This study analyzes the career trajectories of students from Jeonuigam in the late nineteenth centry Joseon dynasty, shedding light on its educational functions by focusing on individuals listed in the Jeonhamsaengdoan and Byeoncheonpalsean. The primary subject of this research, the Jeonhamsaengdoan, is a valuable resource for understanding the career paths of Jeonuigam students, containing enrollment information for 384 individuals. The Byeolcheonpalsean, introduced for the first time in this paper, provides information about an alternative method of enrollment known as ‘Byeolcheon’ for students entering Jeonuigam.The analysis of these individuals’ career paths reveals that many Jeonuigam students had overlapping enrollments in other technical institutions, such as Saekwon and Gwangsangam. This suggests that medical education was not limited to specific disciplines but was part of a broader educational framework. Moreover, the Seogyeong system allowed younger siblings to enroll alongside older ones, while the Byeolcheon system, which facilitated recommendations from other institutions, provided educational opportunities for families. These findings highlight the diverse methods in which medical and vocational education were conducted in the late nineteenth century Joseon dynasty.Approximately 66 percent of Jeonuigam students became medical officials, while others pursued careers in fields such as interpreting and various government roles, contributing to society in multiple ways. This study demonstrates that Jeonuigam was not solely focused on training medical personnel but was intricately linked to broader vocational education systems. Consequently, this study contributes to a historical understanding of medical education in the late Joseon period. Future studies should explore comparisons with Hyeminseo and Naeuiwon, changes in the social status of the middle class, and Jeonuigam’s role during the transition to modern medical systems.

This study analyzes the career trajectories of students from Jeonuigam in the late nineteenth centry Joseon dynasty, shedding light on its educational functions by focusing on individuals listed in the Jeonhamsaengdoan and Byeoncheonpalsean. The primary subject of this research, the Jeonhamsaengdoan, is a valuable resource for understanding the career paths of Jeonuigam students, containing enrollment information for 384 individuals. The Byeolcheonpalsean, introduced for the first time in this paper, provides information about an alternative method of enrollment known as ‘Byeolcheon’ for students entering Jeonuigam.The analysis of these individuals’ career paths reveals that many Jeonuigam students had overlapping enrollments in other technical institutions, such as Saekwon and Gwangsangam. This suggests that medical education was not limited to specific disciplines but was part of a broader educational framework. Moreover, the Seogyeong system allowed younger siblings to enroll alongside older ones, while the Byeolcheon system, which facilitated recommendations from other institutions, provided educational opportunities for families. These findings highlight the diverse methods in which medical and vocational education were conducted in the late nineteenth century Joseon dynasty.Approximately 66 percent of Jeonuigam students became medical officials, while others pursued careers in fields such as interpreting and various government roles, contributing to society in multiple ways. This study demonstrates that Jeonuigam was not solely focused on training medical personnel but was intricately linked to broader vocational education systems. Consequently, this study contributes to a historical understanding of medical education in the late Joseon period. Future studies should explore comparisons with Hyeminseo and Naeuiwon, changes in the social status of the middle class, and Jeonuigam’s role during the transition to modern medical systems.

This study analyzes the career trajectories of students from Jeonuigam in the late nineteenth centry Joseon dynasty, shedding light on its educational functions by focusing on individuals listed in the Jeonhamsaengdoan and Byeoncheonpalsean. The primary subject of this research, the Jeonhamsaengdoan, is a valuable resource for understanding the career paths of Jeonuigam students, containing enrollment information for 384 individuals. The Byeolcheonpalsean, introduced for the first time in this paper, provides information about an alternative method of enrollment known as ‘Byeolcheon’ for students entering Jeonuigam.The analysis of these individuals’ career paths reveals that many Jeonuigam students had overlapping enrollments in other technical institutions, such as Saekwon and Gwangsangam. This suggests that medical education was not limited to specific disciplines but was part of a broader educational framework. Moreover, the Seogyeong system allowed younger siblings to enroll alongside older ones, while the Byeolcheon system, which facilitated recommendations from other institutions, provided educational opportunities for families. These findings highlight the diverse methods in which medical and vocational education were conducted in the late nineteenth century Joseon dynasty.Approximately 66 percent of Jeonuigam students became medical officials, while others pursued careers in fields such as interpreting and various government roles, contributing to society in multiple ways. This study demonstrates that Jeonuigam was not solely focused on training medical personnel but was intricately linked to broader vocational education systems. Consequently, this study contributes to a historical understanding of medical education in the late Joseon period. Future studies should explore comparisons with Hyeminseo and Naeuiwon, changes in the social status of the middle class, and Jeonuigam’s role during the transition to modern medical systems.

