OBJECTIVES: The aim of this study was to examine the relationship between personality of parent and offspring, and offspring's psychological adaptation. METHODS: We examined temperament and character of 65 parents and their offspring (measured using the Junior Temperament and Character Inventory and Temperament and Character Inventory) and offspring's internalizing (anxiety, depression) and externalizing (delinquency, hyperactivity) problems. RESULTS: The internalizing problems of offspring were positively associated with harm avoidance (HA) of offspring and parent, and negatively associated with self-directedness (SD) of offspring and parent. The externalizing problems of offspring were positively associated with novelty seeking of offspring, and were predicted by SD of parent. The interaction between parent's HA and offspring's HA predicted higher levels of anxiety of offspring. CONCLUSION: The association between the offspring's personality and internalizing and externalizing problems can depend on the personality of the parent.
Adaptation, Psychological* ; Anxiety ; Humans ; Parents ; Temperament

OBJECTIVES: This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. METHODS: A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. RESULTS: The satisfaction surveys in all three periods showed similar results for patients (4.46+/-0.70 point) and healthcare practitioners, including nurses (3.82+/-0.62 point) and physicians (3.60+/-0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. CONCLUSIONS: The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage.
Blood Glucose ; Blood Pressure ; Compliance ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Gangwon-do* ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Korea* ; Life Style ; Patient Compliance ; Patient Satisfaction ; Rural Health Services ; Telemedicine*

Although the number of studies using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) for the treatment of high-risk pediatric solid tumors has been increasing, documentation of hematologic recovery after tandem HDCT/autoSCT is very limited. For this reason, we retrospectively analyzed the hematologic recovery of 236 children with high-risk solid tumors who underwent tandem HDCT/autoSCT. The median numbers of CD34+ cells transplanted during the first and second HDCT/autoSCT were 4.3 x 10(6)/kg (range 0.6-220.2) and 4.1 x 10(6)/kg (range 0.9-157.6), respectively (P = 0.664). While there was no difference in neutrophil recovery between the first and second HDCT/autoSCT, platelet and RBC recoveries were significantly delayed in the second HDCT/autoSCT (P < 0.001 and P < 0.001, respectively). Delayed recovery in the second HDCT/autoSCT was more prominent when the number of transplanted CD34+ cells was lower, especially if it was < 2 x 10(6)/kg. A lower CD34+ cell count was also associated with increased RBC transfusion requirements and a higher serum ferritin level after tandem HDCT/autoSCT. More CD34+ cells need to be transplanted during the second HDCT/autoSCT in order to achieve the same hematologic recovery as the first HDCT/autoSCT.
Adolescent ; Antigens, CD34/metabolism ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Blood Cell Count ; Blood Platelets/cytology ; Child ; Child, Preschool ; Combined Modality Therapy ; Erythrocytes/cytology ; Female ; Ferritins/blood ; Humans ; Infant ; Male ; Neoplasms/*drug therapy ; Neutrophils/cytology ; Retrospective Studies ; *Stem Cell Transplantation ; Stem Cells/cytology/metabolism ; Transplantation, Autologous ; Young Adult

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

PURPOSE: For conservative treatment of shaft fractures, the butterfly fragments that were somewhat larger in the closed intra-medullary (IM) nailing. The results of treatment were monitored using radiography separately for the weight-bearing femur and non-weight-bearing humerus. MATERIALS AND METHODS: 27 from Group I and 31 from Group II. In the two groups, the displacement and angulation changes in the fragments, and the degree of improvement of these two factors, were compared using follow-up radiography. RESULTS: The mean angulation of fragments in Groups I and II were 9.2degrees and 9.6degrees, and the mean degree of displacement of the fragments in Groups I and II were 16.7 mm and 21.2 mm, respectively. Follow-up radiography showed that the above factors improved in both groups. The degree of displacement was significantly lower in the normal cases than in the complicated cases (p=0.001). CONCLUSION: Displacement and angulation gradually improved in both groups. It was found that the degree of displacement after the initial reduction is more important than the influence of anatomical position or weight bearing. This indicates that care should be taken when inserting IM nails to prevent displacement or angulation.
Butterflies ; Displacement (Psychology) ; Extremities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Nails ; Weight-Bearing

