PURPOSE: To evaluate mortality and morbidity of very low birth weight infants (VLBWI) in Cheongju area from 2002 to 2004. METHODS: Two neonatal intensive care units (NICU), 1 university hospital and 1 general hospital in Cheongju participated in this study. We performed a retrospective review of medical records of VLBWIs in 2 NICUs with literature review. Survival rate, neonatal morbidity, cause of death, and risk factors contributing mortality and neurodevelopmental complications were analyzed. RESULTS: The total number of VLBWI was 152 (4.65%) including 43 (1.31%) extremely low birth weight infants (ELBWI) who were less than 1,000 g of birth weight. The survival rates were 82.9% and 69.8% for VLBWI and ELBWI, respectively. The incidence of respiratory distress syndrome was 60%, bronchopulmonary dysplasia 20.6%, severe retinopathy of prematurity 24%, and severe intravetricular hemorrhage 7.3%. More than half of death occurred in the first week of life, and the main causes were respiratory distress syndrome and sepsis. The major risk factors contributing mortality and neurodevelopmental complications were birth weight, gestational age, Apgar score, respiratory distress syndrome, and high-grade intraventricular hemorrhage. CONCLUSION: Survival rate (82.9%) of VLBWI in Cheongju area, although lower than those of certain NICUS in Seoul, was comparable to those from nation-wide statistics. The incidence of major morbidity seemed somewhat higher than those of other areas in Korea. A systematic national support would be strongly needed for the balanced development of regional NICUs by means of their facilities, personal resources and financial support, etc.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Cause of Death ; Chungcheongbuk-do* ; Financial Support ; Gestational Age ; Hemorrhage ; Hospitals, General ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care Units, Neonatal ; Korea ; Medical Records ; Mortality ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors ; Seoul ; Sepsis ; Survival Rate

OBJECTIVE: To document the common medical problems and clinical outcomes of near-term infants who were delivered between 35(+0) and 36(+6) weeks of gestation, in order to promote optimal health outcomes for these infants. METHODS: We performed a retrospective review of medical records of 113 near-term infants and 138 term infants as control, who were born at Chungbuk national university hospital in 2003~2004. RESULTS: When compared with term infants, near-term infants had a significantly lower Apgar scores (7.7 vs. 8.7 at 1 minute) and higher frequency of prolonged rupture of membrane (19.8% vs. 6.7%), preeclampsia (20.9% vs. 4.4%), jaundice (46.0% vs. 11.6%), respiratory distress (20.4% vs. 10.9%), feeding problems (19.5% vs. 5.8%), intravenous fluid infusion (63.7% vs. 24.6%), diagnostic work-up for possible sepsis (68.1% vs. 26.1%), and use of antibiotics (58.4% vs. 22.5%). There were no differences in frequency of cesarean section, hypoglycemia, hypothermia and clinical sepsis. More near-term infants were admitted to the neonatal intensive care unit (68% vs. 28%) and delayed in discharge home (60% vs. 27%) with longer hospital stay (7.77+/-5.63 days vs. 4.67+/-3.17 days). CONCLUSION: Near-term infants showed significantly more neonatal problems and longer and repeated hospital stays than full-term infants. Optimal care guidelines for near-term infants including scrupulous monitoring for the development of early complications and meticulous follow-up after discharge need to be developed.
Anti-Bacterial Agents ; Cesarean Section ; Chungcheongbuk-do ; Female ; Humans ; Hypoglycemia ; Hypothermia ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal ; Jaundice ; Length of Stay ; Medical Records ; Membranes ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Rupture ; Sepsis

No abstract available.
Plasma ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans* ; Purpura* ; Warfarin

