Background: Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans. Methods: We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans. Results: Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70). Conclusion Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.

Background: Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans. Methods: We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans. Results: Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70). Conclusion Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.

PURPOSE: To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks and to identify factors related to ARs in children with cerebral palsy (CP).MATERIALS AND METHODS: This was a prospective, cross-sectional study of 35 children with CP. The extent of ARs of the contra-lateral, non-task hand was assessed while performing three unimanual tasks (opening and clenching the fist, a finger opposition task, and tapping fingers). The occurrence of ARs in each trial was evaluated separately for each task using a four-point scale (total scores ranged from 0 to 12). Surface electromyography (SEMG) was used to measure the firing activity of the muscles of the opposite arm during the task. The Manual Ability Classification System and Melbourne Assessment 2 (MA-2) were used to evaluate upper limb function.RESULTS: AR scores were higher in the more-affected limb than in the less-affected limb. SEMG data on the non-task hand showed motor overflow up to the elbow muscles in the more-affected limb. Root mean square ratios of EMG signals were significantly higher in children with ARs than in children without ARs. Multiple regression analysis showed both age and MA-2 to be significant factors related to ARs in the more-affected limb.CONCLUSION: Children with visible ARs showed motor overflow in the non-task limb during unimanual hand tasks. Age and upper limb function were significantly related to the extent of ARs in the more-affected limb of children with CP.
Arm ; Cerebral Palsy ; Child ; Classification ; Cross-Sectional Studies ; Elbow ; Electromyography ; Extremities ; Fingers ; Fires ; Hand ; Humans ; Muscles ; Prospective Studies ; Upper Extremity

Background: Smoking increases total mortality and the risk of complications in patients with diabetes; however, smokers tend to smoke persistently even after the diagnosis of diabetes mellitus. The purpose of this study was to analyze risk factors predicting persistent smoking in Korean adults with diabetes. Methods: This study included 265 persistent-smokers and 146 quit-smokers among the participants with diabetes from the seventh Korea National Health and Nutrition Examination Survey. The subjects were smokers at the time of diagnosis of diabetes and were categorized into two groups according to the change in smoking status between the time of diabetes diagnosis and survey. Factors associated with persistent smoking were evaluated using multiple logistic regression analysis. Results: The prevalence of persistent-smokers with diabetes in this study was 65.3%. After adjusting for covariates, persistent smoking in Korean adults with diabetes was significantly associated with a history of cancer (adjusted odds ratio [aOR], 0.322; 95% confidence interval [CI], 0.116–0.889), strength exercise (aOR, 2.753; 95% CI, 1.361–5.566), stress (aOR, 2.036; 95% CI, 1.046–3.950), non-medical treatment for diabetes (aOR, 6.814; 95% CI, 1.661–27.957), and duration of diabetes (aOR, 0.952; 95% CI, 0.919–0.987). Conclusion Identifying the risk factors related to persistent smoking among Korean adults with diabetes can help in developing effective smoking cessation strategies.

Streptococcus pneumoniae causes many people to suffer from pneumonia, septicemia, and other diseases worldwide. To identify the difference in susceptibility of and treatment efficacy against S. pneumoniae in three ICR mouse stocks (Korl: ICR, A:ICR, and B:ICR) with different origins, mice were infected with 2 × 106, 2×107, and 2×108 CFU of S. pneumoniae D39 intratracheally. The survival of mice was observed until three weeks after the infection. The three stocks of mice showed no significant survival rate difference at 2 × 106 and 2 × 107 CFU. However, the lung and spleen weight in the A:ICR stock was significantly different from that in the other two stocks, whereas the liver weight in B:ICR stock was significantly lower than that in the other two stocks. Interestingly, no significant CFU difference in the organs was observed between the ICR stocks. The level of interferon gamma inducible protein 10 in Korl:ICR was significantly lower than that in the other two stocks. The level of granulocyte colony stimulating factor in B:ICR was significantly lower than in the other two stocks. However, tumor-necrosis factor-alpha and interleukin-6 levels showed no significant difference between the ICR stocks. In the vancomycin efficacy test after the S. pneumoniae infection, both the single-dose and double-dose vancomycin-treated groups showed a significantly better survival rate than the control group. There was no significant survival difference between the three stocks. These data showed that Korl:ICR, A:ICR, and B:ICR have no susceptibility difference to the S. pneumoniae D39 serotype 2.
Animals ; Colony-Stimulating Factors ; Granulocytes ; Interferons ; Interleukin-6 ; Liver ; Lung ; Mice ; Mice, Inbred ICR ; Pneumonia ; Sepsis ; Serogroup ; Spleen ; Streptococcus pneumoniae ; Streptococcus ; Survival Rate ; Treatment Outcome ; Vancomycin ; Virulence

