Background: and Purpose: Alzheimer’s disease (AD) is a neurodegenerative disease characterized by a progressive decline in cognition and performance of daily activities. Recent studies have attempted to establish the relationship between AD and sleep. It is believed that patients with AD pathology show altered sleep characteristics years before clinical symptoms appear. This study evaluated the differences in sleep characteristics between cognitively asymptomatic patients with and without some amyloid burden. Methods: Sleep characteristics of 76 subjects aged 60 years or older who were diagnosed with subjective cognitive decline (SCD) but not mild cognitive impairment (MCI) or AD were measured using Fitbit ® Alta HR, a wristwatch-shaped wearable device. Amyloid deposition was evaluated using brain amyloid plaque load (BAPL) and global standardized uptake value ratio (SUVR) from fluorine-18 florbetaben positron emission tomography. Each component of measured sleep characteristics was analyzed for statistically significant differences between the amyloid-positive group and the amyloid-negative group. Results: Of the 76 subjects included in this study, 49 (64.5%) were female. The average age of the subjects was 70.72±6.09 years when the study started. 15 subjects were classified as amyloid-positive based on BAPL. The average global SUVR was 1.598±0.263 in the amyloidpositive group and 1.187±0.100 in the amyloid-negative group. Time spent in slow-wave sleep (SWS) was significantly lower in the amyloid-positive group (39.4±13.1 minutes) than in the amyloid-negative group (49.5±13.1 minutes) (p=0.009). Conclusions This study showed that SWS is different between the elderly SCD population with and without amyloid positivity. How SWS affects AD pathology requires further research.

Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.

PURPOSE: The purpose of this study was to investigate hemato-oncology patients' discomfort and bleeding in relation to the bedrest time after bone marrow examination. METHODS: A descriptive correlational study was conducted. The data were collected using self-report questionnaire from total of 131 patients who underwent bone marrow examination from January 2017 to September 2017. Data were analyzed with descriptive statistics, Wilcoxon Signed-rank test, McNemar's test and logistic regression. RESULTS: The level of discomfort after 4 hours of bedrest was significantly higher when compared to 2 hours of bedrest(p<.001). The occurrence of bleeding after 2 hours of bedrest was significantly higher than 4 hours of bedrest(p<.001), however the degree of bleeding was slight. No bleeding occurred in 84% of the patients after 2 hours of bedrest. CONCLUSION: The results of this study demonstrated that shortening the bed rest time after bone marrow examination was helpful in improving the patient's well-being. Bedrest time could be shortened according to the site of bone marrow examination and patient's condition.
Bed Rest ; Bone Marrow Examination ; Bone Marrow ; Hemorrhage ; Humans ; Logistic Models

This study was to investigate the effects of individual and district-level socioeconomic status (SES) on the development of cognitive impairment among the elderly. A 3-year retrospective observational analysis (2010–2013) was conducted which included 136,217 community-dwelling healthy elderly who participated in the Seoul Dementia Management Project. Cognitive impairment was defined as 1.5 standard deviations below the norms on the Mini-mental status examination. In the individual lower SES group, the cumulative incidence rate (CIR) of cognitive impairment was 8.7% (95% confidence interval [CI], 8.64–8.70), whereas the CIR in the individual higher SES group was 4.1% (95% CI, 4.08–4.10). The CIR for lower district-level SES was 4.7% (95% CI, 4.52–4.86), while that in the higher district-level SES was 4.3% (95% CI, 4.06–4.44). There were no additive or synergistic effects between individual and district-level SES. From this study, the individual SES contributed 1.9 times greater to the development of cognitive impairment than the district-level SES, which suggests that individual SES disparities could be considered as one of the important factors in public health related to cognitive impairment in the elderly.
Aged* ; Cognition Disorders ; Dementia ; Humans ; Incidence ; Public Health ; Retrospective Studies ; Seoul* ; Social Class

Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.
Adult ; *Fibroma ; *Glomus Tumor ; Humans ; Male ; *Osteochondroma ; *Toes/pathology/surgery

On rare occasions, ingested foreign bodies make their way into the appendix, which can cause an inflammatory reaction with or without perforation. In addition, perforation of the appendix by a foreign body is relatively rare, however, it should be considered in atypical cases of peritonitis, intra-abdominal abscess, or mass, and intestinal obstruction. We experienced a case of appendiceal perforation caused by a fishbone, which presented as chronic abdominal pain and intra-abdominal abscess. A 57-year-old man presented with ambiguous lower right-side abdominal pain with fever for approximately one week. Abdominal computed tomography showed a foreign body in the appendix with abscess formation. Subsequently, a laparoscopic appendectomy was performed and histopathological examination confirmed perforated appendicitis with severe inflammation secondary to a foreign body.
Abdominal Abscess ; Abdominal Pain ; Abscess ; Appendectomy ; Appendicitis ; Appendix ; Fever ; Foreign Bodies ; Inflammation ; Intestinal Obstruction ; Middle Aged ; Peritonitis

