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Objective: To compare the efficacy of two types of progestogen therapy for preventing preterm birth (PTB) and to review the relevant literature. Design: A multicentre, randomised, open‐label, equivalence trial and a meta‐analysis. Setting: Tertiary referral hospitals in South Korea. Population: Pregnant women with a history of spontaneous PTB or short cervical length (<25 mm). Methods: Eligible women were screened and randomised at 16‒22 weeks of gestation to receive either 200 mg of vaginal micronised progesterone daily (vaginal group) or an intramuscular injection of 250 mg 17α‐hydroxyprogesterone caproate weekly (IM group). Stratified randomisation was carried out according to participating centres and indications for progestogen therapy. This trial was registered at ClinicalTrials.gov (NCT02304237). Main outcome measure: Preterm birth (PTB) before 37 weeks of gestation. Results: A total of 266 women were randomly assigned and a total of 247 women (119 and 128 women in the vaginal and IM groups, respectively) were available for the intention‐to‐treat analysis. Risks of PTB before 37 weeks of gestation did not significantly differ between the two groups (22.7 versus 25.8%, P = 0.571). The difference in PTB risk between the two groups was 3.1% (95% CI −7.6 to 13.8%), which was within the equivalence margin of 15%. The meta‐analysis results showed no significant differences in the risk of PTB between the vaginal and IM progestogen treatments. Conclusion: Compared with vaginal progesterone, treatment with intramuscular progestin might increase the risk of PTB before 37 weeks of gestation by as much as 13.8%, or reduce the risk by as much as 7.6%, in women with a history of spontaneous PTB or with short cervical length. Vaginal and intramuscular progestogen showed equivalent efficacy for preventing preterm birth before 37 weeks of gestation. Vaginal and intramuscular progestogen showed equivalent efficacy for preventing preterm birth before 37 weeks of gestation. [ABSTRACT FROM AUTHOR]

Aim To evaluate the self-reported oral health habits and their association with the occurrence of dental caries among children in Pyongyang, Democratic People's Republic of Korea ( DPRK), after 6 years of activities under the auspices of the Children's Oral Health Promotion Programme ( COHPP). Methods The data were collected in September 2013 in two of the most central districts of Pyongyang City, DPRK. The sample consisted of 492 children aged 10 and 13 years who had participated in the COHPP for 6 years. The children filled in a self-completed, structured questionnaire on oral health habits and were examined clinically by a dentist. The differences in mean ( SD) number of decayed primary (dt) and permanent teeth ( DT) and their sum (dt + DT) subdivided according to genders, age groups, districts and self-reported oral health habits were evaluated using Mann-Whitney U-test. The associations between self-reported oral health habits and the occurrence of dental caries were evaluated with chi-square test and logistic regression analyses. Results The school-aged children commonly reported healthy oral hygiene habits but sweet snacks were commonly used. The occurrence of dental caries associated statistically significantly with the frequency of sweet snacking (p=0.011) but not with the frequency of tooth brushing (p=0.725) or the use of water for thirst instead of sugary beverages (p=0.189). Conclusion A more effective promotion of healthy dietary habits with innovative approaches and close collaboration with different social actors will be needed in future. [ABSTRACT FROM AUTHOR]

