Background/Aims: This study aimed to investigate the timing and predictors of death during treatment among patients with multidrug/rifampin-resistant tuberculosis (MDR/RR-TB) in South Korea. Methods: This was a retrospective cohort study that included MDR/RR-TB cases notified between 2011 and 2017 in South Korea. Results: Among 7,226 MDR/RR-TB cases, 699 (9.7%) died at a median of 167 days (IQR 51–358 d) from the initiation of MDR-TB treatment. The cumulative proportion of all-cause death was 35.5% at 90 days and 52.8% at 180 days from treatment initiation. TB-related deaths occurred at a median of 133 days (IQR 32–366 d), which was significantly earlier than the median of 184 days (IQR 68–356 d) for non-TB-related deaths (p = 0.002). In a multivariate analysis, older age was the factor most strongly associated with death, with those aged ≥ 75 years being 68 times more likely to die (aHR 68.11, 95% CI 21.75–213.26), compared those aged ≤ 24 years. In addition, male sex, comorbidities (cancer, human immunodeficiency virus, and end stage renal disease), the lowest household income class, and TB-specific factors (previous history of TB treatment, smear positivity, and fluoroquinolone resistance) were identified as independent predictors of all-cause death. Conclusions This nationwide study highlights increased deaths during the intensive phase and identifies high-risk groups including older people and those with comorbidities or socioeconomic vulnerabilities. An integrated and comprehensive strategy is required to reduce mortality in patients with MDR/RR-TB, particularly focusing on the early stages of treatment and target populations.

Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

Crown fractures are the most frequent traumatic injuries to permanent teeth and mainly involve the maxillary incisors due to their exposed position in the dental arch. One option for managing crown fractures, when the tooth fragment is present and in good condition, is reattachment of the fragment to its original position. This paper reports on three crown fracture cases in which successful esthetic and functional results were achieved by reattachment of the tooth fragment.
Crowns ; Dental Arch ; Incisor ; Tooth

During virus infection, T cells must be adapted to activation and lineage differentiation states via metabolic reprogramming. Whereas effector CD8⁺ T cells preferentially use glycolysis for their rapid proliferation, memory CD8⁺ T cells utilize oxidative phosphorylation for their homeostatic maintenance. Particularly, enhanced AMP-activated protein kinase (AMPK) activity promotes the memory T cell response through different pathways. However, the level of AMPK activation required for optimal memory T cell differentiation remains unclear. A new metformin derivative, IM156, formerly known as HL156A, has been reported to ameliorate various types of fibrosis and inhibit in vitro and in vivo tumors by inducing AMPK activation more potently than metformin. Here, we evaluated the in vivo effects of IM156 on antigen-specific CD8⁺ T cells during their effector and memory differentiation after acute lymphocytic choriomeningitis virus infection. Unexpectedly, our results showed that in vivo treatment of IM156 exacerbated the memory differentiation of virus-specific CD8⁺ T cells, resulting in an increase in short-lived effector cells but decrease in memory precursor effector cells. Thus, IM156 treatment impaired the function of virus-specific memory CD8⁺ T cells, indicating that excessive AMPK activation weakens memory T cell differentiation, thereby suppressing recall immune responses. This study suggests that metabolic reprogramming of antigen-specific CD8⁺ T cells by regulating the AMPK pathway should be carefully performed and managed to improve the efficacy of T cell vaccine.
AMP-Activated Protein Kinases ; Cell Differentiation ; Fibrosis ; Glycolysis ; Immunologic Memory ; In Vitro Techniques ; Lymphocytic choriomeningitis virus ; Lymphocytic Choriomeningitis ; Memory ; Metformin ; Oxidative Phosphorylation ; T-Lymphocytes