PURPOSE: This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy. METHODS: A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated. RESULTS: Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI=.90, AGFI=.86, RMSR=.05, NFI=.87, and CFI=.94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89. CONCLUSION: The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.
Adult ; Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Asian Continental Ancestry Group ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Neoplasms/drug therapy ; Peripheral Nervous System Diseases/*etiology ; Pilot Projects ; *Quality of Life ; Questionnaires ; Republic of Korea ; Research Design ; *Translating

Clonorchis sinensis is one of the most common causes of trematodiasis that is caused by the ingestion of raw fish contaminated with infective cysts. The adult flukes are predominantly present in the intrahepatic bile ducts, but occasionally they may be found in the pancreatic duct and extrahepatic bile ducts. The clinical manifestations depend on the number of flukes, the period of infestation, and complications such as pericholangitic abscess, cholangitis, bile duct stones, and cholangiocarcinoma. However, primary acute cholecystitis associated with C. sinensis infection is extremely rare. Herein, we report on a case of primary acute cholecystitis associated with C. sinensis infection.
Abscess ; Adult ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Cholecystitis, Acute* ; Clonorchis sinensis* ; Eating ; Humans ; Pancreatic Ducts ; Trematoda

PURPOSE: This study was to identify relationships of maternal psychosocial factors including mother's mood state, childcare stress, social support and sleep satisfaction with breastfeeding adaptation and immune substances in breast milk, especially secretory immunoglobulin A (sIgA) and transforming growth factor-beta 2 (TGF-beta2). METHODS: Data were collected from 84 mothers who delivered full-term infants by natural childbirth. Structured questionnaires and breast milk were collected at 2~4 days and 6 weeks postpartum. Data were analyzed using descriptive statistics, Pearson's correlation, multiple linear regression, and generalized estimating equation (GEE). RESULTS: Scores for the breastfeeding adaptation scale were significantly related with child care stress, mood state and social support. Mother's anger was positively correlated with the level of sIgA in colostrum (p<.01). Immune substances of breastmilk was significantly influenced by time for milk collection (p<.001) and the type of breastfeeding (sIgA, p<.001, TGF-beta2, p=.003). Regression analysis showed that breastfeeding adaptation could be explained 59.1% by the type of breastfeeding, childcare stress, the Profile of Mood States, emotional support and sleep quality (F=16.67, p<.001). CONCLUSION: The findings from this study provide important concepts of breastfeeding adaptation program and explanation of psychosocial factors by immune substances in breast milk. Future research, specially, bio-maker research on breast milk should focus on the ways to improve breastfeeding adaptation.
Adaptation, Psychological ; Anger ; Breast Feeding* ; Child ; Child Care ; Colostrum ; Female ; Humans ; Immunoglobulin A, Secretory ; Immunologic Factors ; Infant ; Linear Models ; Milk ; Milk, Human* ; Mothers ; Natural Childbirth ; Postpartum Period ; Pregnancy ; Psychology* ; Surveys and Questionnaires ; Transforming Growth Factor beta2

BACKGROUND/AIMS: The aims of this study were (1) to identify the useful clinical parameters of noninvasive approach for distinguishing nonalcoholic steatohepatitis (NASH) from nonalcoholic fatty liver disease (NAFLD), and (2) to determine whether the levels of the identified parameters are correlated with the severity of liver injury in patients with NASH. METHODS: One hundred and eight consecutive patients with biopsy-proven NAFLD (age, 39.8+/-13.5 years, mean+/-SD; males, 67.6%) were prospectively enrolled from 10 participating centers across Korea. RESULTS: According to the original criteria for NAFLD subtypes, 67 patients (62.0%) had NASH (defined as steatosis with hepatocellular ballooning and/or Mallory-Denk bodies or fibrosis > or =2). Among those with NAFLD subtype 3 or 4, none had an NAFLD histologic activity score (NAS) below 3 points, 40.3% had a score of 3 or 4 points, and 59.7% had a score >4 points. Fragmented cytokeratin-18 (CK-18) levels were positively correlated with NAS (r=0.401), as well as NAS components such as lobular inflammation (r=0.387) and ballooning (r=0.231). Fragmented CK-18 was also correlated with aspartate aminotransferase (r=0.609), alanine aminotransferase (r=0.588), serum ferritin (r=0.432), and the fibrosis stage (r=0.314). A fragmented CK-18 cutoff level of 235.5 U/L yielded sensitivity, specificity, and positive and negative predictive values of 69.0%, 64.9%, 75.5% (95% CI 62.4-85.1), and 57.1% (95% CI 42.2-70.9), respectively, for the diagnosis of NASH. CONCLUSIONS: Serum fragmented CK-18 levels can be used to distinguish between NASH and NAFL. Further evaluation is required to determine whether the combined measurement of serum CK-18 and ferritin levels improves the diagnostic performance of this distinction.
Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/blood ; Asian Continental Ancestry Group ; Aspartate Aminotransferases/blood ; Biological Markers/blood ; Fatty Liver/classification/metabolism/*pathology ; Female ; Ferritins/blood ; Fibrosis/complications ; Humans ; Keratin-18/analysis ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Republic of Korea ; Severity of Illness Index ; Young Adult