PURPOSE: this study was carried out to identify family environmental factors related to changes in sexual attitudes through a sexuality education based on correct sexual attitude for middle school students. METHODS: The subjects were 141 students (67 boys and 74 girls) in 4 classes of the first grade of a coeducational middle school, in Seoul. The school nurse provided the sexuality education for 18 hours over 16 weeks. RESULTS: After the sexuality education, there was a significant increase in sexual attitude(t=59.06, p<.001). For family environmental factors related to changes in sexual attitude, 'relationship with parents' was a significant factor for both boys and girls. For the girls, there were many other related factors such as 'parents' openness', 'family structure', and 'economic status'. Significant factors were 'Family structure' for attitude to abortion and 'parents' openness' for attitude to intercourse before marriage. CONCLUSIONS: Based on these results, systematic sexuality education is needed to enhance correct sexual attitudes in youth. To increase the effect of sexuality education, it should include contents to improve relationships with patents. Also, for parents, programs to improve relationships with their children and to change the values such as openness may also be required.
Adolescent ; Child ; Education ; Female ; Humans ; Marriage ; Parents ; Seoul ; Sex Education* ; Sexuality

Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox’s proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

PURPOSE: The purpose of this study was to analyze the effect of emergency contraceptive pill on adolescent sexuality and contraceptive behaviors through a meta - analysis of intervention studies on advance provision of emergency contraceptives. This study aimed to provide objective data on the transition of general medicines to be discussed in relation to the reclassification of emergency contraceptive pills. METHODS: Using electronic database, 1,820 studies written in Korean or English without limitation of the year were reviewed and for analysis, 5 studies were selected, in which emergency contraceptives were provided to adolescents. RESULTS: The advance provision of emergency contraceptives has increased their use and shortened the time it takes to take contraceptive pills after unprotected sex. There was no change in the frequency of engaging in sexual intercourse and unprotected sex or in existing contraceptive behavior, pregnancy rates decreased, but there was no increase in sexually transmitted infection. CONCLUSION: The results of this study provide objective grounds for the reclassification of emergency contraceptive pills and propose effective interventional programs on contraceptive education, such as on efficacy and side effects of the contraceptive drug and its proper use among the youth who engage in sexual activity, to improve their reproductive health.
Adolescent* ; Coitus ; Contraception Behavior ; Contraceptives, Postcoital* ; Education ; Emergencies* ; Humans ; Pregnancy Rate ; Reproductive Health ; Sexual Behavior* ; Sexuality ; Sexually Transmitted Diseases ; Unsafe Sex

Objectives: . Cochlear implants are widely used for hearing rehabilitation in patients with profound sensorineural hearing loss. However, Cochlear implants have variable results, and central neural plasticity is considered to be a reason for this variability. We hypothesized that resting-state cortical networks play a role in conditions of profound hearing loss and are affected by cochlear implants. To investigate the resting-state neuronal networks after cochlear implantation, we acquired 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) images in experimental animals. Methods: . Eight adult domestic cats were enrolled in this study. The hearing threshold of the animals was within the normal range, as measured by auditory evoked potential. They were divided into control (n=4) and hearing loss (n=4) groups. Hearing loss was induced by co-administration of ethacrynic acid and kanamycin. FDG-PET was performed in a normal hearing state and 4 and 11 months after the deafening procedure. Cochlear implantation was performed in the right ear, and electrical cochlear stimulation was performed for 7 months (from 4 to 11 months after the deafening procedure). PET images were compared between the two groups at the three time points. Results: . Four months after hearing loss, the auditory cortical area’s activity decreased, and activity in the associated visual area increased. After 7 months of cochlear stimulation, the superior marginal gyrus and cingulate gyrus, which are components of the default mode network, showed hypermetabolism. The inferior colliculi showed hypometabolism. Conclusion . Resting-state cortical activity in the default mode network components was elevated after cochlear stimulation. This suggests that the animals’ awareness level was elevated after hearing restoration by the cochlear implantation.

