• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2721-2728
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• 2012

Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.209-220
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• 2001

Objectives : The aim of this study was to investigate the attitude toward the oriental hospital among 100 pediatric outpatients. Methods : A questionnaire about the general characteristics of patients. the reason of choice or alteration was implemented. Results : 1. In distribution of sex & age, 60% was men and 40% women was between 2 and 6 years old. 2. In determinant factor for using Oriental medicine, 43.8% was tolerance increase of the western medicine and 33.0% was recommened by others. 3. In distribution of disease & therapeutic method, 62.5% was respiratory disease and 11.7% gastrointestinal disease, 64.3% was treated with oriental after Western medical therapy and 20.9% only Oriental medical care. 4. The changing causes for using Oriental after Western medicine, 35.9% was ineffective affect and 26.5% side effect. 5. The preference for using Oriental medicine, 41.6% was respiratory disease and 21.0% gastrointestinal disease. 6. The peculiarity of Oriental medicine compared with western medicine, 36% was effectiveness on the cronic disease and 14% for fundamental remedy. 7. The prodominance disease in Western medicine compared with Oriental medicine, 28% was operation, 18% common cold and 15% inflammatory disease 8. The questions about Oriental medicine, 22% was medical material's sanitation and place of origin, 18% harmness or not administered during long time. 9. The controversial point of Oriental medicine, 33.5% was expensive price and 27.7% difficulty of taking medicine. 10. In satisfaction degree of Oriental medicine, 69% was satisfied and 19% was very satisfied. Conclusions : Considering the above results, we have concluded that proper recognition about Oriental Pediatric medicine will be needed among patients.

• Radiation Oncology Journal
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• v.32 no.3
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• pp.179-186
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• 2014

Purpose: To study the long-term outcomes and tolerance in our patients who received dose escalated radiotherapy in the early salvage post-prostatectomy setting. Materials and Methods: The medical records of 54 consecutive patients who underwent radical prostatectomy subsequently followed by salvage radiation therapy (SRT) to the prostate bed between 2003-2010 were analyzed. Patients included were required to have a pre-radiation prostate specific antigen level (PSA) of 2 ng/mL or less. The median SRT dose was 70.2 Gy. Biochemical failure after salvage radiation was defined as a PSA level >0.2 ng/mL. Biochemical control and survival endpoints were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis were used to identify the potential impact of confounding factors on outcomes. Results: The median pre-SRT PSA was 0.45 ng/mL and the median follow-up time was 71 months. The 4- and 7-year actuarial biochemical control rates were 75.7% and 63.2%, respectively. The actuarial 4- and 7-year distant metastasis-free survival was 93.7% and 87.0%, respectively, and the actuarial 7-year prostate cancer specific survival was 94.9%. Grade 3 late genitourinary toxicity developed in 14 patients (25.9%), while grade 4 late genitourinary toxicity developed in 2 patients (3.7%). Grade 3 late gastrointestinal toxicity developed in 1 patient (1.9%), and grade 4 late gastrointestinal toxicity developed in 1 patient (1.9%). Conclusion: In this series with long-term follow-up, early SRT provided outcomes and toxicity profiles similar to those reported from the three major randomized trials studying adjuvant radiation therapy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4497-4502
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• 2015

Background: Due to the increase in morbidity and mortality rate, cancer has become an alarming threat to the human population worldwide. Since cancer is a progressive disorder, timely diagnosis would be helpful to prevent/stop cancer from progressing to severe stage. In Khyber Pakhtunkhwa, Pakistan, most of the time, tumors are diagnosed with endoscopy and biopsy; therefore rare studies exist regarding the diagnosis of gastrointestinal (GIT) carcinomas based on tumor markers, especially CEA. Objectives: This study made a comparative analysis of CEA in admitted hospitalized stomach and colon cancer patients diagnosed as GIT with biopsy. Materials and Methods: In this study, a total of 66 cases were included. The level of CEA was determined in the blood of these patients using ELISA technique. Results: Out of 66 patients, the level of CEA was high in 59.1% of the total, 60.7% in colon cancer patients and 57.9 % in stomach cancer patients. Moreover, the incidence of colorectal and stomach cancer was greater in males as compared to females. Patients were more of the age group of 40-60 and the level of CEA was comparatively higher in patients (51.5%) with histology which was moderately differentiated, than patients with well differentiated and poorly differentiated tumor histology. Conclusions: CEA level was high in more than 50% of the total patients. Moreover, CEA exhibited higher sensitivity for colon than stomach cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.160-167
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• 2015

