OBJECTIVE: This study aims to provide alternative care plans for mental health of North Korean refugees who are in protective facilities in China. METHODS: Personality Assessment Inventory (PAI) was utilized to measure the presence/absence of post traumatic stress disorder (PTSD) among 65 North Korean refugees. RESULTS: The gender differences in PAI t-scores showed that women exhibited meaningfully higher scores largely in anxiety (m=61.85), depression (m=65.23), and schizophrenia (m=60.98). In different age groups, schizophrenia in the 30 age bracket (m=65.23) was meaningfully higher than the teens (m=48.11). Aggression among the treatment features was the highest in the 20 age group (m=59.19) showing higher t-scores than the teens (m=39.67). Duration in the facility affected mental health in that the 3-5 years group (m=63.91) reported the highest in paranoia. Groups of under 1 year and less than 1-3 years showed meaningfully higher scores in nonsupport. The PTSD (including partial PTSD) rate of the group recorded 9.2%. Correlation between the PTSD and PAI scores showed that the full-PTSD group demonstrated higher average scores in negative impression, somatic complaints, anxiety, anxiety-related disorder, depression, paranoia, schizophrenia, antisocial features, suicide ideation, and treatment rejection than the non-PTSD group. CONCLUSION: Mental health of North Korean refugees in China was worse in women, the thirties, and less than 3-5 years in the facility, and it deteriorated as the duration prolonged. To promote better psychological health of North Korean refugees in China, the attention and aid from the protection facilities and domestic and international interests are required.
Adolescent ; Aggression ; Anxiety ; China* ; Depression ; Female ; Humans ; Mental Health* ; Paranoid Disorders ; Personality Assessment ; Refugees* ; Schizophrenia ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic ; Suicide

OBJECTIVES: This study evaluated the quality of life (QoL) of North Korean defectors in South Korean society in the year 2007 for purposes of comparing it to their QoL in 2004 and identifying demographic variables that influence QoL. METHODS: We used the Korean version of WHOQoL-BREF to evaluate the QoL of 106 North Korean defectors. Other instruments included a questionnaire for discerning demographic data, life experiences, and physical health. RESULTS: For last 3 years, more defectors had higher education, married, and higher income. However, their unemployment numbers did not decrease, while their number of believers in a religion did decrease. QoL scores remained low in the areas of negative feelings, financial resources, dependence on treatment and drugs, recreation and leisure activities, and opportunities for new information and skills, but were high in areas of cognitive mental functions, personal beliefs, work capacity, self-esteem, and transportation. Path analysis suggested that the psychological domain influenced overall QoL while other domains influenced overall QoL indirectly, through the psychological domain. Since 2004, defectors' QoL in the physical domain and in opportunities for education and transportation had improved, while QoL with regard to pain and discomfort, mobility, and negative feelings had worsened. Variables that were negatively correlated with QoL included male sex, higher age, being married, experiencing army service in North Korea, and shorter stays in third countries. In South Korea, QoL was negatively correlated with current physical illness but positively correlated to having a family, a stable job, higher income, and someone to talk with. CONCLUSION: These results suggest that defectors' QoL would be improved by tailored services according to their sex and age, focusing on educational programs to provide new information and skills, support for building families, health services, and community support.
Democratic People's Republic of Korea ; Follow-Up Studies ; Health Services ; Humans ; Leisure Activities ; Life Change Events ; Male ; Mental Health ; Quality of Life ; Surveys and Questionnaires ; Recreation ; Republic of Korea ; Transportation ; Unemployment

