Clinical Adaptation According to Anatomical Types of Nasal Septum / Adaptación Clínica Según Tipos Anatómicos de Tabique Nasal

SUMMARY: The purpose of this study was to inform the anatomical types of the nasal septum of which including variations by dissection and to provide guidelines for clinical adaptation. For this purpose dissections were performed on 70 nasal septums of formalin fixed Korean adult cadavers (20 males, 11 females, and 39 of unknown sex) with an age at death of 13-105 years. The septal deviation was checked before midsagittal section the nasal cavity with the aid of a laryngoscope. The mucosa on the nasal septum was then removed to observe the morphology of the nasal septum. The shape of each component of the nasal septum was identified, and photographs were taken from a midsagittal plane. This study has discovered various anatomical types of the nasal septum and its variations. The correlations between septal types according to their proportions were also analyzed. The results reported herein provide detailed anatomical knowledge that can be used as a valuable reference for rhinoplasty procedures.

El propósito de este estudio fue informar los tipos anatómicos del tabique nasal incluyendo las variaciones por disección y brindar pautas para la adaptación clínica. Para este propósito, se realizaron disecciones en 70 tabiques nasales de cadáveres adultos coreanos fijados con formalina (20 hombres, 11 mujeres y 39 de sexo desconocido) con una edad de muerte de 13 a 105 años. La desviación septal se comprobó antes de la sección medio sagital de la cavidad nasal con la ayuda de un laringoscopio. A continuación, se retiró la mucosa del tabique nasal para observar la morfología del tabique nasal. Se identificó la forma de cada componente del tabique nasal y se tomaron fotografías desde un plano mediano sagital. En el estudio se descubrieron varios tipos anatómicos del tabique nasal y sus variaciones. También se analizaron las correlaciones entre los tipos septales según sus proporciones. Los resultados informados en este documento proporcionan un conocimiento anatómico detallado que se puede utilizar como una referencia valiosa para los procedimientos de rinoplastía.

Morphometric analysis of the mandibular lingual foramina using cone-beam computed tomography in elderly Korean / Análisis morfométrico de los forámenes linguales mandibulares mediante tomografía computarizada de haz cónico en adultos mayores coreanos

SUMMARY: The aim of this study was to determine the morphologic characteristics of the lingual foramen and lateral lingual foramen using cone-beam CT in elderly Korean. Cone-beam CT images were obtained from 80 Korean older than 50 years (mean age, 65.2 years). The prevalence of the lingual and lateral lingual foramina at the lingual aspect of the mandible was determined. The diameter and height to the upper margin of the foramina from the mandibular inferior margin, and the bone height to the alveolar crest from the mandibular inferior margin were measured. In addition, the location of the lateral lingual foramen, the direction of its canal, and the presence of communication with the mandibular canal were evaluated. All of elderly Korean possessed at least one lingual foramen, with two or three foramina occurring in 77.5 % of Korean. A lateral lingual foramen was observed in 91.3 % of Korean, with the prevalence being highest at the second premolar in dentulous cases (21.6 %; 33/153). The very high frequencies of these foramina were attributable to high frequencies of relatively small-diameter inferior lingual foramen and lateral lingual foramen in the incisor region. The prevalence of a large-diameter (≥1 mm) superior lingual foramen was high, at 31.0 %. A large-diameter lateral lingual foramen in the premolar region occurred at a frequency of 17.0 %; communication with the mandibular canal was observed in 70.0 % of these cases. These quantitative data on the lingual and lateral lingual foramina of the mandible provide valuable information that could help to avoid surgical complications during implant placement in elderly Korean.

