BACKGROUND: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2–3 times more likely to commit suicide than women, which called the ‘gender paradox of suicide.’ The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. METHODS: The data was collected through the Korean Statistical Information Service. The study areas were 227 si · gun · gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. RESULTS: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. CONCLUSION: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.
Budgets ; Cause of Death ; Chungcheongnam-do ; Depression ; Divorce ; Female ; Gangwon-do ; Geographic Information Systems ; Gyeongsangbuk-do ; Health Behavior ; Humans ; Information Services ; Korea ; Male ; Marriage ; Mortality ; Organisation for Economic Co-Operation and Development ; Residence Characteristics ; Social Security ; Suicide ; Urbanization

PURPOSE: Mangled injury is defined as severe injury, including three or more tissues such as bones, nerves, vessels, muscles, and tendons in the upper or lower extremities. The choice of treatment results in different cosmetic and functional outcomes for mangled injury. In this study, we estimated patients' quality of life after treatment with the future intention of having patients make proper decisions at the time of injury. METHODS: Twenty patients were treated at Asan Medical Center from January, 2009 to November, 2011, and 11 patients were included who agreed with the questionnaire. We used 36-item short form health survey (SF-36) for estimating quality of life after treatments. RESULTS: Subjective satisfaction of cosmetic and functional aspects was higher in the reconstruction group than in the amputation group. However, in the estimation of specified satisfaction using SF-36, the amputation group was more satisfied than the reconstruction group. CONCLUSION: Among the many treatment considerations at the time of injury, expected cosmetic and functional outcomes were important parts determining the decision. In our study, the amputation group showed a better satisfaction level. This result could help patients make more appropriate decisions in the case of mangled injury.
Amputation ; Chungcheongnam-do ; Health Surveys ; Humans ; Intention ; Limb Salvage ; Lower Extremity ; Muscles ; Quality of Life ; Tendons

Noroviruses (NoV) are the major viral pathogen causing epidemic acute gastroenteritis and outbreaks of foodborne and waterborne illness. During the local festival in Chungnam province, group food poisoning occurred outbreak by NoV infections in Jan 2019. In this study, epidemiological analysis and molecular characterization were conducted such as genotyping, phylogeny. The prevalent genotypes of food poisoning events were NoV GII.3 and GII.17, and NoV GII.3 and GII.17 isolates of this study were completely matched in nucleotide sequence comparison of capsid gene region, respectively. In underground water and stream water, various multiple genotypes of noroviruses were detected including NoV GII.3, GII.8 and GI.4 in aquatic environment of the local festival site. Among 32 worker samples, various NoVs of five genotypes (GI.7, GI.8, GII.3, GII.8, GII.17) were detected in 12 samples and expected to causing NoV contaminated by exposure to groundwater. NoV genotype GII.3, which was detected from groundwater 2, was completely consistent with that of patients and workers. Therefore, groundwater within the local festival site could be main cause of food poisoning event. Because NoV outbreaks are caused by fecal to oral transmission, proper management of sewage purification facilities, groundwater and sanitary toilets is required for many visitors, and efforts are needed to maintain clean environment.
Base Sequence ; Capsid ; Chungcheongnam-do ; Disease Outbreaks ; Epidemiologic Studies ; Foodborne Diseases ; Gastroenteritis ; Genotype ; Groundwater ; Holidays ; Humans ; Korea ; Norovirus ; Phylogeny ; Rivers ; Sewage ; Water

