The Role of Health Committee for Health Management of Rural Residents in the COVID-19 Epidemic / 農村醫學 地域保健

Objectives@#The purpose of this study was to suggest the direction of the Healthy Village project for rural residents in accordance with the prolonged COVID-19 by investigating the digital environment for major health problems, the role of a health leader, necessary projects, and non-face-to-face projects for Healthy Village members in the COVID-19 epidemic. @*Methods@#Telephone interview surveys were conducted with 585 residents from November 30, 2020 to December 21, 2020. @*Results@#Health problems perceived by residents were in the order of concerns about infection (48.5%), depression (32.5%), difficulties in using medical services (9.4%), and lack of exercise (7.7%). The role of the health committee in the COVID-19 situation was “encouraging people to follow quarantine rules” with 91.3%. As a necessary health village project, there was a high demand for the provision of health products and mental health projects. 17.9% said that there is a computer or smart device connected to the Internet in their home, and 42.2% said that there is someone in the village who can easily get help if there is a problem in accessing and using Internet information. 36.9% were able to watch videos, and 22.2% were able to use the Internet through public facilities. @*Conclusion@#In a public health crisis, where the provision of public health and medical services to rural residents is not smooth, it is necessary to manage health and quarantine through health leaders in the village, and it is required to establish a digital environment infrastructure that can conduct community participatory health village projects in a non-face-to-face environment.

Bactericidal Effect of the Aos Denti Germ for Denture Cleansing Effervescent Tablet against Oral Microorganisms

Human mouth environment is known to include a variety bacteria, including Streptococcus spp., Staphylococcus spp., Actinomyces spp., Lactobacillus spp., Candida spp., Enterobacteriaceae, et al. Human oral microorganisms can cause dental caries, gingivitis, periodontitis, respiratory tract infection, and cardiovascular disease. Thus, right denture cleaning is essential to oral and general human health. The aim of this study was to evaluate the bactericidal effect of a sodium dichloroisocyanurate-based effervescent tablet (Aos Denti Germ, Aos Company, Chungbuk, Korea) against oral microorganisms. A total of 5 species Streptococcus spp. (Streptococcus anginosus, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, and Streptococcus sobrinus), Actinomyces oris, Candida albicans, and Escherichia coli were used in this study. All strains were exposed to the distilled water prepared with effervescent tablet. After the exposure, the mixture of strains and effervescent tablet was inoculated onto blood agar or MacConkey agar plate and cultured at 36℃. All strains were killed immediately on exposure to effervescent tablet. The results suggested that effervescent tablet could be used as an effective denture cleanser for dental hygiene.

Effectiveness of a Secondhand Smoking Prevention Program on Adolescents

PURPOSE: This study has examined effectiveness of a secondhand smoking prevention program for adolescents. METHODS: The study was done in a nonequivalent control group pretest/posttest design. The subjects of the current study were 198 middle school students from K city in the Gyeongbuk province. The students were assigned to an experimental group (100) and participated in the secondhand smoking prevention program or to a control group (98) and did not take part. Data collection was done from June to July 2012. A Chi-square test, independent t-test, paired t test and ANCOVA were used with the SPSS 18.0 program for data analysis. RESULTS: There were significant differences between the groups in knowledge of short-term influence of secondhand smoking (F=9.65, p<.005), knowledge of long-term influence of secondhand smoking (F=15.53, p<.001), verbal coping skills for secondhand smoking prevention (F=16.35, p<.001), behavioral coping skills for secondhand smoking prevention (F=8.49, p<.005), and assertiveness of secondhand smoking prevention (F=17.30, p<.001) measurements. CONCLUSION: The secondhand smoking prevention program delivered to the adolescents is an effective method of encouraging secondhand smoking prevention and can be utilized as an effective nursing intervention for adolescents.

Development of Mobile Electronic Health Records Application in a Secondary General Hospital in Korea / 대한의료정보학회지

OBJECTIVES: The recent evolution of mobile devices has opened new possibilities of providing strongly integrated mobile services in healthcare. The objective of this paper is to describe the decision driver, development, and implementation of an integrated mobile Electronic Health Record (EHR) application at Ulsan University Hospital. This application helps healthcare providers view patients' medical records and information without a stationary computer workstation. METHODS: We developed an integrated mobile application prototype that aimed to improve the mobility and usability of healthcare providers during their daily medical activities. The Android and iOS platform was used to create the mobile EHR application. The first working version was completed in 5 months and required 1,080 development hours. RESULTS: The mobile EHR application provides patient vital signs, patient data, text communication, and integrated EHR. The application allows our healthcare providers to know the status of patients within and outside the hospital environment. The application provides a consistent user environment on several compatible Android and iOS devices. A group of 10 beta testers has consistently used and maintained our copy of the application, suggesting user acceptance. CONCLUSIONS: We are developing the integrated mobile EHR application with the goals of implementing an environment that is user-friendly, implementing a patient-centered system, and increasing the hospital's competitiveness.

