OBJECTIVES: The objective of this study was to analyze the causal relationship between smoking and depression using longitudinal data. METHODS: Two waves of the Korea Welfare Panel collected in 2006 and 2007 were used. The sample consisted of 14 426 in 2006 and 13 052 in 2007 who were aged 20 and older. Smoking was measured by smoking amount (none/ or = two packs). Depression was defined when the summated CESD (center for epidemiological studies depression)-11 score was greater than or equal to 16. The causal relationship between smoking and depression was tested using logistic regression. In order to test the causal effect of smoking on depression, depression at year 2 was regressed on smoking status at year 1 only using the sample without depression at year 1. Likewise, smoking status at year 2 was regressed on depression at year 1 only using those who were not smoking at year 1 in order to test the causal effect of depression on smoking. The statistical package used was Stata 10.0. Sampling weights were applied to obtain the population estimation. RESULTS: The logistic regression testing for the causal relationship between smoking and depression showed that smoking at year 1 was significantly related to depression at year 2. Smoking amounts associated with depression were different among age groups. On the other hand, the results from the logistic regression testing for the opposite direction of the relationship between smoking and depression found no significant association regardless of age group. CONCLUSIONS: The study results showed some evidence that smoking caused depression but not the other way around.
Adult ; Aged ; Causality ; Depression/epidemiology/*etiology ; Female ; Health Surveys ; Humans ; Logistic Models ; Longitudinal Studies ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Smoking/*psychology ; Young Adult

BACKGROUND: The relationship between fat mass, muscle mass and chronic low back pain is unclear and little is known about it. The aim of this study was to investigate the association between body composition and the risk of chronic low back pain in young and middle-aged Korean adults. METHODS: Data from 1807 men and 1810 women aged 19 to 64 years who participated in the fourth Korea National Health and Nutrition Examination Survey in 2009 were evaluated. Chronic low back pain was defined as pain lasting for more than three months. Sociodemographic, lifestyle, anthropometric and body composition variables were analyzed using logistic regression. RESULTS: The prevalence of chronic low back pain was higher in women (11.5%) than in men (6.4%). In men, the risk for chronic low back pain was significantly associated with education level and alcohol use. In women, the risk factors were age, education level, occupation, physical activity, menopausal status, body mass index and waist circumference. After adjusting for covariates, total and trunk fat mass and total and appendicular lean body mass were not associated as risk for chronic low back pain in both genders. CONCLUSIONS: Fat mass and muscle mass may not be associated with chronic low back pain in young and middle-aged Korean adults.
Adipose Tissue ; Adult ; Aged ; Body Composition ; Body Mass Index ; Female ; Humans ; Korea ; Life Style ; Low Back Pain ; Male ; Motor Activity ; Muscle, Skeletal ; Muscles ; Nutrition Surveys ; Occupations ; Prevalence ; Risk Factors ; Waist Circumference

BACKGROUND: The relationship between fat mass, muscle mass and chronic low back pain is unclear and little is known about it. The aim of this study was to investigate the association between body composition and the risk of chronic low back pain in young and middle-aged Korean adults. METHODS: Data from 1807 men and 1810 women aged 19 to 64 years who participated in the fourth Korea National Health and Nutrition Examination Survey in 2009 were evaluated. Chronic low back pain was defined as pain lasting for more than three months. Sociodemographic, lifestyle, anthropometric and body composition variables were analyzed using logistic regression. RESULTS: The prevalence of chronic low back pain was higher in women (11.5%) than in men (6.4%). In men, the risk for chronic low back pain was significantly associated with education level and alcohol use. In women, the risk factors were age, education level, occupation, physical activity, menopausal status, body mass index and waist circumference. After adjusting for covariates, total and trunk fat mass and total and appendicular lean body mass were not associated as risk for chronic low back pain in both genders. CONCLUSIONS: Fat mass and muscle mass may not be associated with chronic low back pain in young and middle-aged Korean adults.
Adipose Tissue ; Adult ; Aged ; Body Composition ; Body Mass Index ; Female ; Humans ; Korea ; Life Style ; Low Back Pain ; Male ; Motor Activity ; Muscle, Skeletal ; Muscles ; Nutrition Surveys ; Occupations ; Prevalence ; Risk Factors ; Waist Circumference

Purpose: The purpose of this study was to develop an instrument to assess nursing professional pride. Methods: Fifty-six preliminary items were identified through literature review and focus group interview of nurses working in a hospital. Of these, 45 preliminary instruments were completed over 0.80 of content validity index. To verify the reliability and validity of the preliminary instrument, data were collected from 294 nurses. The data were analyzed using factor analysis and multidimensional scaling analysis. Results: From the factor analysis, 27 significant items were divided into 5 subscales. These subscales were as follows: feeling of vocation, role satisfaction, role of problem solver, self-achievement, and willingness to stay. The nursing professional pride also established criterion-related validity, discriminant validity, and group validity. Cronbach’s a of the instrument was .92, and the subscales ranged from .74 to .85. Conclusion The developed scale for nursing professional pride shows validity and reliability. The significance of this study is the development of an instrument capable of measuring nursing professional pride. To verify the relevance of this instrument, conducting comparative studies is suggested.

