Japanese imperial psychiatry in Tokyo: two Korean immigrants in a psychiatric hospital, 1920-1945 / Psiquiatria imperial japonesa em Tóquio: dois imigrantes coreanos em um hospital psiquiátrico, 1920-1945

Abstract During the first half of the twentieth century, Western psychiatry was quickly absorbed in Japan, particularly the versions from Germany and Austria. By 1940, over 130 psychiatric hospitals were caring for approximately thirty thousand patients in cities, while in rural areas about sixty thousand people still depended on family members for care. Japan's empire expanded during this same period, and many immigrants came to the country. Growth in immigration from Korea was particularly important. Korean immigrants encountered Japanese psychiatric hospitals during the second quarter of the twentieth century, and this paper examines the complex nature of their hospital stays.

Resumo Ao longo da primeira metade do século XX, a psiquiatria ocidental foi rapidamente absorvida no Japão, particularmente as versões advindas da Alemanha e da Áustria. Em 1940, mais de 130 hospitais psiquiátricos cuidavam de cerca de trinta mil pacientes nas cidades, enquanto nas áreas rurais cerca de sessenta mil pessoas ainda dependiam dos cuidados de familiares. No mesmo período, o império japonês expandiu-se, e muitos imigrantes vieram para o país. Particularmente importante foi o crescimento da imigração coreana. Hospitais psiquiátricos japoneses e imigrantes coreanos se encontraram no segundo quartel do século XX. O artigo examina a complexidade dessas estadas hospitalares.

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.

Leisure Time Physical Activity to Reduce Metabolic Syndrome Risk: A 10-Year Community-Based Prospective Study in Korea

PURPOSE: Metabolic syndrome (MetS) is a major public health problem related to increased risks of cardiovascular disease and type 2 diabetes. We investigated whether recommended levels of leisure time physical activity (LTPA) decrease the risk of MetS in a community-based prospective cohort study (Ansung and Ansan cohort).MATERIALS AND METHODS: A total of 3910 adults (1890 men, 2020 women) without MetS examined in 2001–2002 (baseline) were included in this study and followed up from 2013 to 2014. We measured LTPA energy expenditure using the standard metabolic equivalent value [metabolic equivalent of task (MET)-h/wk]. Individuals were categorized into five groups (physically inactive, 0.1 to <7.5, 7.5 to <15.0, 15.0 to <22.5, 22.5 to <40.0, and ≥40.0 MET-h/wk).RESULTS: The mean follow-up period was 11.8 years. Among the cohort, 482 men (25.5%) and 541 women (26.8%) were diagnosed with newly developed MetS. Multivariate logistic analysis revealed a 4.4% lower MetS risk among those performing two to three times the recommended minimum of 7.5 MET-h/wk [multivariate relative risk (RR), 0.956; 95% confidence interval (CI), 0.654–1.398] and a 21.9% lower risk among those performing three to four times the physical activity minimum (multivariate RR, 0.781; 95% CI, 0.574–1.063). This association was only significant in females performing three to four times the minimum (crude RR, 0.655; 95% CI, 0.432–0.994).CONCLUSION: We noted that physical activity at more than 2 times the recommended minimum prevents MetS. Healthcare professionals should encourage inactive adults to be physically active during their leisure time to take advantage of its health benefits.

Distribution of Trauma Deaths in a Province of Korea: Is “Trimodal” Distribution Relevant Today?

