• Korean Journal of Child Studies
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• v.13 no.2
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• pp.217-228
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• 1992

The purpose of this study is to examine the effects of early full-time nonparental care during infancy/toddlerhood on children's socioemotional behaviors during the preschool period. Subjects for this study were 105 three- to five-year-olds from middle-class families in the U. S. A. Children were assigned to one of three groups according to their early care history. Children's social interactions with peers and caregivers during indoor free-play sessions in day care centers were observed for 20 minutes. The head teachers rated the children's social and emotional behaviors on two questionnaires. Mothers completed the Attachment Q-sort for attachment assessment for the preschoolers. In addition, mothers were asked to fill out a questionnaire on their parenting practices. Children who had received full-time nonparental care during infancy and/or toddlerhood were rated by their teachers as being more intellectually competent than children who did not receive full-time nonparental care during first three years of life. They were, however, rated by teachers and were observed by the researcher as being more aggressive than children with no full-time nonparental care. These children were observed to engage in less wandering/onlooking behaviors than children who had not had any full-time nonparental care. Children's attachment security scores and dependency scores did not differ as a function of early nonparental care histories. When the effects of early care patterns, sex of child, and current attachment security to mothers on aggressive behaviors of the preschoolers were examined by a hierarchical regression model, then any "pure" effects of nonparental care and of attachment security on child aggression were minimal after controlling for family background, child care center quality, and maternal childrearing practices. Strong buffering factors for the preschool children (family characteristics, parenting styles, and high quality nonparental care) mediated a possible risk factor of early nonparental care and promoted optimal outcomes for the children.

• Korean Journal of Childcare and Education
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• v.17 no.5
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• pp.83-103
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• 2021

Objective: This study aimed to develop a longitudinal predictive model that identifies first-grade children who are at risk for ADHD and to investigate the factors that predict the probability of belonging to the at-risk group for ADHD by using machine learning. Methods: The data of 1,445 first-grade children from the 1st, 3rd, 6th, 7th, and 8th waves of the Korean Children's Panel were analyzed. The output factors were the at-risk and non-risk group for ADHD divided by the CBCL DSM-ADHD scale. Prenatal as well as developmental factors during infancy and early childhood were used as input factors. Results: The model that best classifies the at-risk and the non-risk group for ADHD was the LASSO model. The input factors which increased the probability of being in the at-risk group for ADHD were temperament of negative emotionality, communication abilities, gross motor skills, social competences, and academic readiness. Conclusion/Implications: The outcomes indicate that children who showed specific risk indicators during infancy and early childhood are likely to be classified as being at risk for ADHD when entering elementary schools. The results may enable parents and clinicians to identify children with ADHD early by observing early signs and thus provide interventions as early as possible.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.48-52
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• 2024

Backgrounds/Aims: Splenectomy is the most frequently performed procedure as definitive management or as part of shunt surgery or devascularization in portal hypertension. Splenectomy is technically challenging because of the frequent coexistence of multiple collateral varices, splenomegaly, poor liver function, and thrombocytopenia. Early arterial ligation and late mobilization (EALDEM) is the traditional method for splenectomy in portal hypertension. Early spleen mobilization offers good control of the hilum. We aim to compare the effect of the early mobilization and delayed arterial ligation (EMDAL) technique with that of the conventional splenectomy technique in patients with portal hypertension. Methods: During the study period from September 2011 to September 2022, 173 patients underwent surgical intervention for portal hypertension at our institution. Among these patients, 114 underwent the conventional method of splenectomy (early arterial ligation and late splenic mobilization) while 59 underwent splenectomy with the EMDAL technique. Demographics were compared between the two groups. Intraoperative and postoperative outcomes were analyzed using the Mann-Whitney test in each group. A minimum follow-up of 12 months was performed in each group. Results: Demographics and type of surgical procedure were comparable in the two surgical method groups. Median blood loss was higher in the conventional group than in the EMDAL method. The median duration of surgery was comparable in the two surgical procedures. Clavien-Dindo grade III/IV complications were reported more frequently in the conventional group. Conclusions: The splenic hilum can be controlled well and bleeding can be minimised with early mobilization and delayed arterial ligation.

• Journal of Gastric Cancer
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• v.12 no.4
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• pp.232-236
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• 2012

Purpose: With an increase in life expectancy, more elderly patients are presenting with gastric cancer. As a result it is yet be resolved whether laparoscopy assisted distal gastrectomy is a suitable treatment for elderly patients with early gastric cancer. This study retrospectively compared surgical outcomes of laparoscopy assisted distal gastrectomy between elderly and nonelderly patients with gastric cancer. Materials and Methods: The study group was comprised of 316 patients who underwent laparoscopy assisted distal gastrectomy between April 2005 and December 2010. Of these patients, 93 patients whose ages were 65 years or more were compared with 223 patients who were younger. Results: There were no differences in the short term outcome or minor complication rate between the elderly patients and the nonelderly patients. The hospital stay was significantly longer and the major complication rate was significantly higher for the elderly patients compared with nonelderly patients. Conclusions: Laparoscopy assisted distal gastrectomy for early gastric cancer in the elderly patients had comparable operation time and blood loss with the nonelderly group. However, the safety and advantage of laparoscopy assisted distal gastrectomy in the elderly patients need to be further studied in higher volume trials.

