Association of Dietary Quality with Subjective Health-Related Perception and Chronic Diseases According to Age Segmentation of Korean Elderly / 대한지역사회영양학회지

Objectives@#This study examined the Korean elderly’s dietary intake status, subjective health-related perception and chronic disease prevalence among age groups. Associations of dietary quality with subjective health-related perception and chronic diseases were also examined. @*Methods@#Based on data from the 7th National Health and Nutrition Examination Survey, a total of 3,231 elderly were selected and categorized into 4 age groups of ‘65 ~ 69’, ‘70 ~ 74’, ‘75 ~ 79’ and ‘over 80’. Nutrient intakes, proportions of those with insufficient nutrient intakes, Korean Healthy Eating Index (KHEI), some subjective health-related perceptions and prevalence of major chronic diseases were compared according to the age groups. Differences in the subjective health-related perceptions and odds ratios of the chronic diseases according to the quartile levels of KHEI within the same age group were analyzed. @*Results@#With the increase of age, several nutrient intakes (P < 0.001) and KHEI scores significantly decreased (P < 0.01). In women, activity restriction increased (P < 0.05), and EQ-5D score decreased with age (P < 0.001). Prevalence of hypertension (P < 0.0001), hypercholesterolemia (P < 0.05) and anemia (P < 0.01) significantly increased, while hypertriglyceridemia (P < 0.01) significantly decreased only in men. Obesity prevalence decreased, while underweight prevalence increased (P < 0.05). Subjective health status, EQ-5D score and PHQ-9 score significantly improved as KHEI score increased in certain age groups of women (P< 0.05). Odds ratio of hypercholesterolemia significantly increased with the increase of KHEI score in 65 ~ 69-year-old women. However, hypertension and anemia significantly decreased with the increase of KHEI score in 75 ~ 79-year-old women (P < 0.05). @*Conclusions@#The study findings suggest that nutrition management and policy for the Korean elderly need to apply a segmented age standard that can better reflect their dynamic characteristics.

Endoscopic Submucosal Dissection for Superficial Barrett’s Neoplasia in Korea: a Single-Center Experience

Purpose@#While the incidence of Barrett’s neoplasia has been increasing in Western countries, the disease remains rare in Asian countries. Therefore, very few studies have investigated the endoscopic treatment for Barrett’s neoplasia in Korea. Endoscopic submucosal dissection (ESD) enables en bloc and complete resection of gastrointestinal neoplastic lesions. This study aimed to evaluate the therapeutic outcomes of ESD for Barrett’s neoplasia in a single center in Korea and to examine the predictive factors for incomplete resection. @*Materials and Methods@#We conducted a retrospective observational study of 18 patients who underwent ESD for superficial Barrett’s neoplasia (dysplasia and early cancer) between January 2010 and December 2019 at Pusan National University Hospital. The therapeutic outcomes of ESD and procedure-related complications were analyzed. @*Results@#En bloc resection, complete resection, and curative resection were performed in 94%, 72%, and 61% of patients, respectively. Histopathology (submucosal or deeper invasion of the tumor) was a significant predictive factor for incomplete resection (P=0.047). Procedure-related bleeding and stenosis were not observed, whereas perforation occurred in one case. During the median follow-up period of 12 months (range, 6–74 months), local recurrence occurred in 2 patients with incomplete resection, one patient underwent repeat ESD, and the other patient received concurrent chemoradiotherapy. The 3-year overall and disease-specific survival rates were 73% and 93%, respectively. @*Conclusions@#ESD seems to be an effective and safe treatment for superficial Barrett’s neoplasia in Korea. Nevertheless, the suitability of ESD for Barrett’s cancer cases should be determined considering the high risk of deep submucosal invasion.

Adverse Reactions Following the First Dose of ChAdOx1 nCoV-19 Vaccine and BNT162b2 Vaccine for Healthcare Workers in South Korea

Background@#We performed a prospective survey on the adverse reactions following the first dose of two types of vaccines against coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs) in South Korea. @*Methods@#HCWs at a tertiary referral hospital in Seoul, South Korea, received a chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19) or an mRNA-based vaccine (BNT162b2) between March 5 and March 26, 2021. The HCWs were asked to report adverse reactions through a mobile self-report questionnaire for three days after vaccination. @*Results@#A total of 7,625 HCWs received the first dose of ChAdOx1 or BNT162b2 vaccine during the study period. Of them, 5,866 (76.9%) HCWs (ChAdOx1, n = 5,589 [95.3%];BNT162b2, n = 277 [4.7%]) participated at least once in the survey, of whom 77% were female and 86% were younger than 50 years. The overall adverse reaction rate was 93% in the ChAdOx1 group and 80% in the BNT162b2 group (P < 0.001). Both local and systemic reactions were more commonly reported in the ChAdOx1 group, and the difference was larger in systemic reactions such as fever and fatigue. In the ChAdOx1 group, the incidence of adverse reactions was significantly higher in females and those in the younger age groups, while the BNT162b2 group showed such difference according to age. @*Conclusion@#In our prospective survey, vaccine-associated adverse reactions were more commonly reported in the ChAdOx1 group than in the BNT162b2 group. Females and younger age groups experienced vaccine-associated adverse reactions more frequently.

