Clinical Characteristics of Hospitalized Patients Diagnosed with Scabies:A Retrospective Study / 대한피부과학회지

Background@#Scabies, a common contagious skin disease caused by ectoparasites, is a significant public health concern in healthcare facilities, including tertiary hospitals. @*Objective@#This study aimed to assess the clinical characteristics of hospitalized patients who were diagnosed with scabies. We focused on determining whether patient-related factors such as height, weight, underlying diseases, mobility, mental alertness, cognitive impairment, catheter insertion, and the presence of caregivers influenced the failure of the initial diagnosis or treatment. @*Methods@#We retrospectively analyzed the medical records of 81 patients who were diagnosed with scabies during hospitalization between January 2011 and June 2023. @*Results@#Of the 81 patients, 45 (55.6%) were male, with a mean age of 76.5 years. The most common primary diagnosis was an infectious disease (66.7%). The main suspected routes of infection were care facilities (63.5%) for patients who already had pruritic skin lesions before admission, and contact with caregivers (80.0%) for patients who developed new skin lesions after admission. The initial consultation failed to diagnose scabies in 19.8% of the patients, and among those, 62.5% had not undergone initial microscopic examination. Patients who were initially misdiagnosed had significantly longer hospitalizations and scabies treatment durations. Among the patients who underwent follow-up microscopic examination after the initial treatment, 60.0% showed positive results. Overall, 54.2% of the patients experienced initial treatment failure. Patient-related factors did not significantly differ between patients with and without initial diagnostic failure and between patients with and without initial treatment failure. @*Conclusion@#Dermatologists should consider performing microscopic examinations more frequently in hospitalized patients to improve diagnostic accuracy. Considering the high treatment failure rate, follow-up microscopic evaluation is recommended after initial treatment.

Positional Asphyxia: Remains Hard to Diagnose? / 대한법의학회지

Positional asphyxia is a type of asphyxia where the position of an individual compromises the ability to breathe. It is commonly caused by accidents due to alcohol or drug intoxication, diseases, and/or being in a confined space. In this study, the authors reviewed autopsy cases at their institute over the past 5 years where positional asphyxia is suspected as a contributing factor or cause of death. The autopsy cases (n=24) were divided into three groups: positional asphyxia was the cause of death (n=15); unknown cause of death but positional asphyxia was considered (n=4); and positional asphyxia was suspected to be a contributing factor (n=5). All cases of group A included postures that could interfere with breathing, but the typical jackknife or head-down postures were seen in approximately half of the cases; “classic signs of asphyxia” were also observed in approximately half of the cases. They shared features such as high blood alcohol concentration, therapeutic levels of drugs, various disease, minor head trauma, and morbid obesity; however, no definite diagnostic criteria have been established for forensic practice. Positional asphyxia is a form of mechanical asphyxia which must be differentiated from traumatic asphyxia. In addition to a complete autopsy, thorough laboratory tests and understanding of the circumstances of the case and the situation at the death scene are required for diagnosis. Special attention is required for the diagnosis of special types of positional asphyxia such as death during institutional restraint or prone restraint.

Combined DNA Methylation and Gastric Microbiome Marker Predicts Helicobacter pylori-Negative Gastric Cancer

