In Korea, female workforce has reached more than 40% of total working population but the effects of work on spontaneous abortion are yet to be examined. This study was conducted to investigate the occupational effects on spontaneous abortion. Medical insurance claim data were used to examine the effects of the employment status and industry of employment on spontaneous abortion The study population was composed of females, aged 15~44, who were the beneficiary of medical insurance in the month of June, 1993. The working females covered by medical insurance for industrial workers, hand the highest age-adjusted Spontaneous Abortion rate(SAB rate=claim frequency of spontaneous abortion/claim frequency of complication of pregnancy, childbirth and the puerperium), 6.65% whereas female dependants of medical insurance for industrial workers had the lowest age-adjusted SAB rate, 4.54%. Among industrial workers, the workers in manufacturing industry had the highest age-adjusted Spontaneous Abortion ratio(SAB ratio=claim frequency of spontaneous abortion/claim frequency of completely normal delivery), 43.2/100 whereas those in financing and service industry had age-adjusted SAB ratio, 16.2/100 and 20.5/100, respectively. The results of the study suggest the adverse effect of manufacturing industry on reproduction. Work environment such as chemical exposures, overwork, awkward posture, and job stress should be further studied for their effects on reproductive functions of female.
Abortion, Spontaneous* ; Employment* ; Female ; Female* ; Hand ; Humans ; Insurance ; Korea ; Parturition ; Posture ; Pregnancy ; Reproduction

PURPOSE: Helicopter parenting is emerging in parenting as a way of rearing adolescents and adult children. The aims of this study were to develop a Korean version of the Helicopter Parenting and Autonomy Supportive Behaviors Scale (HPASB). METHODS: The HPASB questionnaire items were translated into Korean and reviewed by experts and Content Validity Index (CVI) in a preliminary study with 10 university students. During September and October, 2014 data were collected from 229 nursing students from five different universities in different locations. For data analysis, SPSS 21.0 statistics which included exploratory factor analysis, t-test, one-way ANOVA were utilized. RESULTS: Content validity was over CVI .8. The 6 factors of K-HPASB were extracted and accounted for 59.30% of variance. The Cronbach's alpha coefficient was .71 indicating high reliability. CONCLUSION: The Korean version of the HPASB was identified as a scale with a high degree of validity and reliability. The results of this study provide a valuable scale which can be useful in the study of parenting as a way of rearing adolescents and adult children in Korea. To enhance the positive aspect of helicopter parenting, we suggest the development of intervention programs on parenting.
Adolescent ; Adult Children ; Aircraft* ; Humans ; Korea ; Parenting* ; Parents* ; Reproducibility of Results* ; Statistics as Topic ; Students, Nursing

PURPOSE: Gastrointestinal stromal tumors (GISTs) are of a mesenchymal origin, and they arise predominantly from the gastrointestinal tract. This study aims to aid the post operative management of GIST patients by analyzing the clinical and immunopathological features of recurrent GISTs. METHODS: We enrolled 98 GIST patients who had been operated on for their primary tumor from 1987 to 2001 at the Catholic Medical Center. Among them, 28 patients had clinical and radiological features that were proved to be recurrence, and the patients' survival rates were compared according to the treatment modalities. RESULTS: When the maximum length of tumor was shorter and the mitotic index lower, then these patients had higher disease free survival rates and lower recurrence rates. The Ki-67 negative group had lower recurrence rates than their Ki-67 positive counterparts. Recurrence was mostly observed as liver metastasis. The mean length of time to recur was 22.96 months. Fifteen patients received additional treatments such as surgery, chemotherapy and radiation therapy, but there was no significant difference in survival rates when they were compared to the 13 patients who did not receive further treatments. CONCLUSION: Of the patients diagnosed with GIST after surgery, those with worse prognostic factors, i.e. a bigger tumor size and higher mitotic index, require more meticulous surveillance for tumor recurrence, and especially for liver recurrence, which was the most common recurrence site, during the follow up exams. In addition, although there have not been any remarkably effective treatments for the recurrent GIST patients, further researches for new therapy such as STI-571 is mandated.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Imatinib Mesylate ; Liver ; Mitotic Index ; Neoplasm Metastasis ; Recurrence ; Survival Rate

Human Respiratory Syncytial virus (hRSV) is a leading cause of severe lower respiratory tract diseases in the pediatric population.hRSV frequently causes severe morbidity and mortality in high risk groups including infants with congenital heart disease and the immunosuppressed patients. Although hRSV is recognized as a major public health threat and economic burden worldwide, there is no licensed vaccine and effective therapeutic agent. Viral nonstructural (NS) proteins have been known to play multiple functions for efficient viral replication and pathogenesis. Especially, diverse functions of influenza A virus NS1 have been extensively studies. Recent studies demonstrated that NS1 and NS2 of RSV also exert diverse functions to modulate cellular environment and antiviral immune responses. Since NS proteins of RSV are required for efficient replication and pathogenesis, NS mutant viruses have been tested as live-attenuated vaccines. This review will outline the recent progress in understanding the various functions of RSV NS1 and NS2.
Heart Defects, Congenital ; Humans ; Infant ; Influenza A virus ; Interferons ; Mortality ; Public Health ; Respiratory Syncytial Virus, Human ; Respiratory Syncytial Viruses* ; Respiratory Tract Diseases ; Vaccines

Extracorporeal membrane oxygenation (ECMO) is a means for supporting adequate gas exchange in patients with severe respiratory failure and is the only therapeutic option for ventilation-refractory patients awaiting lung transplantation. Moreover, defining the patients likely to benefit from ECMO as a bridge to transplantation has recently become a point of interest. Here, we report a case of prolonged ECMO support to a patient awaiting lung transplantation. A 66-year-old woman was diagnosed with acute interstitial pneumonia and was placed on veno-venous (VV) ECMO due to unsatisfactory gas exchange despite maximal ventilator care. She underwent bilateral lung transplantation after 99 days of ECMO and was successfully weaned from it on the 107th ECMO day. This is the longest period of ECMO support to be reported among elderly patients.
Aged* ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Lung Diseases, Interstitial ; Lung Transplantation* ; Lung* ; Respiratory Insufficiency ; Ventilators, Mechanical

BACKGROUND/AIMS: The aims of this study were to evaluate the incidence of reflux esophagitis in patients after a subtotal gastrectomy and to determine risk factors for reflux esophagitis. METHODS: Among 225 patients who underwent a subtotal gastrectomy from June 2003 to December 2004 at Seoul National University Bundang Hospital, 201 patients who received follow-up for more than six months and underwent at least one endoscpoic examination were retrospectively reviewed. We used the Los Angeles (LA) classification system and included a minimal change for reflux esophagitis. RESULTS: There were 173 patients who underwent a Billroth I procedure and 28 patients who underwent a Billroth II procedure. The cumulative incidence of reflux esophagitis was 40.8%. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03), bile reflux gastritis (p<0.01) and postoperative obesity (p=0.02) were significant risk factors for the development of reflux esophagitis including a minimal change. The number of postoperative endoscopies > or =4 (p=0.012), bile reflux gastritis (p=0.002) and postoperative obesity (p=0.038) were risk factors for a minimal change. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03) and Helicobacter pylori eradication before surgery (p<0.01) were independent risk factors for LA grade A/B reflux esophagitis. CONCLUSIONS: Bile reflux gastritis is a risk factor for the development of reflux esophagitis after a subtotal gastrectomy. Preoperative helicobacter eradication is also associated with reflux esophagitis, except for a minimal change, but further studies are needed.
Bile Reflux ; Esophagitis, Peptic ; Follow-Up Studies ; Gastrectomy ; Gastritis ; Gastroenterostomy ; Helicobacter ; Helicobacter pylori ; Humans ; Incidence ; Los Angeles ; Obesity ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVES: There is serological and epidemiological evidence of an association between Chlamydia pneumoniae infection and coronary artery disease. We conducted a randomized study using azithromycin treatment in Korean patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) to determine whether azithromycin treatment reduced the inflammatory markers and major adverse cardiac events (MACE). SUBJECTS AND METHODS: One hundred twenty nine patients were randomly selected to receive 500 mg azithromycin daily for 3 days before and after PCI, followed by 500 mg/week for 2 weeks (Group l: 64 patients, 43 male, 60.0+/-10.0 years), or they received a placebo (Group ll: 65 patients, 45 male, 59.6+/-10.1 years). Patients were followed up for 12 months. The primary endpoints were cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR) and Non-TLR during the 12-month follow-up. RESULTS: There were no differences between the two groups in baseline characteristics, coronary angiography finding, lesion characteristics, baseline inflammatory markers and baseline antibody titers of Chlamydia pneumoniae, Helicobacter pyroli and Mycoplasma. After the antibiotic treatment, ESR and CRP decreased from 19.6+/-20.7 mg/dL and 0.75+/-0.99 mg/dL to 9.36+/-10.5 mg/dL and 0.22+/-0.20 mg/dL in group l (p=0.002, 0.001 respectively), and from 19.6+/-21.5 mg/dL, 1.44+/-2.69 mg/dL to 10.4+/-10.8 mg/dL, 0.55+/-1.48 mg/dL in group ll (p=0.052, <0.0001 respectively). However, there were no significant changes in the serologic markers. MACE developed in 17 (26.6%) out of 64 patients in group l with 2 death, 2 MI and 13 TLR. In group ll, 14 (21.5%) out of 65 patients had MACE with 2 death, 1 MI and 10 TLR during the 12-month clinical follow-up (p=NS). CONCLUSION: Short-term treatment with azithromycin does not reduce the major adverse cardiac events in Korean patients with ACS after PCI.
Acute Coronary Syndrome* ; Azithromycin* ; Chlamydophila pneumoniae ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Death ; Follow-Up Studies ; Helicobacter ; Humans ; Inflammation ; Male ; Mycoplasma ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Secondary Prevention*

A 16-year-old male with a prior history of recurrent syncope was referred to our hospital after being resuscitated from cardiac arrest developed while playing volleyball. His electrocardiogram (ECG) demonstrated ventricular fibrillation at a local emergency department. After referral, an ECG showed bidirectional ventricular tachycardia (VT) and nonsustained Torsade de Pointes. Two days later, his heart rate became regular, and no additional episodes of VT were observed. His ECG showed sinus rhythm with a corrected QT interval of 423 msec, and two-dimensional echocardiography was unremarkable. We made the diagnosis of a catecholaminergic polymorphic VT. However, only premature ventricular complex bigeminy was induced on exercise ECG and epinephrine infusion tests, and the patient showed no episodes of syncope. His father and mother had different missense mutations in the cardiac ryanodine receptor on genetic testing. The proband had both mutations in different alleles and was symptomatic. It was recommended that the patient avoid competitive physical activities, and a beta-blocker was prescribed.
Adolescent ; Alleles ; Catecholamines ; Echocardiography ; Electrocardiography ; Emergencies ; Epinephrine ; Fathers ; Genetic Testing ; Heart Arrest ; Heart Rate ; Humans ; Male ; Mothers ; Motor Activity ; Mutation, Missense ; Referral and Consultation ; Ryanodine Receptor Calcium Release Channel ; Syncope ; Tachycardia ; Tachycardia, Ventricular ; Torsades de Pointes ; Ventricular Fibrillation ; Ventricular Premature Complexes ; Volleyball

Aseptic endocarditis is an uncommon complication of Behcet's disease (BD). We describe a rare case of a 39-year-old female who had BD with aseptic endocarditis of the tricuspid valve (TV) presenting as tricuspid stenosis. She was diagnosed with BD four years ago. The mucocutaneous lesions were well-controlled with colchicine and short courses of corticosteroids. She remained free of signs and symptoms of BD for one year without any medication. Three months before admission, she gradually developed dyspnea on exertion and peripheral edema. Echocardiography revealed dilated right atrium and markedly thickened TV with severe stenosis. TV replacement was performed. Pathologic examination of the valve showed fibrinoid necrotic material and inflammatory cell infiltration. Blood cultures and cultures of the excised valve were negative for microorganisms.
Adrenal Cortex Hormones ; Adult ; Behcet Syndrome ; Colchicine ; Constriction, Pathologic ; Dyspnea ; Echocardiography ; Edema ; Endocarditis ; Female ; Heart Atria ; Humans ; Tricuspid Valve ; Tricuspid Valve Stenosis

BACKGROUND/AIMS: The identification of significant coronary arterial disease (CAD) is important to reduce perioperative ischemic insult and the possibility of repeated open-chest surgery in patients scheduled to undergo valvular surgery. However, there are no published data on the incidence of significant CAD in these patients. Thus, we examined the prevalence of significant CAD in patients scheduled to undergo valvular surgery. METHODS: From January 2005 to June 2011, all consecutive adult patients diagnosed with significant valvular disease and scheduled for an elective open valvular operation were retrospectively investigated at Chungnam National University Hospital and Chonbuk National University Hospital. Patients who underwent emergent valvular operations due to acute aortic dissection or trauma and concomitant valvular operations at the time of coronary artery bypass graft (CABG) surgery were excluded. RESULTS: During the study period, a total of 431 patients (58 +/- 13 years old, 204 males) were included. The distributions of mitral (241 patients) and aortic valvular disease (230 patients) were similar. Coronary angiography was performed in 297 patients (68.9%). Of these, 36 (12.1%) showed significant CAD and 32 underwent concomitant CABG operations. Based on a multivariate analysis, the presence of CAD was significantly associated with old age (> or = 65 years old) [odds ratio (OR) = 3.081, 95% confidence interval (CI) = 1.372-6.921, p = 0.006], more cardiovascular risk factors (> or = 3) (OR = 3.002, 95% CI = 1.386-6.503, p = 0.005), and the presence of aortic stenosis (OR = 2.763, 95% CI = 1.269-6.013, p = 0.010). CONCLUSIONS: The incidence of significant CAD was 12.1% in adult patients who underwent valvular operations in Korea. CAD was more common in patients with old age, aortic stenosis, and multiple cardiovascular risk factors.
Adult ; Aortic Valve Stenosis ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease ; Heart Valve Diseases ; Humans ; Incidence ; Korea ; Multivariate Analysis ; Prevalence ; Retrospective Studies ; Risk Factors ; Transplants