• Journal of Labour Economics
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• v.37 no.4
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• pp.1-24
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• 2014

This paper examines the changes in early reemployment bonus system in Korea and investigates its effects on job finding rates of the unemployed and on their reemployment outcomes. The analysis on the characteristics of the recipients reveals that, after the policy change, the probability of receiving the bonus increases among female, older, and less educated job seekers. This paper also shows that exit hazard from unemployment has not changed significantly while the stability of the subsequent jobs has been substantially improved.

• Korean Journal of Clinical Pharmacy
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• v.20 no.1
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• pp.85-87
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• 2010

Recently, the prevalence of bladder cancer is increasing in the Korean society. As the risk factors of bladder carcinoma are variable, the early-stage diagnosis is regarded the best preventive practice. Hematuria is a specific sign of the malignancy as well as a kind of various medication-related adverse reactions. Some anti-coagulation therapy can cause bleedings including hematuria to the patients with cardiovascular diseases such as paroxysmal atrial fibrillation (PAF). Therefore, to the clinical pharmacists working in the anti-coagulation services (ACS), a closer monitoring of patients can give an opportunity to find certain ailments unexpectedly. In this case, a patient with PAF had episodes of sporadic hematuria in the course of warfarin therapy even though with its low levels of INR. An ACS pharmacist found a discrepancy between the bleeding symptoms and INR values, and recommended properly the patient to refer urologist. Fortunately, an early-stage of bladder carcinoma was found then followed by an excision performed to the lesion. Therefore, alert-minded and precise monitoring done by ACS pharmacist could optimize the therapeutic outcomes as well as increase the quality of life of the patient.

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.87-90
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• 2010

Early gastric cancer (EGC) is defined as tumor invasion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. Lymph node metastasis is the most powerful and important prognostic factor for gastric cancer. Based on the risk of lymph node metastasis in EGC obtained from a large number of surgical cases in Japan, it was suggested that the criteria for endoscopic mucosal resection (EMR) and endoscopic submucosal resection (ESD) as local treatment for EGC might be extended. However, extending the indications for EMR and ESD remains controversial because the long-term outcomes of these procedures have not been fully documented, and there is a risk for lymph node metastasis. Furthermore, current diagnostic imaging techniques are unsatisfactory for accurately predicting metastasis to lymph nodes. Moreover, the long-term results of standard radical gastrectomy including minimally invasive procedures for stage IA have been increasing and have reached 99 to 100%. To determine the true efficacy of endoscopic resection of EGC, we need more evidence of long-term follow-up, standardization of techniques, and pathological interpretation.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.384-388
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• 2014

Background: Recently, single-port video-assisted thoracic surgery (VATS) has been proposed as an alternative to the conventional three-port VATS for primary spontaneous pneumothorax (PSP). The aim of this study is to evaluate the early outcomes of the single-port VATS for PSP. Methods: VATS was performed for PSP in 52 patients from March 2012 to March 2013. We reviewed the medical records of these 52 patients, retrospectively. Nineteen patients underwent the conventional three-port VATS (three-port group) and 33 patients underwent the single-port VATS (single-port group). Both groups were compared according to the operation time, number of wedge resections, amount of chest tube drainage during the first 24 hours after surgery, length of chest tube drainage, length of hospital stay, postoperative pain score, and postoperative paresthesia. Results: There was no difference in patient characteristics between the two groups. There was no difference in the number of wedge resections, operation time, or amount of drainage between the two groups. The mean lengths of chest tube drainage and hospital stay were shorter in the single-port group than in the three-port group. Further, there was less postoperative pain and paresthesia in the single-port group than in the three-port group. These differences were statistically significant. The mean size of the surgical wound was 2.10 cm (range, 1.6 to 3.0 cm) in the single-port group. Conclusion: Single-port VATS for PSP had many advantages in terms of the lengths of chest tube drainage and hospital stay, postoperative pain, and paresthesia. Single-port VATS is a feasible technique for PSP as an alternative to the conventional three-port VATS in well-selected patients.

• Journal of Chest Surgery
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• v.51 no.5
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• pp.322-327
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• 2018

Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.111-116
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• 2013

Background: Heart transplantation in elderly patients has raised concerns because of co-morbidities and limited life expectancy in the era of donor shortage. We examined the outcomes after heart transplantation in elderly patients. Materials and Methods: From March 1994 to December 2011, 81 patients (male:female=64:17, $49.1{\pm}14.0$ years) underwent heart transplantation. The outcomes after heart transplantation in the younger patients (<60 years; group Y, n=60) were compared with those in the elderly patients (${\geq}60$ years; group O, n=21). The follow-up duration was $51.8{\pm}62.7$ months. Results: Early mortality (${\leq}30$ days) occurred in 5.0% (3/60) and 4.8% (1/21) of groups Y and O, respectively (p>0.999). There were no differences in overall survival between the two groups (p=0.201). Freedom from rejection was higher in group O than in group Y (p=0.026). Multivariable analysis revealed that age ${\geq}60$ years was not a significant risk factor for long-term survival; postoperative renal failure was the only significant risk factor for long-term survival (p=0.011). Conclusion: Early and mid-term results of heart transplantation in elderly patients were similar to those in younger patients.