Background/Aims@#While DNA methylation and gastric microbiome are each associated with gastric cancer (GC), their combined role in predicting GC remains unclear. This study investigated the potential of a combined DNA methylation and gastric microbiome signature to predict Helicobacter pylori-negative GC. @*Methods@#In this case-control study, we conducted quantitative methylation-specific polymerase chain reaction to measure the methylation levels of DKK3, SFRP1, EMX1, NKX6-1, MIR124-3, and TWIST1 in the gastric mucosa from 75 H. pylori-negative patients, including chronic gastritis (CG), intestinal metaplasia (IM), and GC. A combined analysis of DNA methylation and gastric microbiome, using 16S rRNA gene sequencing, was performed in 30 of 75 patients. @*Results@#The methylation levels of DKK3, SFRP1, EMX1, MIR124-3, and TWIST1 were significantly higher in patients with GC than in controls (all q<0.05). MIR124-3 and TWIST1 methylation levels were higher in patients with IM than those with CG and also in those with GC than in those with IM (all q<0.05). A higher methylation level of TWIST1 was an independent predictor for H. pylori-negative GC after adjusting for age, sex, and atrophy (odds ratio [OR], 15.15; 95% confidence interval [CI], 1.58 to 145.46; p=0.018). The combination of TWIST1 methylation and GC microbiome index (a microbiome marker) was significantly associated with H. pylori-negative GC after adjusting for age, sex, and atrophy (OR, 50.00; 95% CI, 1.69 to 1,476; p=0.024). @*Conclusions@#The combination of TWIST1 methylation and GC microbiome index may offer potential as a biomarker for predicting H. pylori-negative GC.

Patent Technology Trends of Oral Health: Application of Text Mining / 치위생과학회지

Background@#The purpose of this study was to utilize text network analysis and topic modeling to identify interconnectedrelationships among keywords present in patent information related to oral health, and subsequently extract latent topics and visualize them. By examining key keywords and specific subjects, this study sought to comprehend the technological trends in oral health-related innovations. Furthermore, it aims to serve as foundational material, suggesting directions for technological advancement in dentistry and dental hygiene. @*Methods@#The data utilized in this study consisted of information registered over a 20-year period until July 31st, 2023, obtainedfrom the patent information retrieval service, KIPRIS. A total of 6,865 patent titles related to keywords, such as “dentistry,” “teeth,” and “oral health,” were collected through the searches. The research tools included a custom-designed program coded specifically for the research objectives based on Python 3.10. This program was used for keyword frequency analysis, semantic network analysis, and implementation of Latent Dirichlet Allocation for topic modeling. @*Results@#Upon analyzing the centrality of connections among the top 50 frequently occurring words, “method,” “tooth,” and “manufacturing” displayed the highest centrality, while “active ingredient” had the lowest. Regarding topic modeling outcomes, the “implant” topic constituted the largest share at 22.0%, while topics concerning “devices and materials for oral health” and “toothbrushes and oral care” exhibited the lowest proportions at 5.5% each. @*Conclusion@#Technologies concerning methods and implants are continually being researched in patents related to oral health, while there is comparatively less technological development in devices and materials for oral health. This study is expected to be a valuable resource for uncovering potential themes from a large volume of patent titles and suggesting research directions.

Composite follicular lymphoma and classic Hodgkin lymphoma

Composite lymphoma is very rare and a combination of Hodgkin lymphoma and non-Hodgkin lymphoma and even histiocytic tumors can occur. Because of the unfamiliarity, not only can this cause diagnostic problems, but can also affect treatment plan. We report a case of composite lymphoma in a 40-year-old male. Initial biopsy showed a composite lymphoma of follicular lymphoma grade 1 and classic Hodgkin lymphoma. After chemotherapy, another lymph node was taken because of disease progression, which revealed follicular lymphoma, grade 3a without Hodgkin lymphoma component.

Differential Gene Expression in the Hippocampi of Nonhuman Primates Chronically Exposed to Methamphetamine, Cocaine, or Heroin

Objective@#Methamphetamine (MA), cocaine, and heroin cause severe public health problems as well as impairments in neural plasticity and cognitive function in the hippocampus. This study aimed to identify the genes differentially expressed in the hippocampi of cynomolgus monkeys in response to these drugs. @*Methods@#After the monkeys were chronically exposed to MA, cocaine, and heroin, we performed large-scale gene expression profiling of the hippocampus using RNA-Seq technology and functional annotation of genes differentially expressed. Some genes selected from RNA-Seq analysis data were validated with reverse transcription-quantitative polymerase chain reaction (RT-qPCR). And the expression changes of ADAM10 protein were assessed using immunohistochemistry. @*Results@#The changes in genes related to axonal guidance (PTPRP and KAL1), the cell cycle (TLK2), and the regulation of potassium ions (DPP10) in the drug-treated groups compared to the control group were confirmed using RT-qPCR. Comparative analysis of all groups showed that among genes related to synaptic long-term potentiation, CREBBP and GRIN3A were downregulated in both the MA- and heroin-treated groups compared to the control group. In particular, the mRNA and protein expression levels of ADAM10 were decreased in the MA-treated group but increased in the cocaine-treated group compared to the control group. @*Conclusion@#These results provide insights into the genes that are upregulated and downregulated in the hippocampus by the chronic administration of MA, cocaine, or heroin and basic information for developing novel drugs for the treatment of hippocampal impairments caused by drug abuse.

