Suicide is becoming a public health issue in many countries, and even more so in Korea. Korea has the highest suicide rate in the Organization for Economic Cooperation and Development countries. To address these issues, we investigated the recent trends in suicidal ideation and suicide attempts among the adult population. We used data from four sources: Korean National Health and Nutrition Examination Survey (KNHANES, ‘2007–2012, ‘2013, ‘2015), Korean Community Health Survey (KCHS, ‘2008–2009, ‘2013), Korean Wealth Panel Study (KOWEPS, ‘2012–2015), and Korea Health Panel Survey (KHP, ‘2010–2013). Weighted frequencies and trend tests were used. The rate of suicidal ideation as recent year was 5.10% (KNHANES, ‘2015), 8.95% (KCHS, ‘2013), 2.34% (KOWEPS, ‘2015), or 5.39% (KHP, ‘2013). Regarding the suicide attempts, the rate of suicide attempts as recent year was 0.61% (KNHANES, ‘2015), 0.41% (KCHS, ‘2013), or 0.04% (KOWEPS, ‘2015). Average percent change of suicidal ideation during survey year was -2.80% (KNHANES, ‘2007–2012), 5.78% (KNHANES, ‘2013–2015), 0.62% (KCHS, ‘2008–2013), -5.63% (KOWEPS, ‘2012–2015), and -10.94% (KHP, ‘2010–2013). Average percent change of suicide attempts during survey year was -3.84% (KNHANES, ‘2007–2012), 4.55% (KNHANES, ‘2013–2015), -2.54% (KCHS, ‘2008–2013), and -18.96% (KOWEPS, ‘2012–2015). Those who had lower income level were more likely to have self-reported suicidal ideation and suicide attempts. Our results suggest that further efforts are needed for more effective intervention to identify and manage low income strata with suicide problem.
Adult ; Health Surveys ; Humans ; Korea* ; Nutrition Surveys ; Organisation for Economic Co-Operation and Development ; Public Health ; Suicidal Ideation ; Suicide*

Heterotopic pregnancy occurs when an intrauterine pregnancy co-exists with an ectopic pregnancy. It is a potentially fatal condition, rarely occuring in natural conception cycle. But its incidence is increased since the rise in PID, pelvic surgery, IUD, and advent of assisted reproductive technology involving use of superovulatory drugs and/or in vitro-fertilization. We present a case of intrauterine twin pregnancy and right tubal pregnancy following treatment with in vitro-fertilization. The right tubal pregnancy was diagnosed after rupturing at 6th gestational weeks, and resected via laparoscopy. And healthy twin babies were delivered without complication at 38th gestational week. So we report this case with a brief review of the literatures.
Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Pregnancy, Twin ; Reproductive Techniques, Assisted

As is well known, myxoma of the heart is very rare(incidence 0.03%), constituting nearly 50% of all primary cardiac tumors. It is important because it can be abolished by surgical removal but usually fatal if unrecognized or untreated. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We have experienced a case of bilateral atrial myxoma which simulated mitral valvular disease clinically and had typical three cardinal manifestations such as obstructive, embolic and constitutional symptoms. The patients was 39 years old woman. The left atrial myxoma was diagnosed preoperatively by echocardiography and cardiac angiography and the remainder during open heart surgery under the E.C.C. Both of them were removed successfuly and confirmed as typical myxoma microscopically. This is the first case report of bilateral atrial myxoma in Korea to our knowledge.
Adult ; Angiography ; Echocardiography ; Female ; Heart ; Heart Neoplasms ; Humans ; Korea ; Mass Screening ; Myxoma* ; Thoracic Surgery