Effectiveness of School-based Smoking Prevention Program on Ecological Model in Adolescents

PURPOSE: This study examined the effectiveness of an adolescent school-based smoking prevention program. METHODS: The study was done with a nonequivalent control group pretest-posttest design. The subjects of the present study were 399 non-smoking high school students in Kyongbuk province. The subjects were divided into 184 experimental group members in G city who participated in a school-based smoking prevention program and 216 control group members in K city who did not participate. Data were collected from June to November 2011. collected data were analyzed using SPSS/WIN 18.0 through chi2-test, independent t-test and ANCOVA. RESULTS: The experimental group had significantly increased knowledge of smoking, knowledge of smoking prevention program, attitude of smoking, skill of smoking prevention in comparison to the control group. CONCLUSION: The school-based smoking prevention program delivered to non-smoking adolescents is an effective method of encouraging smoking prevention and can be utilized as an effective nursing intervention for non-smoking adolescents.

Modulation of lipid metabolism by mixtures of protamine and chitooligosaccharide through pancreatic lipase inhibitory activity in a rat model / 한국실험동물학회지

Overweight and obesity are usually related with high fat and calorie intake, and seriously causative of lifestyle-related diseases such as cardiovascular disorders, arteriosclerosis, and colon cancer. In this study, we propose a novel dietary therapy against overweight and obesity using mixtures of protamine and chitooligosaccharide (COS), which are known to interrupt the lipid metabolism in the body. Protamine is a dietary protein originated from salmon reproductive organ, and COS is an oligosaccharide made from chitin or chitosan by chemical or enzymatic hydrolysis. In the enzyme activity analysis in vitro, protamine and COS strongly suppressed the activity of pancreatic lipase, which is the primary enzyme for the digestion and absorption of lipids in the intestine. In in vivo animal test, the mixtures of protamine and COS significantly reduced the serum levels of triglyceride (TG), total cholesterol (T-CHO), and low density lipoprotein-cholesterol (LDLC) and inhibited the accumulation of lipids in liver tissue of Sprague Dawley (SD) rats fed high fat diets. On the other hand, they increased fecal TG and T-CHO contents. From these alterations in lipid metabolism, we verified that protamine and COS mixtures could effectively interrupt the digestion and absorption of dietary lipids in the body by inhibiting pancreatic lipase activity. In addition, protamine and COS mixtures increased the serum level of high density lipoprotein-cholesterol (HDLC), responsible for removing cholesterol from cells and protecting atherosclerosis, and therefore decreased the potential risks of cardiovascular diseases by lowering values of the atherogenic index (AI) and cardiac risk factor (CRF). Taken together, we suggest protamine and COS mixtures as a prominent dietary therapy for the prevention of overweight, obesity, and further cardiovascular diseases related with hyperlipidemia.

Diverse animal models to examine potential role(s) and mechanism of endocrine disrupting chemicals on the tumor progression and prevention: Do they have tumorigenic or anti-tumorigenic property? / 한국실험동물학회지

Acting as hormone mimics or antagonists in the interaction with hormone receptors, endocrine disrupting chemicals (EDCs) have the potentials of disturbing the endocrine system in sex steroid hormone-controlled organs and tissues. These effects may lead to the disruption of major regulatory mechanisms, the onset of developmental disorders, and carcinogenesis. Especially, among diverse EDCs, xenoestrogens such as bisphenol A, dioxins, and di(2-ethylhexyl)phthalate, have been shown to activate estrogen receptors (ERs) and to modulate cellular functions induced by ERs. Furthermore, they appear to be closely related with carcinogenicity in estrogen-dependant cancers, including breast, ovary, and prostate cancers. In in vivo animal models, prenatal exposure to xenoestrogens changed the development of the mouse reproductive organs and increased the susceptibility to further carcinogenic exposure and tumor occurence in adults. Unlike EDCs, which are chemically synthesized, several phytoestrogens such as genistein and resveratrol showed chemopreventive effects on specific cancers by contending with ER binding and regulating normal ER action in target tissues of mice. These results support the notion that a diet containing high levels of phytoestrogens can have protective effects on estrogen-related diseases. In spite of the diverse evidences of EDCs and phytoestrogens on causation and prevention of estrogen-dependant cancers provided in this article, there are still disputable questions about the dose-response effect of EDCs or chemopreventive potentials of phytoestrogens. As a wide range of EDCs including phytoestrogens have been remarkably increasing in the environment with the rapid growth in our industrial society and more closely affecting human and wildlife, the potential risks of EDCs in endocrine disruption and carcinogenesis are important issues and needed to be verified in detail.