Sudden Cardiac Death Caused by a Septic Coronary Artery Embolism as the First Clinical Presentation of Infective Endocarditis / 대한법의학회지

This report describes an uncommon and fatal case of myocardial infarction due to coronary embolus arising from vegetation in the aortic valve with a background of infective endocarditis (IE). There are various causes of fatal IE. Myocardial infarction due to septic emboli is rare. We report a case of sudden death in a 69-year-old woman with hyperlipidemia and no known cardiac disease. She had severe general weakness and was hospitalized for colonoscopy. The patient unexpectedly presented with cardiac arrest and died. The autopsy showed total occlusion of the left anterior descending artery by an embolus, which originated from the septic vegetation of the aortic valve. Myocardial infarction from septic emboli associated with IE can be fatal and manifested as the first presentation. In autopsy practice of deceased patients with IE, careful examination of the coronary arteries is required.

Age-related Effects of Heroin on Gene Expression in the Hippocampus and Striatum of Cynomolgus Monkeys

Objective@#The aim of this study was to investigate differentially expressed genes and their functions in the hippocampus and striatum after heroin administration in cynomolgus macaques of different ages. @*Methods@#Cynomolgus monkeys were divided by age as follows: 1 year (A1, n = 2); 3 to 4 years (A2, n = 2); 6 to 8 years (A3, n = 2); and older than 11 years (A4, n = 2). After heroin was injected intramuscularly into the monkeys (0.6 mg/kg), we performed large-scale transcriptome profiling in the hippocampus (H) and striatum (S) using RNA sequencing technology. Some genes were validated with real-time quantitative PCR. @*Results@#In the hippocampus, the gene expression of A1H was similar to that of A4H, while the gene expression of A2H was similar to that of A3H. Genes associated with the mitogen-activated protein kinase signaling pathway (STMN1, FGF14, and MAPT) and -aminobutyric acid-ergic synapses (GABBR2 and GAD1) were differentially expressed among control and heroin-treated animals. Differential gene expression between A1S and A4S was the least significant, while differential gene expression between A3S and A2S was the most significant. Genes associated with the neurotrophin signaling pathway (NTRK1 and NGFR), autophagy (ATG5), and dopaminergic synapses (AKT1) in the striatum were differentially expressed among control and heroin-treated animals. @*Conclusion@#These results suggest that even a single heroin exposure can cause differential gene expression in the hippocampus and striatum of nonhuman primates at different ages.

Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast

Background@#Pure mucinous carcinoma (PMC) is a rare type of breast cancer, estimated to represent 2% of invasive breast cancer. PMC is typically positive for estrogen receptors (ER) and progesterone receptors (PR) and negative for human epidermal growth factor receptor 2 (HER2). The clinicopathologic characteristics of HER2-positive PMC have not been investigated. @*Methods@#Pathology archives were searched for PMC diagnosed from January 1999 to April 2018. Clinicopathologic data and microscopic findings were reviewed and compared between HER2-positive PMC and HER2-negative PMC. We also analyzed the differences in disease-free survival (DFS) and overall survival according to clinicopathologic parameters including HER2 status in overall PMC cases. @*Results@#There were 21 HER2-positive cases (4.8%) in 438 PMCs. The average tumor size of HER2-positive PMC was 32.21 mm (± 26.55). Lymph node metastasis was present in seven cases. Compared to HER2-negative PMC, HER2-positive PMC presented with a more advanced T category (p < .001), more frequent lymph node metastasis (p = .009), and a higher nuclear and histologic grade (p < .001). Microscopically, signet ring cells were frequently observed in HER2-positive PMC (p < .001), whereas a micropapillary pattern was more frequent in HER2-negative PMC (p = .012). HER2-positive PMC was more frequently negative for ER (33.3% vs. 1.2%) and PR (28.6% vs. 7.2%) than HER2-negative PMC and showed a high Ki-67 labeling index. During follow-up, distant metastasis and recurrence developed in three HER2-positive PMC patients. Multivariate analysis revealed that only HER2-positivity and lymph node status were significantly associated with DFS. @*Conclusions@#Our results suggest that HER2-positive PMC is a more aggressive subgroup of PMC. HER2 positivity should be considered for adequate management of PMC.

Elucidating the relationship of gingivitis and dental calculus with the periodontal health of 12-year-old children / 대한구강보건학회지

OBJECTIVES: This study aimed to investigate factors related to the periodontal health of 12-year-old children.METHODS: In 2015, the Korean Children's Oral Health Survey from the Ministry of Health & Social Welfare conducted a nationwide representative sample comprised of 23,702 12-year-old children. The calibration-trained dentists examined the gingivitis and dental calculus of the children taking into consideration of the Löe and Silness gingival index to diagnose gingivitis with a modified gingivitis scale. We used questionnaires to collect data from the children on dental treatments, the experience of dental pain and gingival bleeding, self-perceived oral health, and oral health behaviors. Data were analyzed using a complex samples Chi-square test, general linear model, and logistic regression. Significance was determined at P < 0.05.RESULTS: The prevalence of gingivitis was higher among males (OR 1.57), among children with poor perception (OR 1.19), dental calculus (OR 3.68), or gingival bleeding experience (OR 2.00), and among children not using dental floss (OR 1.69) or tongue cleaner (OR 1.90). The prevalence of dental calculus was higher among children with gingivitis (OR 3.82) and among children who had not visited a dental clinic in the preceding year (OR 1.31). However, dental calculus was lower among children with a higher frequency of daily toothbrushing (OR 0.75), intake of cariogenic foods (OR 0.90), or a higher DMFT index (OR 0.91).CONCLUSIONS: Children with dental calculus and gingival bleeding who did not visit a dental clinic in the preceding year also had a higher prevalence of gingivitis and dental calculus. The prevalence of children's dental calculus was lower among children with a high frequency of daily toothbrushing.

Caries reduction effect of permanent teeth from community water fluoridation program for 17 years in Jinju city / 대한구강보건학회지

OBJECTIVES: The community water fluoridation program was implemented in 1998 in Jinju city. The aim of the present study was to evaluate the effect of this 17-year community water fluoridation program on caries reduction in permanent teeth. METHODS: Evaluation surveys were conducted in 2015 on subjects aged 8, 10, 12, and 15 years in Jinju city. The examined dental data were compared with that of subjects of the same age groups living in the medium-sized cities from the 6th Korea National Health and Nutrition Examination Survey (KNHANES) (2013–2015). The total number of subjects was 1,026 in Jinju city and 453 in the control group. The odds ratio of caries experience rate and untreated tooth rate on permanent teeth in Jinju city compared to control group was estimated based on the differences in DMF and untreated teeth rates after adjusting for gender, age, and mean number of fissure-sealed teeth. The effect of community water fluoridation program on caries reduction in permanent teeth was estimated by the differences in adjusted DMFT scores between the program and control groups. RESULTS: The odds ratio of caries experience rate and untreated tooth rate on permanent teeth in Jinju city compared to control group was estimated as 0.501 and 0.178, respectively. The effect of community water fluoridation program on caries reduction in permanent teeth was estimated as 40.0%. CONCLUSIONS: These results suggested that the effect of community water fluoridation program on caries reduction in permanent teeth in Jinju city was so high that similar programs should be developed in other regions in Korea.