RESUMEN: El objetivo de este estudio fue determinar las características morfológicas del foramen lingual y del foramen lingual lateral mediante TC de haz cónico en adultos mayores coreanos. Se obtuvieron imágenes de TC de haz cónico de 80 coreanos mayores de 50 años (edad media, 65,2 años). Se determinó la prevalencia de los forámenes linguales y linguales laterales en la cara lingual de la mandíbula. Se midió el diámetro y la altura hasta el margen superior de los forámenes desde el margen inferior mandibular, y la altura ósea hasta la cresta alveolar desde el margen inferior mandibular. Además, se evaluó la ubicación del foramen lingual lateral, la dirección de su canal y la presencia de comunicación con el canal mandibular. Todos los adultos mayores coreanos tenían al menos un foramen lingual, con dos o tres forámenes en el 77,5 %. Se observó un foramen lingual lateral en el 91,3 %, siendo la prevalencia más alta en el segundo premolar en casos dentados (21,6 %; 33/ 153). Las mayores frecuencias de estos forámenes se atribuyeron a altas frecuencias de foramen lingual inferior y foramen lingual lateral de diámetro relativamente pequeño en la región de los incisivos. La prevalencia de un foramen lingual superior de gran diámetro (≥1 mm) fue alta, del 31,0 %. Un foramen lingual lateral de gran diámetro en la región premolar ocurrió con una frecuencia del 17,0 %; se observó comunicación con el canal mandibular en el 70,0 % de estos casos. Estos datos cuantitativos sobre los forámenes linguales y linguales laterales de la mandíbula proporcionan información valiosa que podría ayudar a evitar complicaciones quirúrgicas durante la colocación de implantes en adultos mayores coreanos.

Anti-anger Effects of Herbal Medicine: A Mini-Review of Rat Studies / 中国结合医学杂志

OBJECTIVE@#To analyze the available data on the anti-anger effects of herbal medicines (HMs) as well as their underlying mechanisms in rat models.@*METHODS@#From 6 electronic databases [PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Oriental Medicine Advanced Searching Integrated System (OASIS), and Research Information Sharing Service (RISS)], relevant animal experiments were searched by using "anger," "rats," and "animal" as search keywords. The last search was conducted on November 22, 2019, and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered.@*RESULTS@#A total of 24 studies with 16 kinds of HMs were included. Most studies have used the "tail irritating method" and "social isolation and resident intruder" method to establish anger models. According to the included studies, the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology (Bupleuri Radix, Paeoniae Radix Alba, and Glycyrrhizae Radix), regulation of sex hormones (Bupleuri Radix, Cyperi Rhizoma, and Paeoniae Radix Alba), regulation of neurotransmitters (Cyperi Rhizoma), regulation of anger-related genes (Bupleuri Radix, Glycyrrhizae Radix, and Paeoniae Radix Alba), and other effects. Overall, Liver (Gan) qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used.@*CONCLUSIONS@#This review found the frequent methods to establish an anger model, and major mechanisms of anti-anger effects of HMs. Interestingly, some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM. These findings provide insight into the role and relevance of HMs in the field of anger management.

Korean red ginseng decreases 1-methyl-4-phenylpyridinium-induced mitophagy in SH-SY5Y cells / 中西医结合学报

OBJECTIVE@#Mitophagy is known to contribute towards progression of Parkinson's disease. Korean red ginseng (KRG) is a widely used medicinal herb in East Asia, and recent studies have reported that KRG prevents 1-methyl-4-phenylpyridinium ion (MPP@*METHODS@#SH-SY5Y cells were incubated with KRG for 24 h, and subsequently exposed to MPP@*RESULTS@#MPP@*CONCLUSION@#KRG effectively prevents MPP

The association between urinary bisphenol A levels and nonalcoholic fatty liver disease in Korean adults: Korean National Environmental Health Survey (KoNEHS) 2015-2017

BACKGROUND@#Nonalcoholic fatty liver disease (NAFLD) is becoming a global health problem. Bisphenol A (BPA), one of most widely used environmental chemicals, is suspected to be a contributor to the development NAFLD. This study was performed to examine the relationship between human BPA levels and risk of NAFLD.@*METHODS@#The data (n = 3476 adults: 1474 men and 2002 women) used in this study were obtained from the Korean National Environmental Health Survey III (2015-2017). BPA levels were measured in urine samples. NAFLD was defined using hepatic steatosis index after exclusion of other causes of hepatic diseases.@*RESULTS@#There was a significant linear relationship between the elevated urinary BPA concentrations and risk of NAFLD. In a univariate analysis, odds ratio (OR) of the highest quartile of urinary BPA level was 1.47 [95% confidence interval (CI) 1.11-1.94] compared to the lowest quartile. After adjusted with covariates, the ORs for NAFLD in the third and fourth quartiles were 1.31 [95% CI 1.03-1.67] and 1.32 [95% CI 1.03-1.70], respectively.@*CONCLUSIONS@#Urinary BPA levels are positively associated with the risk of NAFLD in adults. Further experimental studies are needed to understand the molecular mechanisms of BPA on NAFLD prevalence.

