Purpose: Since the division of the Korean Peninsula into South and North Korea in 1948, the gaps in the medical system and the socioeconomic status between these 2 countries has expanded. The purpose of this study was to analyze the distribution of different areas of research, as well as the types of research that was conducted in the North Korean medical journal, ‘Pediatrics, Obstetrics and Gynecology.’ This study aimed to specifically investigate the medical research status of healthcare in women and children. Methods: This study analyzed a total of 949 papers that were published in the North Korean medical journal, ‘Pediatrics, Obstetrics and Gynecology.’ Papers from January 2015 to December 2019 were included. For the analysis, the 8th Korean Standard Classification of Diseases, disease name, subspecialty classification, and research classifications were extracted from the papers.Result: Of the 949 papers included in the analysis, 495, 366, and 88 studies were conducted in the major fields of obstetrics and gynecology, pediatrics, and on breast surgery, respectively. Within the field of obstetrics and gynecology, the most studied subspecialties were maternal and fetal medicine, general gynecology, and gynecologic oncology. To a lesser extent, the following subspecialties were reported: gynecologic endocrinology (6.7%), infertility (6.3%), and urogynecology (approximately 1%). Conclusion Although North Korean papers differ from those published worldwide (due to government intervention), they are still a useful source of information as they are easier to access than alternative data sources. The results from this study have implications for understanding the distribution of research on different areas of healthcare, as well as the burden of healthcare in North Korea.

Schwannomas are slow-growing benign tumors originating from the Schwann cells of the peripheral nerve sheaths. Herein, we report the first documented case of a schwannoma presenting as a painful nipple mass in a 32-year-old woman. This mass initially developed six years ago following a period of breastfeeding. Breast magnetic resonance imaging (MRI) scans revealed an iso-intense mass, with an approximate size of 2.2 cm, on a T1-weighted image with internal cystic changes. The mass exhibited heterogeneously delayed enhancement and restricted diffusion.Surgical excision was performed, and the diagnosis of cutaneous plexiform nipple schwannoma was confirmed histopathologically. A literature review revealed that the MRI findings of the nipple mass in our case were consistent with the common features of a schwannoma.

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is performed to provide enteral nutrition to patients who require tube-feeding support due to impaired oral intake. As life expectancy increases, the need for, and use of PEG also tend to increase. We aimed to evaluate the indications and complications of PEG insertion, and to investigate any differences in the complication group. MATERIALS AND METHODS: We conducted a retrospective analysis of 109 patients who received a PEG procedure between April 2011 and April 2016 in the Korea University Ansan Hospital. We reviewed the indications and complications related to PEG insertion and time interval of tube change. RESULTS: Among 109 patients who underwent a PEG procedure, 71.6% were male, and the mean age was 68.2 years. The most common indications for PEG were central nervous system diseases, including stroke (33.9%), cerebral hemorrhage (29.4%), and hypoxic brain damage (8.3%). The overall complication rate was 14.7%, and the most common complication was peristomal infection (7.3%). Most of the complications occurred within 10 days in 14 of 16 patients (87.5%). The patients with complications were older than those without complications (74.6±11.1 vs. 67.1±14.0 years, P=0.043). The mean time interval for gastrostomy tube change was 7.3 months. CONCLUSIONS: The most common indication of PEG was brain disease, and the complication rate cannot be ignored. Careful attention is needed after a PEG procedure especially in elderly patients.
Aged ; Brain Diseases ; Central Nervous System Diseases ; Cerebral Hemorrhage ; Endoscopy ; Enteral Nutrition ; Gastrostomy* ; Gyeonggi-do ; Humans ; Hypoxia, Brain ; Korea ; Life Expectancy ; Male ; Retrospective Studies* ; Stroke

Retinal detachment is a rare disease in children but cases of serous retinal detachment due to use of systemic corticosteroids have been reported in and out country. Rhematogenous retinal detachment has developed in a child with oral and steroid pulse therapy due to nephrotic syndrome. He was treated with laser and buckling in right and left eye respectively. Currently he is under observation through the out patient department.
Adrenal Cortex Hormones ; Child* ; Humans ; Nephrotic Syndrome* ; Rare Diseases ; Retinal Detachment* ; Retinaldehyde*

