The foundation of medical practice is the doctor-patient relationship. Before the implementation of National Health Insurance in Korea, it was not easy for patients to access doctors, and the doctor-patient relationship was immature. This study aims to describe doctors' social competency and determine measures of its strength in Korea. The current status of research on doctors' social competency in Korea and other countries was reviewed. There is recognition that Korean doctors have confidence in their medical knowledge, but their leadership in the health care sector and society is insufficient. A survey of citizens' expectations regarding doctors' social competency shows that they are not satisfied with their doctors' communication, and feel their doctors have not fulfilled their leadership duties as influential members of society e main reason for respondents' dissatisfaction was the doctors' pursuit of profit. They expected that the quality of care would increase if doctors' social capabilities were strengthened and both the doctors themselves and the government were to participate in capacity building. The preferable approach to reinforcing the social ability of doctors is to include medical humanities and social science in the medical education curriculum. Then, medical students can grow as good doctors and effective leaders. Several reports from outside Korea have confirmed this. Doctors need to recognize that the concept of health is broad, encompassing societal factors as one of the determinants of health. In conclusion, the effort of the community as a whole is needed for strengthening the social competence of doctors in Korea.
Capacity Building ; Curriculum ; Education, Medical ; Health Care Sector ; Humanities ; Humans ; Korea ; Leadership ; Mental Competency ; National Health Programs ; Power (Psychology)* ; Social Sciences ; Students, Medical

During the early phase of coronavirus disease 2019 (COVID-19) pandemic, South Korea was among the countries affected by the novel infectious disease soon after China. A year later, South Korea is considered one of the countries to have successfully responded to COVID-19. Even though South Korea has struggled to learn how to live wisely with COVID-19, much less effort has been put into learning how to die gracefully during the COVID-19 pandemic. From the beginning of the pandemic, the Korean government has recommended (or mandated) cremation for those who die from COVID-19 to prevent further spread of the disease. However, the World Health Organization has announced that corpses are generally not contagious and cremation should be a matter of culture choice and available resources. In South Korea, the government pays compensation to the families of the deceased because they follow the national guidelines for the cremation and disinfection of bodies. However, it is now time to discuss how to support the families of the deceased, helping them to safely grieve and honor their loved one in their own ways, rather than forcing them to wrap the deceased with a plastic bag and proceed with a hasty cremation.

During the early phase of coronavirus disease 2019 (COVID-19) pandemic, South Korea was among the countries affected by the novel infectious disease soon after China. A year later, South Korea is considered one of the countries to have successfully responded to COVID-19. Even though South Korea has struggled to learn how to live wisely with COVID-19, much less effort has been put into learning how to die gracefully during the COVID-19 pandemic. From the beginning of the pandemic, the Korean government has recommended (or mandated) cremation for those who die from COVID-19 to prevent further spread of the disease. However, the World Health Organization has announced that corpses are generally not contagious and cremation should be a matter of culture choice and available resources. In South Korea, the government pays compensation to the families of the deceased because they follow the national guidelines for the cremation and disinfection of bodies. However, it is now time to discuss how to support the families of the deceased, helping them to safely grieve and honor their loved one in their own ways, rather than forcing them to wrap the deceased with a plastic bag and proceed with a hasty cremation.

Parry-Romberg syndrome, first described in 1825 by Parry and in 1846 by Romberg, is a rare disorder characterized by a progressive hemifacial atrophy of the skin and adipose tissue and atrophy of muscle, cartilage, and underlying bony structures. It is sometimes accompanied with such complications as ophthalmologic abnormality, localized alopecia and neurologic symptoms, for example, contralateral Jacksonian epilepsy, trigeminal neuralgia, migrane and hemiplegia. The onset is slow and progressive, starting at the first or second decade of life and lasting for 2-10 years, ending with a face being "burned out". It is often associated with epilepsy but the link between these two conditions is poorly understood. In patients with progressive hemifacial atrophy, a high incidence of abnormal neuroradiologic findings in the brain has been reported. Brain MRI findings include cerebral hemiatrophy, cortical calcification, unilateral focal infarction in the corpus callosum, diffuse deep and subcortical white matter signal changes and mild cortical thickening. We report a case of Parry-Romberg syndrome in a 5-year-old boy who had a progressive Rt. facial hemiatrophy with intractable epilepsy and basal ganglia calcification from brain MRI.
Adipose Tissue ; Alopecia ; Atrophy ; Basal Ganglia ; Brain ; Cartilage ; Child, Preschool ; Corpus Callosum ; Epilepsy ; Facial Hemiatrophy* ; Hemiplegia ; Humans ; Incidence ; Infarction ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Seizures* ; Skin ; Trigeminal Neuralgia

