• Radiation Oncology Journal
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• v.29 no.1
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• pp.36-43
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• 2011

Purpose: To evaluate the effectiveness of radiation therapy (RT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to analyze the prognostic factors. Materials and Methods: From December 2004 to April 2009, 70 patients who had HCC with PVTT were treated with RT at Keimyung University Dongsan Medical Center. Nineteen patients whose total dose was below 30 Gy and one patient who underwent liver transplantation were excluded. The remaining 50 patients (45 males, 5 females; median age 55 years) were analyzed. According to the LCSGJ TNM stage, there were 27 patients (54.0%) with stage III and 23 (46.0%) with stage IV. Total dose of 30~54 Gy was administered (median 45). Thirty patients (60.0%) were treated with concurrent chemoradiation therapy (CCRT). The median follow-up duration was from 13.5 months (range, 3 to 70 months). Results: The median survival time from the start of RT was 9 months. One-year and 2-year overall survival rates were 24.9% and 11.2%, respectively. At the follow-up time, three patients (6.0%) displayed no evidence of disease. Seven patients (14.0%) were alive with disease, and 40 (80.0%) patients had expired due to disease progression. CCRT was associated with worse survival than RT alone (p=0.034), Response to RT (p=0.037), CLIP stage (p=0.017), and TNM stage (p=0.041) were statistically significant prognostic factors. There was no radiation-induced liver disease. Conclusion: RT is an effective and safe modality for HCC with PVTT. Further studies such as prospective randomized trials are needed to confirm the role of RT for HCC with PVTT.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.469-475
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• 1998

Purpose : To determine the role of Pelvic irradiation in stage I or IIA cervical carcinoma with pelvic nodal metastasis after hysterectomy and bilateral pelvic lymphadenectomy. Materials and Methods : This is a retrospective study of 68 cervical carcinoma patients who were found to have pelvic nodal metastasis at hysterectomy and received pelvic irradiation from 1983 to 1996 at Inje University Seoul Paik Hospital. External beam radiation therapy to pelvis was delivered using 4 MeV Linac and intracavitary irradiation was given via vaginal ovoids or cylinders. Five-year survival and disease-free survival were estimated by Kaplan-Meier Method and prognostic factors related to survival were analysed by log-rank test and Cox proportional hazards regression model. Results : Median length of follow-up was 52months. Five-year overall survival and disease-free survival (DFS) were 81.8$\%$ and 81.7$\%$ respectively. Patients with endometrial invasion had a 57.1$\%$ 5-year DFS compared to 87.5$\%$ for those without endometrial invasion (p=0.0074). Multivariate analysis revealed endometrial invasion as an only statistically significant prognostic factor for 5-year DFS. Among total 15 (22$\%$) recurrences. pelvic recurrences occurred in 4 cases and distant metastases occurred in 13 cases. Conclusion : We have been able to confirm previous results demonstrating marked decrease in local recurrence after pelvic irradiation. In view of the high proportion of distant metastasis found in this study, a trial of aggressive adjuvant systemic therapy and irradiation in early stage cervical carcinoma patients with pelvic nodal metastasis, especially with endometrial invasion, appears to be warranted.

• Journal of Nutrition and Health
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• v.47 no.2
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• pp.124-133
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• 2014

Purpose: The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospitalized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002. Methods: Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGSGA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hematocrit, and changes in body weight and food intake, were statistically selected as variables for SMST. Results: According to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, ${\kappa}$ = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, ${\kappa}$ = 0.505), respectively, indicating that SMST held high inter-methods reliability. Conclusion: In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

• Korea journal of population studies
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• v.35 no.2
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• pp.209-232
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• 2012