Evaluation of the Potential of Commercial Vitamin Drinks to Induce Tooth Erosion / 치위생과학회지

BACKGROUND: The market for vitamin drinks is expanding both in Korea and worldwide. However, it was difficult to find studies regarding the possibility of tooth erosion induction due to vitamin drinks. The purpose of the present in vitro study was to evaluate the effect of tooth erosion caused by a few commercial vitamin beverages on bovine teeth enamel in terms of erosion depth and fluorescence loss. METHODS: Three experimental groups (vitamin drinks), a positive control group (Coca-Cola), and a negative control group (mineral water) were established. Each group consisted of 5 specimens obtained from sound bovine teeth. The pH and titratable acidity of beverages were measured. Specimens were immersed in the beverages and artificial saliva for 6 and 18 hours, respectively. This cycle was repeated for 5 days. The depth of the tooth loss caused by tooth erosion (erosion depth) and maximum loss of fluorescence (Max ΔF) were measured using the microscope and quantified light-induced fluorescence-digital, respectively. For the statistical analysis, the Kruskal-Wallis test and ANOVA were used to compare the erosion depth and Max ΔF of the enamel surfaces. In addition, Spearman correlations were estimated. RESULTS: The pH of the three vitamin beverages ranged from 2.65 to 3.01, which is similar to that of the positive control group. All beverages, except mineral water, had sugar and acidic ingredients. Vitamin drinks and the positive control, Coca-Cola, caused tooth erosion lesions, and showed significant differences in erosion depth compared to mineral water (p<0.05). The vitamin beverages with low pH were associated with high erosion depth and Max ΔF. CONCLUSION: Vitamin drinks have the potential to cause tooth erosion.

Periodontal health status of adolescents aged 15 years in Jinju city / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the periodontal status of adolescents aged 15 years in Jinju city. METHODS: The study subjects were 506 adolescents aged 15 years in Jinju city. We investigated the prevalence and severity of periodontal disease using the Community Periodontal Index (CPI) recommended by the WHO. Data on the frequency of daily tooth-brushing were collected through self-reported questionnaires. The information obtained on both the periodontal health status and frequency of daily toothbrushing of adolescents in Jinju city was compared with the data from the 6th Korea National Health and Nutrition Examination Survey 2013-2015 (KNHANES-VI). The software utilized in the analysis was SPSS version 23. Statistical significance was set at P < 0.05. RESULTS: The rate of healthy periodontal status in Jinju city was lower compared to KNHANES-VI (57.7% versus 63.7%). The rate of gingival bleeding in Jinju city and KNHANES-VI was 11.3% and 10.8%, respectively. The rate of calculus in Jinju city and KNHANES-VI was 31.0% and 25.6%, respectively. The rates of gingival bleeding and calculus were not significantly different between Jinju city and KNHANES-VI. The healthy periodontal segments in Jinju city were more than those in KNHANES-VI (5.43 versus 5.25). The bleeding periodontal segments in Jinju city were less than those in KNHANES-VI (0.25 versus 0.45). However, the periodontal segments with calculus in Jinju city were not significantly different from those of KNHANES-VI (0.31 versus 0.30). The frequency of daily tooth-brushing in Jinju city was more than that in KNHANES-VI (2.67 versus 2.47). CONCLUSIONS: These findings suggest that appropriate oral health education should be widely conducted to promote periodontal health in adolescents.

Death Related to Nitrous Oxide Abuse: Two Cases Report / 대한법의학회지

Nitrous oxide is medically used as an anesthetic gas and as an additive in whipped cream production. Few cases of death from nitrous oxide intoxication have been reported in Korea. However, fatalities due to inhalation of pure nitrous oxide in an amount enough to cause death have been recently increasing. We report two cases of death related to nitrous oxide abuse with a review of literature focusing on the fact that nitrous oxide abuse can be considered as a possible cause of death if appliances with nitrous oxide contents were found during the investigation, and the autopsy and toxicological findings cannot be attributed to nitrous oxide intoxication.