OBJECTIVE: Although clinical practice guidelines recommend oral vancomycin for hospitalized patients with severe Clostridium difficile infection (CDI), oral metronidazole is still the preferred regimen due to its tolerability and low cost. In this study, we aimed to compare the clinical efficacy based on clinical cure, recurrence, and 30-day mortality of oral metronidazole and oral vancomycin in treating severe CDI. METHODS: The medical records of patients with the diagnosis of severe CDI in a tertiary hospital in South Korea, between June, 2006 and December, 2013, were analyzed. RESULTS: A total of 162 severe CDI patients were enrolled for this study: 139 received oral metronidazole and 23 received oral vancomycin. The rate of clinical cure was not significantly different between treatments (79.86% for oral metronidazole and 82.61% for oral vancomycin, P>0.99). The rate of recurrence was comparable (20.77% vs. 18.18% for metronidazole and vancomycin, respectively; P>0.99), as was the rate of 30-day mortality (9.35% vs. 4.35%, P=0.69). Risk factors for treatment failure were histamine-2 antagonist treatment (odds ratio [OR], 4.34; 95% confidence interval [CI], 1.64–11.51; P=0.0032) and fever (OR, 2.43; 95% CI, 1.0–5.8; P=0.049). CONCLUSION: The clinical efficacy of oral metronidazole for severe CDI was no difference from oral vancomycin, in a real world setting. Oral metronidazole can be a reasonable option for treating severe CDI.
Clostridium difficile* ; Clostridium Infections ; Clostridium* ; Diagnosis ; Fever ; Humans ; Korea ; Medical Records ; Metronidazole* ; Mortality ; Recurrence ; Risk Factors ; Tertiary Care Centers ; Treatment Failure ; Treatment Outcome ; Vancomycin

OBJECTIVE: This study aims to observe the factors that influence the development of national identity of North Korean refugees who have resettled in South Korea. METHODS: The study population was comprised of 500 North Korean refugees who immigrated to South Korea in 2007. The variables measured national identity as South Korean, a scale for discrimination perceived during daily life, a social for supporting social network, a for childhood trauma experience, traumatic experiences in North Korea, and traumatic experiences during the escape process. Factor analysis was conducted on the result from the scale for national identity as South Korean which produced 4 factors including national consciousness, positive emotions, positive values, and negative values. Multiple regression was done to identify how variables such as demographic data, discrimination, social network, and past trauma had influenced each of 4 factors. RESULTS: National identity was negatively related by traumatic experience during childhood, perceived discrimination, and positively influenced by social networks. Positive emotion was related negatively to education level in North Korea and perceived discrimination, but positively related to traumatic experiences in North Korea. Negative value was related positively age and perceived discrimination but negatively related to supporting social network. CONCLUSION: The results of this study suggests that promoting social networks, decreasing discrimination and healing past traumas were important factors for North Korean refugees in South Korea to facilitate a new national identity as a South Korean.
Consciousness ; Democratic People's Republic of Korea ; Discrimination (Psychology) ; Humans ; Refugees ; Republic of Korea ; Social Discrimination ; United Nations

OBJECTIVES: North Korean defectors' comprehension of South Korean society and satisfaction with their lives in South Korea both symbolize their adaptation to their new society. The current report is an analysis of three serial panel studies of 200 North Korean defectors who entered South Korea in 2000. METHODS: From February 2009 to March 2009, we interviewed 121 defectors face-to-face. RESULTS: The results showed that the participant's satisfaction level had been relatively well-maintained, and their understanding of the South Korean culture and language had increased. However, their attitudes toward fellow North Korean defectors had worsened. Their satisfaction level with government support for medical care was very low. Gender, age, level of education in North Korea, Communist Party membership, completion of military service, and current employment status had significant influences on their interpretation and understanding of South Korea. CONCLUSION: The results suggest creating North Korean defector self-help groups, strengthening the medical support system, developing programs tailored according to defectors' different backgrounds, gender, age, and educational levels, as well as increasing South Koreans' awareness of these North Koreans through a appropriate campaign, will be necessary for the peaceful unification of the Korean Peninsula.
Comprehension ; Democratic People's Republic of Korea ; Employment ; Humans ; Military Personnel ; Republic of Korea ; Self-Help Groups

