• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2467-2471
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• 2012

Introduction: Although bleomycin/etoposide/cisplatinum (BEP) chemotherapy is established as the standard treatment for germ cell tumours, it requires significant experience in administration and toxicity management to maintain optimal dose intensity. A retrospective review of 30 patients was conducted at UKMMC to study treatment outcomes. Methods & Materials: Patients with GCTs and treated with at least two cycles of BEP chemotherapy between January 2003 and Oct 2009 were eligible for this study. Patients received 4-6 cycles of bleomycin 30,000IU IV D1, D8 & D15 and either etoposide $100mg/m^2$ IV D1-D5 and cisplatin $20mg/m^2$ IV D1-D5 (5 day BEP regimen) or etoposide $165mg/m^2$ D1-D3 and cisplatin $50mg/m^2$ D1-3 (3 day BEP regimen) every three weeks per cycle. All patients received prophylactic granulocyte colony-stimulating factor (GCSF) from days 6 to 10 of each cycle. The overall response rates, 2 year progression-free survival and overall survival of the whole cohort were assessed. Results: Thirty patients fulfilled the inclusion criteria. Non-seminomatous GCTs comprised 93.3% of cases and gonadal and mediastinal primary sites were the most common. Sixty percent were classified as IGCCCG poor risk disease. Median follow-up was 26.6 months. The overall response rate (CR+PR) was 70%. The two year PFS and OS were 70% and 66%. There was a significant difference in terms of the overall response rate (85% vs 40%, p = 0.03) and in PFS (94.7% vs 50%, p = 0.003) between gonadal and extragonadal primary sites. Conclusion: It is possible to achieve outcomes similar to those in international clinical trials with close monitoring and good supportive care of patients undergoing BEP chemotherapy. There is a strong argument for patients with IGCCCG poor prognosis disease to be treated in specialist tertiary centres to optimize treatment outcomes.

• Nutrition Research and Practice
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• v.5 no.1
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• pp.52-59
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• 2011

The purpose of this study was to investigate how advanced maternal age influences lifestyle, nutrient intake, iron status, and pregnancy outcomes in pregnant women. The subjects of this study were 112 pregnant women who were receiving prenatal care at gynecologists located in Seoul. The subjects were divided into two groups according to their ages: those over age 35 were the advanced age group of pregnant women (AP) and those under age 35 were the young age group of pregnant women (YP). General factors, nutrient intakes, iron status, and pregnancy outcomes of the two groups were then compared. It was found that 72.5% of the YP group and 51.2% of the AP group had pre-pregnancy alcohol drinking experience; indicating that the YP group had more pre-pregnancy alcohol consumption than the AP group (P<0.05). The only difference found in nutrient intake between the two groups was their niacin intakes which were $16.83{\pm}8.20\;mg$/day and $13.76{\pm}5.28\;mg$/day, respectively. When gestational age was shorter than 38.7 weeks, the average infant birth weight was $2.95{\pm}0.08\;kg$, and when gestational age was longer than 40 weeks, it averaged at about $3.42{\pm}0.08\;kg$. In other words, as gestational age increased, infant birth weight increased (P<0.0001), and when maternal weight increased more than 15 kg, the infant birth weight increased significantly (P<0.05). In conclusion, in order to secure healthy human resources, with respect to advanced aged women, it is necessary to intervene by promoting daily habits that consist of strategic increases in folate and calcium intake along with appropriate amounts of exercise.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.8-14
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• 2018

Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data - including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention - were collected. Results: The mean age of the patients was $69.4{\pm}11.1years$ and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in the intensive care u nit and in the hospital were 1.5 and 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of $85.3%{\pm}0.09%$ and a 5-year MACCE-free survival rate of $72.8%{\pm}0.1%$. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at $9.7{\pm}10.8months$ postoperatively. Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.

• Preventive Nutrition and Food Science
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• v.16 no.4
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• pp.394-407
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• 2011

Better understanding of the complex factors leading to human diseases will be necessary for both long term prevention and for managing short and long-term health problems. The underlying causes, leading to a global health crisis in both acute and chronic diseases, include finite global health care resources for sustained healthy human survival, the population explosion, increased environmental pollution, decreased clean air, water, food distribution, diminishing opportunities for human self-esteem, increased median life span, and the interconnection of infectious and chronic diseases. The transition of our pre-human nutritional requirements for survival to our current culturally-shaped diet has created a biologically-mismatched human dietary experience. While individual genetic, gender, and developmental stage factors contribute to human diseases, various environmental and culturally-determined factors are now contributing to both acute and chronic diseases. The transition from the hunter-gatherer to an agricultural-dependent human being has brought about a global crisis in human health. Initially, early humans ate seasonally-dependent and calorically-restricted foods, during the day, in a "feast or famine" manner. Today, modern humans eat diets of caloric abundance, at all times of the day, with foods of all seasons and from all parts of the world, that have been processed and which have been contaminated by all kinds of factors. No longer can one view, as distinct, infectious agent-related human acute diseases from chronic diseases. Moreover, while dietary and environmental chemicals could, in principle, cause disease pathogenesis by mutagenic and cytotoxic mechanisms, the primary cause is via "epigenetic", or altered gene expression, modifications in the three types of cells (e.g., adult stem; progenitor and terminally-differentiated cells of each organ) during all stages of human development. Even more significantly, alteration in the quantity of adult stem cells during early development by epigenetic chemicals could either increase or decrease the risk to various stem cell-based diseases, such as cancer, later in life. A new concept, the Barker hypothesis, has emerged that indicates pre-natal maternal dietary exposures can now affect diseases later in life. Examples from the studies of the atomic bomb survivors should illustrate this insight.