The Effect of Probiotics, Antibiotics, and Antipyretic Analgesics on Gut Microbiota Modification

Human gut microbial community is playing a critical role in human health and associated with different human disease. In parallel, probiotics, antibiotics, and antipyretic analgesics (AAs) were developed to improve human health or cure human diseases. We therefore examined how probiotics, antibiotics, and AAs influence to the gut microbiota. Three independent case/control studies were designed from the cross-sectional cohort data of 1,463 healthy Koreans. The composition of the gut microbiota in each case and control group was determined via 16S ribosomal RNA Illumina next-generation sequencing. The correlation between microbial taxa and the consumption of each drug was tested using zero-inflated Gaussian mixture models, with covariate adjustment of age, sex, and body mass index (BMI). Probiotics, antibiotics, and AAs consumption yielded the significant differences in the gut microbiota, represented the lower abundance of Megasphaera in probiotics, the higher abundance of Fusobacteria in antibiotics, and the higher abundance of Butyrivibrio and Verrucomicrobia in AAs, compared to each control group. The reduction of Erysipelotrichaceae family was common in three drugs consumption.

The growth inhibitory effect of some vegetable oils on Streptococcus mutans and Lactobacillus casei / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the growth inhibitory effects of some vegetable oils on Streptococcus mutans (S. mutans) and Lactobacillus casei (L. casei). METHODS: Two bacterial strains and 5 kinds of test solutions (3 experimental groups: orange essential oil, olive oil, soybean oil; 1 positive control group: chlorhexidine solution; 1 negative control group: broth medium) were used in this study. S. mutans and L. casei pellets were exposed to 1 ml of one of the test solutions for 1 minute. Then, the treated bacterial cells were incubated in fresh broth medium for 0, 4, 8, 16, and 24 hours. The optical density of the broth medium was measured using an ELISA reader at 620 nm. A nonparametric Kruskal-Wallis test (with Mann-Whitney U tests) was performed to compare the change in optical density between different groups at different time points. RESULTS: Bacterial growth was significantly inhibited in all experimental groups compared to the negative control group. The growth of L. casei was less affected by experimental oils than that of S. mutans. Orange essential oil had the maximum growth inhibitory effect on S. mutans up to 8 hours, similar to that in the positive control group (P<0.01). Experimental oils had greater growth inhibitory effect on L. casei than chlorhexidine solution. CONCLUSIONS: This in vitro study confirmed the growth inhibitory effect of some vegetable oils on S. mutans and L. casei. Rising of the mouth using these vegetable oils is expected to have an anti-plaque effect, but additional clinical studies are needed to confirm this.

Association of the number of existing permanent teeth with the intake of macronutrients and macrominerals in adults aged 55-84 years based on the 5th KNHNES (2010-2012) / 대한구강보건학회지

OBJECTIVES: The aim of this study was to analyze the association between energy sources, fiber and mineral intake, and the number of existing permanent teeth in adults aged 55-84 years from the 5th Korea National Health and Nutrition Examination Survey (KNHNES) (2010-2012). METHODS: The subjects included 6,763 people who received oral examinations and answered questions on household income, smoking status and diet. We estimated the number of existing permanent teeth and food intake according to age group, sex, household income, and smoking status. A complex samples general linear model was applied to analyze the effect of nutrient intake on the number of existing permanent teeth adjusted for sex, household income, smoking status, and food intake. We calculated the mean intake of nutrients related to the number of existing permanent teeth in each tooth group. RESULTS: The reduction in the number of existing permanent teeth correlated with an increased carbohydrate intake and a decreased potassium intake. The carbohydrate intake was lower in subjects with 25 or more teeth than that in subjects with 9 or less teeth. Potassium intake was higher in subjects with 20 or more teeth. CONCLUSIONS: The number of existing permanent teeth showed a negative correlation with carbohydrate intake and a positive correlation with potassium intake. We should reduce carbohydrate intake and increased potassium intake from fruits and vegetables to prevent systemic disease caused by tooth loss.