The prevalence of persistent metopic sutures comparing the Nepalese bone collection with Korean bone collection / Prevalencia de suturas metópicas persistentes que comparan una colección de huesos nepaleses con una colección de huesos coreanos

SUMMARY: Metopic suture can be visualized from the nasion to the bregma along the arch of the frontal bone in mid-sagittal plane. Persistent metopic suture normally closing between 1st and 2nd year of life has also been related with ethnicity. The present study reports the presence of complete and incomplete metopic sutures in Nepalese and Korean population skulls which helps to shed light on its incidence rate. Out of 121 adult skulls in Nepalese population, metopic suture was found to be present in 33 skulls. Incomplete metopic sutures showed variations of morphology, like linear (6.61 %), V-shaped (8.26 %) and double incomplete (10.74 %) and two cases with complete metopic suture, which showed variation in interdigitation between its anterior and posterior ends. Korean population showed metopic suture to be present in 8 skulls out of 104 with metopism in 3 skulls. Incomplete metopic sutures like double incomplete (1.92 %) and linear (2.88 %) were also noted. Alterations to local strains could be the contributing factor for such variation and complexity of interdigitation, which occur during the growth of the braincase. The knowledge of the metopic suture and its variations according to ethnicity is important and should be considered to prevent wrong diagnosis. The presence of different types of metopic sutures as reported by the present study provides informative value on the presence and variation of such sutures in population depending on ethnicity and ought to be helpful in diagnostic sequences in emergency setting.

RESUMEN: La sutura metópica se puede visualizar desde nasión hasta el bregma a lo largo del arco del hueso frontal en el plano mediano sagital. La sutura metópica persistente que normalmente se cierra entre el primer y segundo año de vida, también se ha relacionado con el origen étnico. El presente estudio informa la presencia de suturas metópicas completas e incompletas en los cráneos de la población nepalesa y coreana, lo que además de entregar información sobre su tasa de incidencia. De 121 cráneos adultos en la población nepalesa, en 33 de ellos se encontró la sutura metópica. Las suturas metópicas incompletas mostraron variaciones de la morfología, como lineal (6,61 %), en forma de V (8,26 %) y doble incompleta (10,74 %), además de dos casos con sutura metópica completa, que mostraron variación en la interdigitación entre sus extremos anterior y posterior. De los 104 cráneos de la población coreana en 8 se presentó la sutura metópica y en 3 metopismo. También se observaron suturas metópicas incompletas como doble incompleta (1,92 %) y lineal (2,88 %). Las alteraciones en las etnias locales podrían ser el factor contribuyente para tal variación y complejidad de la interdigitación, que ocurre durante el crecimiento de la cráneo. El conocimiento de la sutura metópica y sus variaciones según el origen étnico es importante y debe considerarse para prevenir un diagnóstico incorrecto. La presencia de diferentes tipos de suturas metópicas según lo informado en el estudio, proporciona un valor informativo sobre la presencia y la variación de tales suturas en la población, dependiendo de la etnia, y debería ser útil en las secuencias de diagnóstico en situaciones de emergencia.

