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.

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

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: Epidemiological data are crucial in designing policies for the control of human immunodeficiency virus (HIV) infections. There is a lack of data on the epidemiology of HIV in Korean correctional facilities such as jails and prisons. Methods: Clinical characteristics of the study population were collected through a medical record review. Results: The number of people with HIV infection were 83 and the HIV infection prevalence in correctional facilities of Korea was 0.15%. Among them, 10 (12.0%) were diagnosed with the infection when they were incarcerated. The number of drug users was 38 (45.8%).Syphilis-HIV coinfection was observed in 21 (25.3%) patients. Individuals from the group comprising the drug users were more likely to belong to the lesbian, gay, bisexual, transgender, queer (LGBTQ) community, and had a higher incidence of psychological disorders (31.6% vs. 11.1%, P = 0.029; 50.0% vs. 28.9%, P = 0.049, respectively). Conclusion Inmates of correctional facilities showed a five times higher prevalence of HIV infection in Korea, nearly half of whom were drug users.

Background: Epidemiological data are crucial in designing policies for the control of human immunodeficiency virus (HIV) infections. There is a lack of data on the epidemiology of HIV in Korean correctional facilities such as jails and prisons. Methods: Clinical characteristics of the study population were collected through a medical record review. Results: The number of people with HIV infection were 83 and the HIV infection prevalence in correctional facilities of Korea was 0.15%. Among them, 10 (12.0%) were diagnosed with the infection when they were incarcerated. The number of drug users was 38 (45.8%).Syphilis-HIV coinfection was observed in 21 (25.3%) patients. Individuals from the group comprising the drug users were more likely to belong to the lesbian, gay, bisexual, transgender, queer (LGBTQ) community, and had a higher incidence of psychological disorders (31.6% vs. 11.1%, P = 0.029; 50.0% vs. 28.9%, P = 0.049, respectively). Conclusion Inmates of correctional facilities showed a five times higher prevalence of HIV infection in Korea, nearly half of whom were drug users.

PURPOSE: The purpose of this study was to understand the coping experience of nursing students in clinical practice. METHODS: In-depth interview was done with semi-structured questionnaire on 32 nursing students taking clinical practice. Data was analyzed through the grounded theory. RESULTS: Core category of coping experience of nursing students was ‘trying to be a meaningful presence’ while clinical practice. Students' coping strategies were ‘overcoming inexperience’, ‘receiving the recognition from the clinical instructors’, and ‘governing mind and body’. Helping components for their coping behaviors were ‘support from people’, ‘personal experience before clinical practice’, ‘dynamics with partners’. Through the coping experience during clinical practice, nursing students became mature and confirmed their identities as student nurses. CONCLUSION: Nursing students taking clinical practice tried to be a meaningful presence.
Adaptation, Psychological ; Grounded Theory ; Humans ; Nursing* ; Students, Nursing*

Coronary stenting for long complex lesion is effective but associated with complication. We compared the results of stenting between with multiple conventional stenting group (group A) and with single long stenting group (group B). Fifty patients were prospectively and randomly enrolled: 25 patients for each group. Each group showed no significant differences of clinical characteristics. One patient died of heart failure in each group, not associated with the procedure itself. One patients had cerebrovascular accident in each group. Five patients had major bleeding (2, group A; 3, group B). Angiographic success rate was 100% in each group and procedural success rate was 96% and 100% in group A and B, respectively. Angiographic and clinical restenosis rate at 6 months follow-up were 60%, 36% in group A and 65%, 44% in group B, respectively (p=S). Multivariate analysis showed that several factors affected the angiographic restenosis rate as follows; a) male gender (M:F=76.9%:25.0%, P<0.001), b) AMI (AMI:stable angina pectoris=72.7%:66.7%, P<0.001), c) lesion length d) residual stenosis. In conclusion, there were no statistical differences of restenosis and complication rate between the two groups. Our data support single long stenting is acceptable and economically more favorable for long diffuse lesion, compared to multiple conventional stenting.
Constriction, Pathologic ; Coronary Stenosis* ; Coronary Vessels* ; Follow-Up Studies ; Heart Failure ; Hemorrhage ; Humans ; Male ; Multivariate Analysis ; Prospective Studies ; Stents* ; Stroke