ETHNOPHARMACOLOGICAL RELEVANCE: Armillariella mellea is an edible mushroom that has been traditionally used as an alternative medicine in many countries because of its anti-microbial and anti-cancer effects. AIM OF THE STUDY: In this study, we examined the ability of Armillariella mellea to induce the expression of intercellular adhesion molecule (ICAM)-1, an important cellular adhesion molecule for the recruitment of immune cells to regional inflammatory sites. MATERIALS AND METHODS: A human monocytic cell line, THP-1 or human peripheral blood mononuclear cells (PBMC) were stimulated with Armillariella mellea extract (AME) and subjected to flow cytometry to examine the expression of ICAM-1 protein on the cell surface. Steady-state mRNA level of ICAM-1 was determined by real-time reverse transcription-polymerase chain reaction. The phosphorylation of JNK protein was examined by Western blot analysis using antibodies specific for non-phosphorylated and phosphorylated forms of JNK. For the analysis of transcription factors regulating ICAM-1 transcription, the nuclear fraction was extracted from AME-treated THP-1 cells and subjected to electrophoretic mobility shift assay. RESULTS: AME induced expression of ICAM-1 and its mRNA in THP-1 cells in dose- and time-dependent manners. AME-induced ICAM-1 expression was also observed on CD14-positive monocytes in human PBMC. Interestingly, AME-induced ICAM-1 production was inhibited by the specific inhibitors of reactive oxygen species (ROS) and JNK, whereas no inhibitory effect was observed when inhibitors of ERK, p38 kinase, phosphatidylinositol 3-kinase, or protein kinase C were used. Concomitantly, AME increased phosphorylation of JNK in a time-dependent fashion. DNA binding activities of NF-kappaB, AP-1, SP-1, and STAT-1 were increased by AME treatment. CONCLUSION: These results suggest that AME induces ICAM-1 expression in human monocytic cells through ROS/JNK-dependent signaling pathways leading to the activation of NF-kappaB, AP-1, SP-1, and STAT-1 transcription factors. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We aim to identify the genetic loci responsible for Sasang constitution type, which is important for effective personalized treatments in traditional Korean medicine. SUBJECTS: Forty (40) individuals in a Korean family were recruited for linkage analysis and 310 unrelated individuals for association analysis to confirm the linkage result. OUTCOME MEASURES: Genome-wide linkage analysis was performed for the Korean family using the Affymetrix 500K arrays. MERLIN software was used for multipoint nonparametric linkage (NPL) analysis. The significant candidate regions in linkage analysis were also investigated with association analysis of independent 310 individuals. RESULTS: Linkage analysis showed four significant peaks, 3q27.3, 8p11.21, 8q11.22-23, and 11q22.1-3, whose NPL Z scores are greater than 5.0. Among the significant loci, the 8q11.22-23 and 11q22.1-3 regions were supported by independent association analysis at the level of p < 0.05. CONCLUSIONS: The 8q11.22-23 and 11q22.1-3 regions were suggested as the candidate region for significant linkage to Sasang constitution. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the relationship between five air pollutants (PM(10), SO(2), NO(2), O(3), CO) measured on the daily basis, and adverse health symptoms using epidemiological surveillance data. The generalized estimated equation (GEE) model, a logistic regression analysis model, was used to estimate the effects of air pollution on children's daily health symptoms, focusing on the morbidity including both respiratory and allergic symptoms in four different cities. Analysis of the effects of each pollutant on children's respiratory and allergic symptoms demonstrated that CO affected all symptoms in all the study areas. When the concentration of SO(2) and NO(2) was elevated, upper respiratory symptoms increased significantly. In contrast, when the concentration of O(3) rose, the symptoms decreased significantly. The relationship between measured concentrations and health symptoms was site-dependent for each pollutant. [ABSTRACT FROM AUTHOR]

Rationale: Although chronic obstructive pulmonary disease is a leading cause of mortality and morbidity worldwide, there are only limited data on its prevalence, especially in Asia.Objectives: A population-based epidemiologic survey of chronic obstructive pulmonary disease in a representative national sample was conducted using spirometry.Methods: A stratified multistage clustered probability design was used to select a nationally representative sample. The survey was performed in conjunction with the second Korean National Health and Nutrition Examination Survey of 9,243 adults over the age of 18 years. The participation rate was 88.8% for questionnaires and 52.1% for spirometry.Results: The prevalence of chronic obstructive pulmonary disease based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria (a ratio of FEV[1] to FVC of less than 0.7) was 17.2% (men, 25.8%; women, 9.6%) among subjects older than 45 years. Among adults of all ages (age > 18 years), the prevalence of airflow obstruction was 7.8% (10.9% in men, 4.9% in women). The majority of these cases were found to be mild in degree, and only a minority of these subjects had received physician diagnosis or treatment. Multivariate analysis revealed that age over 65 years, male sex, smoking more than 20 pack-years, and low income were independent predictors for chronic obstructive pulmonary disease.Conclusions: Seventeen percent of Korean adults over the age of 45 years have mild chronic obstructive pulmonary disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the prevalence and pattern of the metabolic syndrome and its association with hyperinsulinemia in an urban Korean population of 269 men and 505 women.Research Design and Methods: The National Cholesterol Education Program Adult Treatment Panel (ATP) III guidelines were used to calculate the sex-specific prevalence of the metabolic syndrome. After excluding individuals taking medication for hypertension, diabetes, or dyslipidemia, we used factor analysis to examine the pattern of the metabolic syndrome in 206 men and 449 women.Results: The prevalence of metabolic syndrome was 16.0% in men and 10.7% in women aged 30-80 years. However, ATP III criteria for central obesity are not optimal for an Asian-Pacific population; when waist circumference is reduced from 102 to 90 cm in men and 88 to 80 cm in women, the prevalence of the metabolic syndrome increased to 29.0 and 16.8%, respectively. Sex-specific factor analysis showed four factors in men (obesity, glucose intolerance, hypertension, and dyslipidemia) and three in women (obesity-hypertension, glucose intolerance, and obesity-dyslipidemia). Insulin resistance estimated from fasting insulin levels clustered with three of the four factors in men and two of the three factors in women. By ATP III or Asian-Pacific waist circumference criteria, the prevalence of the metabolic syndrome increased with increasing tertiles of insulin resistance, which was estimated by a homeostasis model assessment.Conclusions: The metabolic syndrome is common in an urban Korean population when using Asian-Pacific waist criteria. The prevalence of the metabolic syndrome increased with increasing tertiles of insulin resistance. [ABSTRACT FROM AUTHOR]

