No abstract available.
Cyclosporine* ; Humans ; Vitiligo*

Physicians should be able to address health-related issues of patients and populations from a multidimensional perspective. Therefore, medical schools have a social responsibility to develop and implement curricula that enable trainees to acquire the competencies needed to improve all aspects of patient care and healthcare delivery. This study explored the concept of health systems science concept as the third pillar of medical education (the other two are basic science and clinical medicine) in the Korean context, as well as related educational needs. The theoretical foundation of health systems science is the biopsychosocial conceptual model, which emphasizes the biological, psychological, and social factors surrounding patients. We concluded that the three domains (core functional, foundational, linking) and 12 subcategories of health systems science proposed by the Association of American Medical Colleges could be applied to Korean medical education. Health systems science education must be emphasized to solve the various healthcare problems facing Korea today and to train physicians to provide medical services in line with society’s needs. Introducing a health systems science curriculum will be challenging in the Korean medical environment, which has traditionally emphasized basic science and clinical medical education. Health systems science education should begin in the basic medical education phase, where physicians’ professional identity is formed, and continue through graduate medical education. It is essential to understand related educational needs, develop curricular content, conduct faculty development programs, and provide financial resources for the development of an integrated curriculum.

Systems thinking, a linking domain of health systems science (HSS), is an approach that investigates specific problems from a holistic perspective. It supports improving patients’ health, fulfilling their health needs, and anticipating issues that threaten patient safety within the healthcare system. It also helps solve problems through critical thinking and reflection. This study aimed to develop an curriculum on systems thinking, explore the effectiveness of the course, and investigate the applicability of HSS education at individual universities. In this study, the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model was utilized to design, develop, implement, and evaluate an elective course on systems thinking. In the design process, learning outcomes and goals were developed, and educational content, teaching-learning methods, and student evaluation methods were linked. In the development process, class materials and evaluation materials were prepared. In the implementation process, the course was implemented, and the evaluation process analyzed the results of learning performance and curriculum assessments. The evaluation found the following results. First, the students in the study realized the importance of systems thinking and experienced the need for systems thinking through non-medical and medical situations. Second, the students were very satisfied with the learning activities in the course (mean=4.84), and the results of the self-competence evaluation, conducted before and after the course, also showed a significant improvement. This study confirmed the effectiveness of the elective course, and its results can serve as a reference for developing an HSS curriculum .

In this study, we analyzed the healthcare system of North Korea using Kleczkowski's model which categorizes national healthcare infrastructure into five components: health resources, organization, healthcare delivery system, economic support, and management. It was found that the healthcare system in North Korea, which provides clinical medicine, Koryo medicine and preventive medicine, is constituted of a physician system of independent geographic sectors and centralized delivery system while maintaining free universal health coverage. These systems are all managed by the government and the People's Committee Party. However, North Korea has been confronted with severe economic difficulties since the 1990s, such that we question whether the healthcare system has been able to function properly despite of the lack of resources in general throughout the country.
Clinical Medicine ; Collodion ; Delivery of Health Care ; Democratic People's Republic of Korea ; Health Resources ; Preventive Medicine

Purpose: Pregnant women with diabetes mellitus (DM) and their babies are affected by complications and congenital abnormalities during pregnancy. This study aimed to examine the risk factors for cardiac anomalies and the characteristics of pregestational DM and GDM in mothers and babies in Korea. Methods: This retrospective study used medical records from Bucheon St. Mary's Hospital between January 2013 and July 2021. We studied 1983 infants, with 335 neonates from mothers with DM. Results: Body weight and body mass index were high in mothers with pregestational DM at delivery (p<0.005). The rate of preterm births was lower in the pregestational DM group than in the GDM group. Furthermore, the cardiac anomaly rate was high in the pregestational DM group (p<0.001). The rate of hyperbilirubinemia in the DM group was higher than that in the control group (p<0.001). Multivariate logistic regression analysis revealed no significant risk factors for congenital heart disease. Conclusion DM in pregnant women is associated with congenital anomalies. Therefore, the appropriate management of mothers with DM is important for the prognosis of their neonates.

