OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Adolescent ; Anxiety ; Apathy ; Child ; Depression ; Humans ; Mass Screening ; Mental Health ; Parents ; Personality Disorders ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Adolescent ; Anxiety ; Apathy ; Child ; Depression ; Humans ; Mass Screening ; Mental Health ; Parents ; Personality Disorders ; Reproducibility of Results ; Surveys and Questionnaires

Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury without any association with preceding diarrhea. Dysregulation of the complement system is the most common cause of aHUS, and monoclonal humanized anti-C5 antibodies are now recommended as the first-line treatment for aHUS. However, if the complement pathway is not the cause of aHUS, C5 inhibitors are ineffective. In this study, we report the second reported case of aHUS caused by DGKE mutations in Republic of Korea. The patient was an 11-month-old infant who presented with prodromal diarrhea similar to typical HUS, self-remitted with conservative management unlike complement-mediated aHUS but recurred with fever. While infantile aHUS often implies genetic dysregulation of the complement system, other rare genetic causes, such as DGKE mutation, need to be considered before deciding long-term treatment with C5 inhibitors.

Currently, there are a few reports on viral coinfection that causes an acute watery diarrhea in Korean children. So, to evaluate the features of coinfectious viral agents in children with acute watery diarrhea, we enrolled 155 children with acute watery diarrhea from July 2005 to June 2006. Fecal samples were collected and evaluated for various viral infections such as rotavirus, norovirus, adenovirus and astrovirus. The mean (+/-standard deviation) age of the children was 2.71+/-2.37 yr. The detection rate of viral agents was most common in children between the ages of 1 and 3 yr. Rotavirus was detected in 63 children (41.3%), norovirus in 56 (36.2%), adenovirus in 11 (7.1%), and astrovirus in 1 (0.6%). Regarding rotavirus, there were 38 (60.3%) cases with monoinfection and 25 (39.7%) with coinfection. For norovirus, there were 33 (58.9%) cases with monoinfection and 23 (41.1%) with coinfection. Coinfection with rotavirus and norovirus was most common, and occurred in 20/155 cases (12.9%) including coinfection with adenovirus. So, rotavirus and norovirus were the most common coinfectious viral agents in our study population with acute watery diarrhea.
Acute Disease ; Adenovirus Infections, Human/epidemiology ; Astroviridae Infections/epidemiology ; Caliciviridae Infections/epidemiology ; Child ; Child, Preschool ; Diarrhea/epidemiology/*virology ; Feces/virology ; Humans ; Infant ; Korea/epidemiology ; Norovirus/isolation & purification ; Rotavirus Infections/epidemiology ; Virus Diseases/complications/*epidemiology/virology

Background: Malaria elimination strategies in the Republic of Korea (ROK) have decreased malaria incidence but face challenges due to delayed case detection and response. To improve this, machine learning models for predicting malaria, focusing on high-risk areas, have been developed. Methods: The study targeted the northern region of ROK, near the demilitarized zone, using a 1-km grid to identify areas for prediction. Grid cells without residential buildings were excluded, leaving 8,425 cells. The prediction was based on whether at least one malaria case was reported in each grid cell per month, using spatial data of patient locations. Four algorithms were used: gradient boosted (GBM), generalized linear (GLM), extreme gradient boosted (XGB), and ensemble models, incorporating environmental, sociodemographic, and meteorological data as predictors. The models were trained with data from May to October (2019–2021) and tested with data from May to October 2022. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). Results: The AUROC of the prediction models performed excellently (GBM = 0.9243, GLM = 0.9060, XGB = 0.9180, and ensemble model = 0.9301). Previous malaria risk, population size, and meteorological factors influenced the model most in GBM and XGB. Conclusion Machine-learning models with properly preprocessed malaria case data can provide reliable predictions. Additional predictors, such as mosquito density, should be included in future studies to improve the performance of models.

