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

PURPOSE: The aim of this study was to evaluate the clinical manifestations, contact history, and status of tuberculosis contact investigations in school-age children and adolescents with pulmonary tuberculosis (TB) at two centers. METHODS: This study was conducted with 54 patients in the age ranging from 10 to 18 years, who were diagnosed with pulmonary TB at the Pusan National University Hospital and Pusan National University Children's Hospital, January 2008 to December 2012. We retrospectively reviewed the medical records of the patients. RESULTS: The median age of the patients was 16 years old; 11 patients were aged 10 to 14 and 43 patients were aged 15 to 18. Among 54 patients, 19 had history of contact with pulmonary TB, 10 had contact with house members (household), and remaining 9 had contact with classmates (non-household). One out of 10 patients who had household contacts and 6 out of 9 patients who had non-household contacts were evaluated with contact investigation after the exposure to pulmonary TB. Among 7 patients who were evaluated with contact investigation, 3 were diagnosed with active pulmonary TB, 1 had latent tuberculosis infection (LTBI), and 3 had no evidence of TB or LTBI. The median period of diagnosis after the exposure to active pulmonary TB was 2 years in patients with household contacts and 0.23 years in patients with non-household contacts. CONCLUSION: This study suggested that if the contact investigation conducted properly, it would be helpful for early diagnosis and prevention of pulmonary TB.
Adolescent* ; Busan ; Child* ; Diagnosis ; Early Diagnosis ; Family Characteristics ; Humans ; Latent Tuberculosis ; Medical Records ; Retrospective Studies ; Tuberculosis* ; Tuberculosis, Pulmonary*

In a study of intacranial metastases, 46 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. Theresults were as follows: 1. The male to female ratio of itracranial metastases were 67:33. The 5th decade group(34.8%) was the most prevalent age group, followed by the 6th decade(21.7%) and 7th decade(21.7%). 2. The numberof lesions was found to be: single-25 cases(54.3%); multiple-21 cases(45.7%). 3. The source of intracranialmetastases found to be: lung 15 cases(32.6%); unknown 12 cases(26.0%); chorioca 3 cases(6.5%); liver 3cases(6.5%); liver 3 cases(6.5%); stomach 2 cases(4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca.rhabdomyosarcoma, nasal ca. lymphoma, testicular ca, cervix, each 1 case(2.2%). 4. The locations of theintracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebra hemisphere 15.9% inin frontal region Cerebral hemisphere 13.4% in occipital region Cerebra hemisphere 10.5% in temporal regionCerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5.Peritumor edema was found to be: Grade II-17 cases(37.0%): Grade III-14 cases(30.4%); Grade I-8 cases(17.4%);Grade 0–7 cases(15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were asfollows: Headache 30 cases(65.2%); Vomiting 11 casees(23.9%); deteriorated mental state 10 cases(21.6%);Hemiplegia 7 cases(15.2%); visual disturbance 6 cases(13.0%); hemiparesis 4 cases(8.7%); seizure 4 cases(8.7%);other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases(39.1%);hypodense lesions in 15 cases(32.6%); mixed density in 8 cases(17.4%); isodenisty was present in 5 cases(10.9%).On post-contrast scan, ring enhancement was seen in 19 cases(41.3%); nodular enhancement in 17 cases(37%); mixedring-nodular enhancement in 8 cases(17.4%); only hypodense 2 cases(4.3%).
Breast ; Cerebellopontine Angle ; Cerebrum ; Cervix Uteri ; Edema ; Female ; Headache ; Humans ; Kidney ; Liver ; Lung ; Lymphoma ; Male ; Melanoma ; Meninges ; Neoplasm Metastasis ; Occipital Lobe ; Paresis ; Parietal Lobe ; Prostate ; Protestantism ; Seizures ; Skull ; Stomach ; Vomiting

The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
Cell Differentiation ; Desmin ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Intestine, Small ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Necrosis ; Neurilemmoma ; Stomach