PURPOSE: This study was designed to provide a basis for building a master plan for a regional trauma system by analyzing the distribution of trauma deaths in the most populous province in Korea.MATERIALS AND METHODS: We investigated the time distribution to death for trauma patients who died between January and December 2017. The time distribution to death was categorized into four groups (within a day, within a week, within a month, and over a month). Additionally, the distribution of deaths within 24 hours was further analyzed. We also reviewed the distribution of deaths according to the cause of death and mechanism of injury.RESULTS: Of the 1546 trauma deaths, 328 cases were included in the final study population. Patients who died within a day were the most prevalent (40.9%). Of those who died within a day, the cases within an hour accounted for 40.3% of the highest proportion. The majority of trauma deaths within 4 hours were caused by traffic-related accidents (60.4%). The deaths caused by bleeding and central nervous system injuries accounted for most (70.1%) of the early deaths, whereas multi-organ dysfunction syndrome/sepsis had the highest ratio (69.7%) in the late deaths. Statistically significant differences were found in time distribution according to the mechanism of injury and cause of death (p<0.001).CONCLUSION: The distribution of overall timing of death was shown to follow a bimodal pattern rather than a trimodal model in Korea. Based on our findings, a suitable and modified trauma system must be developed.

Signal Detection of Adverse Events Following Pneumococcal Vaccines from the Korea Adverse Event Reporting System Database, 2005–2016

PURPOSE: We aimed to analyze the surveillance reports of adverse events (AEs) due to different types of pneumococcal vaccines, in addition to detecting and validating signals of pneumococcal vaccines by comparing AEs with labels.MATERIALS AND METHODS: We analyzed the percentages of AEs according to vaccine type [pneumococcal polysaccharide vaccines (PPSVs) and pneumococcal conjugate vaccines (PCVs)] in children and adults using data from the Korea Adverse Event Reporting System (KAERS) database from 2005 to 2016. A signal was defined as an AE that met all three indices of data mining: proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). We validated the detected signals by calculating sensitivity, specificity, as well as positive and negative predictive values of the signals against label information.RESULTS: Of the 39933 AE reports on vaccination, 5718 (7.0%) were related to pneumococcal vaccine. The most frequent AE after vaccination with PPSV was fever (23.9%) in children and injection-site reaction in adults. The most frequent AE after vaccination with PCV in children was pharyngitis (26.2%). In total, 13 AEs met all three indices for signal detection. Among these, hypotension, apathy, sepsis, and increased serum glutamic oxaloacetic transaminase level were not listed on vaccine labels. In validation analysis, PRR and ROR performed slightly better than IC for adults who were vaccinated with PPSVs.CONCLUSION: Overall, 13 new signals of PPSVs, including four signals not listed on the labels, were detected. Further research based on additional AE reports is required to confirm the validity of these signals for children.

Validation of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) and Its Relevance to Disability and Frailty

PURPOSE: This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea.MATERIALS AND METHODS: This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis.RESULTS: WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001).CONCLUSION: WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.

Physical Activity Patterns and Their Associated Factors Measured by Global Physical Activity Questionnaire Survey among Korean / 대한스포츠의학회지

Research on physical activity and health is actively being conducted. In the Korea National Health and Nutrition Examination Survey (KNHANES), the Global Physical Activity Questionnaire (GPAQ) was newly introduced in 2014. The purpose of this study was to investigate the levels of physical activity and related factors in Koreans who were assessed through the GPAQ by dividing the physical activity by occupation, leisure, and transport domain. This study used data from the KNHANES (2014–2016), the study population of which included 17,357 participants aged 12 to 80 years. We compared the differences in physical activity by sociodemographic factors, health-related factors, and psychological health-related factors. Moreover, we also compared the mean metabolic equivalent of task and daily sitting time according to physical activity domain by sex and age group. Finally, we investigated the sociodemographic factors, health-related factors, and psychological health-related factors that significantly affect the average physical activity per week. The various factors were found to differ in the frequency of physical activity levels. In addition, there was a difference in the amount of physical activity per occupation, leisure, and transport domain in each age group. Finally, age, sex, high-density lipoprotein cholesterol levels, arthritis, allergic rhinitis and sinusitis, sleeping time, and perceived health status significantly affected physical activity. The levels of physical activity significantly differed by sociodemographic factors, health-related factors, and psychological health-related factors. There was also a difference in the physical activity levels according to the age and sex per each domain of physical activity.