Association between serum 25-hydroxyvitamin D levels and myopia in general Korean adults

Purpose: We performed this study to determine the association between serum 25-hydroxyvitamin D [25(OH) D] level and myopia in adults. Methods: A total of 25,199 subjects aged ?20 years were included from the National Health and Nutrition Examination Survey 2008�12. Blood 25(OH)D levels were evaluated from blood samples. Refractive error was measured without cycloplegia. Myopia and high myopia were defined as ?-0.50 diopters (D) and ?-6.0 D, respectively. Other covariates such as education, physical activity, and economic status were obtained from interviews. Results: Linear regression analysis showed that as 25(OH) D level increased by 1 ng/mL, myopic refractive error significantly decreased by 0.01 D (P < 0.001) after adjusting for potential confounders including sex, age, height, education level, economic status, physical activity, and sunlight exposure time. The odds ratios for myopia was 0.75 (95% Confidence interval [CI]; 0.67�84, P < 0.001) in the highest 25(OH) D quintile compared to the lowest quintile. The odds ratios for high myopia was 0.63 (95% CI; 0.47�85, P < 0.001) in the highest 25(OH)D quintile compared to the lowest quintile. Conclusion: Serum 25(OH)D level was inversely associated with myopia in Korean adults

Association between dairy product intake and hypertriglyceridemia in Korean adults

BACKGROUND/OBJECTIVES: Hypertriglyceridemia may be a more important predictor of cardiovascular disease in Asian population consuming carbohydrate-rich foods than in Western populations. Dairy products are known to play a beneficial role in obesity, dyslipidemia, and metabolic syndrome, but the results vary depending on gender and obesity. In this study, we investigated the associations between dairy product intake and hypertriglyceridemia in Korean adults.SUBJECTS/METHODS: The participants were selected from the Korea National Health and Nutrition Examination Survey 2007–2012 (KNHANES IV and V). A total of 22,836 participants aged 19–64 years were included in the analysis. A food frequency questionnaire used to determine the frequency of consumption of products (milk and yogurt). Multivariable logistic regression was used to assess the associations between dairy product intake and hypertriglyceridemia.RESULTS: A significantly decreased risk of hypertriglyceridemia was detected in the highest dairy product intake frequency group (≥ 1 time/day) (odd ratio [OR] = 0.79; 95% confidence interval [CI] 0.64–0.97, P for trend = 0.022) compared to that for the lowest dairy product intake frequency group. Among obese participants, the group with the highest intakes of milk (in men, OR = 0.64; 95% CI: 0.46–0.91, P for trend = 0.036) and yogurt (in women; OR = 0.53; 95% CI: 0.29–0.94, P for trend = 0.019) showed inverse associations with hypertriglyceridemia. No associations were detected in normal weight participants.CONCLUSION: The association between dairy product intake and hypertriglyceridemia differed by gender and obesity status. Further prospective studies are needed to confirm these associations.

Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults / 대한지역사회영양학회지

OBJECTIVES: This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults.METHODS: Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model.RESULTS: After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level.CONCLUSIONS: A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.

Nationwide Cross-sectional Study of Association between Pterygium and Alkaline Phosphatase in a Population from Korea

PURPOSE: We determined whether elevated serum alkaline phosphatase (ALP) was related to prevalence, location, type, length, and recurrence of pterygium in a population from the Republic of Korea.METHODS: A nationwide cross-sectional dataset, the Korean National Health and Nutrition Examination Survey (2008–2011), was used in this study. All participants were > 30 years of age and underwent the ALP test and ophthalmic evaluation (n = 22,359). One-way analysis of variance, the chi-square test, and Fisher's exact test were used to compare characteristics and outcomes among participants. Multivariable logistic regression was used to examine the possible associations between serum ALP levels and various types of pterygium. Data were adjusted for known risk factors for development of pterygium and ALP elevation (age, sex, residence, sunlight exposure, drinking, smoking, hypertension, diabetes, BMI, AST, ALT, vitamin D, and HDL).RESULTS: The overall prevalence of pterygium was 8.1%, and participants with pterygium had higher levels of serum ALP (p < 0.001). Participants with higher serum ALP had a significantly higher prevalence of all types of pterygium than those in the lower serum ALP quartiles. After adjusting for potential confounding factors, multivariate logistic regression analysis revealed that ALP was associated with the prevalence of pterygium (odds ratio [OR], 1.001; p = 0.038). Trend analysis between the OR and ALP quartiles revealed a linear trend in overall prevalence and in the intermediate type of pterygium. Subgroup analysis revealed a stronger correlation in participants > 50 years of age. One-way analysis of variance revealed an association between the size of pterygium and serum ALP quartile levels. Serum ALP was not associated with recurrence of pterygium.CONCLUSIONS: Increased serum ALP was associated with the prevalence and size of pterygium.

