The Effects of the Smoking Cessation Program of Life Skill Training Using Flipped Learning for Middle School Male Students

Purpose@#The study is examined the effects of the smoking cessation program of life skills training using flipped learning for male middle school students. @*Methods@#The study was a nonequivalent control group non-synchronized design. The Smoking Cessation Program of life skills training using flipped learning is a Smoking Cessation Program that applied 5 stages of flipped learning such as before class, introductory class, during class, after class, and during work. Participants were 32 male students attending a middle school in D city, with 16 in the control group and 16 in the experiment group. Data collection was conducted from February 26, 2019 to May 14, 2019 for the control group, and from May 28, 2019 to August 19, 2019 for the experiment group. The collected smoking knowledge, smoking attitude, self-efficacy, basic psychological needs, and urine cotinine were analyzed by x2 test, independent t-test, two-way repeated measured ANOVA, and Fishers exact test using the SPSS 25.0 program. @*Results@#The experimental group showed higher smoking knowledge, smoking attitude, self-efficacy, basic psychological need, and urine cotinine negative response than the control group, and there were significant differences. @*Conclusion@#These findings indicate that the Smoking Cessation Program of life skill training using flipped learning is an effective intervention for cessation of middle school male students, and it has a positive effect on the increase in urine cotinine, and a physiological indicator of the cessation effect, and is effective in the success of smoking cessation.

Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus

BACKGROUND: Gastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM). The prevalence of gastroesophageal reflux disease (GERD) in Korea appears to be increasing. Some studies have shown that T2DM is a risk factor for symptomatic GERD. However, this possibility is still debated, and the pathogenesis of GERD in T2DM is not yet fully understood. The aim of this study was to analyze the prevalence and risk factors (including autonomic neuropathy) of GERD in patients with T2DM. METHODS: This cross-sectional case-control study enrolled T2DM patients (n=258) and healthy controls (n=184). All participants underwent physical examinations and laboratory tests. We evaluated medical records and long-term diabetes complications, including peripheral and autonomic neuropathy in patients with T2DM. Esophagogastroduodenoscopy was performed in all patients. The Los Angeles (LA) classification was used to grade GERD. GERD was defined as LA grade A (or higher) or minimal change with GERD symptoms. GERD symptoms were examined using a frequency scale. Data were expressed as mean±standard error. Independent t-tests or chi-square tests were used to make comparisons between groups. RESULTS: The prevalence of GERD (32.6% vs. 35.9%, P=0.266) and GERD symptoms (58.8% vs. 59.2%, P=0.503) was not significantly different between T2DM patients and controls. We found no significant differences between T2DM patients with GERD and T2DM patients without GERD with respect to diabetic complications, including autonomic neuropathy, peripheral neuropathy, duration of DM, and glucose control. CONCLUSION: The prevalence of GERD in patients with T2DM showed no difference from that of controls. GERD was also not associated with peripheral and cardiovascular autonomic neuropathy, age, or duration of DM in patients with T2DM.

The Development and Effects of Timeout Protocol for Safety in Cataract Surgery Patients / 재활간호학회지

PURPOSE: This study was conducted to develop effective timeout protocol in coordination with current practice and test its clinical effectiveness in pursuit of safety management for patients undergoing cataract surgery. METHODS: A total of subjects were 60 women, 50~65 years old, who visit C ophthalmology clinic in D city. They were assigned to 30 experimental group and 30 control group, respectively. Based on the comprehensive literature review, timeout protocol that was suitable for patients undergoing cataract surgery was developed, and then test its effectiveness by measuring blood pressure, pulse, anxiety and sense of well-being among surgical patients. RESULTS: The timeout protocol was found to reduce blood pressure, pulse, and anxiety and increase well-being among surgical patients. CONCLUSION: As a results, it is necessary to introduce an effective timeout protocol giving positive responses to surgical patients, hence it should be develop a timeout protocol and explore the effectiveness of the protocol.

