• Korean Journal of Clinical Laboratory Science
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• v.54 no.4
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• pp.249-255
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• 2022

Alzheimer's disease (AD) represents a major public health concern and has been identified as a research priority. Clinical research evidence supports that the core cerebrospinal fluid (CSF) biomarkers for AD, including amyloid-β (Aβ42), total tau (T-tau), and phosphorylated tau (P-tau), reflect key elements of AD pathophysiology. Nevertheless, advances in the clinical identification of new indicators will be critical not only for the discovery of sensitive, specific, and reliable biomarkers of preclinical AD pathology, but also for the development of tests that facilitate the early detection and differential diagnosis of dementia and disease progression monitoring. The early detection of AD in its presymptomatic stages would represent a great opportunity for earlier therapeutic intervention. The chance of successful treatment would be increased since interventions would be performed before extensive synaptic damage and neuronal loss would have occurred. In this study, the importance of developing an early diagnostic method using cognitive decline biomarkers that can discriminate between normal, mild cognitive impairment (MCI), and AD preclinical stages has been emphasized.

• Nutrition Research and Practice
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• v.17 no.4
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• pp.780-788
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• 2023

BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

• Korean Journal of Social Welfare
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• v.65 no.4
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• pp.61-88
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• 2013

The aim of this study was to explore the work experiences of hospital-based child protection team staffs who had intervened the child abuse cases resulting in death. In order to gather the relevant data, all 62 child protection teams registered nationwide were contacted and 5 teams which had actually experienced at least one child abuse deaths were found. The staffs (hospital social workers and doctors) who belonged to these teams were intensively interviewed, and the interviewed materials were thoroughly analyzed by qualitative research methodology. The result showed that treatment delay was the most important obstacle to prevent unnecessary deaths of the victims. Some abused victims were sent to the hospital only after their physical condition had so gravely deteriorated. In other cases, custodians' bland denial or refusal to treatment made impossible the timely intervention to save the child lives. Nevertheless, child protection team staffs' reasonable suspicion and active intervention could sometimes uncover the hidden truth that child abuse was the actual cause of death. These incidents were regarded as a team's meaningful accomplishments by team members. Meanwhile, lack of awareness and excessive burden about the role and responsibility of mandated reporter precluded medical staffs' active involvement. Also, substantiating the abuse suspicion by securing positive evidences was found to be a facilitatory factor for the rapid public intervention. On the basis of these results, several practice and policy implications were discussed to improve the early detection process, securing evidence and uncovering the actual cause of death in child abuse deaths.

• Clinical and Experimental Pediatrics
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• v.52 no.12
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• pp.1311-1320
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• 2009

Childhood obesity has rapidly increased in Korea during the past 20-30 years. Approximately 1 of 10 children and adolescents is obese. Appropriate prevention and intervention measures urgently need. Obesity prevention starts early in life, i.e., obesity prevention and education begins during the period of fetal development in utero. Behavioral changes are the most positively reflected during pregnancy. Infants should be fed breast milk, and inculcated with healthy eating and behavioral habits during infancy to ultimately establish a healthy lifestyle in children. For achieving a lifestyle and behavior that successfully allow children to overcome obesity, although individual motivation is important, active support of parents and family members is also imperative. Health care providers should also make an effort to actively prevent obesity and take necessary intervention actions. Although the efforts of individuals, family, and healthy care providers are important to prevent the rapid increase in obesity, primary prevention should be encouraged at a higher level. Schools should specifically aim at improving nutrition and physical activity by allocating times for healthy eating, playing, and physical education. Moreover, local communities should provide support by funding for safe recreational environments, such as playgrounds and walking tracks. Public health strategies in community and national policies, such as city planning, food marketing, and advertisements, are required for primary prevention of obesity.

