This study compared key health indicators of poor, older urban adults attending a free clinic with those of the general older population, using data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This cross-sectional comparative study included 60 adults aged ≥60 years who attended the Raphael Nanum Homeless Clinic in Seoul. Participants completed a questionnaire, underwent anthropometric assessment, and provided fasting blood samples for measurement of total cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides (TG). Obesity, current smoking, monthly alcohol use, poor self-rated health, and strength exercise (≥ 2 days/week) were defined according to 2023 KNHANES criteria and compared with age-matched 2023 KNHANES estimates for adults aged ≥ 60 years using independent t-tests and two-proportion z-tests. Results: Participants were predominantly men (80.0%) with a mean age of 79.9 years; 70.0% reported no regular income, and 46.7% rated their health as poor. Compared with their 2023 KNHANES counterparts, the clinic group had a higher prevalence of obesity (50.0% vs. 35.0%), particularly among men, and a more atherogenic lipid profile characterized by higher LDL-cholesterol despite similar total cholesterol levels and lower TG. The prevalence of current smoking (3.3% vs. 10.6%) and monthly alcohol use (31.7% vs. 53.0%) was significantly lower, whereas participation in strength exercise was low in both groups, with no significant differences observed. Conclusion: Poor, older urban adults exhibited multidimensional health disparities, including obesity, adverse lipid profiles, and markedly poorer self-rated health, despite lower levels of smoking and alcohol consumption. Community-based interventions targeting nutrition, physical activity, and chronic disease management are needed to reduce health inequalities in this vulnerable population.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

Background: To evaluate the effects of teneligliptin on glycosylated hemoglobin (HbA1c) levels, continuous glucose monitoring (CGM)-derived time in range, and glycemic variability in elderly type 2 diabetes mellitus patients. Methods: This randomized, double-blinded, placebo-controlled study was conducted in eight centers in Korea (clinical trial registration number: NCT03508323). Sixty-five participants aged ≥65 years, who were treatment-naïve or had been treated with stable doses of metformin, were randomized at a 1:1 ratio to receive 20 mg of teneligliptin (n=35) or placebo (n=30) for 12 weeks. The main endpoints were the changes in HbA1c levels from baseline to week 12, CGM metrics-derived time in range, and glycemic variability. Results: After 12 weeks, a significant reduction (by 0.84%) in HbA1c levels was observed in the teneligliptin group compared to that in the placebo group (by 0.08%), with a between-group least squares mean difference of –0.76% (95% confidence interval [CI], –1.08 to –0.44). The coefficient of variation, standard deviation, and mean amplitude of glycemic excursion significantly decreased in participants treated with teneligliptin as compared to those in the placebo group. Teneligliptin treatment significantly decreased the time spent above 180 or 250 mg/dL, respectively, without increasing the time spent below 70 mg/dL. The mean percentage of time for which glucose levels remained in the 70 to 180 mg/dL time in range (TIR70–180) at week 12 was 82.0%±16.0% in the teneligliptin group, and placebo-adjusted change in TIR70–180 from baseline was 13.3% (95% CI, 6.0 to 20.6). Conclusion Teneligliptin effectively reduced HbA1c levels, time spent above the target range, and glycemic variability, without increasing hypoglycemia in our study population.

An endoscopic mucosal resection (EMR) is an effective and safe therapeutic technique for treating a patient with a laterally-spreading tumor (LST). Colonoscopic-procedure-related complications are noted to be about 2.8% worldwide, and a perforation is the most common. Most colon perforations cause pneumoperitoneum. However, a perforation within the retroperitoneal portion of the colon (rectum and some of sigmoid colon) may cause an extraperitoneal perforation, and the leaking free air may induce pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema, depending on the amount of discharged air. Herein, we present the case of a patient with an extraperitoneal colon microperforation which manifested as pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema after an EMR for a sigmoid LST, which was successfully treated with medical treatment and endoscopic clipping.
Colon ; Colon, Sigmoid ; Colonoscopy ; Humans ; Mediastinal Emphysema* ; Pneumoperitoneum ; Retropneumoperitoneum* ; Subcutaneous Emphysema*