AIMS: To clarify and delineate the concept of family resilience in the context of the chronic illness of a child. This study also investigated the concept of family resilience in relation to family functioning in order to compare and contrast family resilience and family functioning. DESIGN AND METHOD: Three phases of the hybrid model of concept development were applied: theoretical, fieldwork and final analytical. In the theoretical phase, a working definition of family resilience was developed by a literature review. The fieldwork phase comprised in-depth interviews with 11 parents with a chronically ill child, in the paediatric oncology unit of a university hospital in South Korea. The qualitative data obtained from the interviews were analysed to find attributes of family resilience. The final analytical phase compared and interpreted the findings from the theoretical and fieldwork phases in order to clarify and refine the concept of resilience. RESULTS: The definition of family resilience was of an enduring force that leads a family to change its functioning dynamics in order to solve problems encountered. Twenty-one conceptual attributes of family resilience emerging from this study were differentiated into four dimensions: (i) intrinsic family characteristics, (ii) family member orientation related to family characteristics, (iii) responsiveness to stress and (iv) external orientation. CONCLUSIONS: Family resilience is an enduring force that leads a family to change its dynamics of functioning in order to solve problems associated with stresses encountered. This conceptualization led to the development of a model of family coping that incorporates both family resilience and family functioning, as the property and as the process of change, respectively. RELEVANCE TO CLINICAL PRACTICE: In order to build a family that functions better under stress, it is necessary for nurses to focus more attention on family resilience, especially in terms of the development of intervention strategies to strengthen family resilience. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) 'I did wrong,' (b) 'I cannot ask male physicians.' (c) 'I don't want to show the operation site to my husband.' and (d) 'I do household tasks by myself.' The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women's health/illness experience. [ABSTRACT FROM AUTHOR]

The aims of this study were to clarify the concept of family functioning in the context of a female family member's chronic illness, and to describe the processes by which the housewife copes with the situation. The study applied the hybrid model of concept development, which consists of three phases: theoretical, empirical, and analytic. In the theoretical phase, a working definition of family functioning was established and the dimensions of family functioning and subconcepts were identified through an extensive review of the literature. In the empirical phase, in-depth interviews with members of six normal families and seven families in which the housewife had a long-term diagnosis of rheumatoid arthritis were carried out in order to gain descriptions of family functioning in both contexts, and to assess how the housewife coped with her illness in relation to family functioning. The final analytic phase identified the differences and similarities in family functioning between the normal family and family with a chronically ill housewife. A refined definition of family functioning emerged that identified the concept in terms of a complex set of functional dimensions comprising affective, structural, control, cognitive, and external relationships. The data revealed that family functioning is dynamically changed when the housewife becomes ill with a chronic disease. Three types of adaptation process were identified by which the housewives adapted to family functioning in the context of their chronic illnesses: negotiated, self-accommodating, and separated-enduring. The implications of these findings for research and nursing practice are discussed. Copyright 2002 Elsevier Science Ltd. [ABSTRACT FROM AUTHOR]

