Purpose: This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method. Methods: The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/m 2 . The total energy expenditure (TEEDLW ) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days. Results: TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEEDLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by −533.9 ± 228.0 kcal/day (−25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEEDLW , showed that the agreement between them was negatively skewed, ranging from −980.8 kcal/day to −86.9 kcal/day. Conclusion This study showed that the energy intake of elderly women was underreported.Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.

The purpose of this study was to examine the influence of maternal socioeconomic status, maternal oral health behaviors, and oral health behaviors of children, on the prevalence of early childhood caries in children aged 5 years. The Korean National Health and Nutrition Examination Survey data collected between 2007 and 2014 were applied to this study, and the study sample included 824 children who received oral examinations and participated in the health behavior survey. The factor that affected the prevalence of early childhood caries were confirmed by maternal and child factors. The data were analyzed using multiple linear regression. The mothers' age, income level, and job status affected the prevalence of early childhood caries. There was a significant difference in the analysis considering the factors of motherhood and children in the prevalence of early childhood caries according to mother's age, education level, income level, and the child's oral examination. The prevalence of early childhood caries was higher in children who received oral examinations than in those who did not. When the mother's educational level was higher than college education, it was found that the index of child, i.e., there was a difference in the prevalence of early childhood caries according to the mother's educational and income levels. These results indicate that maternal socioeconomic characteristics are correlated with the oral health of children. Therefore, oral health education programs that include mothers for the prevention of early dental caries in children may improve the dental health of children. In addition, specific oral health policies are necessary to address the differences in the oral health between the income groups.
Child ; Dental Caries ; Diagnosis, Oral ; Education ; Health Behavior ; Humans ; Linear Models ; Mothers ; Nutrition Surveys ; Oral Health* ; Prevalence* ; Social Class

OBJECTIVETo investigate the anti-inflammatory effects of Jeju seaweeds on macrophage RAW 264.7 cells under lipopolysaccharide (LPS) stimulation.

METHODSEthyl acetate fractions were prepared from five different types of Jeju seaweeds, Dictyopteris divaricata (D. divaricata), Dictyopteris prolifera (D. prolifera), Prionitis cornea (P. cornea), Grateloupia lanceolata (G. lanceolata), and Grateloupia filicina (G. filicina). They were screened for inhibitory effects on proinflammatory mediators and cytokines such as nitric oxide (NO), prostaglandin E2, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6).

RESULTSOur results revealed that D. divaricata, D. prolifera, P. cornea, G. lanceolata, and G. filicina potently inhibited LPS-stimulated NO production (IC50 values were 18.0, 38.36, 38.43, 32.81 and 37.14 µg/mL, respectively). Consistent with these findings, D. divaricata, D. prolifera, P. cornea, and G. filicina also reduced the LPS-induced and prostaglandin E2 production in a concentration-dependent manner. Expectedly, they suppressed the expression of inducible NO synthase and cyclooxygenase-2 at the protein level in a dose-dependent manner in the RAW 264.7 cells, as determined by western blotting. In addition, the levels of TNF-α and IL-6, released into the medium, were also reduced by D. divaricata, D. prolifera, P. cornea, G. lanceolata, and G. filicina in a dose-dependent manner (IC50 values for TNF-α were 16.11, 28.21, 84.27, 45.52 and 74.75 µg/mL, respectively; IC50 values for IL-6 were 37.35, 80.08, 103.28, 62.53 and 84.28 µg/mL, respectively). The total phlorotannin content was measured by the Folin-Ciocalteu method and expressed as phloroglucinol equivalents. The content was 92.0 µg/mg for D. divaricata, 151.8 µg/mg for D. prolifera, 57.2 µg/mg for P. cornea, 53.0 µg/mg for G. lanceolata, and 40.2 µg/mg for G. filicina.

CONCLUSIONSThus, these findings suggest that Jeju seaweed extracts have potential therapeutic applications for inflammatory responses.

