• Journal of Gastric Cancer
• /
• v.24 no.2
• /
• pp.172-184
• /
• 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 Applied Biological Chemistry
• /
• v.66
• /
• pp.114-121
• /
• 2023

Selective cyclooxygenase (COX)-2 inhibition is a novel strategy to reduce the risk of gastrointestinal side effects caused by conventional nonsteroidal anti-inflammatory drugs. However, some selective COX-2 inhibitors have become apparent to increase the risk of severe cardiovascular disease. The aim of this study was to examine the anti-inflammatory effect of rosemary extract (RE) and confirm the safety of cardiovascular side effects. Inhibition of COX enzyme activity was assessed, and the levels of COX-2 and prostaglandin E₂ (PGE₂) and COX-1 and thromboxane B₂ (TXB₂) were evaluated in lipopolysaccharide (LPS)-induced RAW 264.7 cells. The 40% RE group showed increased COX-2 inhibition activity in a dose-dependent manner, whereas the 50% RE group only exhibited at 100 ㎍/mL. In a cell-based study, COX-2 mRNA expression was similar in both RE groups and PGE₂ levels tended to decrease in the 40% RE group compared to the LPS group in the LPS pretreatment condition. In the LPS posttreatment condition, the COX-2 mRNA expression decreased in the 40% RE group, and PGE₂ levels were increased in the 40 and 50% RE groups. In both conditions, there was no significant difference in COX-1 and TXB₂ levels. In conclusion, 40 and 50% RE showed significant COX-2 inhibition, similar to the positive control group. It was confirmed that the inhibition of the COX-2 expression, but the effect did not affect the balance between prostacyclin and TXB₂. These results indicate that rosemary showed COX-2 inhibition activity with a low risk of cardiovascular diseases.

• Journal of Environmental Health Sciences
• /
• v.50 no.2
• /
• pp.102-112
• /
• 2024

Background: Despite the rise in the number of domestic indoor climbing gyms, there is a lack of specific hygiene standards and research on the holds installed in them. Holds can act as vectors for microbial transmission through the hands, posing a risk of infectious diseases, especially with damaged skin. Objectives: The aim of this study is to investigate the contamination level and species of microorganisms on holds according to the management methods practiced in indoor climbing gyms and identify effective strategies for reducing microbial contamination. Methods: We investigated factors that may influence microbial contamination of holds, including hold management methods, user information, and hygiene management at three climbing gyms in Seoul. A total of 72 holds were sampled, 18 for each management method of brushing, high-pressure washing, and ethanol disinfection. Samples were cultured on LB and blood agar at 37℃ for 48 hours to calculate CFUs. PCR assay targeting 16S rRNA was carried out to identify microorganisms. Dunn-Bonferroni was employed to see the microbial reduction effect of the management method and the difference in microbial contamination by management method and climbing gym. Results: As a result of microbial identification, microorganisms such as Bacillus, Staphylococcus, and Micrococcus, which were derived from various environments such as skin and soil, were discovered on the surface of the climbing hold. Among the discovered microorganisms, some species had potential pathogenic properties that could cause food poisoning, gastrointestinal disease, bacteremia, and sepsis. All hold management methods were effective in reducing microorganisms (p<0.05), with ethanol disinfection being the most effective (p<0.001). Conclusions: Our results indicate that there are potential pathogens on holds that demand thorough management for microbial prevention. Proposed methods include regular brushing and ethanol disinfection in addition to high-pressure washing with long cycles, which are the existing forms of hold management. Further studies on shoe management are advised to curb soil-derived microorganisms.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.5
• /
• pp.548-553
• /
• 2006

Background : Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) Method: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU Results : All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission. Conclusion : In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.

• Journal of Dairy Science and Biotechnology
• /
• v.32 no.1
• /
• pp.17-29
• /
• 2014

GRAS probiotics can be used to modulate intestinal microbiota and to alleviate various gastrointestinal disorders. In several recent studies, researchers have explored the potential expansion and usability of probiotics to reduce the risk factors associated with diseases, including obesity, hypercholesterolemia, arterial hypertension, hyperhomocysteinemia, and oxidative stress. In this review, our aim was to clarify the mechanism underlying interactions between hosts (animal or human) and probiotics and the beneficial effects of probiotics on human health.

