BACKGROUNDS: Vaccination is the primary prevention strategy which aims to prevent various vaccine-preventable diseases and its complications. Although immunization practice had been centered on children in Korea, recent epidemic of several vaccine-preventable diseases such as hepatitis A and novel influenza H1N1 made people pay more attention on adult immunization since 2000. METHODS: This article reviews the general recommendations of adult immunization based on the recent report from the US Advisory Committee on Immunization Practices in 2011. New vaccines which have been introduced or will be introduced are briefly reviewed. RESULTS: Following topics are included: 1) principles for vaccine scheduling, 2) spacing of vaccines and antibody-containing products, 3) vaccination in altered immunocompetence, 4) vaccination in special situations, 5) contraindications and precautions, and 6) preventing and managing adverse reactions. Brief information on various influenza vaccines, adult pertussis vaccine, meningococcal vaccine, and zoster vaccine are reviewed and provided. CONCLUSIONS: Updated general recommendations and information on the new vaccines are intended for clinicians and other health-care providers who vaccinate patients.
Adult ; Advisory Committees ; Child ; Hepatitis A ; Herpes Zoster Vaccine ; Humans ; Immunization ; Immunocompetence ; Influenza Vaccines ; Influenza, Human ; Korea ; Meningococcal Vaccines ; Pertussis Vaccine ; Primary Prevention ; Vaccination ; Vaccines

Immunization is the most effective and cost-beneficial means to prevent infectious diseases in adults as well as in children. However, adult immunization has been beyond the center of attention relatively to children's immunization in Korea. Since the Korean Academy of Family Medicine had published "Vaccination for Adults" in 1994, a recent update was done in this field by the Korean Centers for Disease Control and Prevention and the Korean Society of Infectious Diseases. This paper reviews standard immunization for healthy persons and supplementary immunization for persons with underlying diseases based on those recent recommendations. General information, indications, dosage, route of administration, efficacy and safety were reviewed for vaccination of influenza, pneumococcal infection, tetanus, hepatitis A, hepatitis B, human papilloma virus, varicella and measles/mumps/rubella.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Chickenpox ; Child ; Communicable Diseases ; Hepatitis A ; Hepatitis B ; Humans ; Immunization ; Influenza, Human ; Korea ; Papilloma ; Pneumococcal Infections ; Tetanus ; Vaccination ; Viruses

Immunization is the most effective and cost-beneficial means to prevent infectious diseases in adults as well as in children. However, adult immunization has been beyond the center of attention relatively to children's immunization in Korea. Since the Korean Academy of Family Medicine had published "Vaccination for Adults" in 1994, a recent update was done in this field by the Korean Centers for Disease Control and Prevention and the Korean Society of Infectious Diseases. This paper reviews standard immunization for healthy persons and supplementary immunization for persons with underlying diseases based on those recent recommendations. General information, indications, dosage, route of administration, efficacy and safety were reviewed for vaccination of influenza, pneumococcal infection, tetanus, hepatitis A, hepatitis B, human papilloma virus, varicella and measles/mumps/rubella.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Chickenpox ; Child ; Communicable Diseases ; Hepatitis A ; Hepatitis B ; Humans ; Immunization ; Influenza, Human ; Korea ; Papilloma ; Pneumococcal Infections ; Tetanus ; Vaccination ; Viruses

Problem-based Learning challenges students to be more actively involved in defining what they learn and solving the problem. When it proceeds with the Internet, the Internet program will provide learning materials and guide the clinical reasoning process. We developed the PBL casebank database on the web to facilitate development and maintenance of PBL case modules. The database has the 3-tier structure according to the form of the preexistent Internet program, and possible record forms are text, sound files, and image files. This database system is connected with web using ODBC(Qpen DataBase Connectivity) and ASP(Active Server Pages) technology on the Microsoft Windows NT server. With this PBL casebank system, we are hoping for owning medical education materials in common between universities and distance learning in medicine.
Education, Distance ; Education, Medical* ; Hope ; Humans ; Internet* ; Learning ; Problem-Based Learning*

PURPOSE: The purpose of the study was to examine the recording accuracy of faculty observers and standardized patients (SPs) on a clinical performance examination (CPX). METHODS: This was a cross-sectional study of a fourth-year medical students' CPX that was held at a medical school in Seoul, Korea. The CPX consisted of 4 cases and was administered to 118 examinees, with the participation of 52 SP and 45 faculty observers. For the study we chose 15 examinees per case, and analyzed 60 student-SP encounters in total. To determine the recording accuracy level, 2 SP trainers developed an answer key for each encounter. First, we computed agreement rates (P) and kappa coefficient (K) values between the answer key-SPs and the answer key-faculty observers. Secondly, we analyzed variance (ANOVA) with repeated measures to determine whether the mean percentage of the correct checklist score differed as a function of the rater, the case, or the interaction between both factors. RESULTS: Mean P rates ranged from 0.72 to 0.86, while mean K values varied from 0.39 to 0.59. The SP checklist accuracy was higher than that of faculty observersat the level of item comparison. Results from ANOVA showed that there was no significant difference between the percentage of correct scores by the answer key, faculty observers and SPs. There was no significant interaction between rater and case factors. CONCLUSION: Acceptable levels of recording accuracy were obtained in both rater groups. SP raters can replace faculty raters in a large-scale CPX with thorough preparation.
Checklist ; Clinical Competence ; Cross-Sectional Studies ; Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Korea ; Observer Variation ; Schools, Medical