The purpose of this study was to examine effects of bioactive glass on Vickers hardness of bleached enamel surface. Enamel specimens were bleached with 15% carbamide peroxide (CP) for 14days. After bleaching, Artificial saliva (AS), 45S5 bioactive glass (BAG) and fluoride varnish (FV) are applied each specimens (n=10). The Vickers hardness of the specimens was measured before and after the bleaching, after the remineralized treatment at 1 day and after 7 and 14 days. The Vickers hardness on enamel surface after bleaching decreased statistically (p < 0.05) compared to before bleached enamel surface. The Vickers hardness increased significantly in the BAG and FV groups compared to the AS group values at 1 day and 7 days after remineralization (P < 0.05). 45S5 bioactive glass rapidly increase Vickers hardness of the bleached enamel surface.
Dental Enamel ; Fluorides ; Glass ; Hardness ; Paint ; Saliva, Artificial ; Urea

PURPOSE: The purpose of this study was to investigate the reality, status of clinical nurses' emotional labor and the relationship with physical discomfort, burnout, depression and social support. METHODS: A thousand three hundred sixteen clinical nurses from 42 hospitals nationwide participated in this study. Questionnaires were developed for evaluating the reality and status of emotional labor of clinical nurses after interviewing focus groups and reviewing literatures. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. RESULTS: Ninety eight percent of nurses had answered having emotional labor and they experienced 82 times per year, 9.6 times during last a month which means they experience it every other day. The one who provoke emotional labor were patients, guardians, physicians, supervisor, and colleagues in sequence. Eighty percent of nurses had intention to leave their jobs after experiencing emotional labor. They were doing more surface acting than deep acting of emotional labor. CONCLUSION: Clinical nurses in Korea experienced excessively high level of emotional labor and delayed responding to clients' requests due to lack of time for caring each patient was revealed as one of the main causes of emotional labor.
Depression ; Focus Groups ; Humans ; Intention ; Korea

OBJECTIVES: Vitamin C has various functions such as antioxidative effect and supporting absorption of iron (Fe). Aim of this present study was to provide vitamin C nutrition information and to briefly evaluate absorption interaction of vitamin C and Fe content of vitamin C emphasized products. METHODS: Vitamin C emphasized foods including beverages, cereal, snacks, chocolate products, other cocoa products, and sugary products were examined by HPLC. Fe contents in samples after dry-ashing were examined by ICP. RESULTS: Vitamin C content ranges in various products tested were the following: beverages (n=11) 20.15 ± 0.08~845.41 ± 6.07 mg, cereal (n=11) 52.50 ± 0.23~262.50 ± 0.07 mg, snacks (n=1) 50.00 ± 0.25 mg, chocolate products (n=1) 311.73 ± 2.44 mg, other cocoa products (n=1) 311.73 ± 2.44 mg, other sugary products (n=2) 52.50 ± 0.23~262.50 ± 0.07 mg. Vitamin C (n=27) analysis values ranged from 82 to 450% of the labeled value. Vitamin C content in vitamin C emphasized food (n=6) was estimated 7.7 times~56.6 times more than Fe content. CONCLUSIONS: Analyzed samples ranged more than 80% of the labeled value in vitamin C emphasized products, which complied with food labeling regulation. But, beverages (n=3), cereal (n=4), chocolate products (n=1) were 2 times more than the labeled value. To provide accurate nutrition information, food manufactures should supervise nutrition labeling and understand the interactions between nutrients. Also, consumer should decide about the adequate amount of nutrient intake by thoroughly checking nutrition labeling.
Absorption ; Ascorbic Acid* ; Beverages ; Cacao ; Chromatography, High Pressure Liquid ; Edible Grain ; Food Labeling ; Iron ; Snacks ; Vitamins*

PURPOSE: This paper examined the relationship between knowledge differences of maternal oral health and of relevant demographic variables. METHODS: Participants included 239 pregnant women who were recruited from Women's Hospital located in B city who agreed to participate in this study. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation analysis using the SPSS 21.0 program. RESULTS: Maternal knowledge of oral health was moderate level (10.22±2.36). Scores of maternal knowledge of oral health were different according to age, education, occupation, parity, and dental care experience in pregnancy. Level of oral healthcare knowledge was weakly related to age and education. CONCLUSION: Consequently, it is necessary to encourage pregnant women to take part in oral health education program during antenatal care.
Delivery of Health Care ; Dental Care ; Education ; Female ; Humans ; Occupations ; Oral Health* ; Parity ; Pregnancy ; Pregnant Women*