BACKGROUND: Every practitioner, however skilled, will encounter patients who are unexpectedly difficult to intubation. The incidence of difficult laryngoscopy appears to be approximately 0.5% to 2%. So many methods are used to intubate the trachea, but endotraheal intubation by them is not always possible. The purpose of the this study is to evaluate the effectiveness of magnet on the endotracheal intubation. METHODS: Twenty patients(aged 30 to 59yr, ASA physical status 1) required general anesthesia with an endotracheal tube. Anesthesia was induced with thiopental sodium and succinylcholine, ventilation was controlled with 100% O2. The tip of the epiglottis was exposed wtih a No.3 MacIntosh laryngoscope. A catheter with ferrous stylet was placed behind epiglottis close to tracheal lumen and a magnet was placed over the cricoid cartilage allowing the stylet to be pulled. Endotraheal tube was guided into the trachea over the stylet. The time to intubation, the blood pressure and heart rate of pre- and postintubation, and the difficulty of intubation were recorded and the complications of the endotracheal intubation such as bronchial spasm, oral and tracheal mucosal trauma, and sore throat, were observed. RESULTS: The mean time to intubation was 31.2+/- 8(18 to 50)sec. There were statistically signigicant increase in blood pressure and heart rates following intubation. The incidence of excellent and good intubating condition were 14 and 6 respectively. Seventeen and three intubations were successful on the 1st and 2nd attempts respectively. There were no differences in incidence of complications of endotracheal intubation compared to other reports. CONCLUSIONS: Though magnet guided technique has some limitations to use in case of difficult laryngoscopy, it can be used with merits such as simplicity and cheapness when other methods are not available.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Bronchial Spasm ; Catheters ; Cricoid Cartilage ; Epiglottis ; Heart Rate ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy ; Pharyngitis ; Succinylcholine ; Thiopental ; Trachea ; Ventilation

Diagnosis of scrub typhus is difficult because its symptoms are very similar to other acute febrile illnesses, such as leptospirosis, murine typhus, and other viral hemorrhagic fevers. To differentiate scrub typhus from other acute febrile diseases, a rapid and reliable serological diagnosis is important. We have developed a chimeric recombinant antigen cr56 and two other recombinant antigens, r21 and kr56, from various serotypes of Orientia tsutsugamushi. They were tested for the detection of antibodies against O. tsutsugamushi in the patient's serum samples using enzyme-linked immunosorbent assay (ELISA) and dot-blot analyses. As of conventional immunofluorescence assay (IFA), when the mixture of these three recombinant antigens was used, both sensitivity and specificity of the recombinant antigens were increased up to 98% in IgM and IgG at ELISA and dot blotting. Additionally, both sensitivity and specificity by detection of IgM and IgG antibodies at rapid diagnostic test (RDT), using the mixture of three antigens and gold conjugated antibodies, were 99%. Our results suggest the use of mixture of these recombinant antigen proteins in ELISA or RDT is suitable as a diagnostic test for scrub typhus.
Antibodies, Bacterial/blood/chemistry/immunology ; Antigens, Bacterial/diagnostic use/genetics/metabolism ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique, Indirect ; Gold/chemistry ; Humans ; Immunoassay ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Orientia tsutsugamushi/immunology/*metabolism ; Recombinant Proteins/biosynthesis/diagnostic use/genetics ; Scrub Typhus/*diagnosis ; Sensitivity and Specificity ; Serotyping

BACKGROUND: Osteoarthritis (OA) is a chronic disease that commonly afflicts the elderly. This disease reduces the health-related quality of life (HRQoL) and causes a significant social burden. Whether the effect of coexisting chronic conditions on HRQoL varies according to the presence of OA remains unclear. Therefore, this study aimed to investigate this notion. METHODS: A total of 13,395 participants were identified from the 2009–2013 Korean National Health and Nutrition Examination Survey for analysis. HRQoL was assessed using the European quality of life-5 dimensions (EQ-5D) index. Patients with OA were defined as those diagnosed by a physician or those who displayed both, symptoms and radiological findings consistent with OA at the time of the survey. Associations between OA and 8 chronic conditions were tested using regression analysis. RESULTS: The EQ-5D index was lower in patients with OA than in those without (mean difference, −0.145; 95% confidence interval [CI], −0.138 to −0.151; P<0.001). Most patients with OA and chronic conditions showed a lower score than those without. EQ-5D was particularly lower in OA patients with hypertension, dyslipidemia, stroke, and renal failure. The estimated β coefficient for the interaction term was significant in renal failure (−0.034; 95% CI, −0.055 to −0.012), after adjusting for demographic and socio-economic variables. CONCLUSION: OA significantly affects HRQoL of Korean elderly individuals alone or when combined with other conditions. OA combined with renal failure is particularly detrimental. These results indicate the importance of managing OA, which is an underestimated disease in public health surveys.
Adult* ; Aged ; Chronic Disease* ; Comorbidity ; Dyslipidemias ; Humans ; Hypertension ; Korea* ; Nutrition Surveys ; Osteoarthritis* ; Public Health ; Quality of Life* ; Renal Insufficiency ; Stroke