PURPOSE: The purpose of this study was to identify menstrual distress, coping method and relief of symptoms among female nurses who worked with 3-shift. METHODS: A total of 185 participants were recruited from November 18, 2011 to January 30, 2012. The measurement included menstrual distress and coping method questionnaire and relief of symptoms. The data were analyzed using t-test, ANOVA, Pearson's correlation coefficients with SPSS 19.0. RESULTS: The level of menstrual distress was moderate (mean 3.0), and there were significant differences in menstrual distress by age, education, stress, regularity of menstrual cycle. Among the coping methods, coping according to menstrual cycle specific was the most frequently used, followed by active recognizing coping, active behavioral coping, and avoidance coping. Among the degree of symptom relief, symptom relief score was the highest when used coping according to menstrual cycle specific. Menstrual distress was associated with stress, adequate amount of sleep, dysmenorrhea and number of coping method total. CONCLUSION: Nurses experienced moderate levels of menstrual distress and used various types of coping to relieve it. There is a need for hospital nurses to develop an effective nursing intervention to relieve the menstrual distress and utilize active coping methods.
Dysmenorrhea ; Female ; Humans ; Menstrual Cycle ; Menstruation ; Surveys and Questionnaires

Background and Objectives: Real-world trends in the utility and type of gatekeeping studies in invasive coronary angiography (ICA) requires further investigation. Methods: We identified outpatients who underwent noninvasive cardiac tests or directly ICA for suspected coronary artery disease (CAD) from the nationwide Korea Health Insurance Review and Assessment Service-National Patient Sample database between 2012 and 2018. Results: Among 71,401 patients, the percentage of patients who were evaluated for suspected CAD was 34.7% for treadmill test (TMT), 4.2% for single-photon emission computed tomography (SPECT), 24.2% for coronary computed tomography angiography (CCTA), 1.6% for multiple gatekeepers, and 32.3% for directly ICA without noninvasive studies. The proportion of CCTA as a gatekeeper showed linear increase, (18.6% in 2012 and 28.8% in 2018; p<0.001), while those of TMT, SPECT, and direct ICA have decreased (p<0.001, p=0.03, and p<0.001, respectively). The overall incidence of downstream ICA after gatekeeper was 13.8% (6,662/48,346), and SPECT showed higher ICA rate in pairwise comparison with TMT and CCTA (p<0.001). Patients who performed gatekeepers before ICA showed higher rate of subsequent PCI (34.7% vs. 32.3%; p<0.001) and CABG (3.5% vs. 1.0%; p<0.001), compared to those who directly underwent ICA, and CCTA was associated with higher revascularization rate after ICA in pairwise comparison with TMT and SPECT (p<0.001). Conclusions Nationwide database demonstrated that CCTA is utilized increasingly as a gatekeeper for ICA and is associated with high revascularization rate after ICA in outpatients with suspected CAD.

Background: Injury is a social problem that causes health and property losses, and it is important to identify the size and trend of injury for efficient prevention and management.Therefore, this study analyzed the trends in injury mortality and hospitalization rates from 2005 to 2019 in Korea. Methods: Using mortality data by Statistics Korea and Korea National Hospital Discharge In-depth injury survey by the Korea Disease Control and Prevention Agency (KDCA), age standardized rates were calculated for death and hospitalization to analyze trends and annual changes with the joinpoint regression model. In addition, annual changes in the hospitalization rate of the transport accident and fall injuries by age group were analyzed, which are the major causes of injuries. Results: From 2005 to 2019, the injury mortality rate has been on the decline, but the injury hospitalization rate has been on the rise. The annual rate of change varied depending on the injury mechanism, but the mortality rate tended to decrease or remain similar level, while the rate of hospitalization has steadily increased. In addition, by age group, injury mortality and hospitalization rates were high in the elderly. In particular, the hospitalization rate of the elderly was higher when comparing the hospitalization rate of the children in transport accidents and falls. Pedestrian transport accidents tended to decrease under the age of 15, but remained similar for those aged 65 and older, and bicycle accidents tended to increase in both groups. In addition, hospitalization rates were higher in the fall, with both groups showing a statistically significant increase in hospitalization rates caused by falls. Conclusion This study analyzed the trend of injury mortality and hospitalization and found that transport accidents and falls may vary depending on the means or age of the accident.Since injury is a big social problem that is a burden of disease, safety education and legal sanctions for injury prevention should be further improved in the future, especially by prioritizing vulnerable groups by age and detailed mechanisms of injury.