Effect of hot water extract of Korean ginseng on neuroblastoma cell parthanatos / 南方医科大学学报

OBJECTIVE@#To explore the effect of pretreatment of neuroblastoma cells with hot water extract of Korean ginseng on MNNG-induced parthanatos and its mechanism.@*METHODS@#Neuroblastoma SH-SY5Y cells were pretreated with 1 mg/L hot water extract of Korean ginseng before induction with 250 μmol/L MNNG for 1 h or 4 h. CCK-8 and cell flow cytometry were used to detect cell survival rate. Western blotting was used to detect the changes in poly(ADP-ribose) (PAR) expression in the treated cells. Immunofluorescence assay was used to detect nuclear distribution of apoptosis-inducing factor (AIF), and flow cytometry was used to detect the level of reactive oxygen species (ROS) in the cells.@*RESULTS@#Compared with the blank control cells, MNNG-treated SH-SY5Y cells showed significantly decreased survival rate as the concentration of MNNG and the stimulation time increased ( < 0.05). Stimulation with MNNG also resulted in significantly increased expression of PAR protein in the cells ( < 0.05). Pretreatment of the cells with hot water extract of Korean ginseng obviously inhibited MNNG-induced cell death and significantly reduced AIF expression and nucleation in the cells ( < 0.05). MNNG stimulation significantly increased ROS level in the cells, which was decreased significantly by pretreatment of the cells with the extract ( < 0.05).@*CONCLUSIONS@#Pretreatment with hot water extract of Korean ginseng reduces MNNG-induced parthanatos and ROS production in SH-SY5Y cells.

Relationship between seafood consumption and bisphenol A exposure: the Second Korean National Environmental Health Survey (KoNEHS 2012–2014)

BACKGROUND: This study aimed to identify the relationship between exposure to bisphenol A (BPA) and seafood consumption using a nationally representative data of the general Korean population.METHODS: This study was conducted on 5,402 adults aged 19 years and older (2,488 men, 2,914 women) based on the second Korean National Environmental Health Survey (2012–2014). We stratified the data according to gender and analyzed urinary BPA concentrations in terms of sociodemographic characteristics, health behavior, dietary factor, and seafood consumption. In the high and low BPA exposure groups, the odds ratios (ORs) were calculated using logistic regression analysis according to the top 75th percentile concentration.RESULTS: In men, large fish and tuna and other seafood categories had significantly higher ORs before and after adjustment in the group who consumed seafood more than once a week than in the group who rarely consumed seafood, with an adjusted value of 1.97 (95% confidence interval [CI]: 1.12–3.48) and 1.74 (95% CI: 1.10–2.75), respectively. In the shellfish category, the unadjusted OR was 1.61 (95% CI: 1.00–2.59), which was significantly higher in the group who consumed seafood more than once a week than in the group who rarely consumed seafood. However, the OR after adjusting for the variables was not statistically significant. In women, the frequency of seafood consumption and the concentration of urinary BPA were not significantly associated.CONCLUSIONS: BPA concentration was higher in men who frequently consumed large fish and tuna, shellfish and other seafood in this study.

Influenza Vaccine Effectiveness among Elementary School Students in Korea during the 2016-2017 Seasons: a Cross-Sectional Survey

Subtypes of Sleep Disturbance in Parkinson's Disease Based on the Cross-Culturally Validated Korean Version of Parkinson's Disease Sleep Scale-2

Modelado vectorial tridimensional del corazón y los vasos coronarios a partir de cortes anatómicos del proyecto Korean Visible Human / Visible Human Project: a new computarized virtual dissection table as a learning tool for students and anatomy teachers