OBJECTIVE: This study aims to identify self-reported stressors in the Korean community-dwelling elderly and examine their effects on subjective well-being. METHODS: The subjects of this research were 1,010 elderly people who lived in Suwon, Korea. Each subject was administered the questionnaires regarding the socio-demographic characteristics, self-reported stressors, Concise Measure of Subjective Well-Being (COMOSWB) consisting of life satisfaction, positive emotion and negative emotion, Mini-Mental State Examination for dementia screening and Short Form Geriatric Depression Scale-Korean version. Statistical analyses including the Pearson's correlation test and multiple linear regressions were performed in this study. RESULTS: In our adjusted model for confounding variables, stress from physical problems (S-PP) (ss=-0.133, p<0.001), stress from loneliness or solitude (S-LS) (ss=-0.077, p=0.007), stress from family members (S-FM) (ss=-0.083, p=0.001) were negatively associated with the total score of COMOSWB. In subscale analyses of COMOSWB, we also found that S-PP (ss=-0.184, p<0.001), S-LS (ss=-0.077, p=0.014), stress from economic problems (ss=-0.072, p=0.021) were negatively associated with life satisfaction score. While S-PP (ss=-0.140, p<0.001) and S-FM (ss=-0.079, p=0.003) were negatively associated with positive emotion score, S-FM (ss=0.105, p=0.001) and stress from friends and neighbors (ss=0.072, p=0.016) were positively associated with negative emotion score. CONCLUSION: Stresses from physical problems, loneliness, and family members might be associated with subjective well-being in the elderly. While life satisfaction appears to be affected by one's perceived physical health status, loneliness, and economic conditions, positive and negative emotions appear to be affected by relationships with family members, friends, or neighbors.
Aged* ; Confounding Factors (Epidemiology) ; Dementia ; Depression ; Friends ; Gyeonggi-do ; Humans ; Korea ; Linear Models ; Loneliness ; Mass Screening ; Surveys and Questionnaires

BACKGROUND: Respiratory syncytial virus (RSV) is one of the most important causes of lower respiratory tract infection. The rapid antigen test is a simple, cheap, and quick method for RSV detection, however, it has an acknowledged low sensitivity. The aim of this study is to evaluate the diagnostic performance of the rapid antigen test by comparing it with a multiplex reverse transcription-PCR (RT-PCR). METHODS: A total of 557 nasopharyngeal aspirates or swabs that were submitted for both a rapid antigen test, Binax NOW RSV (Binax; Alere Scarborough, Inc., USA) and multiplex RT-PCR, Seeplex RV7 (Seegene Inc., Korea) were included in this study. We performed both tests according to the manufacturer's recommendations and analyzed the diagnostic performances of a rapid antigen tests based on the results of multiplex RT-PCR. RESULTS: Among the 557 specimens, the positive rates determined from the rapid antigen test and multiplex RT-PCR were 12.2% (N=68) and 25.1% (N=140), respectively. The relative sensitivity and specificity of the rapid antigen test were 46.4% and 99.3% based on the multiplex RT-PCR, respectively. Positive and negative predictive values were 95.6% and 84.7%, respectively. The diagnostic sensitivity was lower (28.6%) in children >36 months compared with children < or =36 months of age. Test sensitivity declined when RSV infection was accompanied by infection with other respiratory viruses. CONCLUSIONS: Binax NOW RSV exhibited good diagnostic performance, easy handling, and rapidity. However, it does have the possibility of false-negative results, and additional tests are needed when there is clinical suspicion of RSV infection.
Child ; Humans ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections ; Sensitivity and Specificity