• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.559-569
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• 2018

Background/Aims Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. Traditionally, GERD has been considered a disease of middle-aged and older people. Since risk factors for GERD affect a growing number of the adult population, concerns have been raised that increasingly younger people may develop GERD. We aim to determine if the proportion of younger patients has increased among the GERD population. Methods The incidence of GERD as well as several variables were evaluated during an 11-year period. Explorys was used to evaluate datasets at a "Universal" and Healthcare system in northern Ohio to determine if trends at a local level reflected those at a universal level. GERD patients were classified into 7 age groups (15-19, 20-29, 30-39, 40-49, 50-59, 60-69, and ${\geq}70$ years). Results The proportion of patients with GERD increased in all age groups, except for those who were ${\geq}70$ years in the universal dataset (P < 0.001) and those who were ${\geq}60$ years in the Healthcare system (P < 0.001). The greatest rise was seen in 30-39 years in both datasets (P < 0.001). Similarly, the proportion of GERD patients who were using proton pump inhibitors increased in all age groups except for those who were ${\geq}70$ years in both datasets (P < 0.001), with the greatest increase being the group 30-39 years (P < 0.001). Conclusion Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years.

• Korean Journal of Clinical Pharmacy
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• v.29 no.2
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• pp.79-88
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• 2019

Backgrounds: Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) increased prevalence and economic burden. Objectives: This study aimed to investigate drug use pattern in IBD patients in a real world. Methods: National Health Insurance claim data from 2010 to 2014 were used in this population-based study. All IBD patients diagnosed during study period were enrolled. IBD medications included 5-aminosalicylic acid (ASA), glucocorticoid, immunomodulator and anti-tumor necrosis factor-${\alpha}$ agent(anti TNF-${\alpha}$). Growth rate of IBD prevalence, prescribed drug classes, duration of drug therapy and medication cost were analyzed. Number and percentage of patients for categorical variables, and mean and median for continuous variables were presented. Results: Total numbers of patients were 131,158 and 57,286 during 5 years, and their annual growth rate were 3.2 and 5.7% for UC and CD. UC and CD were prevalent in the 40-50 (41.2%) and 20-30 age groups (36.0%). About 60% of IBD patients was prescribed any of medications. 5-ASA was the most frequently prescribed, followed by corticosteroid and immunomodulator. Anti TNF-${\alpha}$ use was the lowest, but 5 times higher than UC in CD. Combination therapies with different class of drugs were in 29% for UC and 62% for CD. Mean prescription days per patient per year were 306 and 378, and the median medication cost per patient per year was KRW 420,000 (USD 383) and KRW 830,000 (USD755), for UC and CD, respectively. Conclusions: Increasing prevalence of IBD requires further studies to contribute to achieve better clinical outcomes of drug therapy.

• Journal of the Korean Society of School Health
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• v.34 no.1
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• pp.76-86
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• 2021

Purpose: This study was conducted to describe the experience of school health teachers in regard to the COVID-19 pandemic in South Korea. Methods: We conducted a qualitative study using content analysis. Ten school health teachers were recruited from 6 elementary schools, 2 middle schools and 2 high schools in Seoul, using purposive sampling. They participated in semi-structured in-depth interviews in person or using an online communication system from January to February, 2021. Interviews were transcribed verbatim and analysed using qualitative content analysis. Results: Three main categories and nine generic categories emerged from the analysis. Firstly, it was discovered that school health teachers had psychological and physical stress to cope with COVID-19 due to the 1) fear of the unexpected infectious disease, 2) burden of having to deal with it alone, 3) breakdown of personal life and physical exhaustion and 4) heavy duty as a health teacher caused by the lack of an organic cooperation system with institutions related to school infectious diseases. Secondly, school health teachers had an increased sense of empowerment in regard to infectious disease management as a result of 1) feeling rewarded and appreciated and 2) gaining confidence and trust in infectious disease management. Finally, school health teachers experienced the urgent need for an effective response strategy for infection control because of the 1) confusion over infectious disease response due to lack of practical manuals applicable to the field as well as training, 2) disappointing response system without an expert response team dedicated to managing infectious diseases in schools, and 3) growing awareness of the need for change. Conclusion: It is expected that school health teachers' experience of COVID-19 will be used as important data for building effective and advanced school infectious disease response systems.

• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.