The purpose of this study was to investigate the operational characteristics of the contract-managed highschool foodservice and to analyze the factors to effect the menu price. The data was collected from 249 highschools in Seoul. The results are as follows; Those surveyed highschools were established as 1 national, 74 public, and 174 private institution. Highschools were classified as 176 academic, 66 vocational, and 7 specific purposed institution. Students were organized as 70 boys', 23 girls', and 41 coeducational highschools. Most highschool started contract-managed highschool foodservice from 1999 and the period of foodservice contract was most 3 years and the operation styles in food distribution were 96 classrooms, 105 dining halls and 17 classrooms combined dining halls. The scale of contract foodservice management companies was 63.1% small and medium and 36.9% large enterprises. The surveyed highschools had the average meal price 2,141 won per meal and they had 1,518 pupils on the register. The participating rate to the foodservice was 68.5%. The facilities investment cost of the contract foodservice management company was 179,204,230 won for private institutions and was 138,119,010 won for national&public institutions. The period of the contract was 3.22 years in private institutions, which was significantly higher than national&public institutions which showed 2.85 years. The commissary foodservice schools had higher facilities investment cost than conventional foodservice schools. Classrooms foodservice had higher participating foodservice rate than Dining halls. The investment cost for facilities showed high in order of girls', boys', and coeducational high schools, and the number on the register and the number participating in the foodservice showed high in order of boys', girls', and coeducational high schools. The number on the register showed the highest in academic and vocational schools, specific purposed institutions in sequence, and the number participating in the foodservice showed high in order of academic schools, specific purposed institutions and vocational. However, the participating foodservice rate showed high in specific purposed institution, academic and vocational schools in order, and the meal price, the investment cost for facilities showed high in specific purposed institution, academic and vocational schools in sequence. Regionally, the district south of Han river had the average meal price 2,266.13 won, which showed higher in the eastern part which had 2,033.33 won. The western part had the average investment cost for facilities of 233,331,060 won, and the central district 126,137,140 won. The number on the register showed 1845.68 in the eastern part and 1308.00 in Dong-Jak area, that had clear differences among areas. When the period of the contract went longer, the investment cost for facilities had a tendency to increase. The significant differences were existed among meal price, the investment cost for facilities, the number on the register, the number participating in the foodservice, and the participating foodservice rate. The investment cost for facilities had increased according to the number participating in the foodservice and the participating foodservice rate. And the large enterprises showed higher participating foodservice rate than the small and medium enterprises.
Costs and Cost Analysis ; Humans ; Investments ; Meals ; Pupil ; Rivers ; Seoul*

OBJECTIVE: To identify factors affecting test results of the quiet standing balance evaluation conducted by posturography and to investigate the standardized method by comparing results according to feet width. METHOD: The study cohort consisted of 100 healthy individuals. We assessed the quiet standing balance of subjects by using 3 different methods: standing on a force plate with feet width the same as shoulder width (test 1); with feet width the same as half the shoulder width (test 2); with feet width determined by the subject's comfort (test 3). Subjects underwent each test with their eyes open and closed for 30 seconds each time. Parameters for measuring standing balance included the mean mediolateral and anteroposterior extent, speed, and the velocity moment of center of pressure (COP) movement. RESULTS: All parameters showed better results when the subject's eyes were open rather than closed, and the mean AP extent and speed increased as the age of the subjects increased (p<0.01). However, there was no significant correlation between height and the study parameters, and no differences between men and women. Mean mediolateral extent and speed were significantly longer and faster in test 1 compared with tests 2 and 3 (p<0.01). The results of test 2 were better than the results of test 3, but the difference was not statistically significant. CONCLUSION: COP movements increased with age and when subjects closed their eyes in an evaluation of quiet standing balance conducted by posturography. Gender and height did not affect results of the test. We suggest that an appropriate method for conducting posturography is to have the subject stand on a force plate with their feet width the same as half the shoulder width, because this posture provided relatively accurate balance capacity.
Cohort Studies ; Eye ; Female ; Foot ; Humans ; Male ; Posture ; Shoulder

OBJECTIVETo investigate the methylation of p16(INK4a) and RB gene, and the expression of p16(INK4a) in meningiomas.

METHODSMethylation-specific polymerase chain reaction (MSP) was used to detect the methylation of p16(INK4a) and RB in 50 cases of meningiomas, and immunostaining was performed to analyze the protein expression of p16(INK4a) in 25 of those cases.

RESULTSNo methylation was found in the benign meningiomas, whereas methylation of p16(INK4a)or RB occurred in 6(37.5%) cases of grade II tumors and 4(28.6%) cases of grade III tumors, and among these cases, an atypical meningioma showed methylation of both genes. Thirteen cases showed p16(INK4a) positive expression, but none of them was methylated.

CONCLUSIONThe methylation of p16(INK4a) or RB is related with the tumorigenesis and progression of atypical and anaplastic meningiomas, and a probable mechanism is that methylation causes the loss of expression and leads to dysfuncation of the p16(INK4a)/cyclin D1/CDK4/RB pathway.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cyclin D1 ; genetics ; Cyclin-Dependent Kinase 4 ; Cyclin-Dependent Kinases ; genetics ; DNA Methylation ; Female ; Genes, Retinoblastoma ; Genes, p16 ; Humans ; Male ; Meningeal Neoplasms ; genetics ; Meningioma ; genetics ; Middle Aged ; Proto-Oncogene Proteins