BACKGROUND: We evaluated whether the analgesic superiority of regional block over general anesthesia improves patient satisfaction. METHODS: Patients were anesthetized with either general anesthesia (GA) (n = 30) or axillary brachial plexus block (BPB) (n = 30). GA was standardized to include induction with propofol and alfentanil and maintenance with desflurane in an oxygen/nitrous oxide mixture. BPB was performed using an axillary perivascular approach, and 1.5% lidocaine 20 ml with epinephrine (1 : 200,000) and 0.5% levobupivacaine 20 ml were injected. Pain scores and numbers of times pushing the patient-controlled analgesia (PCA) button were measured preoperatively and at 2, 6, and 24 hours after the end of surgery. On the first day after the operation, one of our researchers visited the patients to document their opinions of their anesthetic experiences and their satisfaction scores. RESULTS: Group BPB had lower visual analog scale scores at 2 hours and 6 hours postoperatively. Numbers of times pushing the PCA button was also lower in Group BPB within the first 2 hours and between 2-6 hours postoperatively. However, patient satisfaction scores were not statistically different between the two groups (84 +/- 11 vs. 88 +/- 12, P = 0.177). CONCLUSIONS: BPB provided superior analgesia after upper limb surgery compared to GA, but for a complete understanding of patients' satisfaction, detailed consideration of factors such as sedation would be necessary.
Alfentanil ; Analgesia ; Analgesia, Patient-Controlled ; Anesthesia, General* ; Brachial Plexus* ; Epinephrine ; Hand* ; Humans ; Lidocaine ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction* ; Propofol ; Upper Extremity ; Visual Analog Scale ; Wrist*

Objective: To investigate the anti-inflammatory effects of Jeju seaweeds on macrophage RAW 264.7 cells under lipopolysaccharide (LPS) stimulation. Methods: Ethyl acetate fractions were prepared from five different types of Jeju seaweeds, Dictyopteris divaricata (D. divaricata), Dictyopteris prolifera (D. prolifera), Prionitis cornea (P. cornea), Grateloupia lanceolata (G. lanceolata), and Grateloupia filicina (G. filicina). They were screened for inhibitory effects on proinflammatory mediators and cytokines such as nitric oxide (NO), prostaglandin E

OBJECTIVES: The aim of this study was to investigate associations between obesity indices and cognitive functions using data from individuals older than 65 years in South Korea. METHODS: A total of 151 Koreans older than 65 years participated in this study voluntarily. Obesity was determined using body mass index (BMI) and waist-hip ratio (WHR). Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination (MMSE-K). The participants were divided into four groups according to BMI : underweight (BMI<18.5), normal (18.5< or =BMI<23.0), overweight (23.0< or =BMI<25.0), and obesity (BMI> or =25.0), and two groups according to WHR : normal (WHR<18.5) and abdominal obesity (WHR> or =0.8). Baseline characteristics were compared among different BMI or WHR subgroups. RESULTS: Older age and smoking habits showed an association with poor cognitive function. Among different BMI groups, the overweight group had the highest scores of MMSE-K ; the item scores for time and place orientation (4.48+/-0.770 and 4.80+/-0.500) and attention/calculation (4.00+/-1.258) as well as total score (25.88+/-2.877). Overweight in BMI showed an association with better cognitive function (OR(adjusted )=0.098, 95% confidence interval=0.017-0.577). CONCLUSION: In this study, the overweight group measured by BMI showed better cognitive function than other groups. Overweight in elderly might be acceptable in order to maintain cognitive performance. Further investigation regarding the underlying mechanism explaining the relationship between cognitive function and body weight will be needed.
Aged* ; Body Mass Index ; Body Weight ; Humans ; Obesity* ; Obesity, Abdominal ; Overweight ; Republic of Korea ; Smoke ; Smoking ; Thinness ; Waist-Hip Ratio

BACKGROUND: Insufficient sample volume can cause unnecessary blood loss and inaccurate arterial blood gas and electrolytes testing. The aim of this study was to determine the adequate sample volume, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. METHODS: Patients had four different arterial blood samples (0.2 ml, 0.4 ml, 0.6 ml and 1 ml [control], respectively) taken sequentially in random order. Samples were analyzed for pH, PaCO2, PaO2, hematocrit, Na+, K+, Ca2+ and Mg2+ using NOVA blood gas analyzer. RESULTS: A total of 27 patients were recruited for the study. All sample volumes tested provided the results of pH, PaCO2, PaO2 and hematocrit that were statistically similar to control values. However, the results of electrolytes (K+, Ca2+ and Mg2+) in all sample volumes tested were significantly lower than the control values and an increasing sample volume equated to blood results trending closer to those obtained with the control sample. CONCLUSIONS: This study showed that there is not one sample volume that will provide accurate results for all blood components. The study tested a variety of sample volumes and found that although even small sample volume of 0.2 ml provided accurate results for pH, PaCO2, PaO2 and hematocrit. No sample volume that was tested provided accurate results for K+, Ca2+ and Mg2+.
Electrolytes ; Hematocrit ; Humans ; Hydrogen-Ion Concentration