• Journal of Korean Academy of Nursing
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• v.34 no.4
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• pp.625-635
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• 2004

Purpose. The purpose of this study was to explore the experiences of gastric cancer couples in Korea and to generate a substantive theory integrating the experiences of gastric cancer survivors and their spouses as a whole. The specific aims of this study were to explore major problems gastric cancer couples faced and how they resolved these problems, focusing on inter-relational dynamics within the couples and on similarities and differences between the couples. Methods. This was a secondary analysis study using grounded theory techniques. The study used the data of 11 married couples which was collected from in-depth interviews from two primary studies. The unit of analysis was dyads of gastric cancer survivors and their spouses. Results. The basic social psychological process that emerged from the analysis was 'taking charge of their health.' Major categories involved in this process were identified as 1) adjusting to new diets, 2) reinforcing physical strength, 3) seeking information, 4) strengthening Ki, 5) lowering life-expectations, and 6) going their separate ways. These six categories represent major strategies in overcoming critical problems that occurred in day-to-day experiences. In terms of the process, the first five categories characterize the earlier stage of the process of 'taking charge of their health,' while 'going their separate ways' indicates the later stage and also the beginning of their separate ways: 'pursuing spiritual life' for the survivors, and 'preparing for the future' for the spouses. Conclusions. The results of this study will help design family care for the people with gastric cancer by providing in-depth understanding and insight on the lives of gastric cancer couples.

• Proceedings of the Korea Information Processing Society Conference
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• 2012.11a
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• pp.450-451
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• 2012

The need of Clinical Decision Support System (CDSS) in healthcare setup is increasing day by day. EHR Meaningful Use advocates CDSS as an important component of EHR/EMR systems. CDSS can be ranged from a simple to a very sophisticated system. The more complex CDSS systems need more attention to develop because of many reasons including its Knowledge Base (KB) structure/maintenance/evolution, inference capabilities and usability. Above all the KB maintenance and evolution is very crucial and important from the perspective of useful decision capabilities. Also the richness of the KB is important to cover the decision gaps handling a particular situation in the course of patient care. It cannot be expected from the clinicians to remember everything in regard to patient diagnosis and treatment. Similarly, it is also crucial for clinicians to keep themselves updated with the new research in the area. That is the reason they frequently require accessing to the online knowledge resources. Literature proved that online knowledge resources are capable providing answers to questions that might not be answered rely only on clinician wisdom and experience. This paper provides the theme of meaningful utilization of online knowledge resources in the context of diagnosis and treatment process for cancer patients more specifically Head and Neck cancer.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

• Journal of Korean Academy of Nursing
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• v.7 no.1
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• pp.39-46
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• 1977

Despite the fact that it is not a fatal symptom. the lower back pain of human species is considered a health problem of modern society: 80% of world population experience it and the distress and dysfunction caused by interferes daily life as well as the general productivity. This study was performed to investigate the general tendency of lower back Pain on nurses: influence of nursing activities, working condition and the physical characteristics of nurses on the pain in order to provide data for prevention and treatment. 386 nurses working at 16 general hospitals throughout the country were sampled. Questionaries developed by the researcher was used for data gathering. Results are as follows : 1. Lower back pain was experienced by most(72.3%) of the nurses: the highest rate of -Pain experience was revealed to be the a9e group of 35-39 (80.8%) followed by 25-29 group (74.2%). 2. In almost all instances (91.4%), the first pain attack occurred before the age of 29, and in 73.1%. the attack occurred between the age of 15-24. 3. In 10.1%, the pain was almost persistent or occurred every other day frequency. In 9%, the pain was relieved by the administration of analgesics or "unable to move". 4. More than 6 days′sick leave due to the pain revealed to be in 2.2%. No significant difference was revealed between specialities of service. 5. Pain experience and the over or under weight revealed not to have significant relations. (X$^2$=0.55224, p〉0.7587) 6. The length of working hour of I. C. U. and O. R, revealed to be longer than that of nurses general ward, however. no significant difference on the rate of pain occurrence apparent. (X$^2$=0.4952, p〉0.8239) No significant difference on the rate of pain occurrence between nurses working over 46 hours/week and under 45 hours/week. (X$^2$=3.86241, p〉0.078318) 7. The most frequent Pain related movement revealed to be "lifting patient or heavy object" (24. 7%, N=68) followed by "the sameness of position, either standing or sitting"(16.8%) 8. Regular physical exercise revealed to have no significant influence on the rate of Pain occurrence. 9. Higher raft of pain experience was revealed in the group of nurses wearing eye glasses. Uncomfortable shoes revealed to have influenced the pain. 10. The most frequent pain relieving treatment revealed to be "rest" (54.2%, N= 151) followed by "analgesics" (12.6%, N=35) and "hot compress/fomentation"(10.5%, N=29). In 13.7% (N=38) no special care was given.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.35-47
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• 1971