PURPOSE: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. METHOD: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, chi-square-test, and Mann-whitney U test were used to analyze the data. RESULTS: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. CONCLUSION: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.
Colostomy* ; Education ; Humans ; Persuasive Communication ; Self Care* ; Self Efficacy* ; Telephone

Objective: The purpose of this study was to identify the associations of chronic physical disease between patients with severe mental illness (SMI) and the general population of South Korea. Methods: This study was conducted with National Health Insurance Corporation data from 2014 to 2019. A total of 848,058 people were diagnosed with SMI in this period, and the same number of controls were established by matching by sex and age. A descriptive analysis was conducted on the sociodemographic characteristics of patients with SMI. Conditional logistic regression analysis was performed to identify the associations between comorbid physical disease in patients with SMI and those of the general population. SAS Enterprise Guide 7.1 (SAS Inc, Cary, NC, USA) were used to perform all statistical tests. Results: The analysis revealed significant differences in medical insurance, income level, and Charlson Comorbidity Index weighted by chronic physical disease, between patients with SMI and the general population. Conditional logistic regression analysis between the two groups also revealed significant differences in eight chronic physical diseases except hypertensive disease. Conclusion This study confirmed the vulnerability of patients with SMI to chronic physical diseases and we were able to identify chronic physical disease that were highly related to patients with SMI.

PURPOSE: To investigate whether bone mineral density(BMD) occurs in association with fatty replacement oflower paraspinal muscles and whether it relates with the area ratio(Ps/V) of psoas muscle(Ps) divided by adjacentvertebral body(V). MATERIALS AND METHODS: For the evaluation of osteoporosis, 100 females underwent quantitativeCT. At L1,L2 and L3 levels, the fatty replacement of lower paraspinal muscles was numerically graded and therelationship between this and BMD of the vertebral body was evaluated. The correlation between BMD and Ps/V at L2and L3 levels was also evaluated, as was the relationship between the thickness of subcutaneous fat tissue at L1,L2 and L3 levels. RESULTS: BMD showed significant inverse correlations with the grade of the fatty replacement oflower paraspinal muscles at L1(p<.01), L2 level and L3 level(p<.001). In particular, significant differenceswere established between grade 0 and 2 (p<.05) at L1 level, and between grade 0 and 2, and 1 and 2 (p<.05) at L2and L3 levels. There was markedly low correlation (gamma=.33) between BMD and Ps/V at L3 level(p<.001) and lowercorrelation (gamma=.22) at L2 level(p<.05). At L2 and L3 levels, there was no correlation between the thickness ofsubcutanous fat tissue and BMD or Ps/V. CONCLUSION: The present study demonstrates that there was significantinverse correlation between BMD and fatty replacement of lower paraspinal muscles, and low correlation between BMDand Ps/V.
Bone Density* ; Female ; Humans ; Osteoporosis ; Paraspinal Muscles* ; Spine* ; Subcutaneous Fat

BACKGROUND AND OBJECTIVES: In Kawasaki disease (KD), high dose intravenous immunoglobulin (IVIG) significantly lowers the coronary complications. However, some patients either do not respond to initial therapy or develop coronary complications. We aimed to identify the predictive factors for unresponsiveness to initial IVIG therapy and coronary artery dilatation (CAD; defined by Z-score≥2.5) in the acute phase and convalescent phase. SUBJECTS AND METHODS: A retrospective review was conducted of 703 patients with KD, admitted to Gachon University Gil Medical Center between January 2005 and June 2013. The patients were divided into two groups-IVIG responders vs. non-responders-based on the IVIG treatments, and presence of fever after treatment. Further, these groups were divided into two subgroups based on their CAD. RESULTS: Among the 703 patients with KD, the rate of non-responders to initial IVIG was 16.8%. Serum total bilirubin, platelet count, and neutrophil proportion were independent predictive parameters of unresponsiveness (p<0.05). CAD was found in 234 patients (33.3%) in the acute phase, and in 32 patients (4.6%) in the convalescent phase. Male gender, fever duration, serum C-reactive protein, and white blood cell count were related to CAD (p<0.05). CAD was detected more frequently in non-responders than in the responders (47.5% vs. 31.5%, p=0.001). Kobayashi, Egami, and Sano scoring systems applied to our study population reflected low sensitivities (28.0-33.9%). CONCLUSION: Several independent parameters were related to unresponsiveness to the initial IVIG or CAD. These parameters might be helpful in establishing more focused and careful monitoring of high-risk KD patients in Korea.
Bilirubin ; C-Reactive Protein ; Child* ; Coronary Vessels* ; Dilatation* ; Fever ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Korea ; Leukocyte Count ; Male ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Platelet Count ; Retrospective Studies