Purpose: The purpose of this study was to develop and compare the prediction model for suicide attempts by Korean adolescents using logistic regression and decision tree analysis. Methods: This study utilized secondary data drawn from the 2019 Youth Health Risk Behavior web-based survey. A total of 20 items were selected as the explanatory variables (5 of sociodemographic characteristics, 10 of health-related behaviors, and 5 of psychosocial characteristics). For data analysis, descriptive statistics and logistic regression with complex samples and decision tree analysis were performed using IBM SPSS ver. 25.0 and Stata ver. 16.0. Results: A total of 1,731 participants (3.0%) out of 57,303 responded that they had attempted suicide. The most significant predictors of suicide attempts as determined using the logistic regression model were experience of sadness and hopelessness, substance abuse, and violent victimization. Girls who have experience of sadness and hopelessness, and experience of substance abuse have been identified as the most vulnerable group in suicide attempts in the decision tree model. Conclusion Experiences of sadness and hopelessness, experiences of substance abuse, and experiences of violent victimization are the common major predictors of suicide attempts in both logistic regression and decision tree models, and the predict rates of both models were similar. We suggest to provide programs considering combination of high-risk predictors for adolescents to prevent suicide attempt.

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient’s various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32–0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57– 0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05–1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30–2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34–2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19–2.11); people having diabetes (OR, 1.81; 95% CI, 1.41–2.32);or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28–8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension.Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

Background: There have been many studies on the associations between body mass index (BMI) and cognitive function. However, no study has ever compared the associations across the methods of categorizing BMI. In this study, we aimed to fill the gap in the previous studies and examine whether the obesity paradox is valid in the risk of cognitive function. Methods: Of the 10,254 people aged 45 and older from the Korean Longitudinal Study of Ageing from 2006 to 2016, 8,970 people were finalized as the study population. The dependent variable was whether a person has a normal cognitive function or not, and the independent variables of interest were BMI categorized by the World Health Organization Western Pacific Regional Office (WHO-WPRO) method, the WHO method, and a 10-group method. Covariates included sociodemographic factors, health behavior factors, and health status factors. A generalized linear mixed model analysis with a logit link was used. Results: In the adjusted model with all covariates, first, in the case of BMI categories of the WHO-WPRO method, underweight (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.15–1.17), overweight (OR, 1.36; 95% CI, 1.35–1.36), and obese (OR, 1.34; 95% CI, 1.33–1.34) groups were more likely to have a normal cognitive function than a normal-weight group. Next, in the case of BMI categories of the WHO method, compared to a normal-weight group, underweight (OR, 1.15; 95% CI, 1.14–1.16) and overweight (OR, 1.06; 95% CI, 1.06–1.07) groups were more likely to have a normal cognitive function; however, obese (OR, 0.62; 95% CI, 0.61–0.63) group was less likely to have it. Lastly, in the case of the 10-group method, as BMI increased, the likelihood to have a normal cognitive function changed like a wave, reaching a global top at group-7 (26.5 kg/㎡ ≤ BMI <28.0 kg/㎡ ). Conclusion The associations between BMI and cognitive function differed according to how BMI was categorized among people aged 45 and older in Korea, which suggests that cognitive function may be positively associated with BMI in some categories of BMI but negatively in its other categories. Health policies to reduce cognitive impairment need to consider this association between BMI and cognitive function.

BACKGROUND: This study aimed to properly manage diseases such as blood sugar control so that patients with diabetes can benefit from both medication and health activities. Also, these health practices are greatly influenced by self-rated health, a subjective assessment of health status. Because self-rated health does not necessarily match the objective health status, it is important to identify which factors affect self-rated health. METHODS: For the study, the data was gathered from the 4th–6th National Health Nutrition Survey (2007–2015). Out of the total 73,353 participants in the survey, 2,303 patients with uncontrolled blood sugar with an HbA1c level of more than 7% were selected for the final study. Dependent variables fell into two categories depending on how the participant reported whether he or she was in good health or not. Independent variables included socio-demographics, health behavioral, and health status factors. This study performed logistic regression analysis. RESULTS: Out of 2,303 participants, 18.1% reported that their heath was ‘good,’ despite the fact that their blood sugar level was not controlled. After running a logistic regression model, the odds ratio of groups that perceive subjective health awareness as good was higher in the groups of people as below: in the people over 60 years old; in the people who graduated from a junior college or higher than those who had a level of education of primary school completion or less; in the people living in Chungnam than those living in Seoul; and in the group with hypertriglyceridemia. CONCLUSION The study identified factors associated with those failed to perceive the blood sugar level as a severe health problem despite of the fact that blood sugar was not controlled. To improve public health, diabetes management policies need to be addressed to population groups with these problems above.