BACKGROUND: Kidney transplantation is an effective renal replacement therapy for patients with end-stage renal disease (ESRD). In this study, we assessed the impact of the baseline characteristics and comorbidities of ESRD patients on the probability of deceased donor kidney transplantation (DDKT) and evaluated the morbidity and mortality during the time spent waiting. METHODS: The study population consisted of 544 ESRD patients on the waiting list for DDKT at Chungnam National University Hospital in South Korea between February 2000 and October 2015. The patients were observed from the date of transplantation list registration to the date of transplantation. Baseline characteristics and comorbidities were investigated together with new-onset comorbidities that occurred during the waiting time. RESULTS: Diabetes mellitus (39.0%), hypertension (25.2%), and glomerulonephritis (21.3%) were the three most common causes of ESRD in this study, and coronary artery disease (9.4%) was the most common comorbidity. The 115 patients (19.3%) who underwent DDKT had a mean waiting time of 1,711 days (768–2,654 days or 4.68 years [2.10–7.27]). Blood groups other than type O, peritoneal dialysis, and nondiabetic ESRD were significantly associated with a higher likelihood of DDKT. Infection was the leading cause of death and the most common comorbidity that arose during the waiting time. Patients who experienced cardiovascular events during the waiting time showed a lower transplant rate compared with those who did not. CONCLUSION: The prevalence of comorbidities was high in renal transplantation candidates. During the often-long waiting time, new comorbidities may occur, with long-term sequelae limiting access to kidney transplantation or resulting in death.
Blood Group Antigens ; Cause of Death ; Chungcheongnam-do ; Comorbidity ; Coronary Artery Disease ; Diabetes Mellitus ; Glomerulonephritis ; Humans ; Hypertension ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney ; Korea ; Mortality ; Peritoneal Dialysis ; Prevalence ; Renal Replacement Therapy ; Tissue Donors ; Waiting Lists

OBJECTIVES: This study examined the status of children's favorite foods intake and the relationship with the policy environment based on the Special Act on Safety Control of Children's Dietary Life for suggesting a supportive policy strategy. METHODS: The subjects were 4th grade students (n=1,638) in elementary school from 45 schools collected from seven areas (Seoul, Daegu, Daejeon, Gyeonggi, Chungnam, Jeonbuk, and Gyeongnam). The children participated in a self-administered questionnaire survey in class under the supervision of the teacher. The questionnaire consisted of items, such as social demographic characteristics, frequency of intake of the children's favorite foods, and policy cognition. A t-test and ANOVA were applied to explore the relationship between the frequency of children's favorite foods intake and policy cognition. The survey was implemented from August 2016 to September 2016. RESULTS: For the boys, the frequency of ‘high-calorie low nutrient foods intake’ (HCLN) was significantly higher than that of the girls (p<0.01). For the children who received information on their favorite foods from the internet, the frequency of HCLN was higher than the other sources (p<0.01). The time of TV viewing and computer usage, and smartphone usage was associated with a higher frequency of HCLN, and a lower healthy favorite food intake (all p<0.001). The intake frequency of healthy favorite foods indicated a positive correlation with the policy cognition, including policy perception, usefulness, necessity and buying intention, and educational experience. CONCLUSIONS: This study showed a correlation with the frequency of children's favorite foods intake and policy. In particular, the frequency of children's healthy favorite foods intake indicated a meaningful relationship with the policy than the frequency of HCLN. This study also found that the consumption of children's healthy favorite foods was positively correlated with the educational experience. To develop a supportive policy for a good dietary environment for children, there is a need to focus on how to collaborate with multiple levels of influences, such as the national level, school level, and family.
Child ; Chungcheongnam-do ; Cognition ; Daegu ; Eating ; Female ; Gyeonggi-do ; Humans ; Intention ; Internet ; Jeollabuk-do ; Organization and Administration ; Smartphone

BACKGROUND: The purpose of this study was to understand the level of successful aging and to analyze the factors that affect successful aging. METHODS: This study was a descriptive study. The data collection of this study using questionnaires was from October 1, 2017 to December 30, 2017, and the 169 elderly people living in Chungcheongnam-do were surveyed. RESULTS: The mean level of successful aging of the subjects was 3.57 (±0.58), which was higher than the median, it was significantly different among the presence of religion, participation in senior facility, regular exercise, pain, and subjective health status. Regression analysis showed that the factors that have the greatest influence on the successful aging of the subjects were the participation in senior facility (β=0.24, P<0.001), self-esteem support (β=0.20, P=0.024), emotional support (β=0.19, P=0.048), regular exercise (β=0.19, P=0.002), and pain (β=−0.14. P=0.029). The explanatory power of these variables on successful aging was 53% (F=20.37, P<0.001). CONCLUSIONS: This study showed that emotional support and support for self-esteem were important in successful aging, and that pain, which was not considered in previous studies, was an important factor.
Aged ; Aging ; Chungcheongnam-do ; Data Collection ; Diagnostic Self Evaluation ; Humans