Objective versus Self-reported Physical Activity and Cardiovascular Disease Risk Factors / 대한스포츠의학회지

PURPOSE: The main purpose of this study was to compare the relationships between physical activity (measured using an accelerometer vs. self-reported) and cardiovascular disease risk factors. Differences in accelerometry physical activity between 10-minute bouts and total bouts were also compared.METHODS: Data originated from the Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict cardiovascular disease risk from physical activity levels.RESULTS: Self-reported physical activity could not significantly predict the odds of having cardiovascular risk. However, the insufficiently active group classified according to the total-bout physical activity had significantly greater odds of having hypertension or prehypertension (odds ratio [OR], 1.35; 95% confidence interval [95% CI], 1.00–1.82), diabetes mellitus (OR, 1.77; 95% CI, 1.01–3.19), and dyslipidemia (OR, 1.65; 95% CI, 1.17–2.36) than the highly active group. Regarding the 10-minute bout physical activity, the inactive group had significantly greater odds of having only hypertension or prehypertension (OR, 1.67; 95% CI, 1.02–2.76) than the highly active group.CONCLUSION: Total-bout physical activity measured using an accelerometer could significantly predict the cardiovascular disease risk compared to 10-minute bout physical activity. However, self-reported physical activity could not significantly predict the cardiovascular disease risk.

Customers' Perceptions of Operational Status of and Needs for Sodium Reduction in the Industry Foodservice in Seoul / 대한지역사회영양학회지

OBJECTIVES: This study aimed to compare customers' perceptions of the need for a low-sodium diet and sodium-reduced operations in the industry foodservice by age. The relationships between health concerns and perceptions of the need for sodium-reduced operations and low-sodium diets in the industry foodservice were analyzed.METHODS: A survey was conducted among 340 industry foodservice customers aged 20–50 years and residing in Seoul, Korea. This study investigated the respondents' health concerns, their perception of the need for sodium-reduced foodservice operations, their perception of a sodium-reduced diet, and the general details of the foodservices they used. A cross-tabulation analysis and ANOVA were performed to identify differences in measurement items by age, and a simple regression analysis was performed to examine relationships between measurement items.RESULTS: For the customers' perception of the need for a sodium-reduced foodservice operation, the item “it is necessary to provide separate spices and sauces to reduce sodium intake” achieved the highest score (3.88 points out of a possible 5 points). For the perception of a sodium-reduced diet, the item “I think it is helpful for one's health” obtained the highest score (4.13 points). Respondents' health concerns had a positive effect on increasing the level of perception of the need for sodium-reduced foodservice operations and that of a sodium-reduced diet.CONCLUSIONS: Foodservice nutritionists could help enhance their customers' perceptions of the needs for sodium-reduced foodservice operations and sodium-reduced diets by frequently providing them with sodium-related health information.

Analysis of Dietary Calcium and Phosphorus Intakes and Contribution Rates of Major Dish Groups according to Gender, Age, and Region in Korea / 대한지역사회영양학회지