OBJECTIVES: The aim of this study was to examine the change in attitudes and satisfaction level of North Korean defectors in South Korea over a 3 year period (2001-2004). METHODS: In our first study in 2001, a total of 200 defectors were interviewed. In the follow up study after 3 years, 151 defectors were re-interviewed by an in-person interview. RESULTS: The level of satisfaction to the governmental support policy to defectors decreased significantly. However, the general level of satisfaction increased slightly (from 3.52 to 3.56 ; 5-score scale). This shows that North Korean defectors are stably adapting to South Korean society. The level of satisfaction significantly correlated with the defectors' confusion of the different value systems, the defectors' understanding of the South Korean people, satisfaction with their physical and mental health, and the prejudice of South Korean people to defectors. In terms of the attitudes, the type of schooling, the military service and the communist party membership in North Korea were not related to the change in attitude. However, there was a significant correlation with gender and age. Women showed a greater change in attitude compared to men. Older people had difficulty in understanding the South Korean people, but they showed little psychological affiliation to North Korea. Moreover, they showed a high level of satisfaction with the economic situation in South Korea and had an optimistic viewpoint for their future than younger people. Even though many defectors attended churches, religion was not associated with the level of satisfaction or their change in attitude. CONCLUSION: The factors that influence the level of satisfaction and attitudes of North Korean defectors have changed over 3 years. Therefore, the government, nongovernmental organizations (NGOs) associated with defectors and the churches need to be more sensitive to these changes and make plans to support the adaptation of defectors to South Korean society.
Democratic People's Republic of Korea ; Female ; Follow-Up Studies* ; Humans ; Korea* ; Male ; Mental Health ; Military Personnel ; Prejudice ; Refugees ; Thinking*

BACKGROUNDThere has been continuous debate as to whether Y chromosome loss is an age related phenomenon or a cytogenetic marker indicating a malignant change. This study aimed to investigate the frequency of Y chromosome loss in the specific patients in order to determine whether it is an age related phenomena or a cytogenetic marker indicating a malignant change.

METHODSFive hundred and ninety-two male patients with a median age of 59 years old (22 - 95 years) were included in this study. These patients were divided into two groups: the study group, including 237 patients who had hematological disorders included myeloproliferative disorder (MPD), myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), multiple myeloma (MM), and lymphoma and the control group including 355 patients with no evidence of hematological disease. Both conventional cytogenetics and fluorescence in situ hybridization using DNA probes specific for the centromere of chromosomes X or Y were performed according to our standard laboratory protocols.

RESULTSTwenty-four out of 237 patients with hematological disorders (10.1%) had Y chromosome loss. Of these 24 patients, 2 patients had AML (5.0% of all AML patients), 2 patients had CML (5.7% of all CML patients), 2 patients had MPD (8.0% of all MPD patients), 3 patients had MM (10.0% of all MM patients), 5 patients had lymphoma (10.6% of all lymphoma patients) and 10 patients had MDS (16.7% of all MDS patients). Twenty-one out of these 24 patients had a loss of Y chromosome as the sole anomaly and the remaining three had a loss of Y chromosome accompanied with other structural changes detected by conventional cytogenetic analysis. Fluorescence in situ hybridization (FISH) analysis confirmed the routine cytogenetic results. All 24 patients had a loss of Y chromosome with a range of 17.5% - 98.5% of cells. Two of the patients, one with AML and another with CML, had karyotype and FISH testing done both at the initial diagnosis and during remission. The results showed a loss of Y chromosome at initial diagnosis but a normal 46, XY karyotype during remission. Only 9 out of 355 patients (2.5%) without evidence of hematological disease had Y chromosome loss, among them 7 patients had cardiovascular diseases and 2 patients had kidney diseases. Comparison of the incidence of Y chromosome loss in patients with hematological disorders or without evidence of hematological disease using statistical analysis showed a statistically significance difference (P < 0.05).

CONCLUSIONSThe present study demonstrated that the frequency of Y chromosome loss is significantly higher in patients with hematological disorders than in patients without hematological disorders, which indicates that the loss of Y chromosome is associated with a neoplastic change.