In East Asia during the second half of the 19th century, overseas mission work by Protestant churches thrived. Missionaries built schools and hospitals and effectively used them for evangelism. In the 20th century when Social Gospel Movement was expanding, medical work has been recognized as a significant mission service in and by itself. This article reviewed the construction and characteristics of missions work conducted by Canadian Presbytery; missionary doctors and Korean doctors who worked at the mission hospitals; why the missionary medical work had to stop; and career paths taken by Korean doctors upon liberation from Japanese occupation. The Canadian Presbytery missionaries, unlike other denomination missionaries, were rather critical of Imperial Japan, but supportive towards Koreans. This could have stemmed from the reflection of their own experience of once a colony of British Empire and also their value system that promotes egalitarian, democratic and progressive theology. The Sung-jin and Ham-heung Mission Bases were a community, interacting organically as a 'Triangle of Church, School and Hospital.' The missionaries mobilized the graduates from Christian schools and organized a Young Men's Christian Association (YMCA). Some of the graduates were trained to become medical doctors or assistants and worked at mission hospitals. Missionary doctors' approaches to balancing evangelism and medical practice varied. For example, Robert Grieson went through confusion and struggled to balance conflicting roles as a pastor for evangelism and also as a physician. Kate McMillan, on the other hand, had less burden for evangelism than Grieson, and focused on medical work by taking advantage of the opportunity that, as a woman, she can easily approach Korean women. Still another case was Florence Murray who practised evangelism within the hospital setting, and successfully carried out the role as a hospital administrator, going beyond 'women's work' as McMillan did. Korean doctors and assistants who worked at the mission hospitals had seen the spread of Protestantism in their youth; had received modern education; had experienced the fall of own country in 1910 and nationwide protest against Japan in 1919. The majority of them were graduates of Severance Medical College, the hub of missionary medicine at the time. After the resignation from the mission hospitals, 80 percent of them became self-employed general practitioners. The operations of the mission hospitals began to contract in 1930 due to tightened control by Imperial Japan. Shrine worship imposed on Christians caused internal conflict and division among missionaries and brought about changes in the form and contents of the mission organization. The incidence of the assault of Dr. Grieson brought about the dissolution of Sung-jin mission base and the interruption of the operation of Je-dong Hospital. As the Pacific War expanded, missionaries were driven out of Korea and returned home. In conclusion, the missions work by Canadian Presbytery missionaries had greatly impacted Protestantism in Korea. The characteristics of Canadian Presbytery were manifested in their support of Korean nationalism movement, openness for Social Gospel, and maintaining equal footing with Korean Christians. Specifically we note the influence of these characteristics in Chosun doctors who had worked in the mission hospitals. They operated their own hospitals or clinics in a manner similar to the mission hospitals by providing treatment for poor patients free of charge or for a nominal fee and treating the patients in a kind and humanistic way. After the 1945 Liberation, Korean doctors'career paths split into two directions. most of them defected to South Korea and chose the path to work as general practitioners. A few of them remained in North Korea and became educator of new doctors. It is meaningful that former doctors of Canadian missionary hosptal became dean of 2 medical colleges among 3 of all in early North Korea. This article does not cover the comparative analysis of the medical work by the missionaries of Canadian Presbytery and other denominations. It is desirable to include this analysis of the contents and the comparison in a future study of Korean doctors who participated in the mission hospitals, by denomination and by geographical region.
Adolescent ; Asian Continental Ancestry Group* ; Democratic People's Republic of Korea ; Education ; Far East ; Fees and Charges ; Female ; Foot ; General Practitioners ; Hand ; Hospital Administrators ; Humans ; Incidence ; Japan ; Korea ; Missions and Missionaries* ; Occupations* ; Protestantism ; Theology