PURPOSE: Presenteeism is a relatively new concept in nursing describing the condition within which registered nurses (RNs) come to work while they are sick. The purpose of this study was to explore and describe presenteeism experiences among RNs in South Korea. METHODS: In this constructivist grounded theory study, a focus group interview (FGI) technique was utilized for data collection. A total of 20 RNs at one hospital in Chuncheon city joined in three different FGIs. Semistructured questions were asked in reference to their sickness experience in the workplace. Data analysis was conducted according to the constructivist grounded theory methodology. RESULTS: All participants had experiences of presenteeism. The overriding theme was "having no caring for nurses leads to losing one's nursing mind". The participants reported that due to either their personal preference or peer pressure they showed up to work, but they felt sad and their pride was hurt by the fact that there was no caring for them from other nurses. This emotional exhaustion often led to the loss of compassion and the resignation of nursing staff. CONCLUSIONS: Care for nurses in the workplace is necessary for RNs to make their presenteeism experience positive and even effective.
Adult ; *Attitude of Health Personnel ; Female ; Grounded Theory ; Humans ; Male ; Middle Aged ; Nursing Staff, Hospital/*psychology ; *Presenteeism ; Qualitative Research ; Republic of Korea ; Surveys and Questionnaires ; Workplace/*psychology

Purpose: Intracorporeal esophagojejunostomy during reduced-port gastrectomy for proximal gastric cancer is a technically challenging technique. No study has yet reported a robotic technique for anastomosis. Therefore, to address this gap, we describe our reduced-port technique and the short-term outcomes of intracorporeal esophagojejunostomy. Materials and Methods: We conducted a retrospective review of patients who underwent a totally robotic reduced-port total or proximal gastrectomy between August 2016 and March 2020. We used an infra-umbilical Single-Site® port with two additional ports on both sides of the abdomen. To transect the esophagus, a 45-mm endolinear stapler was inserted via the right abdominal port. The common channel of the esophagojejunostomy was created between the apertures in the esophagus and proximal jejunum using a 45-mm linear stapler. The entry hole was closed with a 45-mm linear stapler or robot-sewn continuous suture. All anastomoses were performed without the aid of an assistant or placement of stay sutures. Results: Among the 40 patients, there were no conversions to open, laparoscopic, or conventional 5-port robotic surgery. The median operation time and blood loss were 254 min and 50 mL, respectively. The median number of retrieved lymph nodes was 40.5. The median time to first flatus, soft diet intake, and length of hospital stay were 3, 5, and 7 days, respectively. Three (7.5%) major complications, including two anastomosis-related complications and a case of small bowel obstruction, were treated with an endoscopic procedure and re-operation, respectively. No mortality occurred during the study period. Conclusions Intracorporeal esophagojejunostomy during reduced-port gastrectomy can be safely performed and is feasible with acceptable surgical outcomes.

Purpose: No consensus exists on whether to preserve or ligate an aberrant left hepatic artery (ALHA), which is the most commonly encountered hepatic arterial variation during gastric surgery. Therefore, we aimed to evaluate the clinical effects of ALHA ligation by analyzing the perioperative outcomes. Materials and Methods: We retrospectively reviewed the data of 5,310 patients who underwent subtotal/total gastrectomy for gastric cancer. Patients in whom the ALHA was ligated (n=486) were categorized into 2 groups according to peak aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels: moderate-to-severe (MS) elevation (≥5 times the upper limit of normal [ULN]; MS group, n=42) and no-to-mild (NM) elevation (<5 times the ULN; NM group, n=444). The groups were matched 1:3 using propensity score-matching analysis to minimize confounding factors that can affect the perioperative outcomes. Results: The mean operation time (P=0.646) and blood loss amount (P=0.937) were similar between the 2 groups. The length of hospital stay was longer in the MS group (13.0 vs.7.8 days, P=0.022). No postoperative mortality occurred. The incidence of grade ≥ IIIa postoperative complications (19.0% vs. 5.1%, P=0.001), especially pulmonary complications (11.9% vs. 2.5%, P=0.003), was significantly higher in the MS group. This group also showed a higher Comprehensive Complication Index (29.0 vs. 13.9, P<0.001). Conclusions Among patients with a ligated ALHA, those with peak AST/ALT ≥5 times the ULN showed worse perioperative outcomes in terms of hospital stay and severity of complications. More precise perioperative decision-making tools are needed to better determine whether to preserve or ligate an ALHA.