BACKGROUND: We compared clinical outcomes after total knee arthroplasty with the Low Contact Stress (LCS) rotating platform mobile bearing knee system and the Press Fit Condylar Sigma rotating platform high flexion (PFC Sigma RP-F) mobile bearing knee system. METHODS: Fifty cases of total knee arthroplasty were performed with the PFC Sigma RP-F mobile bearing knee system and sixty-one cases were performed with the LCS mobile bearing total knee arthroplasty. The average duration of follow-up was 2.9 years. RESULTS: The mean Hospital for Special Surgery (HSS) knee score was 62.1 (range, 52 to 75) in the LCS group and 61.9 (range, 50 to 74) in the Sigma RP-F group preoperatively, and 90.1 (range, 84 to 100) in the LCS group and 89.8 (range, 83 to 100) in the Sigma RP-F group at the final follow-up. The mean preoperative flexion contracture was 6.7degrees (range, 0degrees to 10degrees) in the LCS group and 9.3degrees (range, 0degrees to 15degrees) in the Sigma RP-F group preoperatively. The mean range of motion was 124.6degrees (range, 105degrees to 150degrees) in the LCS group and 126.1degrees (range, 104degrees to 145degrees) in the Sigma RP-F group at the final follow-up. CONCLUSIONS: After a minimum duration of follow-up of two years, we found no significant differences between the two groups with regard to the range of knee motion or the clinical or radiographic results.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*methods ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Humans ; Knee Joint/*physiology/radiography/surgery ; *Knee Prosthesis ; Male ; Middle Aged ; Pain Measurement ; Range of Motion, Articular/physiology ; Treatment Outcome

OBJECTIVES: Osteoclast differentiation and bone resorption are considered a potential therapeutic target to the treatment of erosive bone diseases, including osteoporosis and rheumatoid arthritis. Poria cocos Wolf (PCW), commonly used herbal medicine, has previously been reported to induce anti-inflammatory effect and anti-cancer effect, and to modulate immunologic responses. However, the effects of PCW on osteoclasts, and its detailed mechanisms are not proven. Therefore, we examined the inhibitory mechanism of PCW on osteoclast differentiation and bone resorption. MATERIALS AND METHODS: To analyze the effects of PCW on osteoclast differentiation, we examined osteoclast differentiation in bone marrow macrophages (BMMs) treated with or without of PCW by TRAP staining. The expression of c-Fos, NFATc1, TRAP and OSCAR mRNA was determined by RT-PCR and the protein levels of c-Fos, NFATc1, p38, ERK, JNK, Akt and IkappaB were assessed by western blot. Also, we evaluated the effect of PCW on bone resorption using hydroxyapatite plate. RESULTS: PCW significantly inhibited RANKL-mediated osteoclast differentiation without any evidence of cytotoxicity. We founded that PCW strongly inhibited RANKL-induced osteoclast formation when added during the early stage of cultures, suggesting that PCW acts on osteoclast precursors to inhibit RANKL/RANK signaling. Among the RANK signaling pathways, PCW inhibited the phosphorylation of p38 and JNK, also inhibited RANKL-induced expression of c-Fos, NFATc1, TRAP and OSCAR. In addition, PCW suppressed the bone resorption of mature osteoclasts. CONCLUSIONS: These findings suggest that PCW may be a potential novel drug for bone disorders by targeting the differentiation of osteoclasts as well as their functions.
Arthritis, Rheumatoid ; Blotting, Western ; Bone Diseases ; Bone Marrow ; Bone Resorption ; Cocos ; Durapatite ; Herbal Medicine ; Macrophages ; Osteoclasts ; Osteoporosis ; Phosphorylation ; Poria ; RNA, Messenger ; Wolves