This study focuses on the formation of medical education in North Korea from 1945 to 1948 in terms of the centralization of medical education, and on the process and significance of the systemization of medical education. Doctors of the past trained under the Japanese colonial system lived and worked as liberalists. More than half of these doctors who were in North Korea defected to South Korea after the country was liberated. Thus the North Korean regime faced the urgent task of cultivating new doctors who would 'serve the state and people.' Since the autumn of 1945, right after national liberation, Local People's Committees organized and implemented medical education autonomously. Following the establishment of the Provisional People's Committee of North Korea, democratic reform was launched, leading to the centralized administration of education. Consequently, medical educational institutions were realigned, with some elevated to medical colleges and others shut down. The North Korean state criticised the liberalistic attitude of doctors and the bureaucratic style of health administration, and tried to reform their political consciousness through political inculcation programs. The state also grant doctors living and housing privileges, which show its endeavor to build 'state medicine'. By 1947, a medical education system was established in which the education administration was put in charge of training new doctors while the health administration was put in charge of nurturing and retraining health workers. In this way, the state was the principal agent that actively established a centralized administrative system in the process of the formation of medical education in North Korea following national liberation. Another agent was deeply involved in this process - the faculty that was directly in charge of educating the new doctors. Studying the medical faculty remains another research task for the future. By exploring how the knowledge, generational experience, socio-political consciousness and world views adopted by these teachers during the colonial era were manifested in their pedagogy after national liberation will shed more light on the 'prototype' of North Korean medical education.
Democratic People's Republic of Korea ; Education, Medical/*history ; History, 20th Century ; Physicians/*history ; Politics ; State Medicine

Purpose: Preterm infants are known to be at a risk of neurodevelopmental delay; however, limited data are available on the outcomes of moderate-to-late preterm (MLPT) infants (born at 32 to 36 weeks’ gestation). The Korean Developmental Screening Test (K-DST) for infants and children is a recently designed screening test for Korean infants and children. The current study aimed to evaluate the neurodevelopmental outcomes of MLPT infants and investigate the risk factors associated with neurodevelopmental delay. Methods: A total of 119 MLPT infants admitted to a neonatal intensive care unit (NICU) of a tertiary hospital in Korea were enrolled. The infants were assessed during two follow-up periods (first: 16 to 24 months of corrected age; second: 24 to 41 months of corrected age). The perinatal factors in the NICU that were associated with delayed development were analyzed. Results: In all sections of the K-DST, the proportion of infants with developmental delay was higher in the second period (5.6% to 9.3%) than in the first period (0.9% to 5.4%). A total of 10% to 17% of the infants presented with persistent delay throughout the two periods based on five sections of the K-DST. Male sex, oxygen therapy duration, and younger maternal age were the risk factors affecting at least one section during the second period. Conclusion MLPT infants showed greater developmental delay than the general infant population. Considering that early intervention is important for good longterm outcomes, close observation of male MLPT infants and MLPT infants who received oxygen therapy is warranted.

Purpose: Preterm infants are known to be at a risk of neurodevelopmental delay; however, limited data are available on the outcomes of moderate-to-late preterm (MLPT) infants (born at 32 to 36 weeks’ gestation). The Korean Developmental Screening Test (K-DST) for infants and children is a recently designed screening test for Korean infants and children. The current study aimed to evaluate the neurodevelopmental outcomes of MLPT infants and investigate the risk factors associated with neurodevelopmental delay. Methods: A total of 119 MLPT infants admitted to a neonatal intensive care unit (NICU) of a tertiary hospital in Korea were enrolled. The infants were assessed during two follow-up periods (first: 16 to 24 months of corrected age; second: 24 to 41 months of corrected age). The perinatal factors in the NICU that were associated with delayed development were analyzed. Results: In all sections of the K-DST, the proportion of infants with developmental delay was higher in the second period (5.6% to 9.3%) than in the first period (0.9% to 5.4%). A total of 10% to 17% of the infants presented with persistent delay throughout the two periods based on five sections of the K-DST. Male sex, oxygen therapy duration, and younger maternal age were the risk factors affecting at least one section during the second period. Conclusion MLPT infants showed greater developmental delay than the general infant population. Considering that early intervention is important for good longterm outcomes, close observation of male MLPT infants and MLPT infants who received oxygen therapy is warranted.