Purpose: We aimed to analyze the effectiveness and safety of low-dose midazolam and ketamine combination for upper gastrointestinal endoscopy (UGIE) in children. Methods: The study included the children (n=425, $10.78{\pm}3.81years$) who underwent UGIE for diagnostic purpose during 1 year period. All children were sedated with low dose midazolam (0.1 mg/kg) and ketamine (0.5 mg/kg) intravenously. Effectiveness of the sedation and complications during the procedure and recovery period were recorded. Results: Endoscopic procedure was successfully completed in 414 patients (97.4%; 95% confidence interval, 95.8-98.9). $Mean{\pm}standard$ deviation (SD) duration of procedure was $6.36{\pm}1.64minutes$ (median, 6.0 minutes; range, 4-12 minutes). Minor complications occurred during the procedure in 39.2% of the patients. The most common complication was increased oral secretion (33.1%). No major complications were observed in any patient. Age and Ramsay sedation scores of patients with complications during the procedure were lower than the others ($9.49{\pm}4.05years$ vs. $11.61{\pm}3.43years$, p=0.002 and $2.10{\pm}1.46$ vs. $4.37{\pm}1.16$, p=0.001). Mean recovery time was 22 minutes (range, 10-90 minutes; $mean{\pm}SD$, $25{\pm}12.32minutes$). Minor complications developed during recovery in 60.1% of the patients. The most common complication was transient double vision (n=127, 30.7%). Emergence reaction was observed in 5 patients (1.2%). Conclusion: The procedure was completed with high level of success without any major complication in our study. Combination of low-dose midazolam and ketamine is a suitable sedation protocol for pediatric endoscopists in UGIE.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4937-4944
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• 2015

MicroRNAs (miRNAs) are emerging as critical regulators in carcinogenesis and tumor progression. Recently, miR-99a has been reported as a tumor suppressor gene in various human cancers, but its functions in the context of anaplastic thyroid cancer (ATC) remain unknown. In this study, we reported that miR-99a was commonly downregulated in ATC tissue specimens and cell lines with important functional consequences. Overexpression of miR-99a not only dramatically reduced ATC cell viability by inducing cell apoptosis and accumulation of cells at G1 phase, but also inhibited tumorigenicity in vivo. We then screened and identified a novel miR-99a target, mammalian target of rapamycin (mTOR), and it was further confirmed by luciferase assay. Up-regulation of miR-99a would markedly reduce the expression of mTOR and its downstream phosphorylated proteins (p-4E-BP1 and p-S6K1). Similar to restoring miR-99a expression, mTOR down-regulation suppressed cell viability and increased cell apoptosis, whereas restoration of mTOR expression significantly reversed the miR-99a antitumor activity and the inhibition of mTOR/p-4E-BP1/p-S6K1 signal pathway profile. In clinical specimens and cell lines, mTOR was commonly overexpressed and its protein levels were statistically inversely correlated with miR-99a expression. Taken together, our results demonstrated for the first time that miR-99a functions as a tumor suppressor and plays an important role in inhibiting the tumorigenesis through targeting the mTOR/p-4E-BP1/p-S6K1 pathway in ATC cells. Given these, miR-99a may serve as a novel prognostic/diagnostic and therapeutic target for treating ATC.

