≥ 40 who initiated MHT for ≥ 6 months during this period. The non-MHT group comprised females aged ≥ 40 who attended menopause-related healthcare visits but did not receive MHT. To account for potential confounding factors, the two groups were matched at a 1:1 ratio using propensity score matching. Results: A cohort of 453,040 postmenopausal females aged ≥ 40 years was identified, with 26,354 assigned to either the MHT or nonMHT group after propensity matching. The median age was 49 years, and the median follow-up was 8.2 years. The Cox proportional hazards model demonstrated an elevated risk of osteoarthritis with MHT (hazard ratio [HR], 1.154; 95% confidence interval [CI], 1.117–1.193) for knee (HR, 1.148; 95% CI, 1.102–1.195) and other arthritis (HR, 1.205; 95% CI, 1.151–1.261), although not statistically significant for hip arthritis. Tibolone (HR, 1.211; 95% CI, 1.161–1.263), estrogen–progestogen therapy (EPT) (HR, 1.092; 95% CI, 1.048– 1.137), and estrogen therapy (ET) (HR, 1.235; 95% CI, 1.148–1.329) were associated with a higher risk of osteoarthritis compared to nonMHT users. Conclusions MHT was associated with an increased risk of osteoarthritis, consistently observed across tibolone, EPT, and ET, particularly affecting joints other than the hip, with a trend toward an elevated risk of hip osteoarthritis.

Objectives: This study aimed to investigate the risk of osteoarthritis associated with menopausal hormone therapy (MHT). Methods: This population-based retrospective cohort study used a database of Korean health insurance claims (2007–2020). Females aged ≥ 40 who initiated menopause-related healthcare visits between 2011 and 2014 were identified. The MHT group comprised females aged ≥ 40 who initiated MHT for ≥ 6 months during this period. The non-MHT group comprised females aged ≥ 40 who attended menopause-related healthcare visits but did not receive MHT. To account for potential confounding factors, the two groups were matched at a 1:1 ratio using propensity score matching. Results: A cohort of 453,040 postmenopausal females aged ≥ 40 years was identified, with 26,354 assigned to either the MHT or nonMHT group after propensity matching. The median age was 49 years, and the median follow-up was 8.2 years. The Cox proportional hazards model demonstrated an elevated risk of osteoarthritis with MHT (hazard ratio [HR], 1.154; 95% confidence interval [CI], 1.117–1.193) for knee (HR, 1.148; 95% CI, 1.102–1.195) and other arthritis (HR, 1.205; 95% CI, 1.151–1.261), although not statistically significant for hip arthritis. Tibolone (HR, 1.211; 95% CI, 1.161–1.263), estrogen–progestogen therapy (EPT) (HR, 1.092; 95% CI, 1.048– 1.137), and estrogen therapy (ET) (HR, 1.235; 95% CI, 1.148–1.329) were associated with a higher risk of osteoarthritis compared to nonMHT users. Conclusions MHT was associated with an increased risk of osteoarthritis, consistently observed across tibolone, EPT, and ET, particularly affecting joints other than the hip, with a trend toward an elevated risk of hip osteoarthritis.