A 22-year-old woman with a 1-month history of shortness of breath that was treated as a case of tuberculosis and pulmonary embolism was referred to the authors’ hospital. Because of the hemodynamic instability in this patient, venoarterial extracorporeal membrane oxygenation (ECMO) was administered in the intensive care unit. She underwent a pulmonary embolectomy for the treatment of progressive circulatory collapse secondary to a pulmonary embolism. The histopathologic result was consistent with a metastatic choriocarcinoma. Despite the surgical management, persistent refractory cardiogenic shock occurred. Subsequently, the patient was treated with chemotherapy in the presence of ECMO and responded well to chemotherapy. She was discharged after 3 months. This case suggests that metastatic choriocarcinoma should be considered as a differential diagnosis in women of childbearing age presenting with a pulmonary embolism, and ECMO may be beneficial in patients with pulmonary embolism for bridging to surgical embolectomy and chemotherapy.
Choriocarcinoma* ; Diagnosis, Differential ; Drug Therapy* ; Dyspnea ; Embolectomy ; Extracorporeal Membrane Oxygenation* ; Female ; Hemodynamics ; Humans ; Intensive Care Units ; Neoplastic Cells, Circulating* ; Pregnancy ; Pulmonary Embolism ; Shock ; Shock, Cardiogenic ; Tuberculosis ; Young Adult

BACKGORUND: The relationship among age, height and sensory block height in elderly patients who underwent spinal anesthesia using 0.5% heavy bupivacaine were studied. METHODS: Ninety-seven elderly patients, 65 years of age or older, who were scheduled for spinal anesthesia were divided into four groups. 8 mg of 0.5% heavy bupivacaine was injected in patients who were shorter than 160 cm, and 9 mg was injected in patients who were taller than 160 cm. Then they were further divided into a 65 74 year old group and an older than 75 year old group, and the area of sensory block was compared by the age and height. RESULTS: Sensory block height was not significantly different between the 65 74 year old group and the older than 75 year old group. Height did not correlate with sensory block height in all groups, and the distribution shapes showed variable patterns. CONCLUSiONS: The effect of age and height on the spinal sensory block height in elderly patients is small.
Aged* ; Anesthesia, Spinal ; Bupivacaine* ; Humans

Purpose: To investigate growth response in children with either idiopathic short stature (ISS) or growth hormone (GH) deficiency (GHD). Methods: The data of prepubertal GHD or ISS children treated using recombinant human GH were obtained from the LG Growth Study database. GHD children were further divided into partial and complete GHD groups. Growth response and factors predicting growth response after 1 and 2 years of GH treatment were investigated. Results: This study included 692 children (98 with ISS, 443 partial GHD, and 151 complete GHD). After 1 year, changes in height standard deviation score (ΔHt-SDS) were 0.78, 0.83, and 0.96 in ISS, partial GHD, and complete GHD, respectively. Height velocity (HV) was 8.72, 9.04, and 9.52 cm/yr in ISS, partial GHD, and complete GHD, respectively. ΔHt-SDS and HV did not differ among the 3 groups. Higher initial body mass index standard deviation score (BMI-SDS) and midparental height standard deviation score (MPH-SDS) were predictors for better growth response after 1 year in ISS and the partial GHD group, respectively. In the complete GHD group, higher Ht-SDS and BMI-SDS predicted better growth response after 1 year. After 2 years of GH treatment, higher BMI-SDS and MPH-SDS predicted a better growth outcome in the partial GHD group, and higher MPH-SDS was a predictor of good growth response in complete GHD. Conclusion Clinical characteristics and growth response did not differ among groups. Predictors of growth response differed among the 3 groups, and even in the same group, a higher GH dose would be required when poor response is predicted.