OBJECTIVES: Calcium (Ca) is an insufficiently consumed nutrient, whereas phosphorus (P) intake has exceeded the recommended intake level in Korea over the past decade. The purpose of this study was to analyze dietary Ca and P intakes and their contribution rate according to dish groups.METHODS: A 24-hour dietary recall survey of 640 healthy adults (aged 19–69 years) was undertaken twice in four Korean provinces. Dietary Ca and P intakes and their rates of contribution from 31 major dish groups were analyzed and compared by gender, age group, and region.RESULTS: The average Ca and P intakes of the subjects were 542.1 ± 222.2 mg/d and 1,068.3 ± 329.0 mg/d, respectively. The intakes of Ca and P as percentages of recommended nutrients intake (RNI%) were 71.7 ± 29.8% and 152.6 ± 47%, respectively, and the percentages under the estimated average requirement were 60.3% for Ca and 3.8% for P. The RNI% of Ca was not significantly different between males and females, but was significantly higher in subjects in the sixties age group than in other age groups and was significantly lower in the Korean capital than in other regions. The RNI% of P did not significantly differ by gender or age groups, but it was significantly higher in the capital than in Gyeong-sang. The five major dish groups contributing to Ca intake (contribution rate) were milks/dairy products 69.2 ± 109.2 mg/d (12.6%), soups 55.6 ± 69.6 mg/d (10.1%), stir-fried foods 53.1 ± 70.7 mg/d (9.7%), stews 43.4 ± 85.4 mg/d (7.9%), and kimchi 38.4 ± 31.8 mg/d (7.0%). The five major dish group contributing to P intake (contribution rate) were cooked rice 160.7 ± 107.1 mg/d (14.9%), stir-fried foods 88.5 ± 89.4 mg/d (8.2%), soups 76.7 ± 85.8 mg/d (7.1%), one-dish meals 63.3 ± 94.4 mg/d (5.9%), and stews 62.6 ± 89.3 mg/d (5.8%). The dish groups contributing to Ca and P intakes differed somewhat by gender, age group, and region.CONCLUSIONS: Programs to improve the nutritional status of Ca and P intakes should consider the differences in Ca and P contribution rates by dish groups as well as by gender, age group, and region.

One-Year Clinical Outcomes between Single- versus Multi-Staged PCI for ST Elevation Myocardial Infarction with Multi-Vessel Coronary Artery Disease: from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH)

BACKGROUND AND OBJECTIVES: Although complete revascularization is known superior to incomplete revascularization in ST elevation myocardial infarction (STEMI) patients with multi-vessel coronary artery disease (MVCD), there are no definite instructions on the optimal timing of non-culprit lesions percutaneous coronary intervention (PCI). We compared 1-year clinical outcomes between 2 different complete multi-vessel revascularization strategies.METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 606 patients with STEMI and MVCD who underwent complete revascularization were enrolled from November 2011 to December 2015. The patients were assigned to multi-vessel single-staged PCI (SS PCI) group (n=254) or multi-vessel multi-staged PCI (MS PCI) group (n=352). Propensity score matched 1-year clinical outcomes were compared between the groups.RESULTS: At one year, MS PCI showed a significantly lower rate of all-cause mortality (hazard ratio [HR], 0.42; 95% confidential interval [CI], 0.19–0.92; p=0.030) compared with SS PCI. In subgroup analysis, all-cause mortality increased in SS PCI with cardiogenic shock (HR, 4.60; 95% CI, 1.54–13.77; p=0.006), age ≥65 years (HR, 4.00; 95% CI, 1.67–9.58, p=0.002), Killip class III/IV (HR, 7.32; 95% CI, 1.68–31.87; p=0.008), and creatinine clearance ≤60 mL/min (HR, 2.81; 95% CI, 1.10–7.18; p=0.031). After propensity score-matching, MS PCI showed a significantly lower risk of major adverse cardiovascular event than SS PCI.CONCLUSIONS: SS PCI was associated with worse clinical outcomes compared with MS PCI. MS PCI for non-infarct-related artery could be a better option for patients with STEMI and MVCD, especially high-risk patients.

Social Inequalities of Oral Anticoagulation after the Introduction of Non-Vitamin K Antagonists in Patients with Atrial Fibrillation