PURPOSE: Epidemiological data indicate that obesity is a risk factor in asthma, however effects related to obesity and adipokines on airway inflammation and bronchial hyper-responsiveness (BHR) have not yet been demonstrated in the human airway. The aim of this study was to investigate the relationship between serum adipokine levels and BHR to mannitol in asthmatic children. METHODS: Serum adipokine levels were measured and pulmonary function tests were perfomed: baseline, postbronchodilator inhalation, methacholine inhalation, and mannitol inhalation. The response to mannitol was expressed as the dose causing a 15% decrease in forced expiratory volume in one second (FEV1) (PD15), and as the response-dose ratio (RDR) (% fall in FEV1/cumulative dose). RESULTS: Sixty-nine prepubertal children between the ages of 6 and 10 years were participated in the study. They comprised asthmatic children (n=40) and healthy (n=29). Twenty-two subjects (55.5%) with asthma had a positive mannitol bronchial provocation test (BPT) result. The body mass index (BMI) was higher in those asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (19.30 kg/m2 vs. 17.60 kg/m2 vs. 17.93 kg/m2, P=0.035, P=0.046). Serum leptin levels were also significantly higher in asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (10.58 ng/mL vs. 5.49 ng/mL vs. 6.75 ng/mL, P=0.002, P=0.016). Leptin values were significantly associated with a PD15 (r=-0.498, P=0.022) and RDR to mannitol (r=0.346, P=0.033) in asthmatic children after adjustment for BMI. CONCLUSION: Serum leptin levels were significantly associated with BHR to mannitol in asthmatic children.
Adipokines ; Asthma ; Body Mass Index ; Bronchial Provocation Tests ; Child* ; Forced Expiratory Volume ; Humans ; Inflammation ; Inhalation ; Leptin* ; Mannitol* ; Methacholine Chloride ; Obesity ; Respiratory Function Tests ; Risk Factors

Benign Tracheobroncheal tumor is a rare disease such as 1.9% of all tumor of pulmonary origin. Because clinical manifestation of benign tracheal tumor resembles that of broncheal asthma, these patients are usually treated in a way that used in broncheal asthma. Therefore, the diagnosis is delayed. We experienced a case of tracheal neurilemmoma that awed by bronchoscopic laser therapy. A 23-year-old woman visited ow hospital be cause of progressing dyspnea especially during inspiration. She was treated with aminophylline and 2 agonist under the impression of bronchial asthma at a local clinic. But because the symptoms were not relieved and pulmonary function test revealed variable extrathoracic lesion, we conducted bronclxaopy and biopsy. There were 1.5 x 2cm sized movable mass with stalk attached right anterior wall of bronchus. The biopsy result was neurilemmoma. Therefore we conducted bronchoscopic Laser therapy four times and the lesion disappeared in bronchosccpy and chest CT.
Aminophylline ; Asthma ; Biopsy ; Bronchi ; Diagnosis ; Dyspnea ; Female ; Humans ; Laser Therapy* ; Neurilemmoma* ; Rare Diseases ; Respiratory Function Tests ; Tomography, X-Ray Computed ; Young Adult

Nitric oxide (NO) seems to play a pivotal role in the vascular endothelial growth factor (VEGF)-induced endothelial cell proliferation. This study was designed to investigate the role and intracellular signal pathway of endothelial nitric oxide synthase (eNOS) activation induced by VEGF. ECV 304 cells were treated with betaVEGF(165) and then cell proliferation, eNOS protein and mRNA expression levels were analyzed to elucidate the functional role of eNOS in cell proliferation induced by VEGF. After exposure of cells to betaVEGF(165) , eNOS activity and cell growth were increased by approximately two-fold in the betaVEGF(165) -treated cells compared to the untreated cells. In addition, VEGF stimulated eNOS expression at both the mRNA and protein levels in a dose-dependent manner. Phosphatidylinositol-3 kinase (PI-3K) inhibitors were used to assess PI-3K involvement in eNOS regulation. LY294002 was found to attenuate VEGF-stimulated eNOS expression. Wortmannin was not as effective as LY294002, but the reduction effect was detectable. Cells activated by VEGF showed increased ERK1/2 levels. Moreover, the VEGF-induced eNOS expression was reduced by the PD98059, MAPK pathway inhibitor. This suggests that eNOS expression might be regulated by PI-3K and the ERK1/2 signaling pathway. In conclusion, betaVEGF(165) induces ECV 304 cell proliferation via the NO produced by eNOS. In addition, eNOS may be regulated by the PI-3K or mitogen-activated protein kinase pathway.
1-Phosphatidylinositol 3-Kinase/*antagonists & inhibitors ; Cell Division/drug effects ; Cell Line ; Endothelial Growth Factors/*metabolism/pharmacology ; Endothelium, Vascular/cytology ; *Gene Expression Regulation, Enzymologic ; Lymphokines/*metabolism/pharmacology ; MAP Kinase Signaling System ; Mitogen-Activated Protein Kinase 1/*antagonists & inhibitors ; Mitogen-Activated Protein Kinase 3 ; Mitogen-Activated Protein Kinases/*antagonists & inhibitors ; Nitric Oxide Synthase/*genetics/metabolism ; Nitric Oxide Synthase Type III ; Signal Transduction ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