Adverse Reactions Following the First Dose of ChAdOx1 nCoV-19 Vaccine and BNT162b2 Vaccine for Healthcare Workers in South Korea

Background@#We performed a prospective survey on the adverse reactions following the first dose of two types of vaccines against coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs) in South Korea. @*Methods@#HCWs at a tertiary referral hospital in Seoul, South Korea, received a chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19) or an mRNA-based vaccine (BNT162b2) between March 5 and March 26, 2021. The HCWs were asked to report adverse reactions through a mobile self-report questionnaire for three days after vaccination. @*Results@#A total of 7,625 HCWs received the first dose of ChAdOx1 or BNT162b2 vaccine during the study period. Of them, 5,866 (76.9%) HCWs (ChAdOx1, n = 5,589 [95.3%];BNT162b2, n = 277 [4.7%]) participated at least once in the survey, of whom 77% were female and 86% were younger than 50 years. The overall adverse reaction rate was 93% in the ChAdOx1 group and 80% in the BNT162b2 group (P < 0.001). Both local and systemic reactions were more commonly reported in the ChAdOx1 group, and the difference was larger in systemic reactions such as fever and fatigue. In the ChAdOx1 group, the incidence of adverse reactions was significantly higher in females and those in the younger age groups, while the BNT162b2 group showed such difference according to age. @*Conclusion@#In our prospective survey, vaccine-associated adverse reactions were more commonly reported in the ChAdOx1 group than in the BNT162b2 group. Females and younger age groups experienced vaccine-associated adverse reactions more frequently.

Development and Evaluation of Booklets and Video Clips to Prevent Children from Developing Picky Eating / 대한지역사회영양학회지

Objectives@#The purpose of this study was to develop and evaluate booklets and video clips to prevent children from picky eating. @*Methods@#Based on a survey conducted on food preferences of preschool children aged 2 to 5 years, 14 kinds of less preferred vegetables were selected. Accordingly, educational videos, activity books, and teaching-learning guides were produced for preschool children using the 'food bridge' theory, and the educational materials were named “Friendly vegetables”. Educational materials were distributed to childcare institutions, and their effectiveness was investigated for preschool children who were instructed on these materials once every 30 days from March to November, 2019. The children were examined for changes in their knowledge of names, colors, taste/texture, methods of cultivation, and preferences for vegetables before and after the instructional course. @*Results@#The awareness of vegetables increased significantly in younger children and the picky eating group. When the assessment was carried out in terms of vegetable knowledge, it was observed that the younger the age or the pickier the in eating food, the more effective the education is compared to the counter part. The preference for vegetables also increased after the instruction compared to the pre-instruction period, but significant changes were seen only in the 2~3 year age group for boys and girls.Also, only the picky group of girls showed changes in preference. The children's average interest in the education materials was 3.85 points out of 5 points. @*Conclusions@#Through this study, we have developed educational materials for standalone use in childcare facilities and confirmed that they have a significant effect on improving awareness and preferences related to vegetables. In summary, the younger the age or the pickier the child in eating food, the more effective the education. It is believed that additional education on mealtime guidance is needed which can alter the eating behavior of preschool children and improve their diet. It is proposed to widen the scope of use of the materials by collecting diverse opinions from child care teachers.

Development and Evaluation of Booklets and Video Clips to Prevent Children from Developing Picky Eating / 대한지역사회영양학회지

