Objectives: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition.The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach. Methods: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and anti resorptive agents in sequential therapy approaches. Results: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to anti resorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for in dividuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment. Conclusions This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

PURPOSE: The aim of the present investigation was to understand the incidence, prevalence of denture stomatitis in denture wearers, who were over 60 years old, and use the results for a fundamental data to promote public awareness about denture stomatitis and its education tools. MATERIALS AND METHODS: From August 21 to September 8 2017, 500 denture wearers, who were more than 60 years old in Seoul and 4 other metropolitan cities (Busan, Daegu, Gwangju, and Daejeon), received questionnaires. The questionnaires included denture wearers' demographic distributions, specific dental treatment experiences, discomforts with current dentures, their oral health conditions, and the method of denture cleansing. RESULTS: Thirty-two percent of 500 denture wearers responded that they have healthy oral conditions. Two hundred and eight respondents (41.6%) were aware of denture stomatitis. Only 131 (26.2%) were informed about the removable denture covered by national health insurance and 327 (65.4%) of denture wearers were using the improper denture cleansing methods. CONCLUSION: A large number of denture wearers still do not recognize the importance of proper treatment for denture stomatitis, insurance covered denture treatments, and adequate denture cleansing methods.
Daegu ; Dental Restoration Wear ; Dentures* ; Education ; Gwangju ; Incidence ; Insurance* ; Methods* ; National Health Programs ; Oral Health* ; Prevalence ; Seoul ; Stomatitis, Denture ; Surveys and Questionnaires

OBJECTIVE: To find out how many causes constitute hemiplegic shoulder pain (HSP) and how they distribute in an individual patient. METHOD: Twenty-three consecutive patients with HSP which had newly developed within 3 months after stroke were enrolled from January 2008 till July, 2008. They all performed a passive range of motion test for adhesive capsulitis, modified Ashworth test for spasticity, simple x-ray for subluxation, ultrasonography for rotator cuff problems and three-phase bone scintigraphy for complex regional pain syndrome (CRPS). The causes of HSP were analyzed in number and distribution. RESULTS: Average 2.26 causes constituted with HSP in an individual patient. Most common causes were adhesive capsulitis and CRPS (respectively 14 patients). Two patients had 4 and eight patients had 3 types of shoulder pathology. CONCLUSION: More than two types of shoulder pathology existed in a patient with HSP. These findings shoulde be carefully considered when treating the patients with HSP.
Bursitis ; Humans ; Muscle Spasticity ; Range of Motion, Articular ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Stroke

PURPOSE: This study was done to examine the difference in cancer screening with mammography and Papanicolaou smear according to Body Mass Index (BMI). METHODS: The participants in this study were 5,912 women ages 40 to 69 yr, selected from the Korean Genomic Regional Cohort in Kangwon province. Mammography and Papanicolaou smear were assessed by questionnaire and body weight (kg) and height (m) measured to calculate BMI. RESULTS: The distribution of BMI was as follows: low weight (1.5%), normal weight (31.1%), over weight (24.6%), mildly obese (36.4%) and severely obese (6.3%). After adjusting for age, education and monthly income, compared with normal weight women, overweight women (odds ratio [OR]=1.283, 95% confidence interval [CI]=1.089-1.513) and mildly obese women (OR=1.214, 95% CI=1.048-1.406) were less likely to have had mammography. In contrast to mammography, cancer screening with Papanicolaou smear was not significantly different by BMI. CONCLUSION: Obese women in rural areas are less likely to screen for breast cancer by using mammography than non obese women. To ensure regular screening for breast cancer, health care providers need to give scrupulous care to obese women and remove barriers originated from obesity. Also, educational and clinical implications are considered to increase the Papanicolaou smear rate.
Adult ; Aged ; *Body Mass Index ; Breast Neoplasms/prevention & control/*radiography ; Cohort Studies ; Demography ; Female ; Humans ; *Mammography ; Middle Aged ; Obesity/psychology ; Republic of Korea ; Rural Population ; Uterine Cervical Neoplasms/*pathology/prevention & control ; *Vaginal Smears ; Women's Health

PURPOSE: The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer. METHODS: A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group(N=18).We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response. RESULTS: Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased. CONCLUSIONS: These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.
Stress, Psychological/etiology/*therapy ; *Social Support ; Middle Aged ; Humans ; Female ; Breast Neoplasms/*psychology ; Adult ; *Adaptation, Psychological

PURPOSE: The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. METHODS: One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly(90min) for 6 weeks. RESULTS: There was a significant decrease in stress scores following the intervention(Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. CONCLUSIONS: Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.
*Adaptation, Psychological ; Adult ; Breast Neoplasms/*psychology ; Female ; Humans ; Korea ; Middle Aged ; *Patient Education as Topic ; Pilot Projects ; *Social Support ; Stress, Psychological/*therapy ; Survivors/*psychology

PURPOSE: The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.
Anxiety ; Checklist ; Depression ; Education ; Gangwon-do ; Humans ; Hydrocortisone ; Nursing ; Relaxation ; Respiration ; Visual Analog Scale

PURPOSE: The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.
Anxiety ; Checklist ; Depression ; Education ; Gangwon-do ; Humans ; Hydrocortisone ; Nursing ; Relaxation ; Respiration ; Visual Analog Scale

Although Crohn's disease is usually found in the ileum and colon, it can be located in the whole gastrointestinal tract from the oral cavity to the anus. The frequency of gastroduodenal Crohn's disease is rare and is reported to range between 0.5% and 4.0% in Crohn's disease. And when Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel and colon. Very rarely, isolated Crohn's disease of the stomach and duodenum may occur. Definite diagnosis requires histologic confirmation, however, endoscopic biopsies often fail to reveal granuloma. Thus, if absence of definite histologic findings, combining clinical, radiologic and endoscopic findings suggest this condition. We experienced a first case of Crohn's disease confined to stomach and reported with review of the literature.
Anal Canal ; Biopsy ; Colon ; Crohn Disease* ; Diagnosis ; Duodenum ; Gastrointestinal Tract ; Granuloma ; Ileum ; Mouth ; Stomach* ; Upper Gastrointestinal Tract

Cytomegalovirus (CMV) colitis occurs almost exclusively in immune-compromised patients namely, HIV infection, immunosuppressant therapy after organ transplantation, anti-cancer chemotherapy, and long- term steroid user. Some patients with solid tumor have gastrointestinal CMV disease without anti-cancer chemotherapy. A 64-year-old male patient underwent surgery due to sigmoid colon cancer. On histopathologic examination of surgical specimen, CMV colitis was found in the colon. The AJCC tumor stage was II. Although CMV colitis is rarely associated with colon cancer, it maybe considered in patients with combined colitis with colorectal cancer.
Adenocarcinoma* ; Colitis* ; Colon* ; Colonic Neoplasms ; Colorectal Neoplasms ; Cytomegalovirus ; Drug Therapy ; HIV Infections ; Humans ; Male ; Middle Aged ; Organ Transplantation ; Sigmoid Neoplasms ; Transplants