A Study on Food Habits and Nutrient Intakes according to BMI in Food and Nutrition Major and Non-major Female Students in Kyungnam University / 대한지역사회영양학회지

OBJECTIVES: This study was performed to investigate the body image, food habits, nutrition knowledge, food intake frequency, nutrient intakes of female university students in Masan. METHODS: Two groups (n = 302, nutrition major: 147, non-major: 155) were classified into underweight, normal weight and overweight/obesity groups according to BMI respectively. RESULTS: Height and weight of all subjects were 161.5 cm, 53.2 kg and were 161.5 cm, 55.1 kg, 161.5 cm, 51.3 kg in major and non-major female students, respectively. The BMI and body weight were significantly different (p < 0.001). Significantly higher proportions of underweight students in both study groups had perceived as 'normal' or 'fat' (p < 0.001). Higher proportion of the subjects skipped breakfast and main reason was no time to eat. Nutrition knowledge score was significantly higher in major than in non-major subjects (p < 0.001). Fish intake frequency score was significantly higher in non-majors, while the vegetable intake frequency score was significantly higher in majors. Nutrient intakes were significantly higher the majors compared to non-majors, particularly the intake of calcium (p < 0.05), zinc (p < 0.001), vitamin C (p < 0.001) and vitamin E (p < 0.01). Subjects in both groups did not have adequate nutrient intakes compared to KDRIs. BMI showed a positive correlation with body image, body weight and nutrition knowledge score (p < 0.01). CONCLUSIONS: These results suggest that systematic nutrition education program which can be applied in real life is important for the formation of correct choices of food and good eating habits.

Comparison of the Efficacy and Tolerability between Same-day Picosulfate and Split-dose Polyethylene Glycol Bowel Preparation for Afternoon Colonoscopy: A Prospective, Randomized, Investigator-blinded Trial

BACKGROUND/AIMS: In the present study, we evaluated the efficacy and tolerability between same-day bowel preparation protocols using 2 sachets of Picosulfate and a 4 L split-dose polyethylene glycol (PEG) bowel preparation for afternoon colonoscopy. METHODS: The study had a single-center, prospective, randomized, and investigator-blinded, non-inferiority design. We evaluated bowel preparation quality according to the Ottawa scale, patient tolerability, compliance, incidence of adverse events, sleep quality, and polyp/adenoma detection rate. RESULTS: Among the 196 patients analyzed (mean age, 55.3 years; 50.3% men), 97 received the same-day regimen of 2 sachets of picosulfate (group A) and 99 received the 4 L split-dose PEG regimen (group B). The Ottawa score of the total colon was 4.05+/-1.56 in group A and 3.80+/-1.55 in group B (P=0.255). The proportion of patients having adequate bowel preparation in the same-day picosulfate group (61.5%) was slightly less than the 4 L PEG group (71.3%); however, the difference was not statistically significant (P=0.133). Tolerability of the group A regimen was superior to that of the group B regimen (P<0.000). The same-day picosulfate regimen was associated with fewer adverse events, such as abdominal bloating (P=0.037) and better sleep quality (P<0.000). CONCLUSIONS: The same-day picosulfate regimen and the 4 L split-dose PEG regimen had similar efficacy in bowel preparation for afternoon colonoscopy. However, the same-day picosulfate regimen was easier to administer, produced fewer adverse events, and enabled better sleep quality.

The Effect of Indigocarmine on Improvement of the Polyp Detection Rate during Colonoscopic Examination with Hood Cap

BACKGROUND/AIMS: Hood cap-assisted chromocolonoscopy using indigocarmine is expected to improve the detection rate of colorectal polyps, especially adenomatous polyps. Therefore, aim of the present study was to evaluate the usefulness of hood cap-assisted chromocolonoscopy in routine colonoscopic examinations. METHODS: From January, 2013 through March, 2013, a total of 86 patients were enrolled (M:F=33:53, mean age=60 years). For each patient, hood cap-assisted colonoscopic examination was performed, followed by hood cap-assisted chromocolonoscopy using 0.2% indigocarmine from the cecum to the hepatic flexure. Total numbers and characteristics of polyps were compared before and after indigo carmine dye spraying. RESULTS: Prior to dye spraying, 48 polyps were found in 37 patients, and after dye spraying, 53 additional polyps were found in 34 patients. Of these undetected polyps, 45 (85%) were small sized polyps (< or =0.5 cm). Histologically, 19 (36%) were adenomatous polyps, and of these, 15 (28%) were tubular adenomas and 4 (8%) were serrated adenomas. As for the polyp detection rate, there was no difference between the expert and the non-expert groups. CONCLUSION: Hood cap-assisted chromocolonoscopic examination using indigocarmine was helpful in detecting cecum and ascending colon polyps, especially small sized polyps (<0.5 cm) and neoplastic polyps.