OBJECTIVES: There were previous studies which indicated that attitude toward suicide is able to influence the suicide outcome in both individual and group levels. In regard to the highest suicide rate in Korea, our study aims to explore the influence that attitude toward suicide has on suicide by comparing the national attitude towards suicide with a representative sample of the general population. METHODS: The target population was 20- to 59-year-old adults from South Korea, Japan, and the United States. The panel data were divided according to gender, age, and residential area of individuals, and an email with a hyperlink to our web survey was sent to the randomly selected participants in each stratum. To measure the perceptual differences about suicide in different cultures, this study adopted the Attitudes Toward Suicide questionnaire. RESULTS: A total of 2247 subjects in three countries participated in this study. According to results from factor analysis, there were different structure of factors and included items within factors in the three countries : five factors with nineteen items in South Korea, five factors with nineteen items in the United States, and five factors with twenty-five items in Japan. With regard to permissive attitude toward suicide, the mean value of permissiveness was not significantly different among countries, but permissiveness according to education level, gender, and marital status was different in each country. CONCLUSIONS: This study is the first nationwide comparative study about attitude toward suicide with a representative sample. Our findings suggest that permissive attitude toward suicide influence the suicide phenomenon in each country ; however, its impact is not a mean score of permissiveness, but the detailed difference by various demographics.
Adult ; Demography ; Education ; Electronic Mail ; Factor Analysis, Statistical ; Health Services Needs and Demand ; Humans ; Japan* ; Korea* ; Marital Status ; Middle Aged ; Permissiveness ; Suicide* ; United States*

Purpose: Under the South Korea’s unique health insurance structure, any new surgical technology must be evaluated first by the government in order to consider whether that particular technology can be applied to patients for further clinical trials as categorized as ‘New Health Technology,’ then potentially covered by the insurance sometime later. The aim of this meta-analysis was to assess the safety and efficacy of transanal total mesorectal excision (TaTME) for rectal cancer, activated by the National Evidence-based Healthcare Collaborating Agency (NECA) TaTME committee. Methods: We systematically searched Ovid-MEDLINE, Ovid-Embase, Cochrane, and Korean databases (from their inception until August 31, 2019) for studies published that compare TaTME with laparoscopic total mesorectal excision (LaTME). End-points included perioperative and pathological outcomes. Results: Sixteen cohort studies (7 for case-matched studies) were identified, comprising 1,923 patients (938 TaTMEs and 985 LaTMEs). Regarding perioperative outcomes, the conversion rate was significantly lower in TaTME (risk ratio, 0.19; 95% confidence interval, 0.11–0.34; P < 0.001); whereas other perioperative outcomes were similar to LaTME. There were no statistically significant differences in pathological results between the 2 procedures. Conclusion Our meta-analysis showed comparable results in preoperative and pathologic outcomes between TaTME and LaTME, and indicated the benefit of TaTME with low conversion. Extensive evaluations of well-designed, multicenter randomized controlled trials are required to come to unequivocal conclusions, but the results showed that TaTME is a potentially beneficial technique in some specific cases. This meta-analysis suggests that TaTME can be performed for rectal cancer patients as a ‘New Health Technology’ endorsed by NECA in South Korea.