To evaluate the achievement of health care services in Korea independent of other socioeconomic factors, we observed the time trend of avoidable death between 1983 and 2004. A list of avoidable causes of death was constructed based on the European Community Atlas of ''Avoidable Death''. We calculated sex- and agestandardized mortality rates of Korean aged 1-64 yr using data of the Korea National Statistical Office. The avoidable mortality rate (per 100,000 persons) decreased from 225 to 84 in men and from 122 to 41 in women. Accordingly, the proportion of avoidable deaths among all classifiable deaths was reduced by 8.1% in men and 6.4% in women. However, mortality rates from some preventable causes such as ischemic heart disease and malignant neoplasms of lung, breast, cervix, and colorectum have been on the rise. Mortality preventable by appropriate medical care showed the greatest reduction (by 77.8%), while the mortality preventable by primary prevention showed the least reduction (by 50.0%). These findings suggest that health care service has significantly contributed to the improvement of health in Korea. However, more effective intervention programs would be needed given the less reduction in mortality avoidable by primary or secondary prevention than expected and unexpectedly increasing mortality from several preventable causes.
Adolescent ; Adult ; Cause of Death ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Korea ; Male ; Middle Aged ; Mortality/*trends ; Neoplasms/mortality ; Primary Prevention/*trends ; Secondary Prevention/*trends ; Sex Factors

PURPOSE: Food intake of COPD patients decreases because of appetite loss, depression, and breathing problems while eating, which increase the likelihood of patients becoming malnourished. This study investigated the nutrient intake and dietary quality of people with and without COPD in Korea. METHODS: There were 2,160 adults aged 50 and over who participated in the 5~6th Korea National Health and Nutrition Examination Survey. The subjects were divided into the COPD group and non-COPD group according to the rate of forced expiratory volume at 1 second (FEV1) against forced vital capacity (FVC). Consumption of food and nutrients were calculated based on the nutrition examination survey. Statistical analyses were conducted using SPSS 19.0. RESULTS: Among individuals in their 50s, intake of vitamin B1 in the COPD group was significantly less than the NCOPD group, while intake of sodium in the COPD group was significantly greater than the NCOPD group. Among individuals in their 60s, the energy intake of the COPD group was significantly less than that of the NCOPD group. The COPD group showed significantly less intake of vitamin B1 and vitamin C, but greater intake of sodium than the NCOPD group. In the group aged 70 and over, The COPD group had significantly less intake of vitamin B1 than the NCOPD group and showed lower nutrient adequacy ratio values in protein, vitamin B1, vitamin B2, and iron than the NCOPD group. CONCLUSION: The COPD group consumed less energy and certain nutrients, and their dietary quality was poor compared to the NCOPD group. Thus, more detailed research is required to understand the concrete relationship between COPD and malnutrition.
Adult* ; Appetite ; Ascorbic Acid ; Depression ; Eating ; Energy Intake ; Forced Expiratory Volume ; Humans ; Iron ; Korea* ; Malnutrition ; Nutrition Surveys* ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive* ; Respiration ; Riboflavin ; Sodium ; Thiamine ; Vital Capacity

BACKGROUND: Menstruation is often regarded as a privilege for women allowing reproductive activity. However, abrupt hormonal fluctuations in menstrual cycle may cause distressing physical and psychological symptoms such as premenstrual syndrome (PMS). PMS is known to have a great impact on daily life activities and social functions, and might result in significantly decreased quality of life (QOL). In this study, we aimed to evaluate a relation between PMS and QOL in young adult Korean women. METHODS: Self-administered questionnaires were distributed to a total of 514 women who were aged 16~35 years and who were employed in an industrial complex located in Gyeonggi-do, Korea. PMS was assessed using diagnostic criteria recommended by the American Psychiatric Association. QOL was assessed using Korean health related Quality of Life Scale. The association between PMS and QOL was examined in 440 women using the two-sample t-test after excluding 74 women who were missing for variables essential for the assessment of PMS and QOL. RESULTS: The prevalence of PMS was 7.3% (32 out of 440 women). Women with PMS had the worse QOL score in almost all domains of QOL except for spiritual health (physical function, psychological health, social function, pain, vitality, role limitation, health status perception, and health status change). CONCLUSION: There was a significant relation between PMS and QOL. The finding of significantly lower QOL in women with PMS suggests that PMS should be evaluated and treated actively in primary care.
Aged ; Female ; Humans ; Korea ; Menstrual Cycle ; Menstruation ; Premenstrual Syndrome ; Prevalence ; Primary Health Care ; Quality of Life ; Women's Health ; Young Adult ; Surveys and Questionnaires

