Public health doctors of Korea contributed significantly to massive coronavirus disease 2019 (COVID-19) testing. They were immediately dispatched to epicenters of the COVID-19 pandemic, and have run tests at screening centers, airport quarantines and hospitals. However, their expertise from in-field experience has been often neglected. It is time to reorganize public health doctor system to better prepare for future epidemics. Transforming and strengthening their roles as public health experts through systematic training is crucial.

PURPOSE: The aim of this study was to evaluate the prognostic effectiveness of multivisceral resections of organs involved by locally advanced colorectal cancer. METHODS: A retrospective study was performed to analyze the data collected for 266 patients who underwent a curative resection for pT3-pT4 colorectal cancer without distant metastasis from January 2000 to December 2007. Of these 266 patients, 54 patients had macroscopically direct invasion of adjacent organs and underwent a multivisceral resection. We evaluated the short-term and the long-term outcomes of a multiviceral resection relative to that of standard surgery. RESULTS: The most common location for the primary lesion was the rectum, followed by the right colon and the sigmoid colon. Among the combined resected organs, common organs were the small bowel, ovary, and bladder. In the multivisceral resection group, tumor infiltration was confirmed histologically in 44.4% of the cases while in the remaining patients, a peritumorous adhesion had mimicked tumor invasion. Postoperative complications occurred in 17.5% of the patients who underwent standard surgery vs. 35.2% of those who underwent a multivisceral resection (P < 0.0001). But the survival rate of patients after a multivisceral resection was similar to that of patients after standard surgery (5-year survival rates: 61% vs. 58%; P = 0.36). CONCLUSION: For locally advanced colorectal cancer, multivisceral resection was associated with higher postoperative morbidity, but the long-term survival after a curative resection is similar to that after a standard resection. Thus, a multivisceral resection can be recommended for most patients of locally advanced colorectal cancer.
Colon ; Colon, Sigmoid ; Colorectal Neoplasms ; Female ; Humans ; Neoplasm Metastasis ; Ovary ; Postoperative Complications ; Rectum ; Retrospective Studies ; Survival Rate ; Urinary Bladder

OBJECTIVES: The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). METHODS: Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. RESULTS: Fifty-eight subjects with ADHD (41 boys, 7.7+/-1.3 years), 21 SIB (8 boys, 8.2+/-1.8 years), and 22 TC (8 boys, 8.5+/-2.1 years) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). CONCLUSION: These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.
Ambulatory Care Facilities ; Child ; Child Psychiatry ; Chungcheongnam-do ; Humans ; Parents ; Pregnancy ; Risk Factors* ; Siblings ; Surveys and Questionnaires

Background/Aims: Beta-lactam (BL) antibiotics are widely prescribed for controlling bacterial infections and relevant culprits of adverse drug reactions (ADRs). BL allergy may vary according to prescription patterns within a given period of time. However, BL allergy in contemporary clinical practice has rarely been a focus of research. Methods: To investigate the clinical characteristics of BL allergy, subjects with ADRs to medicines, including BL antibiotics, were retrospectively reviewed. Results: Among the 175 enrolled subjects, BL antibiotics as culprits were confirmed in 79 (45.1%, female 53.2%, age 49 ± 14 years). Among the patients with confirmed BL allergy, only two (2.5%) were diagnosed via a prescription survey completed as part of multi-drug administration. The others were confirmed by serologic tests in 33 patients (41.8%), skin tests in 29 (36.7%), and drug provocation tests in 15 (19.0%). Regarding the symptoms and signs, onset within an hour of taking medicines was common (61 patients, 77.3%). Itchy skin was most common, followed by hives, rash, breathing difficulty, angioedema, and hypotension. Anaphylaxis occurred in 67%, and one-half (50.6%) of patients visited the emergency room. Cefaclor and amoxicillin were common BL culprits. Among others who did not have BL allergy, nonsteroidal anti-inflammatory drugs were found to be common culprits, followed by quinolones. Conclusions BL allergy is common among patients who experienced ADRs to medicines including BL antibiotics. For multi-drug administration, a prescription survey hardly helped in confirming BL allergy. Anaphylaxis is common in patients with BL allergy, frequently leading to emergency room visits. Cefaclor and amoxicillin are common culprits.

