Purpose: This study explored the effects of the elderly group's digital literacy and health empowerment on communication with doctors, considering moderating effect of health beliefs about chronic diseases. Methods: A one-on-one interview survey was conducted with 500 older adults in South Korea. The main variables were digital literacy, health empowerment, communication with doctors, and health belief of chronic diseases. Results: The interaction effect between health empowerment and susceptibility, and health empowerment and perceived barrier were significant. Conclusion Communication with doctors greatly increased when the elders had high levels of health empowerment and low levels of susceptibility. Also, communication with doctors greatly increased when the elders had high levels of health empowerment and low levels of perceived barriers.

PURPOSE: This study explored the factors influencing disaster response competency, that is, demographic and disaster-related characteristics, personal disaster (household and workplace) preparedness, disaster risk perception, and self-efficacy in handling disasters among emergency medical technicians in South Korea.METHODS: The study follows a descriptive, cross-sectional design and uses a self-reported questionnaire. Emergency medical technicians, amounting to 1,020 in all, currently working in firefighting organizations from four South Korean cities (Busan, Daegu, Daejeon, and Ulsan) participated in the study.RESULTS: Disaster risk perception, self-efficacy for disaster, participation experience in disaster education/training, and personal disaster (household and workplace) preparedness predicted the disaster response competency of emergency medical technicians in South Korea.CONCLUSION: There is a need for an antidisaster program to enhance the disaster risk perception, self-efficacy, personal disaster (household and workplace) preparedness, and the disaster education/training participation rate toward enhancing disaster response competency of emergency medical technicians in South Korea.
Daegu ; Disasters ; Emergencies ; Emergency Medical Technicians ; Humans ; Korea ; Self Efficacy

Objective: To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. Materials and Methods: A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis.Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1–10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. Results: In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5–43.5) and 21.4 (17.9–192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2–29.5) and 13.6 (10.3–30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6–17.7) and 8.0 (1.8–170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). Conclusion Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.

Objective: To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. Materials and Methods: A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis.Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1–10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. Results: In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5–43.5) and 21.4 (17.9–192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2–29.5) and 13.6 (10.3–30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6–17.7) and 8.0 (1.8–170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). Conclusion Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.

Malignant peripheral nerve sheath tumor (MPNST) is rare, soft tissue, spindle cell sarcoma of an ectomesenchymal origin. MPNSTs frequently occur in the extremities and trunk, whereas there has been only one previous report of MPNST originated from the pancreas. A 55-yr-old previously healthy man was admitted for a pancreas head mass, which was detected during a routine health inspection. Fine needle aspiration biopsy showed atypical cells that were suspicious for malignancy. On open exploration, a 2.6cm sized hypervascular well capsulated mass was seen between the duodenal first portion and the pancreas head, and so enucleation was performed. The tumor was composed with spindle cells without a typical storiform pattern and the cells were positive for mesenchymal antigen, S-100 and vimentin, whereas they were negative for epithelial membrane antigen and cytokeratin. It was concluded that the tumor was a MPNST with perineural cell differentiation. Primary MPNST of the pancreas is extremely rare and performing immunohistochemical staining is necessary for making its diagnosis.
Biopsy ; Biopsy, Fine-Needle ; Cell Differentiation ; Extremities ; Head ; Keratins ; Mucin-1 ; Nerve Sheath Neoplasms ; Pancreas ; Peripheral Nerves ; Sarcoma ; Vimentin

Erdheim-Chester disease (ECD), also known as non-Langerhans cell histiocytosis, is a multi-systemic disease with unclear pathogenesis. Based on a small number of case studies, pegylated interferon-α (PEG-IFN-α) has been used as the front-line treatment option. However, there are limited data regarding administration of ropegylated-interferon α-2b (ROPEG-IFN-α 2b) for ECD patients. Herein, we report two cases of severe ECD treated with two types of PEG-IFN-α. One patient with heart and skeleton involvement and BRAF V600E mutation was treated with weekly PEG-IFN-α 2a. Another patient with bone involvement and no BRAF V600E mutation was administered monthly ROPEG-IFN-α 2b. The two types of PEG-IFN-α showed excellent disease control, excellent survival outcomes, and manageable toxicities in ECD patients. These results suggest that ROPEG-IFN-α 2b could be used equivalently to PEG-IFN-α 2a for management of advanced ECD.