Krukenberg tumor in a teenager mimicking advanced ovarian cancer: Case report / 대한산부인과학회지

We experienced a case of Krukenberg tumor arising from transverse colon in a teenager who complained acute abdominal pain, which was confirmed by postoperative pathologic study and initially misdiagnosed as ovarian cancer with a huge pelvic mass, and report with a brief review of literatures.

Risk Factors of Gestational Diabetes Mellitus / 대한주산의학회잡지

OBJECTIVE:The purpose of this study was to identify the prevalence of risk factors related to Gestational Diabetes Mellitus (GDM). METHODS:We retrospectively analyzed medical records of 1,091 pregnant women who had a 50 g oral glucose tolerance test (OGTT) at performed at the department of Obstetrics and Gynecology, Chungbuk National University Hospital from June, 1999 to March, 2006. The 1-hour plasma glucose level higher than 140 mg/dL was considered as a positive screening result. Patients with positive results underwent a 100 g OGTT as the diagnostic test for GDM, and more than 2 positive results were diagnosed as GDM, according to the American National Diabetes Data Group (NDDG) guideline. We investigated age, prevalence of obesity, weight gain, history of fetal anomaly, fetal death in uterus (FDIU), macrosomia, preeclampsia, GDM and familial history of diabetes mellitus, as the risk factors of GDM. RESULTS:Elderly gravida, history of FDIU, perinatal death, preeclampsia, and GDM, familial history of diabetes mellitus were the risk factors of GDM and macrosomia to a statistically significant degree. We found out that BMI and 50 g OGTT results were increased in GDM group. However, there was a pregnant woman with no risk factors who had been diagnosed with GDM. CONCLUSION : Although the pregnant women with risk factors should be managed carefully to detect GDM, we also suggest all pregnant women to take screening test even if they have no risk factors, to improve pregnancy outcomes by detecting and treating unexpected GDM early in pregnancy.

A Study of the Causes and the Predictive Factors in Failed Vaginal Birth After Cesarean Section / 대한주산의학회잡지

OBJECTIVE:The purpose of this study was to determine the factors associated with successful vaginal birth after cesarean section (VBAC), and to analyze the causes of failed VBAC. METHODS:This study was performed based on 193 pregnant women who tried vaginal delivery after cesarean section in Chungbuk National University Hospital from January 1997 to December 2005. Maternal age, gestational age, cervical dilatation at admisson, maternal body mass index (BMI), neonatal bodyweight, history of prior vaginal delivery, and indication of prior cesarean section were retrospectively analyzed between the successful group and the failed group of women who tried labor. The causes of the failed trial were analyzed. RESULTS:Seventy nine percent (153/193) was successful in the trial of VBAC and 21% (40/193) failed. There were no difference in maternal age or gestational age between two groups. The success rate was significantly higher when cervical dilatation at admission was more extended, BMI of pregnant women before pregnancy and birth was lower, and birthweight of newborn was lower. Maternal request was the major cause of failure (47.5%), and others were failure to progress, non-reassuring fetal monitoring and failed induction. CONCLUSION:The factors that had significant differences in this study can be used as predictor of successful VBAC. And failed trial of VBAC due to maternal request can be decreased by adequate explanation regarding the complication of emergency operation, and enough pain control during labor.

Ovarian follicular and peritoneal fluid prostaglandin E2 and F2a levels according to the clinical symptoms in the women with endometriosis / 대한산부인과학회지

OBJECTIVE: The purpose of the present study was to determine whether a relationship exists between the clinical symptoms (dysmenorrhea and infertility) and prostaglandin (PG) concentrations in follicular and peritoneal fluid in the women with endometriosis during the late follicular phase of the menstrual cycle. METHODS: Thirty patients with pelvic endometriosis diagnosed by pelvic surgery were enrolled. Eight patients were suffering from severe dysmenorrhea and 11 had history of primary or secondary infertility among them. Endometriosis patients were grouped by the presence of each symptom and compared with 33 control patients without endometriosis. Peritoneal fluid was collected in the beginning of peritoneal opening and dominant follicular fluid was aspirated by syringe needle at the time of operation. Then PGE2 and PGF2a concentration were measured at each tube. RESULTS: Follicular fluid PGF2a levels were increased in 30 endometriosis patients (P=0.003), and the levels were significantly higher in 11 patients with infertility compared with the control (P=0.001). Peritoneal fluid PGF2a levels were significantly higher in 8 patients with severe dysmenorrhea compared with the others or the control (P=0.028). Follicular or peritoneal fluid PGE2 levels were not different between any group and the control. There was no significant correlation between size of endometrioma and each PG levels. CONCLUSION: Severe dysmenorrhea in endometriosis patients would be related with the high level of peritoneal fluid PGF2a concentration, and infertility in endometriosis would be related with the high level of follicular fluid PGF2a concentration.