False Increase in Whole Blood Tacrolimus Levels due to Interference in an Antibody-Conjugated Magnetic Immunoassay Method

Tacrolimus is an immunosuppressive agent used to prevent post-transplantation rejection. Tacrolimus has a narrow therapeutic window and therefore, its whole blood concentration is measured for therapeutic drug monitoring. In this report, we present two cases of falsely elevated tacrolimus concentrations identified in recipients of solid organ transplants due to analytical interferences in the antibody-conjugated magnetic immunoassay (ACMIA) method used. Tacrolimus concentrations measured using ACMIA were 4- to 8-fold higher than the values obtained using liquid-chromatography-tandem mass spectrometry (LC-MS/MS) or chemiluminescent micro-particle immunoassay. The cause of this interference remains unknown, but the identification of a possible false elevation of tacrolimus is of paramount importance in clinical practice. Pre-treatment of samples by ethanol extraction or using alternative methods of tacrolimus measurement such as LC-MS/MS are necessary to obtain reliable results in the event of an analytical interference.

Korean Housewives Living through Depression: A Grounded Theory Study / 정신간호학회지

PURPOSE: This study was conducted to generate theoretical constructs on depression from the study data by examining and interpreting Korean housewives' experience with depression to elicit its meaning, understand it better, and develop empirical knowledge on it. METHODS: The data were collected in a community public mental health center between April 1, 2012 and September 30, 2012 using in-depth interviews and theoretical sampling. The participants were 12 women aged 40-64 years who scored 7 or higher in the Korean version of the 21-item Hamilton Rating Scale for Depression (Kim, 1980). Collected data were analyzed by grounded theory methodology using open, axial, selective coding process. RESULTS: It was found that the basic socio-psychological process of Korean housewives' living through depression could be summarized into the following four phases: (1) the vanishing of the self into thin air, (2) becoming an empty shell, and (3) searching for the meaning of life, (4) fulfilling of an empty shell. CONCLUSION: This study may enhance the culturally elusive understanding of Korean housewives' experience with depression. As they are living through a hollow empty shell which looks normal on the outside, so can't get support from their families. It's important to educate their families about depressive phases.

Cost-benefit analysis of a water fluoridation program for 11 years in Jinju, Korea / 대한구강보건학회지

OBJECTIVES: The aim of this study was to estimate the economic costs and benefits of a water fluoridation program in the city of Jinju, Korea. METHODS: In 2009, dental surveys were conducted on 2,315 children aged 6-12 years in Jinju, which had been fluoridated for 11 years. The decayed/missing/filled teeth (DMFT) scores of children in Jinju were compared to the DMFT scores of same-aged children in non-fluoridated small- and medium-sized cities in the fourth Korean National Health and Nutrition Examination Survey conducted from 2007 to 2009 by the Korea Centers for Disease Control and Prevention. The reduced number of decayed permanent teeth by the water fluoridation program was estimated as the difference between the DMFT scores of children in Jinju and those in non-fluoridated small- and medium-sized cities. The economic benefits were estimated by the savings from reduced dental treatment costs by using the reduced number of decayed permanent teeth from the water fluoridation program. All annual costs and benefits were calculated from 1998 to 2009. The social rate and untreated rate of decayed teeth were applied as 3% and 20%, respectively. The annual benefit-cost ratio was estimated by using the annual benefits and cumulative program costs. RESULTS: The economic benefit in 2009 from a water fluoridation program was estimated as 57,496,000,000 Korean Won (KRW), and the cumulative cost in 2009 was estimated as 1,387,000,000 KRW. The net present value in 2009 from a water fluoridation program was 56,109,000,000 KRW. The benefit-cost ratio in 2009 was estimated as 41.4. CONCLUSIONS: The economic benefit of a water fluoridation program in Jinju city was evaluated as excellent.