Purpose: This study was conducted with a focus group interview that drew out experiences, limitations, and difficulties in the workplace according to the employment conditions of visiting nurses in the public health centers. Methods: A total of 12 visiting nurses are those working in the public sector in Seoul and Gyeonggi province who were willing to participate in the interview. Analysis categories and coding were divided into three categories: compensation system, occupational status, and opinions to improve their treatment. Using the content analysis method, the current working status and compensation system of visiting nurses were described. Results: The main themes derived from the significant statements of visiting nurses were ‘Ten years of frozen salary system’, ‘Full-time workers of their own league’, ‘Excluded from performance benefits’, ‘Every visiting nurses are virtually precarious’, ‘Experience of exclusion and discrimination’, and ‘Reasons and barriers to be a full-time worker’. All of the visiting nurses working in the community insisted on having equal treatment for work of equal value. Visiting nurses in the public health sector wanted to be set to the same payment system and the fair allowance system as well. It is necessary to continuously seek solutions to the problems left in insisting on the civil service of visiting nurses. Conclusion Visiting nurses who were working in a precarious job position felt job insecurity, and experienced discrimination, alienation, and exclusion. Legal and institutional reform is needed to improve the treatment of visiting nurses.

Background: Outcomes of traditional treatment for osteonecrosis of the femoral head (ONFH) are not always satisfactory. Hence, cell-supplementation therapy has been attempted to facilitate necrotic-tissue regeneration. Adipose-derived mesenchymal stem cell (ADMSC) transplantation is potentially advantageous over bone marrow-derived MSC implantation, but its outcomes for ONFH remain unclear. The aim of this study was to determine 2-year radiological and clinical outcomes of culture-expanded autologous ADMSC implantation for ONFH. Methods: Eighteen hips with necrotic lesions involving ≥ 30% of the femoral head were included. ADMSCs were harvested by liposuction and culture expanded for 3 passages over 3 weeks. With a 6-mm single drilling, ADMSCs were implanted into the necrotic zone. All patients underwent magnetic resonance imaging (MRI), single-photon emission computed tomography/computed tomography (SPECT/CT) at screening and 6 months, 12 months, and 24 months postoperatively. The primary outcome was the change in the size of necrotic area on MRI. Secondary outcomes were changes in clinical scores and radioisotope uptake on SPECT/CT. Conversion total hip arthroplasty (THA) was defined as the endpoint. Results: Preoperatively, the necrotic lesion extent was 63.0% (38.4%–96.7%) of the femoral head. The mean Harris hip score was 89.2, the University of California at Los Angeles (UCLA) score was 5.6, and Western Ontario and McMaster Universities Arthritis index (WOMAC) was 79.4. Three patients underwent THA and 1 patient died in an accident. Finally, 11 patients (14 hips) were available for ≥ 2-year follow-up. At the last follow-up, no surgery-related complications occurred, and 14 of 17 hips (82%) were able to perform daily activities without THA requirement. There was no significant decrease in lesion size between any 2 intervals on MRI.However, widening of high signal intensity bands on T2-weighted images inside the necrotic lesion was observed in 9 of 14 hips (64%); 11 of 14 hips (79%) showed increased vascularity on SPECT/CT at 2 years postoperatively. No significant differences were observed between preoperative and 24-month mean Harris hip score (89.2 vs. 88.6), WOMAC (79.4 vs. 75.7), and UCLA score (5.6 vs. 6.2). Conclusions Our outcomes suggest that culture-expanded ADMSC implantation is a viable option for ONFH treatment without adverse events.

Alcohol-induced flushing syndrome is one of the alcohol hypersensitivity reactions commonly found among Asian population. This study was designed to find markers that can predict this particular propensity among Korean population and to assess the applicability of this finding to build a prediction model as forensic DNA phenotyping tool to operate in practical forensic cases. Five hundred seventy unrelated Koreans were genotyped using microfluidic technology with 24 possible candidate single nucleotide polymorphism (SNP) markers. Of the 24 candidate SNPs, four markers, rs671, rs2074356, rs4646776, and rs10849915, on chromosome 12 showed statistically significant association with P-values ranging from 1.39×10⁻¹⁴ to 0.004988 among our subjects. All four markers show relatively high specificity values, ranging from 0.804651 to 0.972093, presenting their capabilities as differential SNPs that can distinguish a person with or without alcohol-induced flushing syndrome. Maneuvering these candidate SNPs as well as finding additional potential markers through future studies will help building an appropriate prediction model for Koreans that can be used as supplementary tool for individual identification.
Alcohols ; Aldehyde Dehydrogenase ; Asian Continental Ancestry Group ; Chromosomes, Human, Pair 12 ; DNA ; Flushing ; Humans ; Hypersensitivity ; Microfluidics ; Polymorphism, Single Nucleotide ; Sensitivity and Specificity