BACKGROUND: Since many patients with intestinal endometriosis present with gastrointestinal symptoms without a history of endometriosis, endoscopic examination of the intestinal tract is initially performed, often leading to a misdiagnosis. METHODS: We reviewed the clinicopathologic findings of 18 samples from 15 patients with intestinal endometriosis who underwent endoscopic biopsy and/or surgical resection to identify diagnostically helpful findings. RESULTS: All 7 biopsy specimens displayed relatively well-defined submucosal lesions, with non-mucinous glands lined by ciliated epithelium and surrounding cellular stroma containing spiral arteriole-like blood vessels. The stroma was immunopositive for CD10 in all cases. All but one specimen exhibited immunopositivity for ER and PR in both glandular and stromal components. In contrast to the overlying normal colonic mucosa, glandular epithelium with endometriosis was immunopositive for cytokeratin (CK) 7, but immunonegative for CK20 in all cases. Three cases were associated with adenocarcinoma in the same or different segments; specifically, two primary rectal adenocarcinomas and one endometrioid adenocarcinoma arising from endometriosis. CONCLUSIONS: The characteristic features of endometrial glands and stroma, including non-mucinous glands without goblet cells, ciliated columnar epithelium, and cellular stroma with spiral arterioles, facilitate the accurate diagnosis of intestinal endometriosis, which can be confirmed by immunohistochemical staining.
Adenocarcinoma ; Arterioles ; Biopsy ; Blood Vessels ; Carcinoma, Endometrioid ; Colon ; Diagnostic Errors ; Endometriosis ; Epithelium ; Female ; Goblet Cells ; Humans ; Intestines ; Keratins ; Mucous Membrane

Eosinophilic myenteric ganglionitis is a disorder characterized by infiltration of the Auerbach myenteric plexus by eosinophils. As a cause of chronic intestinal pseudo-obstruction (CIPO), eosinophilic myenteric ganglionitis has been rarely reported and the majority of the reported cases in the literature were children. We experienced a case of eosinophilic myenteric ganglionitis associated with CIPO in a 53-year-old female patient. Histologic examination of the resected descending colon showed moderate eosinophilic infiltrates with hypogangliosis in the myenteric plexus. Immunohistochemical study revealed increased number of CD4-positive lymphocytes and stronger but scantier glial fibillary acid protein expression in the inflamed myenteric plexus.
CD4-Positive T-Lymphocytes ; Child ; Colon, Descending ; Eosinophils* ; Female ; Ganglion Cysts* ; Humans ; Intestinal Pseudo-Obstruction ; Middle Aged ; Myenteric Plexus

The prevalence of atopic dermatitis (AD), chronic cutaneous disease, has increased rapidly worldwide. Since AD is the most common disease affecting infants, maternal food intake during pregnancy as well as lactation is important. The purpose of this research was to examine the difference in maternal food intake during pregnancy between mothers having children with or without AD. One hundred forty-eight mothers with children aged under 2 years with AD (AD group, n=74) or without AD (non-AD group, n=74) were included in the study. Diet during pregnancy was examined using a food frequency questionnaire. There were no differences in the status of mothers' food consumption during pregnancy between the AD and non-AD groups. Mothers in the AD group consumed significantly less white fish (P<0.05), carrot & pumpkin (P<0.01), walnut & pine nut (P<0.05), mandarin & orange (P<0.05), and peach (P<0.05) than those in the non-AD group. As food frequencies were categorized according to <1/month, 1~3/month, 1~6/week, and 1~3/day, lower consumption of carrot & pumpkin (Odds Ratio (OR)=6.67, 95% Confidence Interval (CI)=1.98~22.44), tomato (OR=5.11, 95% CI=1.62~16.08), mandarin & orange (OR=8.64, 95% CI=1.59~46.81), and walnut & pine nut (OR=3.85, 95% CI=1.26~11.77) increased the risk of childhood AD. According to the results, maternal food intakes during pregnancy were significantly different between the AD and non-AD groups. Therefore, further studies are necessary to examine the causal relationship between maternal food intake and prevalence of AD in children.
Aged ; Child ; Citrus sinensis ; Cucurbita ; Daucus carota ; Dermatitis, Atopic ; Diet ; Eating ; Female ; Humans ; Infant ; Juglans ; Lactation ; Lycopersicon esculentum ; Mothers ; Nuts ; Pregnancy ; Prevalence ; Prunus persica ; Surveys and Questionnaires

