Social stigma and discrimination are major barriers to an effective national response to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and there have been repeated calls to transform the current surveillance-focused policy. Serious instances of discrimination and clinical service failings increase the urgency and importance of addressing issues relevant to AIDS-related stigma. Yet, progress in achieving effective and people-centered responses to AIDS is insufficient.Current Concepts: Based on a comprehensive multi-sectoral review of a wide range of literature, this article examines the key features of AIDS-related stigma in South Korea and evaluates governmental and organizational efforts to redress them. Three major areas, of issues and possibilities for change, are identified: (1) addressing discrimination in health care settings, (2) decriminalization of HIV transmission, according to the Undetectable=Untransmittable (U=U) principle, (3) improving the quality of life and social inclusion of people living with HIV.Discussion and Conclusion: An extensive examination of existing evidence on AIDS-related stigma, guided by the authors’ long-term experience of public participation and civic empowerment, suggests that by placing these three issues at the center of the national response to AIDS, significant improvement in the AIDS care continuum is achievable. People-centered service delivery models that focus on dismantling structural barriers and incorporating leadership from key populations will enable high-impact public health responses to AIDS and HIV infection.

Since the introduction of effective antiretroviral therapy (ART) in the late 1990s, the prognosis for people living with human immunodeficiency virus (HIV) (PLWH) has dramatically improved. High-income countries like South Korea have had rapid declines in HIV-related deaths. Scientific advancements including pre-exposure prophylaxis (PrEP) and “undetectable equals untransmittable (U = U)” knowledge have contributed progress towards the goal of ending the acquired immune deficiency syndrome epidemic by 2030. However, the application of these advancements has been limited in South Korea. Evidence shows that HIV-related stigma and discrimination in healthcare settings remain strong in this region.We review key principles for stigma reduction and people-centered approaches in the era of U = U and identify three priorities: 1) immediate intervention in HIV stigma drivers in healthcare settings; 2) social stigma reduction on multiple levels; and 3) collaboration with key populations.

PURPOSE: To compare autonomic dysfunction in patients with urge urinary incontinence(UUI), patients with stress urinary incontinence(SUI) and normal group, we measured and analyzed heart rate variability to compare among the three groups. MATERIALS AND METHODS: We studied heart rate variability(HRV) in 30 patients with UUI(mean age, 47.7+/-10.0 years old), 40 patients with SUI(mean age, 47.6+/-8.7 years old), 120 healthy controls(mean age 45.2+/-6.9 years old). The parameters of HRV of the three groups were compared. RESULTS: There was no difference in uroflowmetry and heart rate among the three groups. In time domain, square root of the mean squared difference of successive N-N interval(RMSSD) in UUI was higher than that of the others, and standard deviation of N-N interval(SDNN) showed no difference. In frequency domain, low frequency(LF) in UUI, an indicator of cardiac sympathetic tone, was higher than thar of the others. Very low frequency(VLF), LF, low-frequency/high-frequency ratio(LF/HF ratio) didn't show difference. CONCLUSION: All parameters of HRV analysis in UUI were not same as those of SUI and controls. The increase in RMSSD and HF means that there could be imbalance in autonomic nervous system and it could be the cause of detrusor overactivity in UUI.
Autonomic Nervous System ; Heart Rate ; Humans ; Pilot Projects* ; Urinary Incontinence*

