• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.178-186
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• 2015

Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

• Journal of Cancer Prevention
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• v.22 no.1
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• pp.1-5
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• 2017

Pancreatic cancer is a highly aggressive malignant tumor of the digestive system and radical resection, which is available to very few patients, might be the only possibility for cure. Since therapeutic choices are limited at the advanced stage, prevention is more important for reducing incidence in high-risk individuals with family history of pancreatic cancer. Epidemiological studies have shown that a high consumption of fish oil or ${\omega}3-polyunsaturated$ fatty acids reduces the risk of pancreatic cancers. Dietary fish oil supplementation has shown to suppress pancreatic cancer development in animal models. Previous experimental studies revealed that several hallmarks of cancer involved in the pathogenesis of pancreatic cancer, such as the resistance to apoptosis, hyper-proliferation with abnormal $Wnt/{\beta}-catenin$ signaling, expression of pro-angiogenic growth factors, and invasion. Docosahexaenoic acid (DHA) is a ${\omega}3-polyunsaturated$ fatty acid and rich in cold oceanic fish oil. DHA shows anti-cancer activity by inducing oxidative stress and apoptosis, inhibiting $Wnt/{\beta}-catenin$ signaling, and decreasing extracellular matrix degradation and expression of pro-angiogenic factors in pancreatic cancer cells. This review will summarize anti-cancer mechanism of DHA in pancreatic carcinogenesis based on the recent studies.

• Korea journal of population studies
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• v.24 no.2
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• pp.207-234
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• 2001

Even though the number of Korean Americans has dramatically increased over the last 20 years, there have been very few studies that have examined the health of this population. This paper investigates the contemporary health status of Korean Americans in comparison to Koreans, employing mortality related health measures: life expectance, age-specific death rates, and leading cause of death. Overall, we find that Korean American adults enjoy longer life expectancy and lower age-specific death rates than do their Korean counterparts, suggesting superior health status of the former as compared to the latter. Comparison of leading causes of death indicates that Korean American adults (age of 25-64) are more likely to die from neoplasms than are their Korean counterparts, while Koreans show a dramatically higher probability of death from liver-related diseases than Korean Americans. When these two cause of death are regressed on various demographic and socioeconomic factors, the difference in prevalence of neoplasms between the two populations disappeared, while that of liver-related diseases remains unaffected. Based on the outcomes from this research, we suggest that Korean Americans are a self-selected group in terms of health and socioeconomic status, and they adopt healthy behaviors after immigration. This has resulted in the relatively superior health of Korean Americans as compared to Koreans.

• Journal of Gastric Cancer
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• v.16 no.3
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• pp.152-160
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• 2016

Purpose: Endoscopic diagnosis of gastric cancer (GC) that emerges after eradication of Helicobacter pylori may be affected by unique morphological changes. Using comprehensive endoscopic imaging, which can reveal biological alterations in gastric mucosa after eradication, previous studies demonstrated that Congo red chromoendoscopy (CRE) might clearly show an acid non-secretory area (ANA) with malignant potential, while autofluorescence imaging (AFI) without drug injection or dyeing may achieve early detection or prediction of GC. We aimed to determine whether AFI might be an alternative to CRE for identification of high-risk areas of gastric carcinogenesis after eradication. Materials and Methods: We included 27 sequential patients with metachronous GC detected during endoscopic surveillance for a mean of 82.8 months after curative endoscopic resection for primary GC and eradication. After their H. pylori infection status was evaluated by clinical interviews and $^{13}C$-urea breath tests, the consistency in the extension of corpus atrophy (e.g., open-type or closed-type atrophy) between AFI and CRE was investigated as a primary endpoint. Results: Inconsistencies in atrophic extension between AFI and CRE were observed in 6 of 27 patients, although CRE revealed all GC cases in the ANA. Interobserver and intraobserver agreements in the evaluation of atrophic extension by AFI were significantly less than those for CRE. Conclusions: We demonstrated that AFI findings might be less reliable for the evaluation of gastric mucosa with malignant potential after eradication than CRE findings. Therefore, special attention should be paid when we clinically evaluate AFI findings of background gastric mucosa after eradication (University Hospital Medical Information Network Center registration number: UMIN000020849).

