• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.754-759
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• 1998

Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.256-261
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• 2008

Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.94-101
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• 2018

Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.386-393
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• 2016

The incidence of gallbladder polyps are increasing due to the extended use of ultrasonography. Although there are various reports on the risk of gallbladder polyps, there are few studies of the relationships among the presence of metabolic syndrome including serum biochemistry, lifestyle and the development of gallbladder polyps. The aim of this study was to determine association of the presence of metabolic syndrome, including serum biochemistry, with the development of gallbladder polyps in the Korean population. Among the health examination examinees, 596 people, who underwent abdominal ultrasonography from January, 2013 to December 2013, were included in this study. Physical measurements also taken, such as height, weight, blood pressure, waist measurement, and BMI. The general characteristics including age, sex, smoking, and drinking as the related factors were checked. At the same time, various blood tests were performed and the fasting blood sugar was analyzed through blood-gathering to determine the presence of metabolic syndrome. Regarding the factors associated with gallbladder polyps, the results showed that being male, smoking, non-drinking were significantly high. In addition, testing positive for HBsAg and an increasing BMI was apparently higher the group with metabolic syndrome than the non-metabolic syndrome group. The highest predictive factors for gallbladder polyps was being male (1.8 times), followed by metabolic syndrome (2.3 times) and testing positive for HBsAg (2.6 times).

• Korean Journal of Clinical Laboratory Science
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• v.51 no.3
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• pp.316-322
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• 2019

Helicobacter pylori, a gram-negative bacterium, is one of the risk factors that induces gastritis and gastric cancer. Therefore, much attention has been paid to the compounds that inhibit bacterial growth or eradicate bacteria. Evodiae fructus (EF), the fruit of Evodia rutaecarpa, has been used for treating diarrhea and abdominal pain. EF extract was already found to inhibit the growth of H. pylori. However, to the best of our knowledge, the effect of EF on the virulence factors of H. pylori has not been reported. In this study, when comparing the minimum inhibitory concentration (MIC) of the different methanol concentration extracts, the 95% methanol extract (EF95) showed the lowest MIC value. EF95 extract suppressed the expressions of cagA, vacA and ureB, but interestingly, it up-regulated the expression of ureA. A decrease in production of ammonia in the culture medium and the cell lysates indicated that EF95 inhibited the urease activity in H. pylori, which was the result of EF95 inhibiting the ureB expression. Although the mechanism by which EF95 extract regulates the virulence factors in H. pylori needs further study, EF95 could be used for treatment of gastric troubles induced by H. pylori.

• Nutritional Sciences
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• v.8 no.1
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• pp.42-49
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• 2005

Many of the non-communicable diseases, which are now the major causes of death and disability worldwide, can be linked to our lifestyles, and thus to what eat The life-style related risk factors are - to a great extent - preventable. Public health nutrition (PHN) policies are means through which govemments can have an enornous impact on the reduction of nutrition-related non-communicable diseases, such as diabetes, hypertension, obesity, cancer and cardiovascular disease, by creating and supporting environments which enable healthier food choices and which are conducive to healthy nutrition behavior. More and more countries are developing nutrition policies. Nutrition policies are tools through which governments can intervene and control nutrition-related concerns throughout all levels of society. The need for more concerted action in the Republic of Korea is demonstrated, by showing the lack of priority for nutrition issues. Four recommendations for action are made; the first recommendation places emphasis on the need to implement a structure at the political level, through which nutrition concerns can be addressed, such as a nutrition unit within the Ministry of Health and Welfare. The second recommendation stresses the need for a strong nutrition advocacy strategy, to raise the awareness of the gains that can be achieved by promoting healthy nutrition. The third recommendation calls for more vigorous regulations and stricter enforcement of food and nutrition advertisement, and the fourth recommendation emphasizes the need for a settings-bsed approach to nutrition interventions. Acknowledging the developments that have already occurred in Korea, public health nutrition has yet to become a priority on the agenda of policy makers in Korea.

• Nutrition Research and Practice
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• v.5 no.4
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• pp.329-336
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• 2011

Obesity contributes to an increased risk for chronic diseases, including diabetes, cardiovascular diseases, and certain types of cancer. The prevalence of obesity has increased in Korea. We compared the clinical and dietary characteristics of obese adults (n = 30, 17 men and 13 women, mean age 29.9) to those with a normal weight (n = 15, 8 men and 7 women, mean age 26.5). We determined lipid profiles, fasting blood sugar (FBS), blood pressure, and serum free fatty acid (FFA). Dietary intake was estimated using a food frequency questionnaire (FFQ) and a 3-day dietary record. Exercise patterns and average alcohol intake were determined. The average body mass index was 28.3 kg/$m^2$ in the obese and 21.2 kg/$m^2$ in the normal weight groups. The obese group had significantly higher levels of total cholesterol, LDL cholesterol, and triglycerides, lower levels of HDL cholesterol, and higher blood pressures compared to the normal weight group. FBS was not significantly different between the two groups. The obese group had significantly more subjects with metabolic syndrome (26.7%) compared to the normal weight group (0%). Serum FFA levels tended to be higher in the obese (P = 0.087). No significant difference in caloric intake was observed between the two groups. No differences in carbohydrate, protein, or fat intake between two groups were observed from the FFQ. However, results from the 3-day dietary record showed that the percentage of energy from fat was significantly higher in the obese group. The frequency and amount of exercise did not differ between the two groups. Alcohol consumed per drinking episode was significantly higher in the obese group. These results confirm that excessive weight is associated with disturbances in lipid metabolism in these fairly young and otherwise healthy adults. Dietary factors, including higher fat intake and alcohol consumption, seem to be contributing to the obesity of these subjects.

• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.118-131
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• 2016

Purpose: This study was conducted to develop a useful evidence-based guideline for preventing venous thromboembolism(VTE) in Korea adapting previously developed VTE guidelines. Methods: The guideline adaptation process was performed using 24 steps according to the nursing practice guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed VTE prevention guideline was consisted of 16 domains and 163 recommendations. The number of recommendations in each domain were: 4 general issues, 4 risk factors, 2 intervention at occurrence of VTE, 14 mechanical interventions, 30 pharmacological interventions, 19 VTE prevention for medical patient, 10 stroke patient, 16 cancer patient, 14 pregnancy, 6 for long distance traveller, 5 for abdominal surgery, 10 thoractic surgery, 10 orthopedic surgery, 5 neurosurgery, 4 other surgical patient, 2 urological surgery, 1 ENT surgery, 1 plastic surgery, 3 day surgery, 3 education of VTE prevention. Fourteen point three percent, 61.1%, and 24.6% of the recommendations were graded A, B, and C, respectively. Conclusion: The findings suggest that the new VTE prevention guideline can be more efficiently used to prevent VTE in hospital settings.

• Korean Journal of Community Nutrition
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• v.6 no.3
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• pp.331-339
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• 2001

This study was conducted to examine the predicting factors for the intention of breastfeeding with The Theory of Planned Behavior. The questionnaires were distributed to 131 primigravidas who were in their third trimester of pregnancy in Seoul, Kyonggido, Kyongsangbukdo, and Kyongsnagnamdo. Descriptive statistics, Pearsons Correlation and Multiple Regression were used to analyse the data. The subjects showed strong intention of breastfeeding. The subjects showed favorable attitudes toward breastfeeding. This fact showed significant correlation with the belief that their breastfeeding intention was due to the advantage of breast milk for the infant with regard to allergy prevention, disease protection, contribution to intellectual development, psychological closeness between mother and infant, convenience, cost, and the reduction of breast cancer risk and weight of the mother. No item of outcome evaluation did showed significant correlation with behavioral intension. The subjects were influenced about breastfeeding by their referents such as siblings and friends with breastfeeding experience, their mothers and husbands, and mothers-in-law. Most items of the control beliefs had a significant influence on the intention of breastfeeding. The subjects felt they could not control the situation ie. "when I have to breastfeed in public". However they felt they could control the situation ie. "when I suffer from mastitis", "when I have to cut down on coffee, alcohol, and smoking", "when I have Caesarean section", "when I need to maintain breast condition", and "when the infant hates to suck my nipple". Regression analysis revealed that control beliefs and attitudes toward breastfeeding could predict the behavioral intention of breastfeeding. Control beliefs were the most important factor in predicting behavioral intention. Therefore, nutrition education is needed to enhance the ability to cope with difficult situations while breastfeeding and increase faborable attitudes toward breastfeeding.eding and increase faborable attitudes toward breastfeeding.

• Journal of Microbiology and Biotechnology
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• v.10 no.6
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• pp.865-872
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• 2000

Helocobacter phylori is the major cause of gastritis, peptic ulcer, and a principal risk factor for gastric cancer. As the firs step towards a vaccine against H. pylori infection, Hy.pylori urease was expressed and purified as a recombinant apoenzyme (rUrease) in E. coli. In order to develop an effective immunization protocol using rUrease, the host immune responses were evaluated after the oral immunization of mice with rUrease preparations plus cholera toxin relative to various conditions, such as the physical nature of the antigen, the frequency of the booster immunization, the dose of the antigen, and the route of administration. The protective efficacy was assessed using a quantitative culture following an H. pylori SS1 challenge. It was demonstrated that rUrease, due to its particulated nature, was more superior than the UreB subunit as a vaccine antigen. The oral immunization of rUrease elicited significant systemic and secretory antibody responses, and activated predominantly Th2-type cellular responses. The bacterial colonization was significantly reduced (~100-fold) in those mice immunized with three or four weekly oran doses of rUrease plus cholera toxin (p<0.05), when compared to the non-immunized/challenged controls. The protection correlated well with the elicited secretory IgA level against rUrease, and these secretory antibody responses were highly dependent on the frequency of the booster immunization, yet unaffected by the dose of the antigen (25-200$\mu\textrm{g}$). These results demonstrate the remarkable potential of rUrease as a vaccine antigen, thereby strengthening the possibility of developing an H. pylori vaccine for humans.