This study analyzes the career trajectories of students from Jeonuigam in the late nineteenth centry Joseon dynasty, shedding light on its educational functions by focusing on individuals listed in the Jeonhamsaengdoan and Byeoncheonpalsean. The primary subject of this research, the Jeonhamsaengdoan, is a valuable resource for understanding the career paths of Jeonuigam students, containing enrollment information for 384 individuals. The Byeolcheonpalsean, introduced for the first time in this paper, provides information about an alternative method of enrollment known as ‘Byeolcheon’ for students entering Jeonuigam.The analysis of these individuals’ career paths reveals that many Jeonuigam students had overlapping enrollments in other technical institutions, such as Saekwon and Gwangsangam. This suggests that medical education was not limited to specific disciplines but was part of a broader educational framework. Moreover, the Seogyeong system allowed younger siblings to enroll alongside older ones, while the Byeolcheon system, which facilitated recommendations from other institutions, provided educational opportunities for families. These findings highlight the diverse methods in which medical and vocational education were conducted in the late nineteenth century Joseon dynasty.Approximately 66 percent of Jeonuigam students became medical officials, while others pursued careers in fields such as interpreting and various government roles, contributing to society in multiple ways. This study demonstrates that Jeonuigam was not solely focused on training medical personnel but was intricately linked to broader vocational education systems. Consequently, this study contributes to a historical understanding of medical education in the late Joseon period. Future studies should explore comparisons with Hyeminseo and Naeuiwon, changes in the social status of the middle class, and Jeonuigam’s role during the transition to modern medical systems.

Background: To evaluate whether insulin resistance and impaired insulin secretion are useful predictors of incident diabetes in Koreans using nationwide population-representative data to enhance data privacy. Methods: This study analyzed the data of individuals without diabetes aged >40 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2010 and 2015 and the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). Owing to privacy concerns, these databases cannot be linked using direct identifiers. Therefore, we generated 10 synthetic datasets, followed by statistical matching with the NHIS-HEALS. Homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were used as indicators of insulin resistance and insulin secretory function, respectively, and diabetes onset was captured in NHIS-HEALS. Results: A median of 4,580 (range, 4,463 to 4,761) adults were included in the analyses after statistical matching of 10 synthetic KNHANES and NHIS-HEALS datasets. During a mean follow-up duration of 5.8 years, a median of 4.7% (range, 4.3% to 5.0%) of the participants developed diabetes. Compared to the reference low–HOMA-IR/high–HOMA-β group, the high–HOMA-IR/low– HOMA-β group had the highest risk of diabetes, followed by high–HOMA-IR/high–HOMA-β group and low–HOMA-IR/low– HOMA-β group (median adjusted hazard ratio [ranges]: 3.36 [1.86 to 6.05], 1.81 [1.01 to 3.22], and 1.68 [0.93 to 3.04], respectively). Conclusion Insulin resistance and impaired insulin secretion are robust predictors of diabetes in the Korean population. A retrospective cohort constructed by combining cross-sectional synthetic and longitudinal claims-based cohort data through statistical matching may be a reliable resource for studying the natural history of diabetes.

This study aimed to evaluate the differences in the baseline characteristics and patterns of antibiotic usage among hospitals based on their participation in the Korea National Antimicrobial Use Analysis System (KONAS). We obtained claims data from the National Health Insurance for inpatients admitted to all secondary- and tertiary-care hospitals between January 2020 and December 2021 in Korea. 15.9% (58/395) of hospitals were KONAS participants, among which the proportion of hospitals with > 900 beds (31.0% vs.2.6%, P < 0.001) and tertiary care (50.0% vs. 5.2%, P < 0.001) was higher than that among non-participants. The consumption of antibiotics targeting antimicrobial-resistant gram positive bacteria (33.7 vs. 27.1 days of therapy [DOT]/1,000 patient-days, P = 0.019) and antibiotics predominantly used for resistant gram-negative bacteria (4.8 vs. 3.7 DOT/1,000 patient-days, P = 0.034) was higher in KONAS-participating versus -non-participating hospitals. The current KONAS data do not fully represent all secondary- and tertiary-care hospitals in Korea; thus, the KONAS results should be interpreted with caution.

Purpose: This study aimed to evaluate the effect of prophylactic abdominal drainage (AD) in laparoscopic hemicolectomy, focusing on assessing postoperative pain outcomes. Methods: Patients were categorized into two groups: those with and without AD (AD group vs.no-AD group). A numerical rating scale (NRS) was used to assess postoperative pain on each postoperative day (POD). Further, the inverse probability of treatment weighting (IPTW) method was used to reduce intergroup bias. Results: In total, 204 patients who underwent laparoscopic hemicolectomies by a single surgeon between June 2013 and September 2022 at a single institution were retrospectively reviewed. After adjusting for IPTW, NRS scores on POD 2 were significantly lower in the no-AD group (3.2 ± 0.8 vs. 3.4 ± 0.8, p = 0.043). Further examination of postoperative outcomes showed no statistically significant differences in complications between the AD (17.3%) and no-AD (12.4%) groups (p = 0.170). The postoperative length of hospital stay was 7.3 ± 2.8 days in the AD group and 6.9 ± 3.0 days in the no-AD group, with no significant difference (p = 0.298). Time to first flatus was 3.0 ± 0.9 days in the AD group and 2.7 ± 0.9 days in the no-AD group, with no significant difference (p = 0.078). Regarding readmission within 1 month, there were four cases each in the AD (2.3%) and no-AD (1.7%) groups, with no significant difference (p = 0.733). Conclusion Laparoscopic hemicolectomy without AD resulted in no significant differences in postoperative clinical outcomes, except for postoperative pain. This finding suggests that prophylactic AD may exacerbate postoperative pain.