Amid the increasing interest in medical humanities education, this study developed a medical humanities course that utilized design thinking to foster creative thinking, problem-solving, and collaboration skills that pre-medical students should possess. The course’s efficacy was assessed by evaluating improvements in core design thinking skills. The present study was conducted among 83 first-year medical students after planning and implementing a design thinking course. The reflection journals written by students along the course of the class were examined using the template analysis technique to evaluate the effectiveness of the class. The study’s primary findings showed the successful development of step-by-step medical humanities education content utilizing design thinking and its practical implementation in a class. Moreover, the course improved students’ core design thinking skills effectively, and in a balanced way. These results illustrate the effective application of design thinking in medical school through a medical humanities course. These findings indicate that a medical humanities course can help medical students showcase their abilities to collaborate and solve problems in the real world. This paper suggests the need for further research to develop a curriculum that integrates design thinking and investigate the relationship between medical students’ core competencies and design thinking-based courses.

Pancytopenia represents a unique challenge for primary care doctors and its etiological causes encompass various specialties, including hematology and rheumatology. Despite the existence of effective tests such as bone marrow biopsy and immunoassays to rule out the potential causes of pancytopenia, it is often difficult to pinpoint the exact diagnosis. In this case report, we have described such a ‘gray zone’ patient, who presented with pancytopenia, neutropenia, and splenomegaly, and was being treated for fungal pneumonia before being transferred to Severance Hospital (department of family medicine). As the patient had a 10-year history of multiple, long-term hospital admissions that were having a severely debilitating impact on the quality of life, we performed a partial splenic embolization as a potential cure for the symptoms. Although this induced acute blood count recovery, it failed to prevent eventual mortality from septic shock.

Pancytopenia represents a unique challenge for primary care doctors and its etiological causes encompass various specialties, including hematology and rheumatology. Despite the existence of effective tests such as bone marrow biopsy and immunoassays to rule out the potential causes of pancytopenia, it is often difficult to pinpoint the exact diagnosis. In this case report, we have described such a ‘gray zone’ patient, who presented with pancytopenia, neutropenia, and splenomegaly, and was being treated for fungal pneumonia before being transferred to Severance Hospital (department of family medicine). As the patient had a 10-year history of multiple, long-term hospital admissions that were having a severely debilitating impact on the quality of life, we performed a partial splenic embolization as a potential cure for the symptoms. Although this induced acute blood count recovery, it failed to prevent eventual mortality from septic shock.

No abstract available.
Automation, Laboratory/*methods ; Culture Media/*classification ; Female ; Humans ; Male ; Sputum/*microbiology ; Tuberculosis, Pleural/*diagnosis

Mostly of the sudden deaths, except in-hospital death and death within 48 hours of discharge, are declared in the emergency department by emergency physician. The purpose of this study is to review the protocol of cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest by understanding the cause of sudden death from autopsy results. A retrospective analysis was performed by 48 months of medical records from emergency department of a tertiary hospital. The analysis was made from the patient group which gone through autopsy in the main office of National Institute of Scientific Investigation. In the emergency department, 1913 patients were declared death and 43 patients have received autopsy and 19 (1.0%) were natural death. 14 partients received CPR in the natural death group, and 13 were specified as cardiovascular disease. Result of this study represents the importance of prehospital CPR in case of unexpected cardiac arrest patients. However to generalize this result, all dead patients must go through autopsies for medical purpose which the frequency alse should be increased.
Autopsy ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Death, Sudden ; Emergencies ; Heart Arrest ; Humans ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies ; Tertiary Care Centers

A recent understanding of the dynamic continuous spectrum of Mycobacterium tuberculosis infection has led to the recognition of incipient tuberculosis, which refers to the latent infection state that has begun to progress to active tuberculosis. The importance of early detection of these individuals with a high-risk of progression to active tuberculosis is emphasized to efficiently implement targeted tuberculosis preventive therapy. However, the tuberculin skin test or interferon-γ release assay, which is currently used for the diagnosis of latent tuberculosis infection, does not aid in the prediction of the risk of progression to active tuberculosis. Thus, a novel test is urgently needed. Recently, simultaneous and systematic analysis of differentially expressed genes using a high-throughput platform has enabled the discovery of key genes that may serve potential biomarkers for the diagnosis or prognosis of diseases. This host transcriptional investigation has been extended to the field of tuberculosis, providing promising results. The present review focuses on recent progress and challenges in the field of blood transcriptional signatures to predict progression to active tuberculosis.