OBJECTIVE: In South Korea, the number of deaths from suicide has increased in the last two decades, and suicide has become both a social and political problem. In this study, after controlling the variables influencing suicidal ideation, it was expected that it would be determined if anxiety symptoms are independently related to suicidal ideation. METHODS: Data were obtained from 327 psychiatric outpatients accomplished a self-reported questionnaire that included sociodemographic characteristics and clinical variables as well as self-rating scales for measuring the severity of one's anxiety, depression, and suicidal ideation. Logistic-regression analyses were used to determine the correlation between anxiety symptoms and significant suicidal ideation, adjusting for covariates. RESULTS: The patients with significant suicidal ideation were shown to be less educated, unemployed, never married, divorced, or separated by death, or living alone, and were shown to have a lower income, a drinking habit, a higher number of past suicide attempts, and more family members who committed suicide, than the patients without significant suicidal ideation. After adjusting the covariates influencing significant suicidal ideation, anxiety symptoms were associated with significant suicidal ideation. However, after adjusting for depressive symptoms, only the trait anxiety was associated with significant suicidal ideation. CONCLUSION: These findings suggest that anxiety symptoms are an independent risk factor for suicidal ideation. Clinicians may thus use anxiety symptoms for the screening examination when evaluating suicidal ideation and risk, and will have to actively evaluate and treat the anxiety symptoms of patients with suicidal tendencies.
Anxiety ; Depression ; Divorce ; Drinking ; Humans ; Mass Screening ; Outpatients ; Surveys and Questionnaires ; Republic of Korea ; Risk Factors ; Single Person ; Suicidal Ideation ; Suicide ; Weights and Measures

OBJECTIVES: The misdiagnosis of delirium may result in a delay of correct diagnosis and appropriate treatment of the delirium. Additionally, aggravation of physical illnesses can occur. The objective of this study was to investigate patient characteristics in cases of misdiagnosed delirium upon psychiatric consultation in a university hospital. METHODS: Subjects included patients with delirium among all who we had consulted over a 12 week span. Psychiatric diagnosis was made by two well-trained psychiatrists by means of the DSM-IV-TR. Cognitive function, level of delirium, and physical function were evaluated by the Korean version of Mini Mental Status Examination (MMSE-K), the Delirium Rating Scale-Revised-98 (DRS-R-98), the Clinical Global Impression-Severity (CGI-S), the Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and the Global Assessment of Functioning Scale (GAF). In addition, we collected socio-demographic information, date of admission and consultation, present causes of consultation, and speculated psychiatric diagnoses made by referring physicians. RESULTS: Among 45 subjects with delirium, only 28 patients (62%) were diagnosed with delirium by referring physicians at the time of consultation. The remaining 17 patients (38%) had been diagnosed with other illnesses. The group of misdiagnosed patients tended to have a longer duration of formal education than those that had been correctly diagnosed. CONCLUSION: Early diagnosis and intervention of delirium can minimize subsequent problems related to delayed diagnosis. Therefore, it is vital to identify the factors related to misdiagnoses by referring physicians. This study showed that a longer duration of formal education is a contributing factor for the misdiagnosis of delirium. Longer education may cover up the typical symptoms of delirium. This can keep referring physicians from making a correct diagnosis. This study was a pilot study investigating diagnostic accuracy of delirium by referring physicians. Additional, well-controlled studies are warranted.
Delayed Diagnosis ; Delirium ; Diagnostic Errors ; Early Diagnosis ; Humans ; Mental Disorders ; Pilot Projects ; Psychiatry

BACKGROUND: A reflex cough is often observed after an intravenous (IV) bolus of remifentanil. Since ketamine was reported to be effective in modulating the cough reflex, this prospective, randomized, double-blind, placebo-controlled study was designed to evaluate the efficacy of pretreatment with ketamine on remifentanil-induced cough. METHODS: 320 patients undergoing general anesthesia for elective surgery were randomly allocated into two groups to receive either IV ketamine 0.1 mg/kg (ketamine group, n = 156) or 0.9% saline (saline group, n = 154) 1 min before administration of remifentanil at a target effect-site concentration of 5 ng/ml. Severity of cough was graded (mild, 1-2; moderate, 3-4; and severe, 5 or >5). RESULTS: The overall incidence of cough was significantly higher in the saline group (43/154 patients; 0.28, 95% CI 0.21, 0.36) than that in the ketamine group (18/156 patients; 0.12, 95% CI 0.07, 0.18) (P < 0.001). However, there was no significant difference in the severity and the onset time of cough between the groups. CONCLUSIONS: IV ketamine 0.1 mg/kg one minute before remifentanil was effective in suppressing remifentanil-induced cough without affecting the severity and onset time.
Anesthesia, General ; Cough ; Humans ; Incidence ; Ketamine ; Piperidines ; Prospective Studies ; Reflex