No abstract available.
Surgery, Oral*

PURPOSE: This study aimed to (1) explore current levels of quality of life, depression, resilience and social support and (2) investigate factors associated with quality of life among parents who lost children in the Sewol ferry disaster. METHODS: Data for this descriptive and correlation study was collected from December 2016 to June 2017. Structured questionnaires were completed by 114 parents. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation, and multivariate linear regression. RESULTS: Lower levels of quality of life were reported by parents with no current occupation, who considered emotional support by others as not helpful, not disclosing self as family of a victim, experiencing change in social activities related to the disaster, and not participating in bereavement activities with other families (all p values <.05). Factors associated with quality of life were depression (β=−.53) and resilience (β=.26) and explained 48.0% variance (F=50.37, p<.001), while social support was not a significant factor. CONCLUSION: Our study findings provide fundamental information on the mental health status of families of the Sewol ferry disaster victims. Nursing interventions to improve quality of life of parents who lost their children in the disaster should emphasize both managing depression and improving resilience.
Bereavement ; Child ; Depression ; Disaster Victims ; Disasters ; Humans ; Linear Models ; Mental Health ; Nursing ; Occupations ; Parents ; Quality of Life ; Resilience, Psychological ; Statistics as Topic

X-linked dominant hypophosphatemic rickets are the most common form of familial hypophosphatemic rickets resulting from hypophosphatemia caused by renal phosphate wasting, which in turn is a result of loss-of-function mutations in PHEX.Herein, we report a 39-year-old female with short stature and skeletal deformities and 12-month-old asymptomatic daughter.The female has a history of multiple surgical treatments because of lower limb deformities. Her biochemical findings revealed low serum phosphorus levels with elevated serum alkaline phosphatase activity and normal serum calcium levels, suggesting presence of hypophosphatemic rickets. To identify the molecular causes, we used a multigene testing panel and found a mutation, c.667dup (p.Asp223GlyfsTer15), in PHEX gene. To the best of our knowledge, this is a novel mutation. A heterozygous form of the same variant was detected in daughter, who showed no typical symptoms such as bow legs, frontal bossing, or waddling gate, but presented early signs of impaired mineralization in both X-ray and biochemical findings. The daughter was initiated onto early medical treatment with oral phosphate supplementation and an active vitamin D analog. Because the daughter was genetically diagnosed based on a family history before the onset of symptoms, appropriate medical management was possible from early infancy.