Electronic cigarettes (e-cigarrettes) were recently introduced and advertised as a smoking cession device in South Korea. As the social norm to quit smoking has gained hold in the country, the number of e-cigarette users is growing rapidly. This phenomenon should be urgently considered, because of the lack of research that has been conducted to examine the safety of e-cigarettes and its efficacy as a smoking cessation aid. This paper raises several public health concerns on e-cigarettes in South Korea. Uncertain regulations of the government on e-cigarettes are contributing to an increase of e-cigarette users and allowing the e-cigarette industry to circumvent existing regulations. The aggressive marketing activity of this industry is also a core factor that is responsible for the rapid increase of e-cigarette use, in particular among the youth. Following the enforcement of tobacco control, some cigarette smokers may be encouraged to purchase e-cigarettes in order to circumvent the regulations, even though the dual use of e-cigarette and cigarette may be more harmful. Until there is clear evidence of the e-cigarette's safety, it is recommended that the industry's marketing and promotional activities be banned and closely monitored, and public campaigns be initiated to educate the public regarding e-cigarettes.
Adult ; *Electronics ; Female ; *Government Regulation ; Health Promotion ; Humans ; Male ; Middle Aged ; *Nicotine ; Prevalence ; *Public Health Practice ; Republic of Korea/epidemiology ; Safety ; Smoking/epidemiology/legislation & jurisprudence/*prevention & control ; Smoking Cessation/*legislation & jurisprudence ; Young Adult

Atopic dermatitis (AD) is believed to be associated with the intake of antioxidant nutrients and fatty acids due to its immunological dysfunction. The purpose of this study was to examine the effects of nutrition education promoting vegetable, fruit, and fish intake on the severity of AD in children. Children with AD aged 6 months to 5 years were randomly assigned into education and control groups, and followed for 1 year. Seventy-six children completed the study (38 for control, 38 for education). The education group received education promoting the intakes of antioxidant-rich foods (vegetables, fruits) and n-3 fatty acid foods (fish). A 24-hour food recall was collected for the diet information. After education, all vegetables (p < 0.001), fruits (p < 0.01), and fish (p < 0.05) intakes per 1000 kcal increased significantly in the education group, whereas only vegetable intake increased in the control group (p < 0.001). The SCORAD index, the severity of atopic dermatitis, decreased significantly in the education group (p < 0.05). Increased consumption of dietary vitamin E was significantly associated with reduction in the SCORAD index, after adjusting for age and gender (p < 0.05). A nutritional education program to increase vegetable, fruit, and fish intake may be effective in reducing the severity of AD, and vitamin E intake may be associated with the decreased severity of AD. More controlled studies on the relationship between these intakes and severity of AD, with intensive diet and/or supplement intervention programs, are needed to obtain conclusive results.
Child* ; Dermatitis, Atopic* ; Diet ; Education* ; Fatty Acids ; Follow-Up Studies* ; Fruit* ; Humans ; Vegetables* ; Vitamin E ; Vitamins

Although the Korean government introduced a tobacco tax increase in 2015 and pictorial health warnings on tobacco packages in 2016, the smoking prevalence among Korean adult men has remained steady. More efforts and effective tobacco control policies are needed to tackle the highest smoking prevalence among the member countries of the Organization for Economic Cooperation and Development. Plain or standardized packaging of tobacco products has been evaluated as an effective tobacco control policy after its introduction in Australia in 2012. The purpose of this study was to raise awareness of the need to introduce plain packaging of tobacco products in Korea. This study presents information on the following topics: what plain packaging of tobacco products is; the purposes of this policy; the reasons why we need to implement this policy in Korea; the scientific evidence regarding the effects of plain packaging of tobacco products; international developments in the plain packaging of tobacco products; and what we need to consider in order to prepare for the implementation of this policy in Korea. We propose that introducing plain packaging of tobacco products would be beneficial for reinforcing tobacco control policies in Korea and would simultaneously contribute to implementing articles 11 and 13 of the Framework Convention on Tobacco Control. Further studies must be carried out to develop a plain or standardized packaging design of tobacco products in Korea and to prevent the tobacco industry from interrupting the introduction of this policy in Korea, based on other countries' experience.