• Parasites, Hosts and Diseases
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• v.58 no.3
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• pp.301-308
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• 2020

Owing to global climate change, the global resurgence of vector-borne infectious diseases and their potential to inflict widespread casualties among human populations has emerged as a pivotal burden on public health systems. Tsutsugamushi disease (scrub typhus) in the Republic of Korea is steadily increasing and was designated as a legal communicable disease in 1994. The disease is a mite-borne acute febrile disease most commonly contracted from October to December. In this study, we tried to determine the prevalence of tsutsugamushi disease transmitted by chigger mites living on rodents and investigated their target vector diversity, abundance, and distribution to enable the mapping of hotspots for this disease in 2015. A total of 5 species belonging to 4 genera (109 mites): Leptotrombidium scutellare 60.6%, L. pallidum 28.4% Neotrombicula tamiyai 9.2%, Euschoengastia koreaensis/0.9%), and Neoschoengastia asakawa 0.9% were collected using chigger mite collecting traps mimicking human skin odor and sticky chigger traps from April to November 2015. Chigger mites causing tsutsugamushi disease in wild rodents were also collected in Hwaseong for the zoonotic surveillance of the vector. A total of 77 rodents belonging to 3 genera: Apodemus agrarius (93.5%), Crocidura lasiura (5.2%), and Micromys minutus (1.3%) were collected in April, October, and November 2015. The most common mite was L. pallidum (46.9%), followed by L. scutellare (18.6%), and L. orientale (18.0%). However, any of the chigger mite pools collected from rodent hosts was tested positive for Orientia tsutsugamushi, the pathogen of tsutsugamushi disease, in this survey.

• Journal of Science and Technology Studies
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• v.14 no.2
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• pp.165-198
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• 2014

This study investigated a mechanism of naming a disease, as examining how obesity attain a status of disease. WHO(World Health Organization) warned 'The obesity is definitely a disease to need medical treatment' in 1996 and 1997. However, before then, obesity was classified as unusual or nonstandard body status but it was not categorized as a disease. In order to examine a mechanism how obesity attain the status of disease, this study examined the historical process of construction to obesity in discourse of disease and ontological reality of pathological epidemiological to obesity. As a result of this research, it was found that the medical community manipulated BMI(Body Mass Index) and deliberately narrowed the range of person's normal weight, and institutionalized sizism. Especially, it was found that as the medical community associated the body state of obesity with high blood pressure, diabetes, and etc that causes burden of medical expenses to patients, that was fatphobia. And it tried to from a medical control mechanism to assign obesity to an independent status of a disease. Based on this examination, this study found an entailment: the noninfectious disease such as obesity attains the status of disease not because of the pathologic reason but because of cultural or socio-economical reason which han nothing to do with any medical source.

• Journal of Nutrition and Health
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• v.48 no.3
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• pp.221-227
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• 2015

Purpose: Confronting the growing burden of dementia requires understanding the causes and predictors of dementia in order to develop preventive strategies. In Korea a large proportion (71%) of dementia is Alzheimer's disease, and the risk factors have not yet been elucidated. Dietary factors may be possible risk factors, however research on the relationship between Alzheimer's disease and dietary behaviors has been insufficient. The purpose of this study was to investigate the association between compliance with the "Dietary Guidelines for Elderly (The Ministry of Health and Welfare, 2011)" and Alzheimer's disease among Korean elderly. Methods: Elderly persons who visited a University hospital or a dementia center of Seoul and agreed to participate in the examinations were selected. Among 277 subjects, 89 Alzheimer patients were selected with diagnosis and 118 subjects were assigned to the control group. Diagnosis of Alzheimer's disease was based on Alzheimer's disease criteria of Diagnostic and Statistical manual of Mental Disorders, 4th edition (DSM-IV) and criteria of National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and related Disorders Association (NINCDS-ADRDA). Information on the general characteristics, health related behaviors and compliance with the dietary guidelines for Korean elderly was collected by face to face interview using a structured questionnaire. Anthropometric variables were measured during the survey. Results: Total compliance score of dietary guidelines was significantly lower in the Alzheimer's disease group than in the control group (p = 0.0001). The odds ratio of Alzheimer's disease was significantly decreased in the group with the highest dietary guideline compliance score (OR = 0.47, 95 % CI = 0.18~1.09) compared to the group with the lowest compliance score. Conclusion: The results indicate that increasing compliance with the dietary guidelines could be an effective strategy to decrease the risk of Alzheimer's disease among Korean elderly.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.109-120
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• 2001