Prevalence and predictors of tortuous radial artery in patients undergoing transradialcoronary angiography / 대한내과학회지

BACKGROUND: It is well known that the presence of a tortuous radial artery, in patients undergoing transradial coronary angiography (CAG), may cause undesirable results such as access failure and arterial dissection. Thus, our aim was to investigate the prevalence and predictors of the presence of a tortuous radial artery in patients undergoing transradial CAG. METHODS: We prospectively investigated the tortuosity of the radial artery in 158 consecutive patients. The tortuosity of the radial artery was determined by radial angiography. A tortuous radial artery was defined as one with a maximal angulation of more than 45 degrees. To determine the predictors of a tortuous artery, we examined clinical and intra-procedural characteristics. RESULTS: A right radial angiography was easily performed in 154 patients (97.5%) without any complications. A tortuous radial artery was identified in 34 patients (22%). On the univariate analysis, advanced age, female gender, short stature, underweight, hypertension, and absence of progression of the mini-guide wire were significantly associated with the presence of a tortuous radial artery. Significant independent predictors of a tortuous radial artery by multivariate analysis were: advanced age, absence of progression of the mini-guide wire and hypertension. CONCLUSIONS: These data showed that the presence of a tortuous radial artery could be predicted by advanced age, absence of progression of the mini-guide wire and a history of hypertension. Thus, identification of a tortuous radial artery prior to coronary angiography may be helpful for a safe transradial CAG in patients at high risk for a tortuous radial artery.

Impact of the New AJCC Staging System and Adjuvant Treatment in Rectal Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The combination of chemoradiation and fluorouracil based chemotherapy has been the standard adjuvant treatment for colorectal cancer patients. The aim of this study was to evaluate treatment outcome of patients classified by the new AJCC staging system and to compare treatment outcome of oral doxifluridine and the standard Mayo Clinic regimen after chemoradiation in advanced rectal cancer patients. MATERIALS AND METHODS: One hundred nine patients underwent curative surgical resection and chemoradiation followed by chemotherapy. 45 Gy pelvic irradiation was given to the entire pelvis and the boost radiation with 50.4 to 54 Gy, and simultaneously 5-fluorouracil (5-FU) 375 mg/m2/day was given on day 1~3 and 26~28. After the completion of chemoradiation, patients were given either 6 cycles of the Mayo Clinic regimen (5-FU 425 mg/m2 plus leucovorin 20 mg/m2 intravenous bolus infusion on day 1~5, every 4 weeks) or oral doxifluridine (600 mg/m2/day) for 1 year. RESULTS: The median follow-up duration was 30 months. Among 102 evaluable patients, 38 patients (37.3%) relapsed: the locoregional recurrence in 10 patients (9.8%) and systemic relapse in 28 patients (27.5%). The systemic relapse rate was 15.6% in the stage IIA, 25.0% in the stage IIIB, and 59.1% in the stage IIIC (p=0.048). The 5-year disease-free survival (DFS) rate was significantly higher in the IIA and IIIA patients than the IIIB and IIIC patients (72% and 100% vs 48.1% and 11.2%, respectively. p<0.001). The 5-year overall survival (OS) rate was also significantly different between in the IIA/IIIA patients and the IIIB/IIIC (67.3%/100% vs 48.4%/22.3%. p<0.001). However, the difference in DFS or OS between the oral doxifluridine group and the Mayo Clinic regimen group was not significant. Cox regression multivariate analyses showed that the new AJCC stage and tumor differentiation were significant independent prognostic factors in DFS and OS. CONCLUSION: These results support that the new AJCC staging system is superior to Dukes' staging system in the prognostic stratification. Regarding DFS and OS, oral doxifluridine is comparable to the standard Mayo Clinic regimen in rectal cancer patients when combined with postoperative chemoradiation. Stage IIIC patients should be selected for aggressive therapy as they have a dismal prognosis.