OBJECTIVES: The purpose of this study was to heighten the community residents' support and approval on the community water fluoridation program, which presents the basic data in devising strategies that will expand the program. METHODS: The research subjects of this study were 700 adults, over the age of 20, who resided in the Incheon Metropolitan City. In order to analyze the factors that were related to the approval on administering the community water fluoridation program, the data were analyzed using a chi-squared test and a multiple logistic regression analysis. RESULTS: Respondents approving the implementation of the community water fluoridation program, in Incheon Metropolitan City, were 58.7%. Major reasons for opposing the program were 'harmful', 'influence the taste and color of water', and 'objections without a particular reason'. The approval rate for implementation of the program was higher in the group who perceived that oral health was good and practiced oral health behaviors, like visiting the dental clinics on a regular basis. Also, it was higher in the group who had the experience of hearing of this program at least once and a higher knowledge of the community water fluoridation program. Especially, the strongest correlations were found between the knowledge of community water fluoridation program and the approval rate for implementation the program. CONCLUSIONS: In order to enhance the rate of approval on administrating the community water fluoridation program, it is necessary to publicize the purpose, effect, and stability of this program, through a diverse mass media and reinforce the health education program to oral health management.
Adult ; Surveys and Questionnaires ; Dental Caries ; Dental Clinics ; Fluoridation ; Health Education ; Hearing ; Humans ; Logistic Models ; Mass Media ; Oral Health ; Research Subjects

OBJECTIVES: To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA). METHODS: We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors. RESULTS: Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90). CONCLUSIONS Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.

Suicide has been a public health issue in many countries, and Korea has ranked highest suicide rate among Organization for Economic Cooperation and Development (OECD) countries over a decade. To address these issues, we updated the recent trends in suicidal ideation and suicide attempts among Korean adults followed by previous data observation. We used data from five sources: Korean National Health and Nutrition Examination (KNHANES, '07–12, '13, '15–16), Korean Community Health Survey (KCHS, '08–09, '13), Korean Wealth Panel Study (KOWEPS, '12–16), Korea Health Panel Survey (KHP, '10–13), and cause of death data from Statistics Korea ('07–16). We used weighted frequencies and trend tests. The rate of suicidal ideation as recent year was 5.10% (KNHANES, '15), 8.95% (KCHS, '13), 2.08% (KOWEPS, '16), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.59% (KNHANES, '16), 0.41% (KCHS, '13), and 0.08% (KOWEPS, '16). Annual percentage change of suicidal ideation was −2.80% (KNHANES, '07–12), 5.78% (KNHANES, '13–15), 0.62% (KCHS, '08–13), −8.50% (KOWEPS, '12–16), and −10.94% (KHP, '10–13). Annual percentage change of suicide attempts was −3.84% (KNHANES, '07–12), 2.26% (KNHANES, '13–16), −2.53% (KCHS, '08–13), and −20.22% (KOWEPS, '12–16). Annual percentage change of death by intentional self-harm was −0.49% (Statistics Korea, '07–16). Individuals who had lower income level were more likely to experience suicidal ideation and suicide attempts. According to these results, the rate of suicidal ideation and suicide attempts showed the decreasing tendency. However, the suicide rate of Korea has remained higher than that of OECD countries. Thus, continuous data observation and effective policies on suicide are needed.
Adult ; Cause of Death ; Health Surveys ; Humans ; Korea ; Organisation for Economic Co-Operation and Development ; Public Health ; Suicidal Ideation ; Suicide

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

Laminar flow within large vessels or organs can cause artifact that may simulate thrombus during computed tomographic study. The degree of venous enhancement depends on the size of blood pool and cardiac output in relation to the time of scanning. When venous structures are scanned too fast after injection of contrast material, poor mixing of enhanced and unenhanced blood creates flow artifact that gives an appearance of deep venous thrombosis. As compared with dynamic computed tomography (CT), because of a shorter acquisition time of spiral CT, vascular and organ enhancement on spiral CT scan are more dependent on factor that affect delivery of contrast material into the blood stream. Differentiation from true thrombus can be made by use of delayed scan as well as increased density and finding of relatively poor margination of artifact. In addition, both angiography and echocardiography could complement CT to assure that false-positive results are minimized. We experienced a case of artifact mistaken for intracardiac mass on spiral CT, but it was not noted on echocardiography.
Angiography ; Artifacts* ; Cardiac Output ; Complement System Proteins ; Echocardiography ; Heart Neoplasms* ; Rivers ; Thrombosis ; Tomography, Spiral Computed ; Venous Thrombosis