Adult ; Aged ; Aged, 80 and over ; Chromosome Deletion ; Chromosomes, Human, Y ; Hematologic Diseases ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia ; genetics ; Lymphoma ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Retrospective Studies

OBJECTIVE: This study was conducted at Hanawon-a government sponsored educational facility for the settlement of North Korean refugees during their initial phase in South Korea-in 2004 to explore their mental health status and traumatic experiences in North Korea and during their escape period. METHODS: A survey was conducted in November 2004 with 62 North Korean refugees at Hanawon, and the Trauma Checklist was used to measure their traumatic experiences. To measure their psychological-mental health status, the Personality Assessment Inventory was administered. RESULTS: In comparison with the traumatic experiences of the North Korean refugees found in the study conducted in 2001 at Hanawon using the same methods, the current study showed a relatively lower frequency of traumatic experiences among the participants. The Personality Assessment Inventory results revealed that the study participants scored higher than average South Koreans in all clinical scales. Particularly, their mania (62.51) and schizophrenia (61.75) scores were above 60, a clinically meaningful score. In the gender comparison, the males exhibited meaningfully higher levels of alcohol problem, non-support, and warmth scale scores. CONCLUSION: Compared to the 2001 study, the overall traumatic experiences among North Korean refugees participated in this study. But continous support is necessary for their successful adaptation to South Korean Society have declined. The North Korean refugees at Hanawon experienced difficulties maintaining their mental health and the men in particular requested more intensive care and support for this purpose.
Bipolar Disorder ; Checklist ; Democratic People's Republic of Korea ; Humans ; Critical Care ; Korea ; Male ; Mental Health* ; Personality Assessment ; Refugees* ; Schizophrenia ; United Nations ; Weights and Measures

OBJECTIVES: The present study aimed to analyze the factors that could affect the health-promoting behaviors of North Korean adolescent refugees residing in South Korea. METHODS: Questions about their sociodemographic variables, subjective health status, healthy living habits, and health-promoting behaviors were asked. RESULTS: Statistically significant differences were found in religion (t=2.30, p<0.05), having family members in South Korea (t=2.02, p<0.05), and subjective health status (t=4.96, p<0.01). Scores on health-responsible behaviors were higher with higher age (t=2.90, p<0.01) and for subjects without family or friends (t=2.43, p<0.05). Higher physical-activity behaviors were observed in males (t=3.32, p<0.01), in those with better subjective health status (t=3.46, p<0.05) and lower body mas index (t=3.48, p<0.05), and in smokers (t=3.17, p<0.01). Nutritional behaviors were higher in those who followed a religion (t=2.17, p<0.05). Spiritual growth behaviors were higher in those who followed a religion (t=4.21, p<0.001), had no family in South Korea (t=2.04, p<0.05), and had higher subjective health status (t=5.74, p<0.01). Scores on interpersonal relationships and stress-management behaviors were higher for those with higher subjective health status. A multiple regression analysis showed greater effects on health-promoting behaviors when subjective health status was better. Older people and non-smokers exhibited more health-responsible behaviors, while more physical-activity behaviors and spiritual growth activities were observed when subjective health status was better. Interpersonal relationship behaviors had positive effects on those with good subjective heath status and on non-smokers. CONCLUSIONS: Based on the results of the current study, an alternative was suggested for promoting health in North Korean adolescent refugees.
Adolescent ; Adolescent Behavior/psychology ; Body Mass Index ; Democratic People's Republic of Korea ; Female ; Health Behavior ; *Health Promotion ; Health Status ; Humans ; Male ; Refugees/*psychology ; Republic of Korea ; Socioeconomic Factors ; Surveys and Questionnaires ; Young Adult

Staphylococcus schleiferi has been infrequently reported as a human pathogen. We experienced the case of vascular access infection by Staphylococcus schleiferi in a 65-year-old hemodialysis patient. Metastatic infection occurred despite the removal of infected focus and appropriate antibiotic therapy. This case highlights the importance of considering Staphylococcus schleiferi as a true pathogen in vascular access infection with hemodialysis patients.
Aged ; Humans ; Renal Dialysis* ; Staphylococcus*