Purpose: To analyze growth patterns over 2 years after birth according to preterm infant birth weight and length percentiles. Methods: Anthropometric measurements of 82 preterm infants were retrospectively reviewed. Preterm infants with birth weight or length below the 10th percentile were classified as small for gestational age (SGA) (n=19) and those between the 10th and 89th percentile as appropriate for gestational age (AGA) (n=63). The association between the length standard deviation score (SDS) at 2 years of corrected age and clinical factors were analyzed. Results: The length SDS of the SGA group was significantly increased at 6 months (-1.30±1.71) and 24 months (-0.97±1.06) of corrected age. The length SDS was lower in the SGA group than those in the AGA group at 6 months (-1.30±1.71 vs. -0.25±1.15, P=0.004), 18 months (-0.97±1.39 vs. -0.03±1.29, P=0.015), and 24 months (-0.97±1.06 vs. -0.29±1.12, P=0.022,). The percentage of children with a length SDS of <-2 (growth failure) at 24 months was 15.8% in the SGA group and 4.8% in the AGA group (P=0.108). Multiple linear regression analysis demonstrated that length at 24 months of corrected age was negatively correlated with birth length below the 10th percentile (coefficient β=-0.91, P=0.001) and duration of stay in the neonatal intensive care unit (NICU) (coefficient β=-0.01, P=0.001). Conclusion Despite the fact that catch-up growth occurs during the early period of infancy in a large portion of preterm SGA infants, a significant portion of these infants show growth failure at 24 months of age. Growth over 2 years after birth is affected by birth length and duration of stay in the NICU in preterm children.

BACKGROUND/OBJECTIVES: Male hypogonadism is a condition where the body does not produce enough testosterone and significantly impacts health. Age, obesity, genetics, and oxidative stress are some physiological factors that may contribute to testosterone deficiency.Previous studies have shown many pharmacological benefits of Schisandra chinensis (S. chinensis) Baillon as an anti-inflammatory and antioxidant. However, the molecular mechanism of attenuating hypogonadism is yet to be well established. This research was undertaken to study the effects of S. chinensis extract (SCE) on testosterone deficiency.MATERIALS/METHODS: S. chinensis fruit was pulverized and extracted using 60% aqueous ethanol. HPLC analysis was performed to analyze and quantify the lignans of the SCE. RESULTS: The 2,2-diphenyl-2-picrylhydrazyl and 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) scavenging assays confirmed that the SCE and its major lignans (schisandrol A and gomisin N) inhibit oxidative stress. Effects of SCE analysis on the testosterone level under oxidative stress conditions revealed that both schisandrol A and gomisin N were able to recover the lowered testosterone levels. Through mRNA expression of TM3 Leydig cell, we observed that the SCE lignans were able to induce the enzymes involved in testosterone biosynthesis-related genes such as 3β-HSD4 (P < 0.01 for SCE, and P < 0.001 for schisandrol A and gomisin N), 17β-HSD3 (P < 0.001 for SCE, schisandrol A and gomisin N), and 17, 20-desmolase (P < 0.01 for schisandrol A, and P < 0.001 for SCE and gomisin N). CONCLUSIONS These results support that SCE and its active components could be potential therapeutic agents for regulating and increasing testosterone production.

Background: The rapid economic development of South Korea provides a unique model to study changes in the clinical characteristics, treatment approaches, and clinical outcomes of patients with rheumatic mitral stenosis (MS) relative to socioeconomic growth. Methods: From the Multicenter mitrAl STEnosis with Rheumatic etiology (MASTER) registry, 2,337 patients diagnosed with moderate or severe rheumatic MS between January 2001 and December 2020 were analyzed. Patients were grouped into consecutive 5-year intervals based on their year of diagnosis. Clinical characteristics, echocardiographic data, and clinical outcomes were assessed. Results: Over 20 years, the severity of mitral stenosis increased from 79.1% to 90.2%; similarly, the average age at diagnosis increased from 54.3 to 63.0 years (all P < 0.001). Comorbidities such as hypertension and atrial fibrillation increased (6.3% to 29.5% and 41.4% to 46.9%, respectively; all P for trend < 0.05). The rate of mitral intervention within five years after diagnosis increased from 31.2% to 47.4% (P for trend < 0.001). However, clinical outcomes of rheumatic mitral stenosis deteriorated over time in the composite outcomes (log-rank test, P < 0.001). Conversely, the incidence of stroke remained stable (60.6–73.7%; P < 0.001), which might be attributed to the increased use of anticoagulation therapy. Conclusion This study observed an increase in patient age, comorbidities, and valve disease severity as the country transitioned from a developing to developed status. Despite a rise in mitral valve interventions, clinical outcomes deteriorated over 20 years, highlighting the need for modified treatment approaches to improve patient outcomes.