OBJECTIVES: This study examined the status of children's favorite foods intake and the relationship with the policy environment based on the Special Act on Safety Control of Children's Dietary Life for suggesting a supportive policy strategy. METHODS: The subjects were 4th grade students (n=1,638) in elementary school from 45 schools collected from seven areas (Seoul, Daegu, Daejeon, Gyeonggi, Chungnam, Jeonbuk, and Gyeongnam). The children participated in a self-administered questionnaire survey in class under the supervision of the teacher. The questionnaire consisted of items, such as social demographic characteristics, frequency of intake of the children's favorite foods, and policy cognition. A t-test and ANOVA were applied to explore the relationship between the frequency of children's favorite foods intake and policy cognition. The survey was implemented from August 2016 to September 2016. RESULTS: For the boys, the frequency of ‘high-calorie low nutrient foods intake’ (HCLN) was significantly higher than that of the girls (p<0.01). For the children who received information on their favorite foods from the internet, the frequency of HCLN was higher than the other sources (p<0.01). The time of TV viewing and computer usage, and smartphone usage was associated with a higher frequency of HCLN, and a lower healthy favorite food intake (all p<0.001). The intake frequency of healthy favorite foods indicated a positive correlation with the policy cognition, including policy perception, usefulness, necessity and buying intention, and educational experience. CONCLUSIONS: This study showed a correlation with the frequency of children's favorite foods intake and policy. In particular, the frequency of children's healthy favorite foods intake indicated a meaningful relationship with the policy than the frequency of HCLN. This study also found that the consumption of children's healthy favorite foods was positively correlated with the educational experience. To develop a supportive policy for a good dietary environment for children, there is a need to focus on how to collaborate with multiple levels of influences, such as the national level, school level, and family.
Child ; Chungcheongnam-do ; Cognition ; Daegu ; Eating ; Female ; Gyeonggi-do ; Humans ; Intention ; Internet ; Jeollabuk-do ; Organization and Administration ; Smartphone

PURPOSE: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. METHODS: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. RESULTS: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. CONCLUSIONS: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.
Child ; Chungcheongnam-do ; Disease Transmission, Infectious ; Education ; Exanthema ; Fatigue ; Humans ; Latent Tuberculosis ; Mass Screening ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. METHODS: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for β-lactams and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. RESULTS: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. CONCLUSIONS: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.
Amoxicillin ; Anti-Bacterial Agents ; Cefotaxime ; Child ; Child, Hospitalized ; Chungcheongnam-do ; Erythromycin ; Humans ; Penicillins ; Pneumococcal Infections ; Retrospective Studies ; Streptococcus pneumoniae ; Streptococcus ; Vaccination

BACKGROUND/AIMS: Behavioral factors, such as smoking and heavy alcohol consumption, increase the risk of gastric cancer (GC), but their effects on survival are not clear. We examined associations between prediagnostic smoking and alcohol drinking behavior and GC death by long-term follow-up. METHODS: The participants were 508 GC patients enrolled at Chungnam University Hospital and Hanyang University Guri Hospital from 2001 to 2006. Information on clinicopathologic and behavioral risk factors was collected, and patient survival was prospectively followed until 2016 by medical chart review and telephone survey. RESULTS: During above 10 years follow-up period, overall death was 46.2% (n=226) and GC deaths was 38.2% (n=187) among the 489 GC patients included in the analysis. No significant association was found between smoking habits and overall or GC survival. However, after stratification by histological type, the hazard ratio (HR) of GC death for current smokers tended to be higher for the diffuse type (HR 1.61, 95% CI 0.57–4.59 for current vs. never) rather than for the intestinal type (HR 0.78, 95% CI 0.28–2.19 for current vs. never). Light alcohol consumption was found to be associated with a significantly lower risk of GC death (HR 0.52, 95% CI 0.36–0.75 for <20 g/day for women or <40 g/day for men vs. never and past), and the effects of alcohol drinking habits had similar effects on GC death for the intestinal and diffuse types. CONCLUSIONS: These results suggest smoking and alcohol drinking behaviors before a diagnosis of GC are weakly associated with GC survival. Nevertheless, the effect of smoking behavior on prognosis appears to depend on the histological type of GC.
Alcohol Drinking ; Chungcheongnam-do ; Cohort Studies ; Diagnosis ; Drinking ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Stomach Neoplasms ; Telephone