Purpose: This study aimed to investigate the effectiveness of preoperative patient-controlled analgesia(PCA) education program on older patients with spine surgery. Methods: A quasi-experimental research with a non-equivalent control group pretest-posttest design was conducted to investigate the impact of a PCA education program before surgery on postoperative pain, pain knowledge and attitudes, and frequency of additional analgesic use. The sample size for experimental and control group was 55 respectively. Results: The experimental group, which underwent the PCA education program, had lower postoperative pain scores compared to the control group. Furthermore, the experimental group exhibited a higher level of knowledge on PCA (p<.001) and more positive attitudes toward analgesic use (p<.001). While there was a significant difference in the use of opioid analgesics for additional pain relief between two groups (p<.001), there was no significant difference in the use of non-opioid analgesics. Conclusion The implementation of the PCA education program was found to increase knowledge and positive attitudes on the use of PCA. Moreover, it significantly alleviated pain, particularly during physical activity, within initial 48 hours after spinal surgey in older patients. Therefore, the findings of this study supported that the PCA education program could be used as a preoperative intervention to alleviate postoperative pain for older patients with spinal surgery.

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

The purpose of this study was to investigate the association between daily beverage intake and obesity in young adults. This cross-sectional study was conducted with 256 adults in their 20s and 30s. Obesity was evaluated by anthropometric measurement of body mass index (BMI), waist to hip ratio and waist to height ratio. In addition, the daily intake of milk, caffeinated beverages, sweetened beverages, and alcoholic beverages was investigated using the dietary record and 24-h recall methods. Based on the BMI, men and women were classified into underweight, normal, overweight and obese. Among men, 38.3% were found to be normal, 28.1% were overweight and 31.3% obese. Among women, 11.7% were underweight, 73.4% were normal, and 10.2% were overweight, which was significantly different from men. In women, the BMI of the milk consumers was significantly lower than the non-consumers. Also, the obesity indices of caffeinated beverage consumers were significantly lower than the non-consumers. An analysis of the correlation between beverage intake and the obesity index showed that the intake of caffeinated beverages among women had a significant negative correlation with the obesity index, and intake of alcoholic beverages had a significant positive correlation with waist to height ratio. This study suggests that intake of milk and caffeinated beverage may have a positive effect on obesity, whereas the intake of alcoholic beverages may have a negative effect, especially in young adult women.

BACKGROUND/OBJECTIVES: This study aimed to compare 24-h diet recall (DR) and 24-h urine collection (UC) for estimating sodium and potassium intakes and their ratio (Na/K), identifying factors associated with sodium and potassium intakes and Na/K, and identifying those who were likely to underestimate sodium and potassium intakes by DR. SUBJECTS/METHODS: A total of 640 healthy adults aged 19–69 yrs completed a questionnaire survey, salty taste assessment, anthropometric measurement, two 24-h DRs, and two 24-h UCs. RESULTS: The mean sodium and potassium intakes and Na/K were 3,755 mg/d, 2,737 mg/d, and 1.45 according to DR, and 4,145 mg/d, 2,812 mg/d, and 1.57 according to UC, with percentage differences of −9.4%, −2.7%, and −7.6% in the values between the two methods, respectively.Men, older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who were found to be salty in the salty taste assessment consumed significantly more sodium; older adults, the heavy- activity group, and obese individuals consumed more potassium; and men, younger adults, smokers, and obese individuals had a significantly higher Na/K, according to UC. Compared with UC, DR was more likely to underestimate sodium intake in older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who consumed eating-out/delivery food at least once a day, and potassium intake in older adults, the heavy-activity group, and obese individuals. CONCLUSIONS The mean sodium and potassium intakes and Na/K estimated by DR were comparable to those measured by UC. However, the association of sodium and potassium intakes with sociodemographic and health-related factors showed inconsistent results when estimated by DR and UC. Factors influencing the underestimation of sodium intake by DR compared to UC should be further investigated.

Purpose: This study is to investigate the distribution of natural tooth shades in the Korean elderly population to quantify the correlation and changes of tooth color with age and gender. In addition, the possible effects of habits on tooth color were assessed. Materials and Methods: The tooth color of one of the maxillary central incisors of 200 Korean individuals aged 50 to 89 years, males and female, was measured using the portable intraoral spectrophotometer (VITA Easyshade V).CIELab and CIELCh color coordinates were recorded. We conducted the survey about the tobacco smoking, chronic disease, medication, eating habits, oral health behaviors and satisfaction with tooth color. Experimental data were statistically analyzed by using the t-test (P<0.05), two-way analysis of variance and Pearson’s correlation test.Result: The most frequent color in the Korean elderly population was 3M3 & A3.5 shade. L* and h* values decreased, whereas C*, a* and b* values increased progressively with age. There was a significant interaction between age and color coordinates for b* values (r=0.245, P<0.05). Males generally have significantly higher C*, a*, b* values and lower L*, h* value compared to females. Individuals who consumed alcohol had a higher L* value (P<0.05). Conclusion Within the limitation of this study, the central incisors were getting darker, more reddish, and yellowish with age. Information on the chromatic range of natural teeth by age and gender could help to select colors for esthetic dental restorations.