Recent progress in medical informatics enables us to use medical information regardless of time or place, to make a diagnostic and therapeutic plan, according to increasing need about health of general population. There are many homepages on the web, which provides medical common senses, hospital information, and medical counselling on the web. Virtual Hospital, which offers comprehensive media information, has medical counselling program with various programs such as self-diagnosis, emergency information, drug information, Q and A, and so on. The aim of this study is to examine the content and purpose of medical counselling on the web. The subjects consisted of 150 counselings which were called 'Medical Counselling' in the Virtual Hospital for December 1996 through March 1997. Many questioners wanted to know treatment principles. to make a diagnosis, and to know specific medical knowledge, The most common questions are as follows; general and unspecified, digestive, skin, musculoskeletal problems. These findings suggests that medical counselling may be used to supplement the lack of direct medical interviews with doctors.
Counseling* ; Diagnosis ; Emergencies ; Internet* ; Medical Informatics ; Skin

BACKGROUND: Pediatric obesity is an important global issue in public health. However, previous efforts for childhood obesity prevention have sporadically been implemented in Korea, neither evidence-based nor with proper evaluation. We aimed to investigate the characteristics of an effective intervention for prevention of pediatric obesity by reviewing previous systematic reviews and Meta-analyses. METHODS: PubMed was searched for articles published frombetween January 2005 to November 2015. Inclusion criteria were as follows: (1) articles published in English; (2) child and/or adolescents (between 2 and 18 years of age) as subjects; and (3) systematic reviews or meta-analyses concerning the preventive intervention of pediatric/adolescent obesity. Each study was evaluated via the Assessment of Multiple Systematic Reviews for quality assessment. We conducted a quantitative analysis to evaluate the implications, strengths, and limitations of each study. RESULTS: Our final analysis included 35 articles, of which 15 were systematic reviews and 20 were meta-analyses. Among these, 24 studies (69%) advocated the efficacy of preventive intervention for pediatric obesity. Multidimensional approach including diet, exercise, and environmental factors conducted in schools with a parent and community involvement wasis more effective at preventing obesity. The efficacy of intervention varied depending on the age, sex, region, and socioeconomic characteristics of participantssubjects. CONCLUSIONS: Preventive intervention of pediatric obesity demonstrated smallminor improvements in body mass index and had positive effects on behavioral and clinical variables, which are associated with obesity. For the efficient prevention of pediatric obesity, it is necessary to consider efforts for developing various intervention programs, with active as well as the participation of school, family, and social community groups.
Adolescent* ; Body Mass Index ; Child* ; Diet ; Humans ; Korea ; Obesity* ; Parents ; Pediatric Obesity ; Public Health

Medicine in the twenty-first century will be different from the medicine of today. Recent changes in medical environment, such as changes in disease and mortality pattern and rapid increase in medical knowledge, require change and adaptation of medical education. The task of medical education is to help people entering medicine to prepare to meet their professional obligations in this new context. So we tried to join Problem-base learning(PBL), which challenges students to be more actively involved in defining what they learn and how they learn, and Computer-assisted learning(CAL), which uses multimedia and medical informatics as learning tools. Finally we developed Problem-oriented medical education program using the Internet. First, using simulated patient cases, we built clinical database with patients' history, physical examinations, and various laboratory findings. To provide PBL program through the Internet, we constructed client-server system using IJS(Internet Information Server) on Windows-NT settings, and made user-friendly dynamic interface with HTML, JAVA, JAVA Script and so on. PBL on the Web will make students learn effectively and actively, and offer vivid multimedia environment for medical education. We expect this PBL program to be used as an effective learning tool for residents or doctors as well as for medical students in the near future. The Internet
Education, Medical* ; Humans ; Indonesia ; Internet* ; Learning ; Medical Informatics ; Mortality ; Multimedia ; Physical Examination ; Students, Medical

No abstract available.
Cohort Effect ; Cohort Studies ; Female ; Humans ; Menarche

BACKGROUND: Obesity is associated with various chronic diseases, especially abdominal fat affect cardiovascular disease, metabolic disease, diabetes mellitus and mortality. The aim of this study was to estimate the accuracy of the visceral fat area measured by bioelectric impedence analysis (BIA) that easily used in many clinical settings, and to compare with the visceral fat area measured by CT and other abdominal obesity measures. METHODS: Participants were 71 premenopausal adult women whose BMI was over 23 kg/m2. BMI, waist circumference, total abdominal fat area, visceral fat area, subcutaneous fat area by CT and truncal fat by dual-energy X-ray absorptiometry (DEXA) were measured. Visceral fat area measured by Inbody 720 were compared with variables examining abdominal obesity using partial correlation analysis and Bland-Altman analysis. The accuracy of the visceral obesity by BIA was compared with that diagnosed by CT as gold standard. RESULTS: There was significant difference between visceral fat area measured by CT and BIA in women below BMI 30 kg/m2, whereas the difference was not significant in women with BMI > or = kg/m2. Visceral fat area measured by BIA was significantly correlated with visceral fat area measured by CT only in subjects with BMI less than 30 kg/m2 after adjusting for age (r = 0.495, P < 0.01). Bland-Altman plot analysis showed a tendency regardless of BMI status; the more visceral fat area increased, the less the difference between two measures. The sensitivity and the specificity to diagnose visceral obesity by BIA was 50.0%, 81.8% respectively among women with BMI less than 30 kg/m2, and 100.0%, 25.0% respectively among women with BMI > or = 30 kg/m2. CONCLUSION: BIA is not appropriate for evaluation of abdominal visceral obesity.
Abdominal Fat ; Absorptiometry, Photon ; Adult ; Cardiovascular Diseases ; Chronic Disease ; Diabetes Mellitus ; Female ; Humans ; Intra-Abdominal Fat ; Metabolic Diseases ; Obesity ; Obesity, Abdominal ; Sensitivity and Specificity ; Subcutaneous Fat ; Waist Circumference