Ulcerative Colitis Complicating Pseudomembranous Colitis of the Right Colon

Clostridium difficile (C. difficile) is a cytotoxin-producing anaerobic gram-positive rod that is responsible for pseudomembranous colitis (PMC). The incidence of C. difficile is increasing in ulcerative colitis (UC) and inflammatory bowel disease patients and is associated with a more severe course, a longer hospital stay, higher financial costs, a greater likelihood of colectomy, and high mortality. PMC may occur anywhere along the intestinal tract, but it is often found in the distal colon. PMC involving the proximal colon with rectosigmoid sparing is rarely reported in patients with UC. We describe the case of a 35-year-old woman in remission from UC who presented with frequent diarrhea and abdominal pain. She was treated with ciprofloxacin for infectious enterocolitis at a local hospital; however, her symptoms did not improve. A colonoscopy revealed yellow-white plaques with edematous, erythematous from the proximal ascending colon to the cecum, and feces positive for C. difficile toxin. She was treated with metronidazole (500 mg, three times a day) for two weeks, and improved rapidly. Physicians should carefully examine the entire colon via colonoscopy, and perform stool exams for C. difficile in patients with UC who have been treated with antibiotics and in those who develop prolonged diarrhea despite medical treatment.

A Case of Corrosive Esophagogastritis after Copper Sulfate Ingestion / 대한소화기내시경학회지

Copper sulfate ingestion is a rare cause of corrosive gastrointestinal injury in the Republic of Korea. In developing countries, copper sulfate is chiefly used for agricultural purposes as a pesticide and in the leather industry. It is also used in school science classes in the form of bright blue crystals. Copper sulfate is a powerful oxidizing agent that is corrosive to mucous membranes. Concentrated solutions are acidic, with a pH of 4. We report a case of corrosive gastritis and esophagitis due to accidental copper sulfate ingestion in a 12-year-old boy.

Esosinophilic Gastroenteritis with Clostridium difficile-associated Colitis: A Case Report / 대한소화기내시경학회지

Eosinophilic gastroenteritis is an uncommon disease characterized by eosinophilic infiltration in the bowel wall and presents various symptoms depending on the affected site and bowel layer. Pseudomembranous colitis is an antibiotic-associated infection caused by abnormal overgrowth of the toxin-producing Clostridium difficile in the large bowel. A 16-year-old boy was admitted with abdominal pain for 6 days. On admission, we performed an endoscopy and diagnosed gastroduodenitis. Then, we prescribed gastritis medication but he still presented with diffuse abdominal pain and fever above 38.0degrees C after admission. We considered infectious enterocolitis, so we prescribed an antibiotic. The next day, he presented with bloody diarrhea. A diagnosis of pseudomembranous colitis was confirmed by a colonoscopic examination with a biopsy. We also obtained a diagnosis of eosinophilic gastroenteritis through a histological diagnosis. This is the first case of the simultaneous occurrence of eosinophilic gastroenteritis and pseudomembranous colitis in the Korean medical literature. We report this case with a brief review of the literature.

Long-term survival in a case of hepatocellular carcinoma with portal vein thrombosis treated with transarterial chemoembolization Kwan / 대한내과학회지

Hepatocellular carcinoma (HCC) is the third most common malignancy in Korea and the prognosis of patients with HCC is generally poor. Most patients with HCC have unresectable disease at presentation and only a small proportion of patients diagnosed early receive curative treatment. Transarterial chemoembolization (TACE) is a widely used palliative treatment for advanced HCC and its prognostic benefit has been proven in several studies. TACE is contraindicated for patients with portal vein tumor thrombosis (PVT) because it carries a potential risk of acute hepatic failure. Recently, however, a few studies have provided evidence of a survival benefit after TACE in patients with PVT if they have good hepatic reserve and collateral circulation around the portal trunk. We experienced a case of HCC with PVT, with long-term survival and no evidence of recurrence or hepatic failure after TACE, and present this case with a review of the relevant literature.