La disección virtual es una herramienta educativa sumamente valiosa en anatomía. Es particularmente útil cuando hay escasez de cadáveres o en los casos en que la disección no sea posible por motivos religiosos o éticos. En este trabajo los autores presentan una reconstrucción 3D de un corazón masculino a partir de la información del proyecto Korean Visible Human, realizado en el marco de asociaciones de la cátedra de anatomía digital de la UNESCO creada recientemente en la Universidad Descartes. La segmentación manual de 1640 cortes anatómicos se logró a través del software Winsurf, produciendo un modelo vectorial 3D interactivo del corazón y la anatomía que lo rodea. Se reconstruyeron ochenta y cuatro estructuras, incluyendo el corazón y sus vasos (27 estructuras), tráquea, esófago, pulmones, cayado aórtico, vena cava inferior, riñones, sistema esquelético conformado por 58 estructuras, entre ellas: esternón, cartílagos costales, vértebras torácicas y discos intervertebrales, sacro, coxales y piel. El modelo vectorial 3D obtenido se exportó en formato PDF 3D produciendo una verdadera herramienta de disección virtual a través de la interfaz de Acrobat: las estructuras anatómicas pueden individualizarse y manipularse interactivamente como 84 objetos 3D separados. Además, se pueden agregar "etiquetas" con el nombre de cada elemento anatómico. Esta nueva mesa de disección virtual computarizada es una herramienta simple y poderosa tanto para alumnos como para docentes de anatomía. Además, resulta ser la base para futuras herramientas de simulación que contribuirán al entrenamiento de cirujanos

The virtual dissection is a remarkable learning tool in anatomy. It is particularly useful in the case of lack of cadavers or if anatomical dissection is impossible due to ethical or religious reasons. The authors present here a 3D reconstruction of the female's heart from the Visible Korean human data, made in the frame of the projects of the UNESCO chair of digital anatomy created recently at the Descartes University.The manual segmentation of 1640 anatomical slices was achieved with the Winsurf ® software producing an interactive 3D vectorial model of the heart and surrounding anatomy. Eighty four anatomical structures were reconstructed, including the heart and its vessels (27 structures), trachea, oesophagus, lungs, aortic arch, superior vena cava, azygos system, inferior vena cava, right and left kidneys, skeletal system (58) structures including: sternum, xiphoid process, clavicles, ribs, costal cartilage, thoracic vertebrae, intervertebrales discs, sacrum, hip bones, and femurs) and skin. The obtained 3D vectorial model was exported in 3D PDF format, producing a true virtual dissection tool through the Acrobat's interface: the anatomical structures can be individually and interactively manipulated as 84 separated 3D objects. 3D labels can be added with the name of each anatomical element. This new computerized virtual dissection table is a simple and powerful learning tool for students and anatomy teachers. It is also the basis of future simulation tools for surgeon's training

Korean hospitalist system implementation and development strategies based on pilot studies

The Korean hospitalist system was introduced in 2016. The new inpatient care system that provides direct care from a specialist required great efforts from various parties to implement successfully. This study outlines the implementation of the Korean hospitalist system and the development strategies based on pilot studies. The definition of the Korean hospitalist includes two elements which are 1) hospitalist is a physician who is in charge of a patient from admission to discharge and 2) hospitalist should stay in the hospitalist ward, where a hospitalist provides medical services to patients at their point of needs. The purpose of the Korean hospitalist system is to provide high-quality care and to ensure the safety of admitted patients. Due to a gap in the healthcare workforces in hospitals caused by changes in the residents' working hours and training period of the residents, the implementation of a new system was inevitable to provide care for patients. The result of private and public pilot studies indicated that hospitals, physicians, and patients are keen to have the hospitalist system in place. Also, those stakeholders agreed that reasonable and accurate fee-schedules for hospitalist services would enhance the service system. Within the current system, hospitals are reimbursed for providing the service, while patients pay out-of-pocket. Therefore, the service can only be applied to a patient who agrees to pay the additional fee for the service. As the Korean medical system is facing a paradigm shift, the Korean hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients.