This is a research on general evaluation of the nursing profession which is a professional job, a suitable calling to women and is developing academically day by day. The author gave some questions to the patients, doctors, people, student nurses-themselves and got the following results; (A) General concept about nursing profession A nurse is a member, of a medical team who works for people′s health promotion(50.8%). The reason that the nursing profession is a good one is that it is a rewarding job to care for sick patients(78.9%). The spirit is the most important factor for the nurse(84.8%) and the nursing profession is a suitable calling to women (76%). The description of nurses as "The angels in white dress" is an appropriate one (44.6%) or only a beautiful expression(47.4%) (B) Nurses as actually seen by doctors and patients. They work only obligatorily (47.8%)-Doctors They try to relieve, the patient′s physical discomforts in all sincerity (65.6%), also they to decrease the patient′s mental apprehension (56.7%). (C) Satisfaction in the nursing profession. Nurses satisfaction in the nursing profession is general(68.8%) and student nurses satisfaction in selecting nursing is fulfilled (50.9%). One reason for dissatisfaction among nurses and student nurses is people's failure to understanding the nursing profession(40.1%), One reason for satisfaction is that it is a rewarding job caring for sick patients(35%). (D) Is the nursing professional job? People think the nursing profession is a professional job like doctors or lawyers (60.2%). (E) Are they academic? People think the nurses are academic(37.8%) but nurses read only interesting items in the "Journal of Korean Nurse"(67.7%). (F) Opinions about nurses′going out of the country. Doctors and nurses agree that after 1-2 years′experience in this country(78.5%) and student nurses want to go out where there is on opportunity(73.1%). Student's purpose of going out is to enrich their stock of information(71.3%), doctors think, it is for training in nursing knowledge and skills (47.8%). (G) Opinions about nurse′s social affairs. They want nurses to be controlled(44.4%) and also think that the nurse's demonstration in the National Conte. was reasonable (36.3%). (H) Would you make your daughter a nurse? They favour their daughter′s becoming a nurse(17.4%) because they think it is a rewarding job to care for sick patients(42.5%).

• Journal of Korean society of Dental Hygiene
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• v.10 no.6
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• pp.1083-1093
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• 2010

Objective : The purpose of this study was to examine the relationship of the oral health behavior of oral prophylaxis clients and some residents in a community to their simplified oral environment index. Methods : The subjects in this study were 520 people who had their teeth cleaned in the oral prophylaxis practice lab in the department of dental hygiene at J health college. A survey was conducted from March 23 to June 3, 2010, by way of the self-reported questionnaire. The data materials are analyzed by general characteristics frequency and ratio, the relationship of oral health behavior and sex, age, scaling experience, simplified oral hygiene index $x^{2}$ test analysis. Results : 1. Concerning links between gender and oral health behavior including daily toothbrushing frequency, the largest group of the respondents brushed their teeth three times a day(p<0.05). As to educational experiences on toothbrushing method and the use of oral hygiene supplies, the women had more educational experiences than the men(p<0.05). 2. Regarding connections between age and oral health behavior involving daily toothbrushing frequency, the largest number of the respondents brushed their teeth three times a day in every age group (p <0.001). As for educational experiences on toothbrushing method, those who were in their 50s and up(64.7%) learned about that, and they had more educational experiences with age(p<0.05). As for scaling experiences, the older respondents had their teeth scaled more often (p<0.001). 3. As to relationship between scaling experiences and oral health behavior, there were differences in toothbrushing frequency according to scaling experiences(p <0.05). Regarding educational experiences on toothbrushing method, those who had their teeth cleaned received more toothbrushing education(p<0.001). Concerning smoking, the nonsmokers had more experiences to get their teeth cleaned (p<0.001). 4. As for links between simplified oral environment index and oral health behavior including a time for toothbrushing, the respondents who did toothbrushing after every meal(80.4%) had good simplified oral environment indexes(p<0.05). 5. In regard to relationship between simplified oral environment index and oral health behavior, oral environment index had a positive correlation to the use of oral hygiene supplies( r=0.129**), toothbrushing time(r=0.116**) and educational experiences on toothbrushing method (r=0.099**). Smoking(r=-0.092**) had a negative correlation to that. Conclusion : The above-mentioned findings illustrate that oral health behavior is one of crucial factors to affect oral health status and oral environment care. Therefore oral prophylaxis practice lab visitors should receive education on the right toothbrushing method and the use of oral hygiene supplies to promote their oral health, and an incremental oral health care system that involves regular scaling should be introduced.