This study was designed to assess profile preferences among Korean youths in the year 1992. Facial esthetics was evaluated by means of silhouette profiles, eliminating the influence of a number of aspects that may affect judgment when normal lateral photographs are used. The main points of preference to be clarified here are as follows: First, on facial convexity, Second, on nasion depth, Third, on mentolabial sulcus depth, Fourth, on the position of upper and lower lips, Fifth, on facial type according to Angle's classification of malocclusion, Sixth, on Song's tangents. The 54 subjects printed in questionnaire as black and white silhouettes were selected from 300 tracings from cephalometric radiographs of people whose age ranging from 11 to 20 years. Photographs of six female subjects were retouched by computer graphic software and printed in color and black/white photographs which were used for adaptation of eyes of participants in selecting profiles in silhouette. They constitute 2 questions. The 54 subjects were grouped as 22 questions, each of them composed of 6 subjects, according to the aspects to be clarified. Twenty four questions in total were asked to assess profile preferences. For the assessment, the profile line, the facial esthetic triangle, Song's tangents, and Angle's classification of malocclusion were introduced. The profile line is composed of 11 component points which are Trichion, Glabella, Nasion, Pronasale, Subnasale, Labrale superius, Stomion, Labrale inferius, Supramentale, Pogonion, and Gnathion. The facial esthetic triangle is composed of 3 tangents: A-tangent which is the tangent of dorsum of nose, B-tangent which is the line passing through Sn and Ls, and C-tangent which is drawn on the turning point of the curve which lies between mentolabial sulcus (Sm) and pogonion (Pg). Angle's classification has 3 types of malocclusion which are Class I, Class II, and Class III. Class II malocclusion is subdivided into Division 1 and Division 2. The participants of the survey were composed of 861 college students (448 male students, 413 female students) whose majors grouped as Fine Arts Liberal Arts, and Natural Sciences, and whose mean age 21.8 years. The statistics program SPSS/PC + of SPSS Inc. was used to analyze answers of participants. Crosstabulation, Chi-square test, and Kendall test were done. The conclusions are as follows: First, Korean youths have a tendency to prefer the slightly convex face to the flat or concave face. Second, they prefer a moderately deep nasion. Third, they prefer a moderately deep mentolabial sulcus. Fourth, they prefer the position of lips which are near to Ricketts' E-line. The position of the upper lip which is slightly posterior to E-line is preferred. The upper lip which lies too far anterior or posterior to the lower lip is not perferred. Fifth, they prefer most, according to Angle's Classification of Malocclusion, Class I facial profile which has a slight inclination to Class II division 2. The order of preference is Class I, Class II division 2, Class III, and Class II division 1. Sixth, they prefer the type 2 and 3 of Song's tangents. The facial profile within which A-and B-tangent meet is preferred. The facial profile which has C-tangent that meets with A-tangent slightly posterior to the crossing point of A-and B-tangent or that parallels with B-tangent is preferred.
Adolescent* ; Computer Graphics ; Esthetics ; Female ; Humans ; Judgment ; Lip ; Male ; Malocclusion ; Natural Science Disciplines ; Nose ; Surveys and Questionnaires

Background: The learning environment is an essential factor influencing students’ educational processes and personal quality of life. The purpose of this study was to examine medical students’ perceptions of the learning environment at a medical school over the most recent 4 years and explore possibilities for learning environment reform and revision based on the results. Methods: Participating students were asked about their perceptions of the learning environment using the Dundee Ready Education Environment Measure (DREEM) questionnaire, which was distributed to first-year, third-year, and fourth-year students, representing each learning period. In total, 349 students participated in this study. Analysis of variance was conducted to determine differences in DREEM scores among years and learning periods. Results: There were no statistically significant differences in DREEM scores by year and learning period, except for students’ perceptions of teachers and students’ perceptions of atmosphere. However, in an analysis of differences in DREEM scores in the class of 2018 cohort by learning period, four domains of the DREEM (except for students’ academic self-perceptions) and the total DREEM score were found to be significantly different. Conclusions Students’ perceptions of the learning environment at Kosin University College of Medicine were relatively high. The total score increased from 2019 to 2022, except for 2021. Another significant result was that basic science students had the highest perceptions, whereas students in basic clinical science had the lowest perceptions. To improve the learning environment for medical students, continuing support for students’ emotional stability, learning motivation, physical environment, social relationships, and counseling is essential.

Coronavirus disease 2019 (COVID-19) has had an extremely large impact on methods of teaching and learning, and the need for online learning has grown enormously during the COVID-19 pandemic. Because most professors and students adjusted their mode of teaching and learning to this new context, online learning seemed to be going well. The problem is that distance learning was abruptly adopted as an alternative method of classroom instruction. To increase the effectiveness of online learning, more consideration is needed to explore future directions of creating learning environments. Therefore, this study suggests seven design guidelines for designing learning environments at medical schools based on a theoretical background and experiences from the pandemic. Constructivism and situated learning theory are introduced as the theoretical background for learning environment design, and the basic principles of learning environment design with the paradigm shift to learner-centered classrooms and experiences using EdTech, including HyFlex learning, flipped learning, learning management systems, and interactive learning tools, were used to develop the design guidelines. Each design guideline is strategically matched with the basic principles: learner-centeredness, real-world tasks and contexts, problem-solving, new roles of professors as facilitators or tutors, collaboration, and new perspectives of evaluation and assessment.