3-Year Follow up Study of the Way of Thinking and Satisfaction Level of North Korean Defectors in South Korea / 신경정신의학

OBJECTIVES: The aim of this study was to examine the change in attitudes and satisfaction level of North Korean defectors in South Korea over a 3 year period (2001-2004). METHODS: In our first study in 2001, a total of 200 defectors were interviewed. In the follow up study after 3 years, 151 defectors were re-interviewed by an in-person interview. RESULTS: The level of satisfaction to the governmental support policy to defectors decreased significantly. However, the general level of satisfaction increased slightly (from 3.52 to 3.56 ; 5-score scale). This shows that North Korean defectors are stably adapting to South Korean society. The level of satisfaction significantly correlated with the defectors' confusion of the different value systems, the defectors' understanding of the South Korean people, satisfaction with their physical and mental health, and the prejudice of South Korean people to defectors. In terms of the attitudes, the type of schooling, the military service and the communist party membership in North Korea were not related to the change in attitude. However, there was a significant correlation with gender and age. Women showed a greater change in attitude compared to men. Older people had difficulty in understanding the South Korean people, but they showed little psychological affiliation to North Korea. Moreover, they showed a high level of satisfaction with the economic situation in South Korea and had an optimistic viewpoint for their future than younger people. Even though many defectors attended churches, religion was not associated with the level of satisfaction or their change in attitude. CONCLUSION: The factors that influence the level of satisfaction and attitudes of North Korean defectors have changed over 3 years. Therefore, the government, nongovernmental organizations (NGOs) associated with defectors and the churches need to be more sensitive to these changes and make plans to support the adaptation of defectors to South Korean society.

Recurrence and Survival Analysis in Skin-Sparing Mastectomy with Immediate Reconstruction Compared with Conventional Mastectomy / 한국유방암학회지

PURPOSE: A skin-sparing mastectomy (SSM), followed by immediate reconstruction, which has aesthetic advantages, is being increasingly used to treat many early breast carcinomas; however, there are few data regarding the outcome and safety of this procedure. The objective of this study was to evaluate the safety of utilizing a SSM with immediate reconstruction compared with the outcome of a conventional mastectomy. METHODS: A retrospective review was performed on 169 patients who underwent a SSM with immediate reconstruction, and 2102 patients who received a conventional mastectomy between January 1996 and December 2002, at the Asan Medical Center. The patient and tumor characteristics, as well as the types of reconstruction, incidences of recurrence and survival rates were examined. RESULTS: The mean age of the SSM group was younger (39 vs. 47 years, p < 0.001), and the mean tumor size smaller than those of the mastectomy group (2.6 vs. 3.2cm, p = 0.002). Lymph node involvement was present in 39.6% and 48.4% of the SSM and mastectomy groups, respectively (p = 0.24). The proportion at early stages (0 and 1) in the SSM group was higher than those in the mastectomy group (50.9 vs. 30.7%, p < 0.001). In the high-risk patients, postoperative radiation was administered to 24.1 and 54.9% of the SSM and mastectomy group, respectively (p = 0.002). With a median follow-up of 41 months, the recurrence rates for the SSM and mastectomy groups were 11.8 (20 of 169 patients) and 14.4% (303 of 2102 patients), respectively (p = 0.22). There were no differences in the locoregional and distant recurrences between the two groups. The 5-year disease free survivals for the SSM and mastectomy groups were 81.9 and 81.7%, respectively (p = 0.71). The 5-year overall survivals for the SSM and mastectomy groups were 91.7 and 88,8%, respectively (p = 0.13). In a univariate analysis, the factors associated with a recurrence and the survival rates were the tumor stage and a lymph node positive state. CONCLUSION: No significant differences were found in the recurrence and survival rates of the SSM group, with immediate reconstruction, compared to those of the mastectomy only group. A skin-sparing mastectomy, with immediate reconstruction, which has greater aesthetic benefits, appeared to be an oncologically safe treatment option for breast carcinomas.

The Way of Thinking and Satisfaction Level of North Korean Defectors in South Korea / 신경정신의학

OBJECTIVES: This study was performed to study the way of thinking and satisfaction level of North Korean defectors in South Korea on various topics and their relationship with each other. METHODS: Direct interview was performed for 553 North Korean defectors in South Korea. 44 items of life satisfaction were rated. Satisfaction level was rated on a 5 point scale (1-unsatisfactory and 5-fully satisfied). Factor analysis and correlation of the factors were performed. RESULTS: The average level of satisfaction was 3.39. Relatively high satisfaction items were adjustment of their children, family life, and residence area. But relatively low satisfaction items were psychological and mental area, leisure, and income. In governmental support systems, medical support was the most satisfactorily rated item, but financial support for settlement and support for employment or job training were the most dissatisfied. In the factor analysis, 44 items of satisfaction were grouped into 13 factors. The correlation of these factors showed that general satisfaction is significantly correlated with satisfaction with housing, economic status, governmental support and lower degree of confusion on the sense of value. Confusion on the sense of value was high when defectors do not have close friends, have difficulties in understanding South Korean people, and are not satisfied with their economic status. Religion did not have significant correlation with the their sense of value. And self and social consciousness of the defectors were strongly correlated with the their employment status. CONCLUSION: This result showed that the satisfaction of North Korean defectors is correlated not only with material aspects, but also psychological and mental aspects. The results of study should be considered in helping defector to adjust to living in South Korea.