PURPOSE: To evaluate the pathological and clinical effects of preoperative chemoradiation (CCRT) in cases of locally advanced rectal cancer and to determine the predictive factors for tumor downstaging. MATERIALS AND METHODS: From March 2004 to August 2008, 33 patients with locally advanced rectal cancer were treated with preoperative CCRT. Twenty-eight patients (84.8%) were treated using a concomitant boost technique while five (15.2%) patients were treated using a cone down boost technique. All patients received 50.4 Gy of irradiation and concurrent chemotherapy with 5-fluorouracil. The median follow-up duration was 24.2 months (range, 9.8 to 64.7 months). RESULTS: Thirty-one (93.9%) patients underwent surgery. Twenty-four patients (72.7%) underwent anal sphincter-preserving surgery. The 3-year disease free survival (DFS) and overall survival rates were 63.4% and 78.8%, respectively. Post-operative factors were more important for DFS. Pathologic N stage, margin status, and pathologic differentiation were significant prognostic factors (p=0.001, 0.029, 0.030). Tumor size and lymphovascular invasion were also associated with marginal significance (p=0.081, 0.073). However, only pre-treatment T stage was a significant pre-operative factor (p=0.018). The complete pathological response rate was 9.1%. T-downstaging was observed in ten (30.3%) patients, whereas N-downstaging was found in 24 (72.7%) patients. Pre-treatment T stage and the interval between CCRT and operation were the predictive factors for downstaging in a univariate analysis (p=0.029, 0.027). Pre-treatment carcinoembryogenic antigen was also associated with marginal significance (p=0.068). CONCLUSION: The survival of rectal cancer patients can be better determined based on post-operative findings. Therefore, pre-operative CCRT for downstaging of the tumor seems to be important. Pre-treatment T stage and the interval between CCRT and operation can be used to predict downstaging.
Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Rectal Neoplasms ; Survival Rate

OBJECTIVE: Self-report is being used in most of studies investigating the therapeutic effect of smoking cessation clinics of public health centers in Korea instead of cotinine or other chemical markers of nicotine exposure. This study was conducted to evaluate the agreement between self-report and urinary cotinine test after smoking cessation program. METHODS: The study subjects were 333 adult male who visited public health center and participated in 12-week scheduled smoking cessation program. Questionnaires including demographic data and information about cigarette use, blood test, and urinary cotinine test were performed to all subjects during initial evaluation. At the end of the program, smoking status of subjects was assessed by an oral self-report and additional blood and urinary cotinine tests were done to the subjects who agreed. RESULTS: 52 participants who gave both self-report on smoking status and urine sample were included in the final analysis. The overall percentage agreement was 67.3%, and the overall Kappa index was 0.367. The sensitivity, specificity, positive predictive value, and negative predictive value of self-report in detecting smoking state were 46.43%, 91.67%, 86.67%, and 59.46%, respectively. CONCLUSION: The agreement between self-report and urinary cotinine test in detecting smoking status after smoking cessation program was relatively low on account of participants who failed to quit smoking but reported their smoking status incorrectly. Therefore, the use of objective measures such as urine cotinine should be considered in evaluation of successful smoking cessation.
Adult ; Cotinine ; Hematologic Tests ; Humans ; Korea ; Male ; Nicotine ; Public Health ; Surveys and Questionnaires ; Sensitivity and Specificity ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products

OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
Adoption ; Confidentiality ; Delivery of Health Care ; Electronic Health Records ; Hospital Information Systems ; Information Systems ; Management Information Systems ; Quality of Health Care ; Radiology Information Systems ; Referral and Consultation

PURPOSE: The concentration of soluble transferrin receptor (sTfR) is estimated as an iron parameter to evaluate erythropoiesis and iron status. The aim of our study is to evaluate the correlation between sTfR concentration and inflammatory parameters and to distinguish iron deficiency anemia from anemia of inflammation. METHODS: One hundred and forty-four infants younger than two years of age who visited Gyeongsang University Hospital for 7 years from 2000 to 2006 were enrolled. Patients who had hemoglobin (Hb) <11 g/dL and ferritin <12 mg/L were excluded. Routine hematologic lab, serum ferritin, sTfR, and inflammatory markers [C-reactive protein(CRP), interleukin-6(IL-6), and absolute neutrophil count (ANC)] were investigated. RESULTS: In all patients, the sTfR concentration showed a correlation with Hb, ferritin, MCV, and ANC, but not with CRP and IL-6. In multiple regression models, positive correlations were found between sTfR concentration and IL-6 (r=0.078, P=0.043), and negative correlations were found between sTfR concentration and ANC (r=-0.117, P=0.033) and MCV (r=-0.027, P=0.009). CONCLUSION: sTfR concentration was influenced by inflammatory parameters. Therefore, sTfR does not appear to be a useful parameter for discriminating between iron deficiency anemia and anemia of inflammation in infants.
Anemia ; Anemia, Iron-Deficiency ; Erythropoiesis ; Ferritins ; Hemoglobins ; Humans ; Infant ; Inflammation ; Interleukin-6 ; Iron ; Neutrophils ; Pyridines ; Receptors, Transferrin ; Thiazoles ; Transferrin