No abstract available.
Adrenoleukodystrophy*

Objectives: This study explored changes in individuals’ behavior in response to social distancing (SD) levels and the “no gatherings of more than 5 people” (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission. Results: In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance. Conclusions SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

Objectives: This study explored the direct and indirect effects of knowledge of new technology (e.g., artificial intelligence, the Internet of Things, and the Fourth Industrial Revolution), attitudes towards technology use, and smartphone utilization skills on older adults’ willingness to use home-based information and communication technology (ICT) for self-health management. Methods: A phone survey was conducted among 300 older adults aged 65 or older in Gangwon Province, Republic of Korea. A path analysis was performed to identify the direct and indirect effects of knowledge of new technology, attitudes towards technology use, and smartphone utilization skills on willingness to use home-based healthcare ICT. Socioeconomic variables were used as control variables. Results: Knowledge of new technology, but not attitudes towards technology use, had a direct impact on smartphone utilization skills. Attitude towards technology use and smartphone utilization skills showed significant effects on willingness to use home-based healthcare ICT. One standard unit change in attitudes towards technology use contributed to a 0.172 unit change in willingness (p = 0.001), and one standard unit change in smartphone utilization skills changed willingness by 0.246 units (p < 0.001). In addition, older adults with a higher education level and economic status, and lower self-related health status, were more willing to use home-based healthcare ICT. Conclusions These findings underscore the necessity of enhancing the smartphone utilization skills of older adults and attitudes towards technology use. Providing more user-friendly services and increasing smartphone utilization skills among older adults would contribute to willingness to use home-based ICT for healthcare management.

Objectives: This study explored the direct and indirect effects of knowledge of new technology (e.g., artificial intelligence, the Internet of Things, and the Fourth Industrial Revolution), attitudes towards technology use, and smartphone utilization skills on older adults’ willingness to use home-based information and communication technology (ICT) for self-health management. Methods: A phone survey was conducted among 300 older adults aged 65 or older in Gangwon Province, Republic of Korea. A path analysis was performed to identify the direct and indirect effects of knowledge of new technology, attitudes towards technology use, and smartphone utilization skills on willingness to use home-based healthcare ICT. Socioeconomic variables were used as control variables. Results: Knowledge of new technology, but not attitudes towards technology use, had a direct impact on smartphone utilization skills. Attitude towards technology use and smartphone utilization skills showed significant effects on willingness to use home-based healthcare ICT. One standard unit change in attitudes towards technology use contributed to a 0.172 unit change in willingness (p = 0.001), and one standard unit change in smartphone utilization skills changed willingness by 0.246 units (p < 0.001). In addition, older adults with a higher education level and economic status, and lower self-related health status, were more willing to use home-based healthcare ICT. Conclusions These findings underscore the necessity of enhancing the smartphone utilization skills of older adults and attitudes towards technology use. Providing more user-friendly services and increasing smartphone utilization skills among older adults would contribute to willingness to use home-based ICT for healthcare management.

Objectives: This study explored changes in individuals’ behavior in response to social distancing (SD) levels and the “no gatherings of more than 5 people” (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission. Results: In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance. Conclusions SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

Objectives: The purpose of this study is to investigate changes in public health-related perceptions of residents of Gangwon province after the outbreak of Coronavirus disease-19(COVID-19) of the public. Methods: We performed paired T-test analysis to measure the change in public health-related perceptions before and after COVID-19. We also utilized generalized estimating equations to identify demographic factors correlated with public health-related perceptions. Results: The public perceived public health as ‘All citizens can use medical care and protect/promote health.’ The concept was the most popular, from 94.3% in 2019 to 95.5% in 2020. In addition, after COVID-19, residents of Gangwon province's satisfaction with medical services increased, but the overall level was not high. Among the eight essential healthcare needs after COVID-19, cardiovascular disease and injury services have emerged as preferred services. However, by sociodemographic factors, distinctive responses were detected. Conclusions Through COVID-19, Gangwon residents' awareness of the public's health rights has increased. Those living in vulnerable areas or with unmet medical care, supported strengthening public health care. In addition, although medical satisfaction has increased, it is not satisfied, so listening to the voices of the population group with low satisfaction is essential. Lastly, since the necessity of essential health care may change due to specific events, the local government needs to plan health projects reflecting the needs of residents. Therefore, when designing the public health care strategy in Gangwon province, the local government should consider not only political factors but also environmental factors, demographic and conceptual factors.

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

PURPOSE: Expression levels of tumor necrosis factor (TNF)-alpha expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-alpha has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis of FPIES. METHODS: Fifteen infants diagnosed as having FPIES using standard oral challenge test and 5 controls were included. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining was performed to identify the apoptotic cell death bodies. Immunohistochemical staining of TNF-alpha, Fas ligand (FasL) for TNF family and TNF-related apoptosis-including ligand (TRAIL) receptor 1 (DR4), TRAIL receptor 2 (DR5), and Fas for TNF-receptor family were performed to determine the apoptotic mechanisms. RESULTS: TUNEL+ was significantly more highly expressed in the duodenal mucosa of FPIES patients than in controls (P=0.043). TNF-alpha (P=0.0001) and DR4 (P=0.003) were significantly more highly expressed in FPIES patients than in controls. Expression levels of FasL, Fas, and DR5 were low in both groups and were not significantly different between the 2 groups. CONCLUSION: These results suggest that FPIES pathogenesis is induced by apoptosis, and that TNF-alpha expression and DR4 pathway may have an important role in apoptosis.
Apoptosis ; Atrophy ; Cell Death ; Enterocolitis ; Epithelial Cells ; Fas Ligand Protein ; Humans ; Infant ; Intestine, Small ; Mucous Membrane ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Tumor Necrosis Factor-alpha ; Up-Regulation

A nine-year old boy was found unconscious by his father in his apartment house. He was transferred to the emergency unit immediately but resuscitation was failed. Drain cleansing was performed just before the deceased came home. The father stated that there was foul odor in the house when he opened the door. The autopsy finding showed only nonspecific findings including severe pulmonary edema. Significant amount of sulfide ion was detected from blood and brain tissue. The cause of death was concluded as hydrogen sulfide poisoning.
Autopsy ; Brain ; Cause of Death ; Emergency Service, Hospital ; Fathers ; Humans ; Hydrogen Sulfide* ; Hydrogen* ; Male ; Odors ; Poisoning* ; Pulmonary Edema ; Resuscitation

Adrenal insufficiency, which is related to hemodynamic instability and increased mortality, has been reported in patients with advanced liver disease regardless of the presence of septic conditions. In this regard, the hepatoadrenal syndrome has been recently proposed as adrenal insufficiency in critically ill patients with liver disease. We describe here a 67-year-old female patient with hepatic failure and adrenal insufficiency. The patient showed stable vital signs and no evidence of sepsis preoperatively. Despite hydrocortisone replacement and inotropics administration, severe intraoperative hemodynamic instability was observed. Hydrocortisone administration was continued postoperatively, nevertheless inotropics could not be tapered. On postoperative day 11, the patient died due to pneumonia and septic shock. Hepatoadrenal syndrome may have played a key role in her severe hemodynamic fluctuation and poor outcome, reinforcing the importance of adrenal function in the liver transplantation surgery.
Adrenal Insufficiency ; Critical Illness ; Female ; Hemodynamics ; Humans ; Hydrocortisone ; Liver ; Liver Diseases ; Liver Failure ; Liver Transplantation ; Pneumonia ; Sepsis ; Shock, Septic ; Vital Signs