This study has been done in order to help the people understand the cancer patients and provide the basic materials for the care of cancer patients by deeply understanding the living experience of the practice of alternative therapy for cancer patients. Data were collected with several in depth interviews and observations. Collected datas were analyzed by using phenomenological method of study by Giorgi (1970). The trial experience of alternative therapy for cancer patients has been classified into the one of having concerns, following, being infatuated, and coming out by pushing, and the experience of having concerns appeared as the meaning of the limit of modern medicine, despair, loneliness. hope, emotional support. dissolution of the feeling of uneasiness. the feeling of burden of the medical expense, self-treating, the subject of treatment. and indifference while the experience of following appeared as the meaning of blind following, temptation, going outside to look for something, wandering. following unconditionally, advise of the professionals, mistaken belief. self-abandonment, powerlessness. disconnection of dialogue with the medical staff. elevation of immunity, strengthening the physical power, absence of the source of examined information, clinging, self-responsibility. the experience of being infatuated appeared as the meaning of thorough trial. affirmative experience. devotion. diverse efforts, faithful trial. affirmative self-suggestion. change of the style of life. the feeling of burden of expense, being envious, bitter feeling toward the family, considering family, family discords, and difficulty of enforcement. The experience of coming out by pushing appeared as the meaning of waiting. self-reflection. maintaining the distance. cutting attachment, throwing the greed away, coming out by pushing. being thoughtful. accepting disease. individual difference of physical quality, and ambivalence. But they return to the experience of being concerned all over again in case of recurrence or metastasis of the disease even though they come out of such stage, and they always have ambivalence even in the condition with no recurrence and metastasis. In conclusion, the trial of alternative therapy for cancer patients could be explained as the adaptive behavior to the disease which is difficult to be cured. the cancer. The cancer patients are exposed to the side effects and harm without the examined information resources. Therefore the nurse should well aware of the alternative therapy and be able to do the appropriative management through the open communication with the patients who are under the trial of alternative therapy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.1
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• pp.52-56
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• 2016

Propionic acidemia (PA) is a rare autosomal recessive metabolic disease caused by the deficiency of propionyl-CoA carboxylase (PCC). PA affects the catabolism of branched chain amino acid and oddchain fatty acid then results in accumulation of propionic acid and other metabolites in plasma and urine. Catabolic stress such as infection, illness or any stress can precipitate cause acute metabolic decompensation, especially in the first years of life. Acute metabolic decompensation commonly calls for emergency treatment or admission and if the patient is in a serious condition, it can lead to coma or death. But frequent admissions or visiting the emergency room are much burden to the patients and their kins. And we experienced the propionic academia with a confirmed novel mutation and the patient suffered from frequent admission and visiting the emergency room. So, we tried the regular home carebased fluid therapy after securing a central venous line. Finally, we succeeded in preventing frequent admissions resulted from acute metabolic decompensation and could contribute to relieving the burden to the patient and their family.

• Journal of Nutrition and Health
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• v.39 no.3
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• pp.286-298
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• 2006

The study aimed to identify major factors related to global self-rated health of the community-dwelling elderly people in rural areas. Interviews were conducted with 433 persons over 65 years of age. The socio-economic characteristics, chronic disease status, measures of functional and mental health, life satisfaction, health-related behaviors including smoking, drinking, exercise, social activity, dietary habit, and food intakes were analyzed to determine their influence on self-rated health index. Data on food intake were obtained through the 24-hour recall method. The self-rated health of rural elderly was poor or very poor as reported by 42.6% and 52.4% of the men and women, respectively. Poor self-rated health was found to be related to elderly aged $65{\sim}74$, female, absence of work, more chronic diseases, dependence on Instrumental Activity Daily Living (IADL), higher mental unhealthy days, lower current life satisfaction, less social activity, lower dietary habit scores, lower intake of total food, fruit, eggs, fishes & shell fishes, vitamin C (%RDA), and Nutrient Adequacy Ratio (NAR). The results of the multiple regression analysis showed that poor self-rated health index is significantly associated with more chronic diseases, mental unhealthy days, gastrointestinal disease, musculoskeletal disease, less social activity, and lower intake of fruits. The results also suggested that improving the nutritional status and functional ability, and reducing the burden of chronic diseases are beneficial to the self-rated health index of the elderly.