Purpose: Pregnant women with diabetes mellitus (DM) and their babies are affected by complications and congenital abnormalities during pregnancy. This study aimed to examine the risk factors for cardiac anomalies and the characteristics of pregestational DM and GDM in mothers and babies in Korea. Methods: This retrospective study used medical records from Bucheon St. Mary's Hospital between January 2013 and July 2021. We studied 1983 infants, with 335 neonates from mothers with DM. Results: Body weight and body mass index were high in mothers with pregestational DM at delivery (p<0.005). The rate of preterm births was lower in the pregestational DM group than in the GDM group. Furthermore, the cardiac anomaly rate was high in the pregestational DM group (p<0.001). The rate of hyperbilirubinemia in the DM group was higher than that in the control group (p<0.001). Multivariate logistic regression analysis revealed no significant risk factors for congenital heart disease. Conclusion DM in pregnant women is associated with congenital anomalies. Therefore, the appropriate management of mothers with DM is important for the prognosis of their neonates.

Purpose: Pregnant women with diabetes mellitus (DM) and their babies are affected by complications and congenital abnormalities during pregnancy. This study aimed to examine the risk factors for cardiac anomalies and the characteristics of pregestational DM and GDM in mothers and babies in Korea. Methods: This retrospective study used medical records from Bucheon St. Mary's Hospital between January 2013 and July 2021. We studied 1983 infants, with 335 neonates from mothers with DM. Results: Body weight and body mass index were high in mothers with pregestational DM at delivery (p<0.005). The rate of preterm births was lower in the pregestational DM group than in the GDM group. Furthermore, the cardiac anomaly rate was high in the pregestational DM group (p<0.001). The rate of hyperbilirubinemia in the DM group was higher than that in the control group (p<0.001). Multivariate logistic regression analysis revealed no significant risk factors for congenital heart disease. Conclusion DM in pregnant women is associated with congenital anomalies. Therefore, the appropriate management of mothers with DM is important for the prognosis of their neonates.

Purpose: Pregnant women with diabetes mellitus (DM) and their babies are affected by complications and congenital abnormalities during pregnancy. This study aimed to examine the risk factors for cardiac anomalies and the characteristics of pregestational DM and GDM in mothers and babies in Korea. Methods: This retrospective study used medical records from Bucheon St. Mary's Hospital between January 2013 and July 2021. We studied 1983 infants, with 335 neonates from mothers with DM. Results: Body weight and body mass index were high in mothers with pregestational DM at delivery (p<0.005). The rate of preterm births was lower in the pregestational DM group than in the GDM group. Furthermore, the cardiac anomaly rate was high in the pregestational DM group (p<0.001). The rate of hyperbilirubinemia in the DM group was higher than that in the control group (p<0.001). Multivariate logistic regression analysis revealed no significant risk factors for congenital heart disease. Conclusion DM in pregnant women is associated with congenital anomalies. Therefore, the appropriate management of mothers with DM is important for the prognosis of their neonates.

Purpose: Pregnant women with diabetes mellitus (DM) and their babies are affected by complications and congenital abnormalities during pregnancy. This study aimed to examine the risk factors for cardiac anomalies and the characteristics of pregestational DM and GDM in mothers and babies in Korea. Methods: This retrospective study used medical records from Bucheon St. Mary's Hospital between January 2013 and July 2021. We studied 1983 infants, with 335 neonates from mothers with DM. Results: Body weight and body mass index were high in mothers with pregestational DM at delivery (p<0.005). The rate of preterm births was lower in the pregestational DM group than in the GDM group. Furthermore, the cardiac anomaly rate was high in the pregestational DM group (p<0.001). The rate of hyperbilirubinemia in the DM group was higher than that in the control group (p<0.001). Multivariate logistic regression analysis revealed no significant risk factors for congenital heart disease. Conclusion DM in pregnant women is associated with congenital anomalies. Therefore, the appropriate management of mothers with DM is important for the prognosis of their neonates.

Being born small for gestational age (SGA) has been strongly associated with mortality during the perinatal period and long-term risk of metabolic syndrome, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and coronary heart disease. Insulin resistance is an important factor in the development of metabolic syndrome in SGA, with several proposed hypotheses. Here, we report two cases of non-obese adolescent patients with early onset type 2 diabetes who were born SGA. Of these, one experienced catch-up growth, while the other did not. Both had a high body fat percentage at the time of diagnosis of type 2 diabetes and were diagnosed with fatty liver and hyperlipidemia before adolescence, at the age of 7 years. Early interventions for SGA are needed for healthy catch-up growth to prevent metabolic diseases in the future.