• Journal of Gastric Cancer
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• v.24 no.2
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• pp.172-184
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• 2024

Purpose: The original eCura system was designed to stratify the risk of lymph node metastasis (LNM) after endoscopic resection (ER) in patients with early gastric cancer (EGC). We assessed the effectiveness of a modified eCura system for reflecting the characteristics of undifferentiated-type (UD)-EGC. Materials and Methods: Six hundred thirty-four patients who underwent non-curative ER for UD-EGC and received either additional surgery (radical surgery group; n=270) or no further treatment (no additional treatment group; n=364) from 18 institutions between 2005 and 2015 were retrospectively included in this study. The eCuraU system assigned 1 point each for tumors >20 mm in size, ulceration, positive vertical margin, and submucosal invasion <500 ㎛; 2 points for submucosal invasion ≥500 ㎛; and 3 points for lymphovascular invasion. Results: LNM rates in the radical surgery group were 1.1%, 5.4%, and 13.3% for the low-(0-1 point), intermediate- (2-3 points), and high-risk (4-8 points), respectively (P-fortrend<0.001). The eCuraU system showed a significantly higher probability of identifying patients with LNM as high-risk than the eCura system (66.7% vs. 22.2%; McNemar P<0.001). In the no additional treatment group, overall survival (93.4%, 87.2%, and 67.6% at 5 years) and cancer-specific survival (99.6%, 98.9%, and 92.9% at 5 years) differed significantly among the low-, intermediate-, and high-risk categories, respectively (both P<0.001). In the high-risk category, surgery outperformed no treatment in terms of overall mortality (hazard ratio, 3.26; P=0.015). Conclusions: The eCuraU system stratified the risk of LNM in patients with UD-EGC after ER. It is strongly recommended that high-risk patients undergo additional surgery.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.191-202
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• 1985

As the result of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 20 years, the life expectancy of the Korean people has lengthened considerably and as a result the number of old aged people has markedly increased. Such an increase of the number of aged people brought about many problems. Authors would like to take a medical look at the "Problem of old aged people" presently facing us in Korea. Currently the number of people over 65 has increased rapidly and is 1,620,000, 4% of total population. But it is still much lower than 8.9% in Japan, 10.7% in U.S.A., and 14.9% in the United Kingdom. Over 25% of these aged people were found to have at least more than one disease which requires medical care. Diseases occur in the circulatory system, 30.9%, respiratory system, 17.1%, digestive system 8.6%, mental disorders, 8.4%, malignant neoplasms, 7.0%. About 51% of the aged over 65 are under medical security benefit, mostly with partial coverage plan. Their clinic visit rate was very low (2.0% in 1981), which might be due to financial reasons. Since diseases affecting the aged progress chronically, early detection and long term care are utter most important. However there is almost no special facility, long term care center or geriatric specialist. For proper management of medical problems in the growing population of the Korean eldery expansion of medical security coverage, greater number of specialized facilities, education of geriatric special manpower and efficient operating system should be established.

• Journal of agriculture & life science
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• v.43 no.2
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• pp.39-46
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• 2009

Ten animal hospitals in Seoul were selected, and of which 41,305 practice in total for recent 1 year were analyzed based on international classification of disease(ICD) of WHO. Of the entire practice, prophylaxis cases accounted for 42.2%. Of the 9,376 cases of internal diseases, digestive system diseases accounted for 4,957 cases(52.9%), respiratory system diseases 1,776 cases(18.9%), circulatory system diseases 1,239 cases(13.2%), and neoplasms diseases 413 cases(4.4%), respectively. In the estate investment expenses, to be specific, rental guarantee deposit accounted for about 50% of the entire estate cost, foregift(48%), and monthly rent(2%). Dividing the income of animal hospitals into medical service, articles selling, and pet-dog beauty, medical service accounted for 71.6% of the entire sales, selling of articles 16.7%, and pet-dog beauty 11.6%. Publicity work for the animal hospital was done mostly through web sites on internet(47%), then through local advertising papers(23.5%), and through bulletins and telemarketing(11.8%). Manpower of the animal hospitals in this study was mostly composed of veterinarians(45.5%) up to about half of the entire staffs, while there was no veterinary technician who had specialized education in that area.