Background: Despite the considerable disease burden due to trauma injury, sufficient effort has not been made for the assessment of nationwide trauma care status in Korea. We explored the feasibility of a diagnosis code-based injury severity measuring method in light of its realworld usage. Methods: We used datasets from the National Emergency Department Information System to calculate the survival risk ratios (SRRs) and the Korean Trauma Data Bank to predict models, respectively. The target cohort was split into training and validation datasets using stratified random sampling in an 8:2 ratio. We established six major mortality prediction models depending on the included parameters: 1) the Trauma and Injury Severity Score (TRISS) (age, sex, original Revised Trauma Score [RTS], Injury Severity Score [ISS]), 2) extended International Classification of Diseases-based Injury Severity Score (ICISS) 1 (age, sex, original RTS, ICISS using international SRRs), 3) extended ICISS 2 (age, sex, original RTS, ICISS using Korean SRRs based on 4-digit diagnosis codes), 4) extended ICISS 3 (age, sex, original RTS, ICISS using Korean SRRs based on full-digit diagnosis codes), 5) extended ICISS 4 (age, sex, modified RTS, and ICISS using Korean SRRs based on 4-digit diagnosis codes), 6) extended ICISS 5 (age, sex, modified RTS, and ICISS using Korean SRRs based on full-digit diagnosis codes). We estimated the model using training datasets and fitted it to the validation datasets. We measured the area under the receiver operating characteristic curve (AUC) for discriminative ability. Overall performance was also evaluated using the Brier score. Results: We observed the feasibility of the extended ICISS models, though their performance was slightly lower than the TRISS model (training cohort, AUC 0.936–0.938 vs. 0.949).Regarding SRR calculation methods, we did not find statistically significant differences.The alternative use of the Alert, Voice, Pain, Unresponsive Scale instead of the Glasgow Coma Scale in the RTS calculation did not degrade model performance. Conclusion The availability of the practical ICISS model was observed based on the model performance. We expect our ICISS model to contribute to strengthening the Korean Trauma Care System by utilizing mortality prediction and severity classification.

Background: Despite the considerable disease burden due to trauma injury, sufficient effort has not been made for the assessment of nationwide trauma care status in Korea. We explored the feasibility of a diagnosis code-based injury severity measuring method in light of its realworld usage. Methods: We used datasets from the National Emergency Department Information System to calculate the survival risk ratios (SRRs) and the Korean Trauma Data Bank to predict models, respectively. The target cohort was split into training and validation datasets using stratified random sampling in an 8:2 ratio. We established six major mortality prediction models depending on the included parameters: 1) the Trauma and Injury Severity Score (TRISS) (age, sex, original Revised Trauma Score [RTS], Injury Severity Score [ISS]), 2) extended International Classification of Diseases-based Injury Severity Score (ICISS) 1 (age, sex, original RTS, ICISS using international SRRs), 3) extended ICISS 2 (age, sex, original RTS, ICISS using Korean SRRs based on 4-digit diagnosis codes), 4) extended ICISS 3 (age, sex, original RTS, ICISS using Korean SRRs based on full-digit diagnosis codes), 5) extended ICISS 4 (age, sex, modified RTS, and ICISS using Korean SRRs based on 4-digit diagnosis codes), 6) extended ICISS 5 (age, sex, modified RTS, and ICISS using Korean SRRs based on full-digit diagnosis codes). We estimated the model using training datasets and fitted it to the validation datasets. We measured the area under the receiver operating characteristic curve (AUC) for discriminative ability. Overall performance was also evaluated using the Brier score. Results: We observed the feasibility of the extended ICISS models, though their performance was slightly lower than the TRISS model (training cohort, AUC 0.936–0.938 vs. 0.949).Regarding SRR calculation methods, we did not find statistically significant differences.The alternative use of the Alert, Voice, Pain, Unresponsive Scale instead of the Glasgow Coma Scale in the RTS calculation did not degrade model performance. Conclusion The availability of the practical ICISS model was observed based on the model performance. We expect our ICISS model to contribute to strengthening the Korean Trauma Care System by utilizing mortality prediction and severity classification.