BACKGROUND AND OBJECTIVES: Nationwide social inequalities of oral anticoagulation (OAC) usage after the introduction of non-vitamin K antagonist oral anticoagulants (NOACs) have not been well identified in patients with atrial fibrillation (AF). This study assessed overall rate and social inequalities of OAC usage after the introduction of NOAC in Korea.METHODS: Between January 2002 and December 2016, we identified 888,540 patients with AF in the Korea National Health Insurance system database. The change of OAC rate in different medical systems after the introduction of NOAC were evaluated.RESULTS: In all population, overall OAC use increased from 13.2% to 23.4% (p for trend <0.001), and NOAC use increased from 0% to 14.6% (p for trend <0.001). Compared with pre-reimbursement (0.48%), the annual increase of OAC use was significantly higher after partial (1.16%, p<0.001), and full reimbursement of OAC (3.72%, p<0.001). Full reimbursement of NOAC (adjusted odds ratio, 2.10; 95% confidence interval, 2.04–2.15) was independently associated with higher OAC use. However, the difference of overall OAC usage between tertiary referral hospitals and nursing or public health centers increased from 17.9% in 2010 to 36.8% in 2016. Moreover, usage rate of NOAC was significantly different among different medical systems from 37.2% at the tertiary referral hospital and 5.5% at nursing or public health centers.CONCLUSIONS: Introduction of NOACs in routine practice for stroke prevention in AF was associated with improved rates of overall OAC use. However, significant practice-level variations in OAC and NOAC use remain producing social inequalities of OAC despite full reimbursement.

How to Overcome Social Inequalities of Oral Anticoagulation Usage in Korea?

No abstract available.

Clinical Perceptions and Practice Patterns for Amblyopia in Korea

PURPOSE: We used a questionnaire to explore perceptions and clinical practice patterns of Korean pediatric ophthalmologists in terms of amblyopia.METHODS: From September to November 2018, we conducted a web-based questionnaire survey of 99 specialists of the Korean Association for Pediatric Ophthalmology and Strabismus who operated ophthalmology clinics in Korea. We received 56 responses (56.57%) and retrospectively analyzed the data.RESULTS: The average specialist age was 44.0 ± 9.7 years. The mean age of treated amblyopia patients was 3 to 5 years (69.6%); the most common amblyopia was refractive anisometropic amblyopia (75.0%). On average, treatment commenced at 4 years of age (53.6%); child and parent co-operation most significantly influenced treatment success (46.4%). The preferred test was cycloplegic refraction (96.4%) and the preferred treatment occlusion therapy (100%) with glasses correction (98.2%). Occlusion therapy was most commonly performed for 2 hours/day (69.6%); the minimum age for eyeglasses prescription was 2.10 ± 1.18 years. Only three respondents (5.36%) prescribed contact lenses and only one (1.79%) performed refractive surgery.CONCLUSIONS: In Korea, amblyopia treatment is based on occlusion therapy and glasses correction. However, the time of treatment commencement, the duration of occlusion therapy, and the glasses used for correction varied. It is necessary to develop guidelines for amblyopia treatment; these should reflect current medical conditions.

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.

Prospects on the increase of radiological examinations in Korea

Due to technological advances and the establishment of evidence-based medicine, radiological examinations are playing a crucial role in modern medicine, as a result of which they have been steadily increasing, and the rate of increase has intensified in the 2000s. Although this is a global phenomenon, the increase of radiological examinations in Korea is also high due to the introduction of the National Health Insurance Coverage Expansion Policy, so-called Moon Jae-in Care, for ultrasonography and magnetic resonance imaging. For accurate and rapid diagnosis of diseases, it is necessary for doctors to order appropriate radiological studies. However, the increase in radiological examination has created many problems, such as increased medical costs, decreased diagnostic accuracy due to radiologist burnout, and increased patient exposure to radiation. To reduce unnecessary imaging studies, a number of measures could be deployed including the development of clinical guidelines to select appropriate radiological examinations for each clinical situation.