• Nutrition Research and Practice
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• v.14 no.3
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• pp.230-241
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• 2020

BACKGROUND/OBJECTIVES: Inadequate nutrition in infants and young children affects physical growth and neurocognitive development. Therefore, early nutritional intervention is important to promote catch-up growth in young children with faltering growth. The aim of this study was to evaluate the effect of nutritional supplementation with a pediatric concentrated and balanced nutritional supplement formula on promoting growth and improving nutritional status in children with nonorganic faltering growth. SUBJECTS/METHODS: Children aged 12-36 months whose body weight-for-age was < 5^th percentile on the Korean Growth Charts were enrolled. Children born premature or having organic diseases were excluded. Children were instructed to consume 400 mL of formula per day in addition to their regular diet for 6 months. Pediatricians and dietitians educated the parents and examined the subjects every 2 months. Anthropometric parameters were measured at baseline and at 2, 4, and 6 months, and laboratory tests were done at baseline and 6 months. The good consumption group included children who consumed ≥ 60% of the recommended dose of formula. RESULTS: Total 82 children completed the 6-month intervention. At baseline, there were no significant differences in all variables between the good consumption and poor consumption groups. Weight and weight z-scores were significantly improved in the good consumption group compared to the poor consumption group at the end of the intervention (P = 0.009, respectively). The good consumption group showed a significant trend for gaining weight (P < 0.05) and weight z-score (P < 0.05) compared to the poor consumption group during 6 months of formula intake. The concentration of blood urea nitrogen was significantly increased in the good consumption group (P = 0.001). CONCLUSIONS: Nutritional supplementation with a concentrated and balanced pediatric nutritional formula along with dietary education might be an effective approach to promote catch-up growth in children with nonorganic faltering growth.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

• The Journal of the Korea Contents Association
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• v.19 no.8
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• pp.252-264
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• 2019

The purpose of this study is to explore the meaning of the essence through the parenting experience of the mother with ADHD child and to divide the parenting experience into the domains and categories. The data was collected through several depth interviews with 12 semi-structured questionnaires of the mother with ADHD child. The analysis of the data has adopted a consensus qualitative research method(CQR) that describes the phenomenon based on the collected data and can deduce inductive conclusions. Through CQR, various experiences of ADHD mothers were deeply analyzed. Through the consensus process, 12 cases were combined and quantified to understand the overall pattern and specificity. As a result, 11 domains and 51 categories were derived. The 11 areas were classified as 'Ignorance of ADHD symptom', 'Confronting ADHD diagnosis', 'Peripheral reaction after ADHD diagnosis', 'Acceptance of ADHD diagnosis', 'Ambivalence for medication', 'ADHD active treatment intervention', 'Family support','Social support', 'Social perception change', and 'Mature parent'. This suggests that early treatment and intervention for ADHD child is significant. Also, appropriate intervention is required based on accurate understanding through acceptance of ADHD diagnosis and that parent education can lead to positive life for child and mother of ADHD. Finally, based on this, I made suggestions the future research.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.69-83
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• 2022

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.433-438
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• 2013

Background: Surgical repair of post-infarct ventricular septal defect (VSD) is considered one of the most challenging procedures having high surgical mortality. This study aimed to evaluate the outcomes of the surgical repair of post-infarct VSD. Methods: From May 1991 to July 2012, 34 patients (mean age, $67.1{\pm}7.9$ years) underwent surgical repair of post-infarct VSD. A retrospective review of clinical and surgical data was performed. Results: VSD repair involved the infarct exclusion technique using a patch in all patients. For coronary revascularization, 12 patients (35.3%) underwent concomitant coronary artery bypass graft, 3 patients (8.8%) underwent preoperative percutaneous coronary intervention, and 9 patients (26.5%) underwent both of these procedures. The early mortality rate was 20.6%. Six patients (17.6%) required reoperation due to residual shunt or newly developed VSD. During follow-up (median, 4.8 years; range, 0 to 18.4 years), late death occurred in nine patients. Overall, the 5-year and 10-year survival rates were $54.4%{\pm}8.8%$ and $44.3%{\pm}8.9%$, respectively. According to a Cox regression analysis, preoperative cardiogenic shock (p=0.069) and prolonged cardiopulmonary bypass time (p=0.008) were independent predictors of mortality. Conclusion: The early surgical outcome of post-infarct VSD was acceptable considering the high-risk nature of the disease. The long-term outcome, however, was still dismal, necessitating comprehensive optimal management through close follow-up.

• Journal of Korean Academy of Nursing
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• v.48 no.1
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• pp.50-58
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• 2018

Purpose: The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients. Methods: This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis. Results: Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (${\beta}=-.39$, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (${\beta}=.17$, p=.026), social well-being (SWB) (${\beta}=.49$, p=.010), and functional well-being (FWB) (${\beta}=.38$, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (${\beta}=-.07$, p=.024), SWB (${\beta}=-.19$, p=.008), and FWB (${\beta}=-.15$, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB. Conclusion: Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.