OBJECTIVE: To determine whether providing education about the disease pathophysiology and drug mechanisms and side effects, would be effective for reducing the use of pain medication while appropriately managing neurogenic pain in spinal cord injury (SCI) patients. METHODS: In this prospective study, 109 patients with an SCI and neuropathic pain, participated in an educational pain management program. This comprehensive program was specifically created, for patients with an SCI and neuropathic pain. It consisted of 6 sessions, including educational training, over a 6-week period. RESULTS: Of 109 patients, 79 (72.5%) initially took more than two types of pain medication, and this decreased to 36 (33.0%) after the educational pain management program was completed. The mean pain scale score and the number of pain medications decreased, compared to the baseline values. Compared to the non-response group, the response group had a shorter duration of pain onset (p=0.004), and a higher initial number of different medications (p<0.001) and certain types of medications. CONCLUSION: This study results imply that an educational pain management program, can be a valuable complement to the treatment of spinal cord injured patients with neuropathic pain. Early intervention is important, to prevent patients from developing chronic SCI-related pain.
Complement System Proteins ; Early Intervention (Education) ; Education ; Humans ; Neuralgia* ; Pain Management ; Patient Education as Topic* ; Prospective Studies ; Spinal Cord Injuries* ; Spinal Cord*

Osmotic demyelination syndrome (ODS) is a demyelinating disorder related to the rapid correction of hyponatremia. It usually affects the pontine area; hence, the name central pontine myelinolysis (CPM). However, it rarely occurs with the correction of hypernatremia and hyperosmolarity and involves extrapontine areas. A 56-year-old chronic alcoholic had been admitted with a history of confusion. He had been in alcohol withdrawal for 4 days. Laboratory examinations showed severe hypernatremia and hyperosmolarity. After serum sodium level was normalized; however, his clinical course did not improve and deteriorated to semicoma progressively. Magnetic resonance imaging (MRI) revealed abnormal signal intensity in the pontine and extrapontine areas, including the basal ganglia, thalamus, and cerebral cortices. This is the first case report of combined central pontine and extrapontine demyelination after alcohol withdrawal and correction of hypernatremia in a chronic alcoholic.
Alcoholics* ; Basal Ganglia ; Cerebral Cortex ; Demyelinating Diseases ; Humans ; Hypernatremia* ; Hyponatremia ; Magnetic Resonance Imaging ; Middle Aged ; Myelinolysis, Central Pontine* ; Sodium ; Thalamus

OBJECTIVES: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. MATERIALS AND METHODS: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. RESULTS: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and ‘responder group’ and ‘non-responder group,’ but there was no significant difference with the ‘worsened group.’ In addition, the age of the patients was a relative factor with BRONJ stage. CONCLUSION: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.
Bisphosphonate-Associated Osteonecrosis of the Jaw* ; Busan ; Creatinine ; Diphosphonates ; Filtration ; Holidays ; Human Body ; Humans ; Kidney ; Oral and Maxillofacial Surgeons ; Osteomyelitis ; Renal Insufficiency, Chronic

This correction is being published to correct the approval number of the Institutional Review Board in this article.

PURPOSE: Accurate preoperative detection by radiologic assessment is necessary to specifically identify patients with at least three positive nodes, who can directly undergo axillary lymph node (ALN) dissection, and avoid unnecessary surgical procedures. We evaluated the usefulness of the standardized uptake value (SUV) ratio of ALN in primary breast tumor, using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and magnetic resonance imaging (MRI) to predict the necessity of ALN dissection during breast cancer surgery. METHODS: In this retrospective study we enrolled 316 consecutive patients with invasive breast cancer. The SUV ratio of ALN to primary breast tumor uptake was calculated. Optimal cutoff values were determined by receiver operating characteristic curve analysis for predicting the presence of ≥3 ALN metastases. Diagnostic performance of FDG-PET and MRI features for the prediction of ≥3 ALN metastases were determined by sensitivity, specificity, and diagnostic odds ratio (DOR). A subgroup analysis for FDG-avid tumors was also performed. RESULTS: Of the 316 patients, 36 (11.4%) showed involvement of ≥3 ALNs, with 101 (32%) having at least one metastatic lymph node. Axillary 18F-FDG uptake was positive in 75 patients (23.7%), and the optimal ratio of maximum SUV of axillary lymph node and primary tumor for determining ALN dissection was 0.3. MRI scans revealed suspicious ALN involvement in 147 patients (46.6%). The sensitivity and specificity of MRI detection were 88.9% and 56.2%, respectively, while for SUVLN/T ratio, they were 69.4% and 86.8%, respectively. DOR values for MRI and SUVLN/T ratio were 10.37 and 9.7, respectively. The area under the curve (AUC) was improved to 0.896 (95% confidence interval [CI], 0.817–0.975) for the SUVLN/T ratio in patients with FDG-avid primary tumors (FDG ≥3.9, n=108), but the MRI AUC was worsened (0.681; 95% CI, 0.569–0.793). The DOR, sensitivity, and specificity for the SUVLN/T ratio of FDG-avid cancers were 25.68, 89.0% and 86.0%, respectively. CONCLUSION: SUVLN/T ratio outperformed MRI features in predicting the need for ALN dissection in FDG-avid primary breast cancer. PET/CT may be a potential noninvasive diagnostic technique for identifying the presence of ≥3 ALN metastases.
Area Under Curve ; Breast Neoplasms* ; Breast* ; Fluorodeoxyglucose F18 ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Odds Ratio ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity