OBJECTIVE: This paper reviews the existing Korean medical and public health, and nursing academy articles on disease-specific and domain-specific quality of life, and provides recommendations for the universally validated core quality of life instruments and for use of these measures in clinical trials widely. METHODS: Quality of Life Instruments Database (QOLID) was searched in order to identify all relevant disease-specific, population-specific, and domain-specific QOL instruments. Titles and abstracts of 27 articles related to QOL research conducted by Korean researchers were retrieved from MEDLINE and RICH database. These articles were comprehensively reviewed to analyse the cross cultural adaptation, validation and other aspects of application of Korean version of QOL measures. RESULTS: 1. The journal search yielded a total 27 disease-specific and domain-specific articles, of which 22 were published in Korean nursing academic journal, 5 in medical and public health journals 2. Search for QOLID resulted in 92 specific QOL measures. Thirty-six instruments of which 31 were disease-specific measures, 2 symptom-specific, 2 population-specific, and 1 domain-specific, were translated into Korean language among them. Four Korean version of specific QOL measures were used in articles in MEDLINE. They were Health Assessment Questionnaire (HAQ), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Childhood Health Assessment Questionnaire (CHAQ), and Child Health Questionnaire (CHQ). An article using Korean version of Fibromyalgia Impact Questionnaire (FIQ) is in press. 3. The Korean validated instruments published at international academic articles were HAQ, WOMAC, CHAQ, and CHQ. 4. The Korean version of Parkinson's Disease Questionnaire (PDQ), Kidney Disease Quality of Life Instrument (KDQOL), Functional Assessment of Cancer Therapy (FACT), Functional Assessment of Anorexia/Cachexia (FACTT), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT- F), Functional Assessment of Spiritual Wellbeing (FACT-Sp), and FACT-Anemia are going on Korean validation and data collection under the author contact and permission. 5. Twenty six studies out of 27 Korean articles reported the use of 16 kinds of Western instrument. There were some flaws such as omission of validation steps, deletion of items, arbitrary change of response scale, and absence of cultural adaptation and conceptual consideration in those articles. CONCLUSION: To use the health outcomes disease-specific instruments universally and to perform multi-national studies, it is suggested that cross-cultural equivalence across all translated versions and conceptual equivalence of translated instruments to the original version must be verified and the quality of life assessment need to be applied to clinical trials.
Arthritis ; Child ; Child Health ; Chronic Disease ; Data Collection ; Fibromyalgia ; Kidney Diseases ; Korea* ; Nursing ; Ontario ; Parkinson Disease ; Public Health ; Quality of Life* ; Surveys and Questionnaires

OBJECTIVE: This paper reviews the existing Korean medical, nursing and public health academy articles on health-related quality of life, and provides recommendations for the universally validated core quality of life instruments and for wide use of these measures in clinical trials widely. METHODS: A comprehensive review of 116 Korean articles from www.richis.org was conducted. A review of the application, Korean validation, and publishment of Western quality of life instrument from www.QOLID.org. and Medline was conducted in the 116 Korean academic articles. RESULTS: 1. The journal search yielded a total 116 articles, of which 81 were published in Korean nursing academic journal, 35 in medical and public health journals 2. The 4 generic instruments were developed in Korea (1 for middle-aged adult in Seoul, 1 for geriatrics, Korean Quality of Life Scale, Catholic Medical Center Health Survey). The instrument for Korean middle-aged adult was used in 50 Korean articles, but the deletion of items and domains, and change of response scales without conceptual considerations showed. 3. The Korean articles used Western Instruments were 43, of which 13 used generic instruments, 24 used disease-specific, and 2 used domain-specific instruments. 4. The translated instruments in Korean were 4 instruments of COOP-chart, Ferrans and Powers Quality of Life Index-Generic version (QLI), Medical Outcomes Study (MOS) 12-Items Short Form (SF-12), Medical Outcomes Study (MOS) 36-Items Short Form (SF-36) among 33 kinds of quality of life instrument from www.QOLID.org. There was no evidence of publishment internationally on Medline searching. The Korean version of Euro-Qol (EQ-5D) instrument is going on the publishment. 5. Thirteen studies out of 116 Korean articles reported the use of Western Instrument including QLI, WHQOL, General Health Questionnaire (GHQ), COOP-C, COOP-WONCA, Nottingham Health Profile (NHP) and SF-36 among 33 generic quality of life instruments in Korean academic articles. The ommission of international validation step, deletion of items and domains, change of response scales without cultural adaptation and conceptual considerations showed in Korean studies used Western instruments. CONCLUSION: To use the health outcomes instruments universally and to perform multi-national studies, it is suggested that cross-cultural equivalence across all translated versions and conceptual equivalence of translated instruments to the original version must be verified and the quality of life assessment need to be applied to clinical trials.
Adult ; Geriatrics ; Humans ; Korea* ; Nursing ; Public Health ; Quality of Life* ; Surveys and Questionnaires ; Seoul ; Weights and Measures

PURPOSE: To evaluate the reliability and validity of the Korean version of the 39-item Parkinson's disease questionnaire (PDQ-39). METHODS: Cross-cultural adaptation was performed according to the international guidelines: forward and backward translation, focus group meeting, and a field test. With Korean consensus translation produced, validation was assessed by evaluating reliability and validity. Ninety-three outpatients with Parkinson's disease (PD) and 89 healthy aged controls were recruited. Internal consistency reliability was assessed by Cronbach's alpha. Validity was assessed by Spearman correlation analysis, t test, factor analysis, and analysis of variance with Duncan's multiple range tests. RESULTS: In the PD group, mean age was 65.13 +/- 9.84 years, and mean duration of PD was 42.41 +/- 37.01 months. Ceiling and floor effects ranged 1.1%-2.2% and 1.1%-15.1%, respectively. Cronbach's alpha of eight dimensions ranged from .70 to .97. All dimensions were correlated with each other, except for the stigma dimension. PD patients had significantly lower quality of life than healthy aged controls did, except for the bodily discomfort dimension. Eight dimensions of Korean PDQ-39 loaded on one factor. PD patients with a Modified Hoehn and Yarh Staging score of 4 had the worst quality of life. The relationships among the eight dimensions of Koran PDQ-39 and the Modified Hoehn and Yarh Staging is fair to good, except for the stigma and social support dimension. CONCLUSION: The Korean PDQ-39 was proved to be reliable and valid. Our results suggest that Korean PDQ-39 could be used in clinical research to assess and evaluate the disease process and its impacts on health-related quality of life in Korean PD patients.
Aged ; Case-Control Studies ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Parkinson Disease/*psychology ; Psychometrics/*standards ; Quality of Life ; Questionnaires/*standards ; Reproducibility of Results ; Republic of Korea ; Translations

Purpose: To compare the results of lacrimal syringing performed in clinical practice and under general anesthesia, and the clinical efficacy of lacrimal syringing under general anesthesia before endoscopic dacryocystorhinostomy and dacryoscintigraphy. Methods: The study included 148 eyes of 82 patients who underwent endoscopic dacryocystorhinostomy and silicone tube intubation from August 2018 to April 2019. The patients were examined with lacrimal syringing in clinical practice and re‐examined under general anesthesia. Based on the change in lacrimal syringing, the patients were assigned to inconsistent and consistent groups. The inconsistent group was subclassified into complete (‘regurgitation’ of lacrimal syringing changes to a ‘passage’ pattern) and partial improvement groups (the degree of regurgitation improves under general anesthesia). Results: Twenty (13.5%) eyes showed inconsistent results of lacrimal syringing performed in clinical practice and under general anesthesia; all showed improved passage under general anesthesia. The surgical results did not differ significantly (p = 0.336) between the consistent and inconsistent groups, but did between the complete and partial improvement groups (p < 0.01). Conclusions Lacrimal syringing under general anesthesia may enable an accurate preoperative diagnosis of the degree of obstruction. The combined results of dacryoscintigraphy and lacrimal syringing performed in clinical practice and under general anesthesia allow surgeons to evaluate the lacrimal drainage anatomy precisely and may be useful for predicting the functional success of endoscopic dacryocystorhinostomy.

BACKGROUND: The red blood cell (RBC) deformability test is a useful method for measuring the ability of RBCs to adapt their shape to the flow conditions. Using this test, several investigators have shown the relationship between RBC deformability and numerous clinical conditions. For the quality control (QC) of RBC deformability test, we evaluated whether frozen-thawed-deglycerolized RBCs can be used as QC materials. METHODS: Packed RBCs were frozen with 40% (wt/vol) glycerol and stored at -80degrees C for 3 months. For 10 different frozen RBC panels, RBCs were thawed, deglycerolized and stored at 4degrees C for 4 weeks. Using microfluidic ektacytometer, we measured RBC deformability of the thawed RBCs. The stability of thawed RBCs was tested once a day for 28 days of storage time and was analyzed by simple regression analysis. The precision of the test using thawed RBCs was analyzed for 7 days of storage time by calculation of CV values of intra-assay (10 measurements/assay) and between-day measurements. RESULTS: Frozen-thawed-deglycerolized RBCs were stable for 1 week. Within-run and between-day precisions of the RBC deformability test during 7 days of storage of thawed RBCs were 1.4-2.9%, and 1.9-2.8%, respectively. CONCLUSIONS: Frozen-thawed-deglycerolized RBCs used in RBC deformability test showed satisfactory within-run and between-run precisions and stability for one week after thawing, and may be used as QC materials for this test.
Blood Preservation ; Cryopreservation ; Cryoprotective Agents/chemistry/isolation & purification ; *Erythrocyte Deformability ; Erythrocytes/immunology/physiology ; Glycerol/chemistry/isolation & purification ; Hematologic Tests/standards ; Humans ; Quality Control

OBJECTIVE: This study is to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D (KEQ-5D) in various rheumatic patients. METHODS: We performed translation, backward translation and cognitive debriefing by the guidelines of the EuroQol group. The validity was evaluated by using the KEQ-5D, Korean Short- Form 36 (KSF-36) and disease-specific measures on 508 out-patients with ankylosing spondylitis, fibromyalgia syndrome, rheumatoid arthritis, osteoarthritis or systemic lupus erythematosus. Construct validity were evaluated by testing a-priori hypotheses of the association between the KEQ-5D and other measures. For the verification of reliability, we gave the same questionnaires twice to another 57 patients 1-week apart, and intra-class correlations and Kappa statistics were estimated. To test responsiveness, 60 patients with RA repeated the KEQ-5D at 12-week intervals within the context of 12-week clinical trials of a TNF blocker, and we calculated the t-test, effect size and standardized response mean RESULTS: There were no major modifications on the cross-cultural adaptation. The relationships between the KEQ-5D and the generic or disease-specific measures were observed to be as we expected previously in a-priori hypotheses:higher KEQ-5Dindex and KEQ-5DVAS scores were correlated with generic or disease-specific measures on the better health status, and groups with a better functional class showed higher KEQ-5D scores. The intra-class correlations of the KEQ-5Dindex and KEQ-5DVAS were 0.751 and 0.767, respectively, and Kappa statistics for agreement ranged from 0.455 to 0.772 across five dimensions. The standardized response means of KEQ-5Dindex and KEQ-5DVAS were 0.649 and 0.410. CONCLUSION: The KEQ-5D had good validity and sensitivity in several rheumatic conditions. Also, its reliability and responsiveness were moderate to good.
Arthritis, Rheumatoid ; Fibromyalgia ; Humans ; Korea ; Lupus Erythematosus, Systemic ; Osteoarthritis ; Outpatients ; Quality of Life ; Surveys and Questionnaires ; Rheumatic Diseases* ; Spondylitis, Ankylosing

PURPOSE: The C677T polymorphism of the methylenetetrahydrofolate reductase(MTHFR) has been suggested as a risk factor of maternal meiotic nondisjunction for Down syndrome. Recently, a second genetic polymorphism in MTHFR at position 1298 was reported. However, a positive association between the A1298C MTHFR polymorphism and Down syndrome has not been reported. Therefore, this study was undertaken to determine which polymorphism of MTHFR gene was associated with the increased risk of a child suffering from Down syndrome(DS). METHODS: We enrolled 33 patients with Down syndrome and 100 healthy individuals and analyzed the MTHFR C677T and A1298C polymorphism by a PCR-restriction fragment length assay. RESULTS: Frequencies of MTHFR C677T genotypes(CC, CT, and TT) were 9(27%), 22(67%), and 2 (6%) in the DS patients and 24(24%), 55(55%) and 21(21%) in the control, respectively. The frequency of mutant 677TT was significantly low in the DS patients(OR : 0.14; 95% CI : 0.02-0.95; P= 0.04). For the MTHFR A1298C polymorphism, frequencies of genotypes(AA, AC, and CC) were 16(48 %), 15(45%) and 1(3%) in DS patients and 77(77%), 21(21%) and 2(2%) in the control, respectively. The frequency of mutant 1298AC was significantly increased in DS patients with an odds ratio of 3.3(95% CI : 1.39-7.82; P=0.007). CONCLUSION: Our results suggest that MTHFR mutant 677TT may have a protective effect against Down syndrome, but MTHFR mutant 1298AC may be an independent risk factor in Down syndrome.
Child ; Down Syndrome* ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Odds Ratio ; Polymorphism, Genetic ; Risk Factors

PURPOSE: This study was done to identify fat distribution and blood pressure according to anthropometric change patterns between NIDDM patients and control subjects. METHODS: Cross-sectionally 167 NIDDM patients and 87 controls were studied. Previous maximal body weight and acute weight loss was obtained. Current height, body weight, BMI, waist-hip ratio(WHR), skinfold thicknesses(abdomen, subscapular and triceps), and blood pressure was measured. Three anthropometric change patterns were categorized by BMI changes from the maximum lifetim's BMI to the current time (obese-obese, obese-nonobese and nonobese-nonobese: obese: BMI > or =25 kg/m2, nonobese: BMI<25 kg/m2). The data was analyzed by chi-square, t-test, age adjusted ANCOVA and Least Squares Means(LSM) for multiple comparison. RESULT: Acute body weight loss(p=0.01), anthropometric change types (p=0.001), WHR (P=0.05), and skinfold thickness (p=0.002) of NIDDM were significantly higher than those of the controls. The mean arterial pressure, WHR and skinfold thicknesses were greater in both obese-obese and obese-nonobese NIDDM and control subjects compared with both nonobese-nonobese NIDDM and control subjects. (all p's<0.05). CONCLUSION: NIDDM patients had more central and upper body adiposicity. Also both obese-obese and obese-nonobese NIDDM and control subjects had higher mean arterial pressures and central body obesity.
Adult ; Anthropometry ; *Blood Pressure ; *Body Fat Distribution ; Body Mass Index ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*diagnosis/epidemiology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Multivariate Analysis ; Obesity ; Waist-Hip Ratio

PURPOSE: Disseminated intravascular coagulation(DIC) occurs most frequently in premature infants. The purpose of this study is to evaluate the influencing factors in treatment of DIC among premature infants. METHODS: A retrospective chart review for 41 premature infants who were admitted to Pochun CHA University neonatal intensive care unit between May 2001 and July 2002 was done. Infants were divided into two groups depending upon their response in improvement of symptoms and laboratory values occurring within or after 72 hours of initiation of therapy. A comparative analysis of various parameter to delineate influencing factors affecting treatment outcome was studied. RESULTS: The factors related to delayed response in treatment of DIC between early response group (19) and late response group (22) included male, low birth weight, severe birth asphyxia, prolongation of prothrombin time, petechiae and oozing of puncture site. CONCLUSION: Awareness of factors associated with delayed response in treatment of DIC may aid in prediction of treatment outcome among premature infants with DIC.
Asphyxia ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Male ; Parturition ; Prothrombin Time ; Punctures ; Purpura ; Retrospective Studies ; Treatment Outcome

PURPOSE: The objective of this study was to evaluate differences of Scores for Neonatal Acute Physiology (SNAP) in between neonates with bronchopulmonay dysplasia (BPD) and control group, and to utilize SNAP as an early predictive tool for development of BPD. METHOD: A retrospective chart review was done for a total of 30 neonates who were admitted to Pochun CHA University neonatal intensive care unit between April, 1995 and May, 2001. A study group included 15 neonates with BPD and a control group included 15 neonates matched for gestational age and birth weight. SNAP and cumulative SNAP were obtained at 1st, 4th, 6th postnatal day for each group. A comparative analysis of cumulative SNAP scores of various parameters was done in two groups. RESULTS: SNAP of 10.86 and 6.86 were obtained at 4th postnatal day for BPD and control group, respectively (P<0.05). Cumulative SNAP for 1st, 4th, 6th postnatal day were 30.40 and 21.93 in BPD and control group (P=0.059). A comparison of cumulative SNAP of various parameters between two groups showed that respiratory rate and apnea to be significant parameters as well as for blood pressure and arterial oxygen tension in neonates with BPD. CONCLUSION: Score for Neonatal Acute Physiology could be utilized as a tool to predict the development of BPD although larger study is needed to simplify its scoring system to be used easily and better predict the development of BPD.
Apnea ; Birth Weight ; Blood Pressure ; Bronchopulmonary Dysplasia* ; Gestational Age ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Oxygen ; Physiology ; Respiratory Rate ; Retrospective Studies