OBJECTIVES: Klinefelter syndrome is the most common genetic cause of male infertility and presents with 47, XXY mainly or 46, XX/47, XXY mosaicism. It is characterized by hypogonadism and azoospermia due to testicular failure, however, sporadic cases of natural pregnancies have been reported. With the development of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI), sperm can be retrieved successfully and ART is applied in these patients for pregnancy. It has been suggested that the risk of chromosome aneuploidy for both sex chromosome and autosome is increased in the sperms from 47, XXY germ cells. Considering the risk for chromosomal aneuploidy in the offspring, preimplantation genetic diagnosis (PGD) could be applied as a safe and more effective treatment option in Klinefelter syndrome. The aim of this study is to assess the outcome of PGD cycles by using FISH for sex chromosome and autosome in patients with Klinefelter syndrome. MATERIALS AND METHODS: From Jan. 2001 to Dec. 2003, PGD was attempted in 8 cases of Klinefelter syndrome but TESE was failed to retrieve sperm in the 3 cases, therefore PGD was performed in 8 cycles of 5 cases (four 47, XXY and one 46, XY/47, XXY mosaicism). In one case, ejaculated sperm was used and in 4 cases, TESE sperm was used for ICSI. After fertilization, blastomere biopsy was performed in 6~10 cell stage embryo and the chromosome aneuploidy was diagnosed by using FISH with CEP probes for chromosome X, Y and 17 or 18. RESULTS: A total of 127 oocytes were retrieved and ICSI was performed in 113 mature oocytes. The fertilization rate was 65.3+/-6.0% (mean+/-SEM) and 76 embryos were obtained. Blastomere biopsy was performed in 61 developing embryos and FISH analysis was successful in 95.1% of the biopsied blastomeres (58/61). The rate of balanced embryos for chromosome X, Y and 17 or 18 was 39.7+/-6.9%. The rate of aneuploidy for sex chromosome (X and Y) was 45.9+/-5.3% and 43.2+/-5.8% for chromosome 17 or 18, respectively. Embryo transfer was performed in all 8 cycles and mean number of transferred embryos was 2.5+/-0.5. In 2 cases, clinical pregnancies were obtained and normal 46, XX and 46, XY karyotypes were confirmed by amniocentesis, respectively. Healthy male and female babies were delivered uneventfully at term. CONCLUSION: The patients with Klinefelter syndrome can benefit from ART with TESE and ICSI. Considering the risk of aneuploidy for both sex chromosome and autosome in the sperms and embryos of Klinefelter syndrome, PGD could be offered as safe and more effective treatment option.
Amniocentesis ; Aneuploidy ; Azoospermia ; Biopsy ; Blastomeres ; Chromosomes, Human, Pair 17 ; Embryo Transfer ; Embryonic Structures ; Female ; Fertilization ; Germ Cells ; Humans ; Hypogonadism ; Infertility, Male ; Karyotype ; Klinefelter Syndrome* ; Male ; Mosaicism ; Oocytes ; Pregnancy ; Preimplantation Diagnosis* ; Prostaglandins D ; Sex Chromosomes ; Sperm Injections, Intracytoplasmic ; Spermatozoa

This study was aimed for comparison of efficacy in detecting epileptiform discharges, which was originating from mesiobasal temporal lobe, among the four non-standard non-mvasive skm surface electrodes such as ear lobe(Al/A2), zygomatic(Zl/Z2), surface sphenoidal(SS1/SS2) and true anterior temporal electrode(Tl/T2). The study was performed with simultaneous placement of the nonstandard electrodes including standard electrodes(F7/F8). The resul ts were as follows. Among the non-standard electrodes, zygomatic and true anterior temporal electrodes detected more epileptiform discharges compared to the other two electrodes, although there was no statistical significancy. Compared to the standard electrodes, zygomatic and true anterior temporal electrode showed statistically high significant detecting rate (p<0. 01). Also average detection rate of epileptiform discharges of the whole non-standard electrodes which was compared to the rate of the standard electrodes showed statistically significance (p<0.05). In conclusions, non-standard surface electrodes, especially zygomatic and true anterior temporal electrode, are considered as valuable to detect the epileptiform discharges from temporal lobe if they were used at the routine initial EEG examination.
Ear ; Electrodes* ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Temporal Lobe*