The purposes of this study is to calculate the gender-based Life Expectancy and Disability Free Life Expectancy of 65-year-olds in accordance with the regions of 16 in Korea based on the years 2005 and 2010 by using the Sullivan method. We used the Census in 2005, 2010, the Korea National Statistical Office(10% sample). We also reviewed examining the changes in LE and DFLE and understanding the relevance between the DFLE of 65-year-olds of the year 2010 and related factors. As a result of this study, it was shown that the LE of the group of all 65-year-old in Korea increased from 18.15 years in 2005 to 19.75 years in 2010 and DFLE increased from 11.41 years in 2005 to 11.64 years in 2010. Regionally, the highest LE for total of 65-year-olds was found to be the entire Jeju area and DFLE was the highest in the city of Seoul. And the highest LE and the highest DFLE for 65-year-old male were found to be in the city of Seoul. Regarding the regional LE of 65-year-old female, both in 2005 and 2010 Jeju area was seen to be the highest. The results of a correlation analysis showed that the DFLE of 65-year-olds in 2010 was found to be increasing with high LE and high population density and in regions with low average temperatures, low number of beds and low age standardized death rates of malignant neoplasms and circulatory disease.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.538-555
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• 2018

Purpose: This study examined the association of the type and frequency of coffee consumption with the health-related quality of life and metabolic bio-markers in adult men and women from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 11,201 subjects (4,483 men and 6,718 women) were classified according to the type of coffee consumption (non-coffee, black coffee, 3-in-1 coffee) and type and frequency of coffee consumption (non-coffee, ${\leq}2$ times/day of black coffee, > 2 times/day of black coffee, ${\leq}2$ times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee) using food frequency questionnaires. Dietary nutrient intake data were assessed using food frequency questionnaires. The health-related quality of life was measured using the EuroQol-5 dimension (EQ-5D) and EQ-5D index score. Data on metabolic bio-markers were obtained from a health examination. Results: Among men and women, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower among the 3-in-1 coffee consumption group, and the proportion of subjects with iron intakes below the estimated average requirements (EAR) was lower among the 3-in-1 coffee consumption group. Women (OR: 0.810, 95% CI: 0.657 ~ 0.998) with the ${\leq}2$ times/day of 3-in-1 coffee had a lower risk of impaired health-related quality of life (lowest 20% level in the EQ-5D score) compared to the non-coffee consumers after a multivariable adjustment. In both men and women, the type and frequency of coffee consumption was not associated with metabolic bio-markers risk after multivariable adjustment. Conclusion: These results suggest that 3-in-1 coffee consumption may be associated with a lower risk of impaired health-related quality of life and may not be associated with the metabolic bio-markers risk in adult men and women.

• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.39-47
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• 2019

Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.11-21
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• 2019

Purpose: We aimed to investigate the epidemiological characteristics of Staphylococcus aureus bacteremia in Korean children. Methods: We retrospectively collected and analyzed data from the medical records of the patients with S. aureus bacteremia ${\leq}18years$ of age in Gil Medical Center from 2002 to 2016. Results: A total of 212 SAB cases were detected. The annual incidence of SAB from 2002 to 2016 ranged from 0.77 to 1.95 per 1,000 patients hospitalized. The neonate group (<28 days of age) and the pediatric group (28-18 years of age) were 51.4% (n=109) and 48.6% (n=103), respectively. According to the origin of infection, there were 93 cases (43.9%) of community-associated (CA)-SAB and 119 cases (56.1%) of healthcare-associated (HA)-SAB. The rates of HA-SAB among the neonate group and among the pediatric group were 64.2% and 47.6%, respectively (P=0.015). There was no difference in complications between CA-SAB and HA-SAB, but mortality was higher in HA-SAB. The proportion of methicillin-resistance S. aureus (MRSA) was the highest in neonates (88.1%), decreased with age, and was 36.4%-37.5% among children aged ${\geq}5years$. The MRSA proportion was 72.2%, showing no consistent trend over the period. Conclusions: The annual incidence of SAB and the proportion of MRSA in SAB remained constant in the recent 15 years in children. Judicious decision of antimicrobial agents for treatment considering the patient's age and the origin of infection is necessary.