Identifying the Causes of Nutrition Inadequacy in Vietnamese Married Immigrant Women and Korean Spouses through Qualitative Research

This study examined the possible causes of nutritional inadequacy in Vietnamese immigrant women married to Korean husbands. Qualitative in-depth interviews were conducted with a sample of 34 Vietnamese marriage immigrant women and 17 Korean spouses participating in or having experienced Nutrition Plus from four Community Health Centers in Seoul, Korea. The study results showed that the nutritional staus of the Vietnamese marriage immigrant women was affected by the unfamiliar Korean food (cultural factor), low household income (economical factor), difficulty in purchasing Vietnamese food (environmental factor), and low accessibility to nutrition support systems (social factor). The Korean husbands' nutritional status was affected by the unfamiliar Vietnamese food (cultural factor), low household income (economic factor), and irregular working conditions (social factors). Nutritional interventions as a public service to the community needs to be developed and applied. Suggestions are presented regarding the future efforts to better understand and meet the nutrition needs of intermarried couples to respond to their heterogeneous needs and deliver adequate nutrition service to ever increasing intermarried families.

Clinical Utility and Cut-Off Scores of the Korean Adult Attention-Deficit/Hyperactivity Disorder Rating Scale

OBJECTIVES: This study was conducted to re-validate the clinical efficacy of the Korean Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale (K-AARS), which is a self-report scale for ADHD in adults, and to determine the clinical utility and cut-off scores of K-AARS. METHODS: The participants were 135 drug naïve adults with ADHD and 144 healthy controls. To diagnose ADHD based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, two board-certified pediatric psychiatrists interviewed the participants and completed the Mini International Neuropsychiatric Interview. K-AARS was applied to all participants. K-AARS comprises six clinical subscales, one impairment subscale, and one driving behavior subscale. The receiver operating characteristic analysis was conducted to calculate the cut-off scores of K-AARS. RESULTS: All subscale scores, including six clinical subscale, impairment subscale, and driving behavior subscale scores, were found to be significant in distinguishing adults with ADHD from healthy controls. The sensitivity and specificity of the six clinical subscales were 63.0–77.0% and 66.7–79.9%, respectively. The combined total score of the six clinical subscales, had a sensitivity of 80.0% and specificity of 79.9%. CONCLUSION: The discriminative power of K-AARS for the diagnosis of ADHD in adults was excellent, and K-AARS and the empirical diagnosis of adults can be useful in diagnosing ADHD in adulthood.

A Validation Study of the Korean Child Behavior Checklist 1.5-5 in the Diagnosis of Autism Spectrum Disorder and Non-Autism Spectrum Disorder

OBJECTIVES: The purpose of this study was to analyze the discriminant validity and the clinical cut off scores of the Child Behavior Checklist 1.5-5 (CBCL 1.5-5) in the diagnosis of autism spectrum disorder (ASD) and non-ASD. METHODS: In total, 104 ASD and 441 non-ASD infants were included in the study. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. RESULTS: The discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, and Total problems, along with the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC analysis showed that the following subscales significantly separated ASD from normal infants: Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. Moreover, the clinical cut off score criteria adopted in the Korean-CBCL 1.5-5 were shown to be valid for the subscales Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. CONCLUSION: The subscales of Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems significantly discriminated infants with ASD.

Cognitive Function, Emotional and Behavioral Problems, and Temperament of Premature Children

OBJECTIVES: We aimed to compare preterm, neurodevelopmentally disordered and healthy full-term children. METHODS: We enrolled 47 children who were born preterm, 40 neurodevelopmentally disordered children, and 80 healthy children as control participants, in order to assess the cognitive functioning and the risk of behavioral problems at the age of 5. Children were assessed using the Korean Wechsler Preschool and Primary Scale of Intelligence-4th edition (K-WPPSI-IV), the Child Behavior Checklist (CBCL), and the Temperament and Character Inventory (TCI). RESULTS: The mean K-WPPSI-IV score of the preterm group was 87.19±17.36, which was significantly higher than that of the neurodevelopmental disorder group (69.98±28.63; p < 0.001) but lower than that of the control group (107.74±14.21; p < 0.001). The cumulative CBCL scores of the preterm children were not significantly different from those of the control group. Additionally, the TCI scores for reward dependence of the preterm children were higher than those of the control group. CONCLUSION: The cognitive performance of preterm infants was lower than that of healthy full-term infants at the age of 5, and there was an association between slower growth and decreased cognitive ability.