Alcohol-induced flushing syndrome is one of the alcohol hypersensitivity reactions commonly found among Asian population. This study was designed to find markers that can predict this particular propensity among Korean population and to assess the applicability of this finding to build a prediction model as forensic DNA phenotyping tool to operate in practical forensic cases. Five hundred seventy unrelated Koreans were genotyped using microfluidic technology with 24 possible candidate single nucleotide polymorphism (SNP) markers. Of the 24 candidate SNPs, four markers, rs671, rs2074356, rs4646776, and rs10849915, on chromosome 12 showed statistically significant association with P-values ranging from 1.39×10⁻¹⁴ to 0.004988 among our subjects. All four markers show relatively high specificity values, ranging from 0.804651 to 0.972093, presenting their capabilities as differential SNPs that can distinguish a person with or without alcohol-induced flushing syndrome. Maneuvering these candidate SNPs as well as finding additional potential markers through future studies will help building an appropriate prediction model for Koreans that can be used as supplementary tool for individual identification.

BACKGROUND: Mitochondrial heteroplasmy, the co-existence of different mitochondrial polymorphisms within an individual, has various forensic and clinical implications. But there is still no guideline on the application of massively parallel sequencing (MPS) in heteroplasmy detection. We present here some critical issues that should be considered in heteroplasmy studies using MPS. METHODS: Among five samples with known innate heteroplasmies, two pairs of mixture were generated for artificial heteroplasmies with target minor allele frequencies (MAFs) ranging from 50% to 1%. Each sample was amplified by two-amplicon method and sequenced by Ion Torrent system. The outcomes of two different analysis tools, Torrent Suite Variant Caller (TVC) and mtDNA-Server (mDS), were compared. RESULTS: All the innate heteroplasmies were detected correctly by both analysis tools. Average MAFs of artificial heteroplasmies correlated well to the target values. The detection rates were almost 90% for high-level heteroplasmies, but decreased for low-level heteroplasmies. TVC generally showed lower detection rates than mDS, which seems to be due to their own computation algorithms which drop out some reference-dominant heteroplasmies. Meanwhile, mDS reported several unintended low-level heteroplasmies which were suggested as nuclear mitochondrial DNA sequences. The average coverage depth of each sample placed on the same chip showed considerable variation. The increase of coverage depth had no effect on the detection rates. CONCLUSION: In addition to the general accuracy of the MPS application on detecting heteroplasmy, our study indicates that the understanding of the nature of mitochondrial DNA and analysis algorithm would be crucial for appropriate interpretation of MPS results.
Computational Biology ; DNA, Mitochondrial* ; Gene Frequency ; High-Throughput Nucleotide Sequencing* ; Methods ; Sequence Analysis, DNA

Forensic DNA phenotyping (FDP) using human externally visible characteristics (EVCs) is an emerging new technique that allows for the prediction of phenotypic traits of a person of interest using relevant sets of genetic markers. This technique predicts not only physical appearances, but also the behavioral characteristics as well as biogeographical information, serving as a powerful supplementary tool to narrow down the investigative pool in various forensic cases. Over the past few years, many countries, Europe and America being at the forefront, have conducted significant research to identify related markers for predicting pigmentation traits such as eye, hair, and skin color. Furthermore, some commercial platforms are now available for practical use in forensic cases. Korea and other Asian countries have also dedicated remarkable research to identify relevant markers to utilize FDP in forensic investigations. However, a slightly different approach is needed because Asians have limited phenotypic variations than Western populations. Thus, medically irrelevant and simple propensity traits such as smoking and alcohol consumption could be used to compensate for the limited phenotypic variations. This article is intended to inform readers about the progress and worldwide trends in EVC research, as well as the whereabouts and future prospects of FDP-related research in Korea. Although various legal and ethical disputes must be resolved beforehand, employing an FDP system can certainly be a powerful complementary tool for providing additional clues in forensic investigations.
Alcohol Drinking ; Americas ; Asian Continental Ancestry Group ; Dissent and Disputes ; DNA* ; Europe ; Genetic Markers ; Hair ; Humans ; Investigative Techniques ; Korea ; Phenotype ; Pigmentation ; Polymorphism, Single Nucleotide ; Skin Pigmentation ; Smoke ; Smoking