In order to produce a stable denture for severe alveolar bone loss area, it is not only important that .0a suitable occlusion is established but also to consider compatibility with the surrounding muscle to form a suitable polished surfaces. Neutral zone is defined as a potential area where the neuromuscular system of the tongue, cheeks and lips is balanced can be determined through the neutral zone impression technique. And if artificial teeth are aligned within the neutral zone and the polished surface follows the anatomical form of the dynamic muscle, higher stability and retention of the denture may be obtained through coordination with the surrounding muscle tissue. This case is being reported since the concept of the neutral zone was applied to a patient with severely atrophic residual alveolar ridge and the result was clinically satisfactory in both function and aesthetics.
Alveolar Bone Loss ; Alveolar Process ; Cheek ; Denture, Complete ; Dentures ; Esthetics ; Humans ; Lip ; Rehabilitation ; Tongue ; Tooth, Artificial

Clinical course of depression is variable. The serotonin transporter gene is one of the most studied genes for depression. We examined the association of serotonin transporter gene polymorphisms with chronicity and recurrent tendency of depression in Korean subjects. This cross-sectional study involved 252 patients with major depression. Patients were genotyped for s/l polymorphisms in 5-HTT promoter region (5-HTTLPR), s/l variation in second intron of the 5-HTT gene (5-HTT VNTR intron2). Chronicity was associated with 5-HTTLPR. Patients with l/l had higher rate of chronicity than the other patients (l/l vs s/l or s/s; odds ratio, 4.45; 95% confidence interval, 1.59-12.46; P=0.005; logistic regression analysis). Recurrent tendency was not associated with 5-HTTLPR. Chronicity and recurrent tendency were not associated with 5-HTT VNTR intron2. These results suggest that chronic depression is associated with 5-HTTLPR.
Aged ; Chronic Disease ; Cross-Sectional Studies ; Depression/*genetics ; Female ; Genotype ; Humans ; Introns ; Male ; Middle Aged ; Odds Ratio ; *Polymorphism, Genetic ; Promoter Regions, Genetic ; Recurrence ; Serotonin Plasma Membrane Transport Proteins/*genetics

PURPOSE: The number of suicide attempts has increased in Korea. Not only physical therapy, but also psychiatric treatment is important. And urgent follow-up community mental health care is needed. This study reports on a management program associated with community mental health centers for suicide attempters who visited a regional emergency medical center; we suggest establishment of community mental health centers with an emergency department on a national scale. METHODS: We conducted a retrospective analysis of 582 suicide attempters who visited a regional emergency medical center from March 1, 2009 to October 31, 2010. We recorded information on gender, age, patient's identification number, method of suicide attempt, number of previous attempts, past history of psychiatric disease, patient disposition, and Risk-rescue rating scale (RRRS). We analyzed fatality according to gender, age, method of suicide attempt, number of previous attempts, past history of psychiatric disease, and RRRS. We used Pearson's chi-square test and Mann-Whitney test for statistical analysis. RESULTS: Women had more suicide attempts than men and drug intoxication was the most common method of attempted suicide. Significant differences in fatality were observed according to age, gender, methods of attempted suicide, RRRS and no past history of psychiatric disease. Thirty three suicide attempters were registered to community mental health centers and underwent regular follow-up. CONCLUSION: Follow up through community mental health centers is important. However, there is a limitation of low enrollment and a regional medical center. Therefore, government support for community mental health centers is needed. If follow-up studies with community mental health centers are conducted on a national scale, the number of suicide attempters will be reduced.
Community Mental Health Centers ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Mental Health ; Retrospective Studies ; Suicide ; Suicide, Attempted

OBJECTIVE: Both clinical and biological factors influence the course of depressive disorders. This study tested for associations between the brain-derived neurotrophic factor (BDNF) gene at the Val66Met locus and the course of major depressive disorder (MDD). METHODS: Three hundred ten Korean subjects (209 patients, 101 controls) were genotyped for rs6265 at nucleotide 196 (G/A), which produces an amino acid substitution at codon 66 (Val66Met) of the gene for BDNF. Course of illness was evaluated both by chronicity of current episode (episode duration >24 months) and by the lifetime history of recurrences. RESULTS: Patients with the Met/Met BDNF genotype had a significantly higher rate of chronic depression than all others. There was a significant dose effect of the Met allele on chronicity. Compared with the Val/Val genotype, the relative risk of chronicity was 1.67 for the Val/Met genotype, and 2.58 for the Met/Met genotype. Lifetime history of recurrent episodes was not related to BDNF genotypes but was significantly associated with younger age of onset and with a history of depression in first degree relatives. CONCLUSION: BDNF genotyping may be informative for anticipating chronicity in major depression.
Age of Onset ; Alleles ; Amino Acid Substitution ; Biological Factors ; Brain-Derived Neurotrophic Factor ; Codon ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Genotype ; Humans