PURPOSE: To compare the usefulness of test bolus examination in three-dimensional contrast enhanced MR angiography of the carotid artery with that of the fixed delay time method. MATERIALS AND METHODS: Sixty consecutive patients (mean age, 60.1 years) in whom carotid arterial disease was suspected and who were examined during a 17-month period were divided into two equal groups. For group A, a fixed delay time of 5 secs was used, while for group B, the delay time of the test bolus examination was calculated from the signal intensity versus time curve of the carotid artery, obtained after the test injection of 1 ml contrast material into the right brachal vein. Overall image quality, discrimination between the arterial and the venous phase, and the contrast-to-noise ratio(CNR) of the carotid artery were compared between the two groups. Overall image quality was classified as excellent, good, moderate or poor, and discrimination between the two phases was graded IV-I according to the degree of jugular venous enhancement. RESULTS: In group A, overall image quality of the carotid artery was classified as excellent or good in 13 (43.3%)and 9 (30.0%) cases, respectively, while in group B the corresponding figures were 23 (76.7%) and 5 (16.7%). The differences between the two groups were statistically significant (p<0.05). In terms of discrimination between the arterial and venous phase, 20 (66.7%) of the 30 cases in group A were assigned grade IV or III, while 28 (93.3%) of the 30 in group B were assigned these same grades (p<0.05). The CNR of the carotid artery was higher in group B(67.1 +/-16.1) than in group A(27.3 +/-17.8), with statistical significance(p<0.05). CONCLUSION: For examination of the carotid artery, contrast enhanced MR angiography using a test bolus is su-perior to the fixed delay time method.
Angiography* ; Carotid Arteries* ; Carotid Artery Diseases ; Discrimination (Psychology) ; Humans ; Veins

PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

PURPOSE: To compare the sedation outcome according to the dose of per os chloral hydrate in children who underwent laceration repair in the emergency department (ED). METHODS: This retrospective study was performed to the children who underwent sedation using chloral hydrate for laceration repair in the ED from January 2015 through November 2015. A total of 370 children aged younger than 6 years underwent the sedation. We compared the induction time, duration of sedation, and ED length of stay (EDLOS) between the single dose (50 mg/kg) and additional dose (plus 25 mg/kg) groups. RESULTS: Of 370 children, 335 (90.5%) were sedated successfully, 284 (76.8%) were sedated with initial dose (the single dose group), and 51 (13.8%) were sedated with additional dose (the additional dose group). The induction time and EDLOS were longer in the additional dose group (induction time: 31.0 ± 17.2 minutes vs. 96.2 ± 25.4 minutes, P < 0.001; EDLOS: 137.2 ± 35.5 minutes vs. 193.0 ± 36.0 minutes, P < 0.001). The duration of sedation showed no difference between the 2 groups (44.4 ± 24.0 minutes vs. 42.0 ± 20.8 minutes; P = 0.500). No one had serious adverse reactions. CONCLUSION: Additional dose of chloral hydrate can increase the induction time and EDLOS without increasing the duration of sedation and causing serious adverse reactions. This information may improve the efficiency of ED workflow when shared with parents of the children.
Child* ; Chloral Hydrate* ; Conscious Sedation ; Emergency Service, Hospital ; Humans ; Lacerations* ; Length of Stay ; Parents ; Retrospective Studies

Background: and PurposeIn 2021, lung cancer in school food workers was first recognized as an occupational cancer. The classification of the carcinogenicity of cooking fumes by International Agency for Research on Cancer (IARC) was based on Chinese epidemiological data. This study aimed to determine the hazard levels of school cooking fumes in Korea. Materials and Methods: Based on public school cafeterias in one area, 25 locations were selected for the survey according to the number per school type, ventilation states, and environmental pre-assessments of cafeterias. Two inside cooking areas using a heat source and one outside cooking area were selected as control measurement points. Measurements of CO, CO2, polycyclic aromatic hydrocarbons (PAHs), and total volatile organic compounds (TVOCs), including benzene, formaldehyde, and particulate matter (PM10, PM2.5, PM1, respectively), were taken. The concentrations and patterns of each substance in the kitchens were compared with the outdoor air quality.ResultKnown carcinogens, such as the concentrations of PAHs, formaldehyde, TVOC (benzene), and particulate matter in school cooking fumes, were all detected at similar or slightly higher levels than those found outside. Additionally, substances were detected at relatively low concentrations compared to the Chinese cooking fumes reported in the literature. However, the short-term exposure to high concentrations of CO (or composite exposure with CO2) and PM2.5 in this study were shown. Conclusion The school cooking fumes in South Korea was a relatively less harmful than Chinese cooking fumes, however short-term, high exposure of toxic substances can cause a critical health effect.