OBJECTIVES: We aimed to assess the serum folate, vitamin B12, and homocysteine status in Korean adolescents and adults using national data. METHODS: Blood samples were collected from participants aged ≥10 years in the Korea National Health and Nutrition Examination Survey 2013-2015. The stored serum samples were used to measure folate, vitamin B12, and homocysteine concentrations. A total of 8,016 participants were included in this analysis. Unweighted descriptive statistics and adjusted geometric means of the B vitamins and homocysteine concentrations were estimated. RESULTS: Females had higher serum folate and vitamin B12 concentrations and lower serum homocysteine concentrations than males. Folate deficiency (<6.8 nmol/L) and hyperhomocysteinemia (>15 μmol/L) were found in 8.6% and 11.8% of males, respectively. Approximately 3% of males had low or marginally low vitamin B12 status (≤221 pmol/L). Folate and vitamin B12 deficiencies and hyperhomocysteinemia were found in <2% of females. Suboptimal folate status was prevalent among adolescents and young adults, while suboptimal vitamin B12 status and hyperhomocysteinemia were relatively higher in older adults. Adjusted mean homocysteine concentrations were sharply decreased from the first to second decile of serum folate in males. CONCLUSIONS In the Korean population, the proportion of males who achieved desirable folate and homocysteine concentrations were lower than those of females. Although most Koreans have adequate vitamin B12, a suboptimal folate status is common, particularly among adolescents and young adults. These findings could establish a foundation for public health initiatives aimed at improving folate levels in the Korean population.

Background: This study aimed to investigate the effect of a forest healing program on psychological and physiological changes in employees exposed to work-related stress. Methods: This study included 38 employees whose workplaces were located in Naju and Jeonnam. They were given a set of forest healing programs. They completed self-rating scales to assess changes in anxiety, depression, and workrelated stress. Salivary cortisol levels, electroencephalography changes, and photoplethysmography components were also assessed. The mean differences in these parameters before and after treatment were analyzed. Results: The mean ages of male and female employees were different (p<0.010). After controlling for age as a covariate, all variables were examined for main and sex-associated effects using two-way repeated measures analysis of variance. Although the mean changes in saliva cortisol levels were significantly lower after treatment, the sex-associated and interaction effects were found to be insignificant. Conclusion Although the short-term forest healing program did not provide notable results, it may have beneficial effects on certain psychological and physiological aspects. Further studies are warranted to determine the feasibility of the forest healing program as a suitable stress management strategy for employees.

BACKGROUND: In Korea, clinical performance examination (CPX) has been included in license examination for medical doctors since 2009 in order to improve clinical performance of medical students. This study aimed to evaluate the contribution of CPX to medical education. METHODS: Clinical competency in the differential diagnosis of secondary headache was compared between the incoming interns in 2009 unexposed to CPX and the incoming interns in 2010 exposed to CPX, using the data of patients who visited the emergency department due to headache (181 patients seen by 60 CPX non-exposed interns and 150 patients seen by 50 CPX-exposed interns). We obtained the data by reviewing electronic medical records and nominal lists of doctors. Clinical competency was assessed by sensitivity and specificity between the diagnostic impression by interns and the final diagnosis. The association between CPX exposure and clinical competency in secondary headache diagnosis was evaluated using multiple logistic regression analysis. RESULTS: When we assessed clinical competency on the basis of all listed diagnostic impressions, sensitivity and specificity were 67.9% and 80.0%, respectively, for headaches seen by CPX-exposed interns, and 51.7%, and 71.7%, respectively, for headaches seen by CPX non-exposed interns. Multivariable adjusted logistic regression analysis showed exposure to CPX was not associated with increased competency for identifying secondary headache. CONCLUSION: Exposure to CPX as a part of the medical license examination was not effective for the improvement of clinical competency of interns in identifying secondary headache.
Competency-Based Education ; Diagnosis ; Diagnosis, Differential* ; Education, Medical ; Electronic Health Records ; Emergency Service, Hospital ; Headache* ; Humans ; Internship and Residency ; Korea ; Licensure ; Logistic Models ; Sensitivity and Specificity ; Students, Medical