Mitochondrial DNA (mtDNA) genome analysis has been a potent tool in forensic practice as well as in the understanding of human phylogeny in the maternal lineage. The traditional mtDNA analysis is focused on the control region, but the introduction of massive parallel sequencing (MPS) has made the typing of the entire mtDNA genome (mtGenome) more accessible for routine analysis. The complete mtDNA information can provide large amounts of novel genetic data for diverse populations as well as improved discrimination power for identification. The genetic diversity of the mtDNA sequence in different ethnic populations has been revealed through MPS analysis, but the Korean population not only has limited MPS data for the entire mtGenome, the existing data is mainly focused on the control region. In this study, the complete mtGenome data for 186 Koreans, obtained using Ion Torrent Personal Genome Machine (PGM) technology and retrieved from rather common mtDNA haplogroups based on the control region sequence, are described. The results showed that 24 haplogroups, determined with hypervariable regions only, branched into 47 subhaplogroups, and point heteroplasmy was more frequent in the coding regions. In addition, sequence variations in the coding regions observed in this study were compared with those presented in other reports on different populations, and there were similar features observed in the sequence variants for the predominant haplogroups among East Asian populations, such as Haplogroup D and macrohaplogroups M9, G, and D. This study is expected to be the trigger for the development of Korean specific mtGenome data followed by numerous future studies.

BACKGROUND: Total hip arthroplasty with subtrochanteric shortening osteotomy is widely performed for high hip dislocation. However, suboptimal leg length discrepancy correction and nonunion of the osteotomy site remain concerns. Although total hip arthroplasty using trochanteric osteotomy without subtrochanteric osteotomy was introduced, cemented implants have been more commonly used than contemporary cementless implants in this procedure. We evaluated the long-term results of cementless total hip arthroplasty with trochanteric osteotomy without subtrochanteric osteotomy for high hip dislocation. METHODS: From 1990 to 2002, 27 cementless total hip arthroplasties using trochanteric osteotomy without subtrochanteric osteotomy were performed in 26 patients with Crowe III or IV high hip dislocation and a mean age of 36.4 ± 12.9 years. Seven ceramic-on-ceramic, 8 ceramic-on-polyethylene, 10 metal-on-polyethylene, and 2 metal-on-metal bearings were inserted. Mean follow-up was 15.1 ± 3.7 years. We retrospectively reviewed medical records and radiographic data and evaluated the clinical and radiological results including the Harris hip score, implant survival, correction of leg length discrepancy, and occurrence of complications. RESULTS: The mean Harris hip score and leg length discrepancy improved significantly from 73.3 to 94.9 points and from 4.3 cm to 1.0 cm, respectively. With revision for loosening set as the end point, implant survival rates at 10 and 15 years postoperatively were 96.0% and 90.9% for stems and 74.1% and 52.3% for cups. In 8 of 10 hips with the metal-on-polyethylene bearing and 4 of 8 hips with the ceramic-on-polyethylene bearing, revision surgery was performed for aseptic loosening. However, no revision was performed in hips with the ceramic-on-ceramic bearing or the metal-on-metal bearing. Implant survival was significantly different by the type of bearing surface. Two permanent neurologic complications occurred in patients with a limb lengthening over 3.5 cm. CONCLUSIONS: With proper selection of the bearing surface coupled with adjustment of lengthening, cementless total hip arthroplasty using trochanteric osteotomy without subtrochanteric osteotomy might be a favorable treatment option for high hip dislocation.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Crows ; Dislocations ; Extremities ; Femur* ; Follow-Up Studies ; Hip Dislocation* ; Hip Dislocation, Congenital ; Hip* ; Humans ; Leg ; Leg Length Inequality ; Medical Records ; Osteotomy* ; Retrospective Studies ; Survival Rate

Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls.
Accidental Falls/*statistics & numerical data ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Female ; Fractures, Bone/etiology ; Humans ; Incidence ; Interviews as Topic ; Logistic Models ; Male ; Middle Aged ; Postpoliomyelitis Syndrome/*pathology ; Postural Balance ; Republic of Korea ; Risk Factors ; Surveys and Questionnaires ; Telephone ; Young Adult

Recently, it has been reported that transfused patients can generate admixture-like genetic profiles. As genetic material of the donor can survive for a reasonable time after transfusion, the recipient's genomic DNA is likely to have a mixture pattern. An autopsy case of a man transfused perimortem generated a mixture patterned short tandem repeat profile. Notably, the patient was transfused mostly with nuclear-deficient cells, limiting the donor genetic material available for the recipient. As a result, mixture-like patterns were observed consistently, regardless of change in input DNA content; the sample DNA content, which was serially diluted, ranged from 1 ng to 0.0625 ng. The distributions of foreign peaks appeared to be irreproducible, showing stochastic behaviors throughout the genotyped results. This study suggests that a cautious approach is required when genotyping of a patient who has undergone recent transfusion. One must consider the possibility of obtaining a mixture patterned profile in such patients, and therefore, choose parenchymal organs or tissues for reliable results.
Autopsy ; Blood Transfusion ; DNA ; DNA Fingerprinting ; Humans ; Microsatellite Repeats* ; Tissue Donors