Comparison of Transient Elastography and Hepatic Fibrosis Assessed by Histology in Chronic Liver Disease / 대한소화기학회지

BACKGROUND/AIMS: Transient elastography (Fibroscan, Echosens, France) is a new, simple, and non-invasive method to assess the degree of hepatic fibrosis by measuring liver stiffness. Recent reports have shown that liver stiffness measurement using Fibroscan allowed accurate prediction of hepatic fibrosis in patient with chronic hepatitis C. The aim of this study was to evaluate accuracy of Fibroscan for the detection of hepatic fibrosis in Korea with various etiologies of chronic liver disease by comparison with fibrosis assessed by histologic examination. METHODS: Fifty-four patients with chronic liver diseases, which were histologically confirmed within recent 6 months were enrolled. Etiologies were HBV, HCV infection, autoimmune hepatitis, and non alcoholic steatohepatitis. Hepatic fibrosis was graded on the basis of standard guideline proposed by the Korean Study Group for the Pathology of Digestive Diseases. RESULTS: Fibroscan values were significantly higher in F3 (16.96 kPa) and F4 (19.86 kPa) than others (p=0.003). Liver stiffness measurement was significantly correlated to the fibrosis stage (r=0.614, p<0.0001). CONCLUSIONS: Liver stiffness measurement by Fibroscan is a promising method for the assessment of hepatic fibrosis in chronic liver disease because it accompanies no complication.

Clinicopathologic characteristics of gastric cancer diagnosed at health screening / 대한내과학회지

BACKGROUND/AIMS: Stomach cancer is the most common malignancy and one of the leading causes of cancer-related death in Korea. The early diagnosis and treatment of gastric cancer are very important because the prognosis of early gastric cancer is excellent. Gastric screening may provide an opportunity to detect asymptomatic early gastric cancer. We analyzed the characteristics of gastric cancer diagnosed with a health screening test to evaluate the usefulness of a screening program for gastric cancer. METHODS: We retrospectively reviewed the clinicopathological characteristics of 111 gastric cancer patients diagnosed using gastric endoscopy as a gastric screening test at the Health Promotion Center of Kyungpook National University Hospital from July 1997 through December 2005. RESULTS: The incidence of gastric cancer was 0.38% and the mean patient age was 58.5 years old. The proportion of early gastric cancer was 73% of all gastric cancer. In 55 cases, constituting 49.6% of all gastric cancer and 68% of early gastric cancer, the lesions were confined to the mucosa. The most common macroscopic types were type IIc in early gastric cancer and Borrmann type 3 in advanced gastric cancer. There were significant positive correlations between lymph node metastasis and both the depth of tumor invasion and size of the lesion. The 5-year survival rates are 82.7% in total gastric cancer and 97.2% in early gastric cancer. CONCLUSIONS: Gastric cancer detected during health screening has a favorable prognosis because gastric cancer confined to the mucosa predominates and early gastric cancer detected at screening has a lower incidence of metastasis to regional lymph nodes.

Prevalence and risk factors of gallstones in a general health screened population / 대한내과학회지

BACKGROUND: Gallstone is the most common disease of the biliary system. Most cases of gallstone are asymptomatic and we incidentally found gallstones during a community health survey. Our study was designed to determine the prevalence and risk factors for gallstone in a population who underwent health screening. METHODS: We enrolled a total of 36,314 persons who visited the health promotion center in Kyungpook National University Hospital in Korea from 1998 to 2004. They had their gallbladder or biliary system examined with using ultrasonography. The body mass index and biochemical parameters from liver function tests, the lipid profiles and the fasting blood sugar were all measured. All the subjects were divided into several groups and the particular prevalence for gallstone disease for each group was calculated. Chi-square tests and logistic regression analysis assessed the risk factors for gallstone disease. RESULTS: Among 36,314 persons, (19,345 males (53.3%) and 16,969 females (46.7%)), gallstone was found in 735 persons (2.0%). On univariate analysis, the risk factors for gallstone disease were age, body mass index, fasting blood sugar, total cholesterol, LDL-cholesterol, triglyceride and serum aspartate aminotransferase. On multivariate logistic regression analysis, the the risk factors were high body mass index, older age and high fasting blood sugar. CONCLUSIONS: The risk factors seem to show a common pathogenesis for gallstone disease. Although the relation between gallstone disease and metabolic syndrome has not been established, it appears to be associated with metabolic syndrome, but further study on a general population is required.

A Case of Cholestatic Hepatitis Induced by Epstein-Barr Virus Infection / 대한간학회지

Acute viral hepatitis in human can be caused by a large number of viruses with a wide range of clinical manifestations and laboratory findings. EBV is a rare causative agent of an acute hepatitis, during the course of infectious mononucleosis. Hepatic manifestations of EBV are usually mild and resolve without serious complications. EBV is rather uncommonly confirmed as an etiologic agent in acute viral hepatitis of adults and it rarely causes cholestatic hepatitis. We report a case of EBV hepatitis with cholestatic feature that was verified through serum viral marker and liver biopsy.