Background: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea. Methods: We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients’ electronic medical records were reviewed to identify clinical characteristics. Results: During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m 2 .Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754–18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439–35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321–37.357), and combined blood stream infection (OR, 7.092;95% CI, 1.061–18.181) were identified as independent predictors of mortality in total patients.Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group.The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m 2 ), and the one remaining patient died from a secondary infection. Conclusion About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m2 ) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.

BACKGROUND/OBJECTIVES: The purpose of this study was to develop a sodium index, which is a tool for estimating and assessing sodium intake easily and quickly, to assist in the prevention of various diseases induced by excess sodium intake in Korean adults. SUBJECTS/METHODS: The 24-h urine collection and dietary behavior surveys were performed on 640 healthy people in 4 regions of South Korea, and an equation for the estimation of 24-h sodium intake was developed. The validity and reliability of the equation were verified with 200 adults. The sodium index was developed by converting the estimated sodium intake using the equation. Finally, the sodium intake status of 1,600 adults was assessed using the sodium index. RESULTS: The equation included sex, age, body mass index, eating habit and dietary behaviors related to sodium intake. In validity test of the equation, the mean bias between sodium intake using 24-h urine analysis and using the equation from the Bland-Altman plots was −1.5 mg/day. The sensitivity and specificity of the equation for estimation of sodium intake were 80.5% and 64.4%, respectively. In the reliability test of the equation, there was no significant difference between the first and second sodium intakes calculated using the equations, and Spearman's correlation coefficient between the 2 sodium intakes was 0.98. Sodium intake can be assessed as ‘very moderate’ for 75–100 on the sodium index, ‘moderate’ for 100–150, ‘careful’ for less than 75 or 150–200, and ‘severe’ for 250 or more. When sodium intake was assessed using the sodium index in 1,600 subjects, 54.3% and 24.3% of the subjects were assessed to be in the ‘careful’ and ‘severe’ categories, respectively. CONCLUSIONS Using a simple questionnaire, the sodium index can be used to monitor and assess sodium intake status, assisting in nutrition education and counseling in a large population.

Background/Aims: Human adenovirus type 55 (HAdV-55), an emerging epidemic strain, has caused several large outbreaks in the Korean military since 2014, and HAdV-associated acute respiratory illness (HAdV-ARI) has been continuously reported thereafter. Methods: To evaluate the epidemiologic characteristics of HAdV-ARI in the Korean military, we analyzed respiratory virus polymerase chain reaction (RV-PCR) results, pneumonia surveillance results, and severe HAdV cases from all 14 Korean military hospitals from January 2013 to May 2018 and compared these data with nationwide RV surveillance data for the civilian population. Results: A total of 14,630 RV-PCRs was performed at military hospitals. HAdV (45.4%) was the most frequently detected RV, followed by human rhinovirus (12.3%) and influenza virus (6.3%). The percentage of the military positive for HAdV was significantly greater than the percentage of civilians positive for HAdV throughout the study period, with a large outbreak occurring during the winter to spring of 2014 to 2015. The outbreak continued until the end of the study, and non-seasonal detections increased over time. The reported number of pneumonia patients also increased during the outbreak. Case fatality rate was 0.075% overall but 15.6% in patients with respiratory failure. The proportion of severe patients did not change significantly during the study period. Conclusions A large HAdV outbreak is currently ongoing in the Korean military, with a trend away from seasonality, and HAdV-55 is likely the predominant strain. Persistent efforts to control the outbreak, HAdV type-specific surveillance, and vaccine development are required.

Coronavirus disease 2019 vaccinations for healthcare workers (HCWs) have begun in South Korea. To investigate adverse events (AEs) of the first dose of each vaccine, any symptom was collected daily for seven days after vaccination in a tertiary hospital. We found that 1,301 of 1,403 ChAdOx1 nCoV-19 recipients and 38 of 80 BNT162b2 recipients reported AEs respectively (90.9% vs. 52.5%): injection-site pain (77.7% vs. 51.2%), myalgia (60.5% vs.11.2%), fatigue (50.7% vs. 7.5%), headache (47.4% vs. 7.5%), and fever (36.1% vs. 5%; P < 0.001 for all). Young HCWs reported more AEs with ChAdOx1 nCoV-19 than with BNT162b2.No incidences of anaphylaxis were observed. Only one serious AE required hospitalization for serious vomiting, and completely recovered. In conclusion, reported AEs were more common in recipients with ChAdOx1 nCoV-19 than in those with BNT162b2. However, most of the reported AEs were mild to moderate in severity. Sufficient explanation and preparation for expected AEs required to promote widespread vaccination.