Comparison of the risks of combustible cigarettes, e-cigarettes, and heated tobacco products

E-cigarettes (ECs) and heated tobacco products (HTPs) have become popular in Korea; hence, it is important to determine whether ECs and HTPs are less hazardous than combustible cigarettes (CCs). In general, the levels of harmful and potentially harmful constituents (HPHCs) are lower in ECs and HTPs than in CCs, although the levels of some heavy metals and HPHCs are higher in ECs and HTPs than in CCs. ECs and HTPs showed possible adverse effects on respiratory and cardiovascular system function, which could result in chronic respiratory and cardiovascular system diseases in animals. An analysis of biomarkers showed that ECs had possible adverse health effects on the respiratory and cardiovascular systems, in addition the effects of HTP on respiratory and cardiovascular systems were not significantly different than those of CC. Epidemiological studies identified positive associations between EC use and asthma, chronic obstructive pulmonary disease, and myocardial infarction. Only one epidemiologic study reported a positive association between ever using HTPs and asthma, allergic rhinitis, and atopic dermatitis among adolescents. Modelling studies of ECs did not show consistent findings regarding the health effects compared with those of CCs. A modeling study of HTPs, performed by tobacco industry, has been criticized for many unfounded assumptions. Lower levels of HPHCs in ECs and HTPs, compared with those in CCs, cannot be directly translated into health benefits because the relationship between exposure and effects is non-linear for cardiovascular diseases and because the duration of exposure is more important than the level of exposure in determining lung cancer mortality. In summary, there is no definite health benefit in using ECs or HTPs instead of CCs, for the individual or the population; hence, tobacco control measures should be the same for ECs, HTPs, and CCs. ECs and HTPs have become popular in Korea; hence, it is important to determine whether ECs and HTPs are less hazardous than CCs.

Current trends in minimally invasive surgery for benign prostatic hyperplasia

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.

Updates of adult immunization in Korea

An increase in the number of patients with infectious diseases in Korea, can be attributed to various factors, such as the prevalence of new infectious diseases of the 21st century, the re-emergence of past infectious diseases, an increase in the number of elderly individuals, patients with chronic diseases, immune deficiency, and globalization. In this context, vaccination becomes vital for the adult population. Although, the guidelines for adult immunization are currently being updated, the rate of adult vaccination remains lower than that of infant vaccination. At present, the major challenges for increasing the rate of adult immunization include negative views on the need for some immunizations and a lack of understanding of group immunity among the youth. Consequently, a successful immunization program will be required to direct efforts towards educating patients and spreading awareness. Based on the current guidelines and practical applications, varicella zoster; Japanese encephalitis; tetanus, diphtheria, and pertussis; pneumococcus; measles, mumps, and rubella; and hepatitis A vaccines could effectively be considered for adult vaccination.

Prescription of antibiotics after tooth extraction in adults: a nationwide study in Korea

OBJECTIVES: This study aimed to understand the nationwide patterns of antibiotic prescription after tooth extraction in adult patients.MATERIALS AND METHODS: This study analyzed dental records from the National Health Insurance Service–National Sample Cohort (NHIS–NSC) database on 503,725 tooth extractions performed in adults (≥19 years) during 2011–2015. Patient sex, age, household income, systemic disease (diabetes mellitus and hypertension), type of dental institution, region of dental institution, year of prescription, and type of tooth extraction procedure were considered. The antibiotic prescription rate and broad-spectrum antibiotic prescription frequency were analyzed using chi-squared tests. Factors affecting the prescription of broad-spectrum antibiotics were evaluated using multivariate logistic regression analysis.RESULTS: The rate of antibiotic prescription after tooth extraction was 81.85%. Penicillin was most commonly prescribed (45.25%), followed by penicillin with beta-lactamase inhibitors (18.76%), metronidazole (12.29%), and second- to fourth-generation cephalosporins (11.52%). The proportion of broad-spectrum antibiotics used among all prescribed antibiotics was 45.88%.CONCLUSION: The findings of this study demonstrate that the rate of antibiotic prescription after tooth extraction is higher in Korea than in other countries. Furthermore, broad-spectrum antibiotics are used more frequently, which may indicate unnecessary drug prescription, an important contributor to antibiotic resistance.