• Nutrition Research and Practice
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• v.14 no.1
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• pp.12-19
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• 2020

BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

• Journal of Korean Medicine for Obesity Research
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• v.14 no.1
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• pp.36-45
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• 2014

Objectives: The purpose of this studay was to compare the eating-related index and the patterns of pre- and post-prandial gut hormone level in normal-overweight and obese subjects of Taeemin population. Methods: We enrolled healthy male participants who were diagnosed with Taeeumin by Sasang Constitutional diagnosis and who were normal-overweight ($18.5kg/m^2{\leq}$body mass index [BMI)< $25kg/m^2$) or obese ($25.0kg/m^2{\leq}$BMI< $30kg/m^2$). Eating behavior and gastrointestinal problems were assessed by using standardized scale. Subjective appetite ratings using visual analogue scales and the profiling of serum levels of ghrelin and peptide YY (PYY) were assessed before and after a standard meal (6 time points: 30 minutes pre-prandial, immediately before meal, 15, 30, 60, and 120 minutes post-prandial). Results: Tewnty two healthy Taeeumin people classified as normal-overweight group or obese group are the final subjects. External eating score of Dutch eating behavior questionaire scores is higher in normal-overweight group than in obese group. The variations of subjective appetite ratings in obese group are smaller than in normal-overweight group. The pattern of ghrelin in normal-overweight group shows a high peak at 30 minutes post-prandial point, which is contrary to existing studies. The pattern of PYY in obese group decreases from 15 minutes post-prandial point and shows lower peak level, whereas in normal-overweight group shows increasing tendency from pre-prandial point until 30 minutes post-prandial point. Conclusions: There are differences in the eating-related index and the gut hormone patterns related to obesity.

• The Korean Journal of Pain
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• v.30 no.2
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• pp.86-92
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• 2017

Osteoblasts, originating from mesenchymal cells, make the receptor activator of the nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) in order to control differentiation of activated osteoclasts, originating from hematopoietic stem cells. When the RANKL binds to the RANK of the pre-osteoclasts or mature osteoclasts, bone resorption increases. On the contrary, when OPG binds to the RANK, bone resorption decreases. Denosumab (AMG 162), like OPG (a decoy receptor), binds to the RANKL, and reduces binding between the RANK and the RANKL resulting in inhibition of osteoclastogenesis and reduction of bone resorption. Bisphosphonates (BPs), which bind to the bone mineral and occupy the site of resorption performed by activated osteoclasts, are still the drugs of choice to prevent and treat osteoporosis. The merits of denosumab are reversibility targeting the RANKL, lack of adverse gastrointestinal events, improved adherence due to convenient biannual subcutaneous administration, and potential use with impaired renal function. The known adverse reactions are musculoskeletal pain, increased infections with adverse dermatologic reactions, osteonecrosis of the jaw, hypersensitivity reaction, and hypocalcemia. Treatment with 60 mg of denosumab reduces the bone resorption marker, serum type 1 C-telopeptide, by 3 days, with maximum reduction occurring by 1 month. The mean time to maximum denosumab concentration is 10 days with a mean half-life of 25.4 days. In conclusion, the convenient biannual subcutaneous administration of 60 mg of denosumab can be considered as a first-line treatment for osteoporosis in cases of low compliance with BPs due to gastrointestinal trouble and impaired renal function.

• Journal of the Korean Society of Food Science and Nutrition
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• v.29 no.5
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• pp.865-869
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• 2000

This experiment was carried out to investigate the effects of dietary mulberry leaf power on gastrointestinal function of rats. Plot containing one and ten percent mulberry leaf powder was supplied with rats. The food efficiency ratio (FER) of rat fed with 10% mulberry leaf powder was decreased 14%. the transit time of rat fed with 1% and 10% mulberry leaf was faster 16% and 21% than that of control respectively. Intestine length was increased 10% and 11% at 1% and 10% dietary mulberry leaf respectively. The transit speed was faster 30% at 1% dieatry mulberry leaf than that of control. The pH of rat's feces supplied with mulberry leaf was lower than that of control. The amount of daily rat's feces fed mulberry leaf was much than that of control. As above results, we suggest that mulberry leaf was evaluated to improve the function of rat's gastrointestine.