PURPOSE: Influenza is a self-limiting acute respiratory disease, but can be complicated by pneumonia, encephalitis, or myocarditis. If diagnosed, symptomatic treatment of upper respiratory symptoms, early initiation of antiviral therapy, and careful observation of complication occurrence is vital. However, admission of influenza patients can increase the risk of in-hospital infection to previously admitted patients. For this reason, admission or discharge criteria are required. METHODS: This was a retrospective observational study. The characteristics of hospitalized cases were compared with those of discharged cases. Medical records from November 1, 2013 to February 28, 2014 were reviewed and the patient characteristics, clinical symptoms and signs, and other clinical variables were analyzed. RESULTS: A total of 242 patients who showed positive RAT and underwent laboratory and radiologic testing were enrolled in this study. Among them, 203 patients were discharged from the ER and 39 patients were hospitalized, 32 patients in GW and 7 patients in ICU. In the hospitalized group, compared to the discharged group, the average age, complaint of dyspnea, incidence of leukocytosis, level of ESR and CRP, incidence of hypoxemia, and incidence of acute lesion on chest x-ray was high with statistical significance. CONCLUSION: Admission would be considered for patients with ILI with the findings mentioned above.
Age Factors ; Animals ; Anoxia ; C-Reactive Protein ; Dyspnea ; Emergencies* ; Encephalitis ; Hospitalization* ; Humans ; Incidence ; Influenza, Human* ; Intensive Care Units ; Leukocytosis ; Medical Records ; Myocarditis ; Observational Study ; Patient Admission ; Pneumonia ; Rats ; Retrospective Studies ; Thorax

In the article, the weighted overall mean MLA cut-off value has been miscalculated. Tha authors deeply apologize for any inconvenience it may have caused.

PURPOSE: To describe the spiral CT findings of CRCC and to correlate these with the pathologic features, nuclear grading, tumor staging, and prognosis. MATERIALS AND METHODS: We encountered eleven cases of CRCC among 167 cases of histopathologically proven RCC, retrospectively evaluating the spiral CT findings of CRCC including tumor size, internal texture, attenuation, margin, and the involvement of veins or lymph nodes. In addition, the CT findings were correlated with the pathologic features, Fuhrman's nuclear grade, Robson's staging, and the prognosis. Between 27 and 80 (mean, 49.6) months later, the follow-up CT scans of tea patients were examined for tumor recurrence. RESULTS: All tumors, which ranged in size from 2.5 to 15 (mean, 7.7) cm, were solid and well demarcated from renal parenchyma. Pre-contrast CT scans showed that their attenuation was equal to (n=1) or slightly lower (n=10) than that of renal parenchyma, and on early and delayed phase post-contrast enhanced scans, attenuation was low in all cases. In three, focal areas in which attenuation was lower than in the rest of the tumor were observed; histopathologically, these represented hyalinization. There was neither venous nor lymph node involvement, and no distant metastasis. Histopathologic examination demonstrated cystic change (n=1), hemorrhage or necrosis (n=5), complete encapsulation (n=3) and perirenal fat infiltration (n=3). Nuclear grading was II (n=6) or III (n=5), and tumor staging was I (n=8) or II (n=3). Among the five cases in which the nuclear grade was III, three were stage I and two were stage II. Follow-up scans showed no evidence of tumor recurrence, and all patients survived. CONCLUSION: Pre-, early- and late-phase post-contrast enhonced spiral CT scans showed that the attenuation of a CRCC was lower than that of renal parenchyma. Even where the nuclear grade was higher, a well-demarcated soild mass was observed, the tumor stage was lower and the prognosis better.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyalin ; Lymph Nodes ; Necrosis ; Neoplasm Grading ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis* ; Recurrence ; Retrospective Studies ; Tea ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Veins