• Korean Journal of Community Nutrition
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• v.3 no.5
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• pp.748-758
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• 1998

The Recommended Dietary Allowances(RDAs, Nutrient standards), dietary guidelines, and food guides, each define aspects for a healthy diet in different ways. The RDA and food guide for Koreans were first established in 1962 by the Food and Nutrition Committee of the Korea FAO Association. The committee released the RDA and suggested ways to intake the recommended nutrients. Every five years, the committee has added more data and released revisions. The latest edition of the RDA is the 6th revision. In the beginning, the concept of basic food groups was emphasized as basic data for planning means based on RDA. In the 5th revision, the basic food groups and dietary guideline for public health from the Ministry of Health and Welfairs(December, 1990) suggests that, 1) Eat a variety of foods with a recommended fat intake equaling or less than 20% of total calories ; 2) Maintain ideal body weight and prevent obesity ; 3) Eat foods low in salt. Salt intake should not exceed 10g ; 4) Do not drink too much ; 5) Eat regularly and enjoy meals. After these guidelines were established, the first nutritonal education efforts guidelines were developed in 1984. Despite broad possibilities for application, they had limited use, mainly as a nutritional assessment and food balance sheet preparation. They were not well utilized in public nutritional education and nutritonal policy through the media because of the weakness of the government's food and nutriton policy. Also a lack of administrative support and dietitians in the health department and administrative organizations was partly to blame. In regard to public health and nutrition status, life expectancy has increased 10 years since the 70's and the elderly population increased threefold in 1995 compared to 1960. The common causes of death in 1996 by 19 Chapters classification, were first disease of the circulatory system ; the second, neoplasms ; the third, external causes fo mortality ; the forth, diseases of the digestive system ; and the fifth, respiratory system diseases, In food intake, grain and complex starch intake has decreased while fruit and animal foods have considerably increased. Therefore, energy from carbohydrates has decreased while energy from protein and fat has increased. Energy intakes from protein, fat and carbohydrates were respectively 12.5, 7.2 and 80.3% in 1969 but 16.1, 19.1 and 64.8% in 1995. 62.9% of the householes had the fat energy less than 20%, while 37.1% had the fat energy above 20%. The only intakes of vitamin A and calcium were below RDA levles. Therefore, nationwide attention should be focused on public nutriton education and public activities with supplementation of the RDAs, according to the food guide and the dietary guideline.

• Journal of Gastric Cancer
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• v.21 no.2
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• pp.203-212
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• 2021

Purpose: The impact of the interval between previous endoscopy and diagnosis on the treatment modality or mortality of undifferentiated (UD)-type gastric cancer is unclear. This study aimed to investigate the effect of endoscopic screening interval on the stage, cancer-related mortality, and treatment methods of UD-type gastric cancer. Materials and Methods: We reviewed the medical records of newly diagnosed patients with UD gastric cancer in 2013, in whom the interval between previous endoscopy and diagnosis could be determined. The patients were classified into different groups according to the period from the previous endoscopy to diagnosis (<12 months, 12-23 months, 24-35 months, ≥36 months, and no history of endoscopy), and the outcomes were compared between the groups. In addition, patients who underwent endoscopic and surgical treatment were reclassified based on the final treatment results. Results: The number of enrolled patients was 440, with males representing 64.1% of the study population; 11.8% of the participants reported that they had undergone endoscopy for the first time in their cancer diagnosis. The percentage of stage I cancer at diagnosis significantly decreased as the interval from the previous endoscopy to diagnosis increased (65.4%, 63.2%, 64.2%, 45.9%, and 35.2% for intervals of <12 months, 12-23 months, 24-35 months, ≥36 months, and no previous endoscopy, respectively, P<0.01). Cancer-related mortality was significantly lower for a 3-year interval of endoscopy (P<0.001). Conclusions: A 3-year interval of endoscopic screening reduces gastric-cancer-related mortality, particularly in cases of UD histology.

• Journal of Digestive Cancer Research
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• v.8 no.2
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• pp.81-90
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• 2020

We performed a comprehensive meta-analysis on whether Helicobacter pylori (H. pylori) eradication can prevent gastric cancer in individuals with precancerous lesions (chronic atrophic gastritis, intestinal metaplasia, and dysplasia). The studies evaluating the effect of H. pylori eradication on gastric cancer were searched from PubMed, KoreaMed, EMBASE, and Cochrane Library. Subgroup analyses by precancerous lesions, regions and follow-up time were performed. Six randomized clinical trials were included. In the overall population, H. pylori eradication significantly decreased the risk of gastric cancer (risk ratio [RR]=0.56; 95% confidence interval [CI]: 0.41-0.77, p<0.01). Eradication therapy significantly reduced the risk of gastric cancer in Asian and group who followed up more than 10 years (RR=0.51; 95% CI: 0.35-0.73, p<0.01; I²=0%, p=0.46). However, subgroup analysis according to the precancerous lesions did not show any significant results (p>0.05). In the general population especially in Asian population, H. pylori eradication can reduce the risk of gastric cancer. The effect of the eradication treatment is remarkable upon the long-term follow-up. In contrast, there is insufficient evidence whether the eradication should be recommended for the individuals with precancerous lesions.