Background/Aims: Helicobacter pylori (HP) infection is positively associated with metabolic syndrome (MS). However, the long-term effects of eradication therapy on MS and sex differences have not been thoroughly studied. We aimed to investigate the long-term effects of HP eradication on MS and sex differences. Methods: This study included 2,267 subjects who visited a tertiary referral center between May 2003 and May 2019. HP was diagnosed by histology, a Campylobacter-like organism test, and culture, and the subjects were prospectively followed up. The participants were categorized into three groups: HP uninfected, HP infected but non-eradicated, and HP eradicated. The baseline characteristics and changes in metabolic parameters after HP eradication were compared over a 5-year follow-up period. Results: Among 1,521 subjects, there was no difference in baseline metabolic parameters between the HP-uninfected (n=509) and HP-infected (n=1,012) groups, regardless of sex. Analysis of the metabolic parameters during follow-up among HP-uninfected (n=509), HP-non-eradicated (n=346), and HP-eradicated (n=666) groups showed that high-density lipoprotein (HDL) and the body mass index (BMI) increased after eradication, with a significant difference at 1-year of follow-up. In females, HDL increased after eradication (p=0.023), and the BMI increased after eradication in male subjects (p=0.010). After propensity score matching, the HDL change in female remained significant, but the statistical significance of the change in BMI in the male group became marginally significant (p=0.089). Conclusions HP eradication affected metabolic parameters differently depending on sex. HDL significantly increased only in females over time, especially at 1-year of follow-up. In contrast, BMI showed an increasing tendency over time in males, especially at the 1-year follow-up.

As of September 3, 2022, 5,388,338 coronavirus disease 2019 (COVID-19) cases and 46 deaths (3 in 2021 and 43 in 2022) were reported in children ≤ 18 years in Korea. Cumulative confirmed cases accounted for 67.3% of the population aged ≤ 18 years and case fatality rate was 0.85/100,000. Among 46 fatal cases, 58.7% were male and median age was 7 years.Underlying diseases were present in 47.8%; neurologic diseases (63.6%) and malignancy (13.6%) most common. Only four had history of COVID-19 immunization. COVID-19 associated deaths occurred at median 2 days from diagnosis (range: −1 to 21). Among COVID-19 deaths, 41.3% occurred before admission; 2 before hospital arrival and 17 in the emergency department. Among children whose cause was documented, myocarditis, respiratory and multiorgan failure were most common. COVID-19 associated death was seen early after diagnosis in children and public health policies to provide access to medical care for children with COVID-19 are essential during the pandemic.

Background: We aimed to analyze the risk factors for sudden death after diagnosis of coronavirus disease 2019 (COVID-19) in South Korea and to provide evidence for informing prevention and control interventions for patients at risk of sudden death. Methods: We included 30,302 COVID-19 related deaths registered in the patient management information system (Central Disease Control Headquarters) between January 1, 2021, and December 15, 2022. We collected their epidemiological data recorded by the reporting city, province, or country. We performed multivariate logistic regression analysis to identify risk factors for sudden death after diagnosis of COVID-19. Results: Among the 30,302 deaths, there were 7,258 (24.0%) and 23,044 (76.0%) sudden and non-sudden deaths, respectively. Sudden death means a person who died within 2 days of diagnosis and who did not receive inpatient treatment. Underlying condition, vaccination status, and place of death were significantly associated with the survival period in all age groups. Moreover, region, sex, and prescription were significantly associated with the survival period only in certain age groups. However, reinfection was not significantly associated with the survival period in any age group. Conclusion To our knowledge, this is the first study on the risk factors for sudden death after a diagnosis of COVID-19, which included age, underlying condition, vaccination status, and place of death. Additionally, individuals aged < 60 years without an underlying condition were at high risk for sudden death. However, this group has relatively low interest in health, as can be seen from the high non-vaccination rate (16.1% of the general population vs. 61.6% of the corresponding group). Therefore, there is a possibility for the presence of an uncontrolled underlying disease in this population. In addition, many sudden deaths occurred due to delayed hospital visits to continue economic activities even after the onset of COVID-19 symptoms (7 days overall vs. 10 days average for the group). In conclusion, ‘continued interest in health’ is a key factor in avoiding sudden death in the economically active group (under 60 years of age).