• Laboratory Medicine Online
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• v.1 no.1
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• pp.26-34
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• 2011

Background: Laboratory diagnosis of new influenza A (H1N1) is crucial for managing patients and establishing control and prevention measures. We compared the diagnostic accuracies of the real time RT-PCR (rRT-PCR) test recommended for the confirmation of the new flu and the viral culture method used conventionally for viral disease with that of the rapid antigen test (RAT). Methods: We performed RAT, R-mix culture, and real-time PCR by using 861 respiratory samples collected from December 2009 to January 2010 and evaluated the abilities of these methods to detect new influenza A. The relationship among the positive rates of RAT, grades of culture, and the cycle threshold (Ct) values of rRT-PCR was also evaluated. Results: Of the 861 patients, 308 (35.8%) were diagnosed with new influenza A. The sensitivities, specificities, positive predictive values, and negative predictive values of the tests were respectively as follows: 59.7%, 99.5%, 98.4%, and 81.6% for RAT; 93.2%, 100%, 100%, and 96.3% for R-mix culture; and 95.8%, 100%, 100%, and 97.7% for rRT-PCR. Samples with weak positive grade in culture and those with Ct values of 30-37 in rRT-PCR showed positivities as low as 25.3% and 2.3% in RAT, respectively. The hospitalization rate and death rate of the confirmed patients were 3.2% and 0.3%, respectively, and gastrointestinal symptoms were observed in 7.2% of the patients. Conclusions: R-mix culture and rRT-PCR tests showed excellent reliability in the diagnosis of new influenza A and could be very useful, especially for samples with low viral load.

• 한국노년학
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• v.34 no.2
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• pp.259-275
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• 2014

The purpose of this study is to check if group art therapy is effective in improving self esteem and self integrity of rural elderly women. Study subjects are forty seven rural elderly women in A-city who have participated in producing specialized products in their rural area. They are divided into experimental group (EG, n=25) who wish to participate in the group art therapy program, a part of the A-city sponsored program named 'Making the Rural Elderly Happy', to improve and enhance the elderly's self esteem and self integrity, and control group (CG, n=22) with no wish to participate. However, only forty four elderly women are selected as the final study subjects for data analysis, due to those who either missed the program session more than once or died of old age during the program period. The group art therapy program was given from March 16 to May 18 of 2010, every Tuesday between 1pm through 3pm for a total of 12 sessions, with the help of two college student assistants in the region and one staff member for the city program. SPSS WIN version 12.0 is adopted to evaluate and analyze the effects of the therapy program, independent t-test for equivalence check of pretests, and frequency check for general characteristics of each group. The study results are obtained by the mean and standard deviation to grasp the changes between pretest and post-test on both groups, together with ANCOVA to evaluate effects of the therapy program with the pre-test as covariant. The results are as follows. First, self esteem of EG is significantly improved than that of CG after intervention of group art therapy. Second, self integrity is significantly higher in EG than CG after the group art therapy intervention. Therefore, it can be claimed that group art therapy is effective in improving and enhancing self esteem and self integrity of the rural elderly women.

• Journal of Korea Entertainment Industry Association
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• v.13 no.2
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• pp.197-205
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• 2019

This study was to compare arterial stiffness and hemodynamic responses between male smokers and non-smokers. This study also investigates the influences of smoking before exercise on arterial stiffness and hemodynamic responses. 24 male subjects of age 20-29 without history of cardiorespiratory disease were divided into smokers and non-smokers. Smokers had more than 5 years of smoking experience. In order to evaluate the effects of pre-exercise smoking, smokers were tested twice, once with a cigarette before the exercise and the other once without one. Data was collected from bio-impedance analysis, SphygmoCor XCEL, graded exercise test, and fitness test. Main results of this study are as follows: First, there are differences between smokers and non-smokers in cardiorespiratory and hemodynamic response functions, as shown by maximal oxygen consumption, exercise duration, and heart rate. Second, the although the arterial stiffness between smokers and non-smokers showed statistically significant differences in the speed of the pulse wave velocity and augmentation index, smoker had a faster rate. It shows that smoking behavior has a negative impact on the cardiovascular system. Third, pre-exercise smoking behavior does have an impact on cardiorespiratory and hemodynamic response functions, as shown by exercise duration and heart rate. Lastly, arterial stiffness between smokers and non-smokers showed statistically not significant in the speed of the pulse wave velocity and augmentation index. However, the difference was not statistically significant. Brachial systolic pressure, a component of pulse wave analysis, on the other hand, was significantly dependent on pre-exercise smoking behavior. Subjects who participated in this study are college students in early 20s. Given their relatively short history of smoking, it is possible that their smoking habits are not severe enough to develop into cardiorespiratory or cardiovascular diseases. But Smokers showed lower levels of cardiopulmonary functions, as maximal oxygen consumption and exercise duration than nonsmokers.