Objectives@#The purpose of this study was to develop and evaluate booklets and video clips to prevent children from picky eating. @*Methods@#Based on a survey conducted on food preferences of preschool children aged 2 to 5 years, 14 kinds of less preferred vegetables were selected. Accordingly, educational videos, activity books, and teaching-learning guides were produced for preschool children using the 'food bridge' theory, and the educational materials were named “Friendly vegetables”. Educational materials were distributed to childcare institutions, and their effectiveness was investigated for preschool children who were instructed on these materials once every 30 days from March to November, 2019. The children were examined for changes in their knowledge of names, colors, taste/texture, methods of cultivation, and preferences for vegetables before and after the instructional course. @*Results@#The awareness of vegetables increased significantly in younger children and the picky eating group. When the assessment was carried out in terms of vegetable knowledge, it was observed that the younger the age or the pickier the in eating food, the more effective the education is compared to the counter part. The preference for vegetables also increased after the instruction compared to the pre-instruction period, but significant changes were seen only in the 2~3 year age group for boys and girls.Also, only the picky group of girls showed changes in preference. The children's average interest in the education materials was 3.85 points out of 5 points. @*Conclusions@#Through this study, we have developed educational materials for standalone use in childcare facilities and confirmed that they have a significant effect on improving awareness and preferences related to vegetables. In summary, the younger the age or the pickier the child in eating food, the more effective the education. It is believed that additional education on mealtime guidance is needed which can alter the eating behavior of preschool children and improve their diet. It is proposed to widen the scope of use of the materials by collecting diverse opinions from child care teachers.

Duodenal Leiomyosarcoma Presenting with Gastrointestinal Bleeding and Obstruction: A Case Report / 대한소화기학회지

Duodenal leiomyosarcoma is a rare condition with a poor prognosis. Early diagnosis of duodenal leiomyosarcoma is challenging because it presents with nonspecific symptoms and endoscopic biopsies usually do not enable a definitive diagnosis. Duodenal leiomyosarcomas are diagnosed on the basis of the histopathological identification of a mesenchymal lesion composed of malignant tumor cells that on immunohistochemical examination is positive for smooth muscle actin and desmin. We report the case of a 38-year-old man who presented with gastrointestinal bleeding and obstruction who was diagnosed with duodenal leiomyosarcoma after surgical resection.

Negative pathology after endoscopic resection of gastric epithelial neoplasms: importance of pit dysplasia

BACKGROUND/AIMS: Endoscopic resection (ER) is a well-established treatment modality for gastric epithelial neoplasm. However, there is a discrepancy between forceps biopsy and ER specimen pathology, including a negative pathologic diagnosis (NPD) after ER. It has been suggested that pit dysplasia (PD) is a subtype of gastric dysplasia, and the aim of this study was to assess the significance of PD in cases with NPD after ER for early gastric neoplasms. METHODS: After ER, 29 NPD lesions that had an associated pretreatment forceps biopsy specimen, were correctly targeted during ER, and had no cautery artifact on the resected specimen were included in this study. RESULTS: Sixteen lesions showed PD and 13 had no neoplastic pathology. The initial pretreatment forceps biopsy diagnoses of 29 NPD lesions were low-grade dysplasia (LGD) in 17 lesions, high-grade dysplasia (HGD) in seven lesions, and adenocarcinoma in five lesions, which after review were revised to PD in 19 lesions, LGD in four lesions, adenocarcinoma in two lesions, and no neoplastic pathology in four lesions. Overall, nine lesions (31%) were small enough to be removed by forceps biopsy, four NPD lesions (14%) were initially misinterpreted as neoplastic lesions, and 16 PD lesions (55%) were misinterpreted as NPD lesions on ER slides. CONCLUSIONS: Approximately half of the lesions initially diagnosed as LGD or HGD were subsequently classified as PD. Therefore, including PD as a subtype of gastric dysplasia could reduce the diagnostic discrepancy between initial forceps biopsy and ER specimens.

Venous Invasion in Colorectal Cancer: Impact of Morphologic Findings on Detection Rate / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Venous invasion (VI) is widely accepted as a poor prognostic factor in colorectal cancer (CRC), and is indicated as a high-risk factor determining the use of adjuvant chemotherapy in CRC. However, there is marked interobserver and intraobserver variability in VI identification and marked variability in the real prevalence of VI in CRC. MATERIALS AND METHODS: We investigated the detection rate of VI in 93 consecutive cases of T3 or T4 CRC based on the following: original pathology report, review of hematoxylin and eosin (H&E) slides with attention to the "protruding tongue" and "orphan arteriole" signs, and elastic stain as the gold standard. RESULTS: Overall, the detection rate of VI was significantly increased as follows: 14/93 (15.1%) in the original pathology report, 38/93 (40.9%) in review of H&E slides with attention to the "protruding tongue" and "orphan arteriole" signs, and 45/93 (48.4%) using elastic stain. VI detection based on morphologic features showed 77.8% sensitivity and 91.1% specificity and showed a linear correlation (Spearman correlation coefficient, 0.727; p < 0.001) with VI detected by elastic stain. In addition, improved agreement between detection methods (detection on the basis of morphologic features, κ=0.719 vs. original pathology report, κ=0.318) was observed using kappa statistics. CONCLUSION: Slide review with special attention to the "protruding tongue" and "orphan arteriole" signs could be used for better identification of VI in CRC in routine surgical practice.