Clinical aspects of gastrointestinal stromal tumors / 대한내과학회지

BACKGROUND: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The GISTs are immunohistochemically defined as KIT (CD117) positive tumors. To evaluate the prognostic factors for GISTs, we investigated the clinicopathological factors and the patient's survival rate. METHODS: Between 1996 and 2002, 37 patients were diagnosed with GIST at Dong-A University Medical Center, and 34 of these patients with localized GIST underwent surgical resection. For the immunohistochemical staining, we used KIT, CD34, s100 and SMA. RESULTS: The primary tumor site was the stomach (60%), and this was followed by small intestine (40%). The most common tumor morphology was spindle cell (83%) followed by epithelial cell (17%). An immunohistochemical analysis revealed that KIT was expressed 100% and CD34 was expressed in 29 cases (78.4%), SMA in 13 patients (35%), and s100 in 7 patients (18.9%). According to the tumor size and mitotic count, 4 patients were classified as very low, 8 were low, 14 were intermediate and 8 patients were high risk. Nine patients (24.3%) underwent adjuvant chemotherapy. The median follow up duration was 29 months. The 5-year disease free survivalrate was 55.1%, and 5-year overall survival rate was 72.8%. The 5-year disease free survival rates for patients with very low and low risk classifications were 100%, and the intermediate risk and high risk were 76.4% and 38.9%, respectively (p=0.1489). The five year overall survival rates for patients with very low and low risk classification were 100%, and intermediate risk and high risk were 90.0% and 0%, respectively (p=0.0179). However, age, pathologic subtype, adjuvant chemotherapy, and immunohistochemical stain results were not significant prognostic factors. CONCLUSION: These results suggest that risk stratification was the most important prognostic factor in GISTs.

A Case of Strongyloidiasis Associated with Intestinal obstruction in a Patient with Alcoholic Liver Disease / 감염과화학요법

Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.

A Case of Strongyloidiasis Associated with Intestinal obstruction in a Patient with Alcoholic Liver Disease / 감염과화학요법

Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.

A case of severe bleomycin-induced pulmonary fibrosis: reversal with high dose prednisolone / 대한내과학회지

We report the case that a 41-year-old male treated for testicular seminoma with combination chemotherapy that included bleomycin, developed life threatening pulmonary fibrosis. After orchiectomy, he completed four cycles of chemotherapy with bleomycin, etoposide, and cisplan. He developed a dry cough and progressive breathlessness and had bilateral fine inspiratory crackles on auscultation. Chest radiography showed bilateral interstitial infiltration and lung function tests confirmed a restrictive defect. Transbronchial biopsy specimens showed intersititial fibrosis. We thought that bleomycin lung toxicity was the likely diagnosis and he had clinical and radiographic improvement following prednisolone medication. This report suggests that bleomycin-induced pulmonary fibrosis may be reversible if treated aggressively. We report a case of bleomycin-induced pulmonary fibrosis with a review of the literature.

A Case of Protein Energy Malnutrition After Whipples' s Operation / 대한피부과학회지

Protein energy malnutrition occurs when inadequate protein and calories are ingested. PEM is not confined to children and is common in hospitalized patients. PEM is diagnosed by a weight loss and hypoalbuminemia. We report a case of PEM in a 27-year-old man after Whipple's operation. He had brittle hair, loss on the scalp and brownish colored papules with desquamation on extremities. Also he had erosion and fissuring on the perioral area and beef tongue. Treatment with zinc sulfate, albumin and vitamin resulted in a good response.

Favorable effect of chemotherapy with BAM-M in mycosis fungoides / 대한피부과학회지

Mycosis fungoides is an unusual malignancy of helper T-lymphocyte origin which presents initiaily with skin disease and progresses to the lymph nodes, peripheral blood. and viseral organs, and frequently results in death. A 51-year-old woman was admitted to the hospital in October, 1930 for the evaluation of a painful reddish brown tumor with ulceration of 6 months duration on the abdomen. Lymphadenopathy was not present, and routine laboratory examinations revealed negative or, within normal limits. She was diagnosed as mycosis fungoides with stage IIb according to the commirtee on staging and classification of cutaneous T-cell lymphoma, and treated with chemotherapy;regimen, BAM-M consisted of Bleomycin, Adriamycin, Methotrexate and topical nitrogen mustard. she achieved complete remission of the tumor with five cycles of BAM-M chemotherapy. We report favorable response after BAM-M chemotherapy in a pacent with advanced stage of mycosis fungoides(TNM IIb).

A case of lupus erythematosus profundus / 대한피부과학회지

No abstract available.