Mutations at the PKD1 locus account for 85% of cases of the common genetic disorder called autosomal dominant polycystic kidney disease (ADPKD). Screening for mutations of the PKD1 gene is complicated by the genomic structure of the 5′-duplicated region encoding 75% of the gene. To date, more than 90 mutations of the PKD1 gene have been reported in the European and American populations, and relatively little information is available concerning the pattern of mutations present in the Asian populations. We looked for mutations of the PKD1 gene in 51 unrelated Korean ADPKD patients, using polymerase chain reaction (PCR) with primer pairs located in the 3′ single-copy region of the PKD1 gene and by single-strand conformation polymorphism (SSCP) analysis. We found three novel mutations, a G to A substitution at nucleotide 11012 (G3601S), a C to A substitution at nucleotide 11312 (Q3701X), and a C to T substitution at nucleotide 12971 (P4254S), and a single polymorphism involving a G to C substitution at nucleotide 11470 (L3753L). These mutations were not found in control individuals, and no other mutations in the 3′ single-copy region of the PKD1 gene of patients with these mutations were observed. In particular, P4254S segregated with the disease phenotype. The clinical data of affected individuals from this study, and of previously reported Korean PKD1 mutations, showed that patients with frameshift or nonsense mutations were more prone to develop end-stage renal failure than those with missense mutations. Our findings indicate that many different PKD1 mutations are likely to be responsible for ADPKD in the Korean population, as in the Western population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To propose directions for future research on menopause, we analyzed and critiqued 158 studies on the menopausal experience of a group of Korean women. In this paper, we take a feminist stance that the menopausal experience of Asian women does not come from pure biology, but from their continuous interactions with their environment. DESIGN: Systemic review. SETTING: NA. POPULATION: Menopausal Korean women. INTERVENTIONS: An extensive literature search on menopause in Korean women was conducted using the MEDLINE and MELVYL data retrieval systems. Korean literature was searched through four major university libraries in South Korea. A total of 158 studies were reviewed, and the collected articles were analyzed and critiqued in terms of biases present in the research process. MAIN OUTCOME MEASURE(S): Issues in conceptualization included biomedical oriented perspectives and underlying assumptions and language differences. Issues related to research methods included inadequate instruments, passive relationships between researchers and research participants, culturally inappropriate communication style, inadequate study designs, limited contextuality, and homogeneous research participants. Issues related to interpretation of results included misinterpretation of symptoms and communication of study findings. The analyses of research on the menopausal experience of Korean women indicate limitations of the research process from conceptualization to interpretation. RESULTS/CONCLUSIONS: The analyses of research on the menopausal experience of Korean women indicate limitations of the research process from conceptualization to interpretation. This suggests that interpretation, understanding, and generalization of the findings of the previous studies on menopausal experience of Asian women during menopausal transition should be undertaken with caution. [CINAHL abstract] [ABSTRACT FROM AUTHOR]

A health care system that includes institutions such as the home, clinic, or hospital as well as interpersonal relationships between providers and receivers of health care is a part of any culture. Clinical issues are a part of all cultures, and cross-cultural comparisons are useful in understanding health care. With immigration and travel, a better understanding of the situation of families who have a child with cancer in various countries, different health care systems, and different cultures is needed. Understanding the situation for families with a child who has cancer in South Korea will lead one to a better understanding of a Korean family who has immigrated to the west and has a child develop cancer or is in need of treatment. [ABSTRACT FROM AUTHOR]

The article presents a study of mutation spectrum of RB1 gene in South Korean patients with retinoblastoma, the most common form of childhood intraocular tumor. It involved extracting of DNA from peripheral blood leukocytes and screening of RB1 gene mutations through sequence analysis of exons using an ABI 3730 analyzer and multiple ligation probe-dependent amplification (MLPA) method. The study reveals high detection of germline mutations with sporadic bilateral retinoblastoma.

Study Design: Retrospective study.Objective: To evaluate the prognostic value of preoperative pulmonary function test (PFT) for postoperative pulmonary complications and to identify the operability associated with severely decreased forced vital capacity (FVC) (<30%) status in flaccid neuromuscular scoliosis.Summary Of Background Data: The preoperative PFT, especially more than 30% FVC, is known as a critical factor for the operability of flaccid neuromuscular scoliosis. But only one study reported that patients with pre-existing respiratory failure on nocturnal noninvasive ventilation can undergo an operation for deformity correction without mortality and severe complications.Methods: A total of 74 patients (45 male and 29 female) presented with flaccid neuromuscular scoliosis. For all patients, preoperative PFTs were evaluated and subdivided into three groups (<30% FVC, 30%-50% FVC, and >50% FVC). Then postoperative pulmonary complications, pneumothorax, pneumonia, atelectasis, prolonged ventilator care in the intensive care unit (more than 72 hours), and postoperative tracheostomy were evaluated.Results: Among these patients, 59 had muscular dystrophy; 5, spinal muscular atrophy; 2, cerebral palsy; and 8, others. The mean age at surgery was 16.8 years (range, 5-32 years). The mean preoperative Cobb angle was 54.6° (16°-135°). The overall postoperative pulmonary complication rate was 31% (23 complications in 74 patients). The less than 30% FVC group had 6 complications among 18 patients; the 30% to 50% FVC group had 7 complications among 18 patients; and the more than 50% FVC group had 10 complications among 38 patients. There were no deaths during the perioperative period. There is no statistical difference between the three groups (P = 0.6195).Conclusion: Patients with flaccid neuromuscular scoliosis can undergo an operation for deformity correction regardless of the severely decreased pulmonary function. [ABSTRACT FROM AUTHOR]