• Clinical and Experimental Pediatrics
• /
• v.49 no.11
• /
• pp.1186-1193
• /
• 2006

Purpose : Enterovirus infection is a type of viral infection that occurs relatively frequently in children during summer. It has clinical symptoms of non-specific fever, aseptic encephalomeningitis, gastrointestinal diseases, skin rash and, hand-foot-mouth disease. However, it can also occcaisionally, result in fatal symptoms like myocarditis, epicardial inflammation, transverse myelitis, quadriplegia and etc. There have been epidemic enterovirus studies, but not in the Chungnam area. Therefore, we undertook this study in order to comprehend the cause viruses in this area. Methods: We enlisted 157 children hospitalized with enteroviral infections at Soonchunhyang University hospital in Cheonan between May and August 2005. Cerebrospinal fluids or feces were collected during the acute phase after hospitalization, and observed the cytopathic effects caused by enterovirus and using reverse transcription polymerase chain reaction (RT-PCR). Results : The number of children hospitalized due to possible enteroviral infection during the period of study was 157. The number of children who tested positive with the reverse transcription polymerase chain reaction totalled 32 cases (20.4 percent). Among the children with entroviral diseases, 20 were male and 12 were female, thus the sex ratio of male to female was 1.67:1. Their clinical symptoms included fever most frequently (93.7 percent), was followed by headaches (90.0 percent), meningeal irritation signs (65.0 percent), and abdominal pain (30.0 percent). As for the type of isolated enterovirus, there were 17 cases of echovirus 18 and 6 cases of coxsackievirus B5. Furthermore, there were 2 cases of echovirus 9, 1 case of coxsackievirus A6 and coxsackievirus B3, respectively. But 5 cases were not determined by genotype. Conclusion : Echovirus 18 is circulating in Korea. We reported on identified enteroviruses, including echovirus 18, using RT-PCR in the Chungnam area during the summer of 2005.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.5
• /
• pp.618-627
• /
• 1999

Background : Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy. Usually the RFP resistant M.tuberculosis is also resistant to isoniazid (INH), so the RFP resistance is the marker of multi-drug resistant (MDR) tuberculosis. But unusual cases of mono-RFP-resistant tuberculosis have been recently reported with increasing frequency, especially associated with HIV infection in western countries. Therefore, we conducted a retrospective study to investigate the frequency, causes, and the clinical characteristics of mono-RFP-resistant tuberculosis in Korea. Methods : Of the bacteriologically confirmed and susceptibility-proven 699 pulmonary tuberculosis patients (921 isolates) who visited Asan Medical Center from January 1990 to August 1997, eighteen patients with INH-susceptible and RFP-resistant tuberculosis were evaluated. Previous history of tuberculosis, antituberculous drug compliances, associated systemic illness, drug susceptibility patterns, and clinical outcomes were analysed. And rpoB gene sequencing was done in 6 clinical isolates of M. tuberculosis. Results : The mean age of 18 patients was $43{\pm}14$ years, and the sex ratio is 12:6 (M : F). Sixteen (89%) patients had previous history of tuberculosis. None had diagnosed gastrointestinal disorders, and 2 HIV tests that were performed came out negative. Susceptibility tests were done repeatedly in eleven patients, and six (55%) were mono-RFP resistant repeatedly while five (45%) evolved to MDR tuberculosis. Eight (44%) patients were cured, six (33%) failed, three (17%) were lost to follow-up, and the other one is now on treatment. rpoB gene sequencing showed 5 mutations, codon 531 TCG to TIG mutation in 4 isolates and 526 CAC to TAC in 1 isolate. Conclusion : The clinical characteristics of mono-RFP resistant tuberculosis were similar to that of MDR tuberculosis in Korea where the HIV infection rate is lower than western countries. But some patients with mono-RFP-resistant tuberculous could be cured by primary drug regimens including RFP, suggesting that mono-RFP-resistant tuberculous is a different entity from MDR tuberculosis.

• Pediatric Infection and Vaccine
• /
• v.7 no.1
• /
• pp.94-107
• /
• 2000

Purpose : The purpose of this study is to know the clinical manifestations and the severity of adenoviral lower respiratory tract infections(LRTI) in Korean children. Methods : Adenoviral respiratory infection was diagnosed by viral culture in HEp-2 cell and indirect immunofluorescent technique with nasal aspirates. Isolated adenoviruses were typed by neutralization test. Retrospective chart review was done in patients with adenoviruses were typed by neutralization test. Retrospective chart review was done in patients with adenoviral lower respiratory tract infection, who were brought to Seoul National University Children's Hospital from November 1990 through February 1998. Results : Adenovirus was isolated in 87 cases. Of 84 cases serotyped, type 1 was recovered in 3 cases, type 2 in 13 cases, type 3 in 13, type 4 and 5 in 4 cases each other, type 6 in 1 cases, type 7 in 36 cases, type 11 in 1 case and the other types in 9 cases. Adenoviral lower respiratory infection occurred sporadically throughout the year but from November 1995 through February 1998, an outbreak of adenovirus type 7 lower respiratory infection was observed in number upto 36 case. The incidence of adenoviral infection peaked in young children between 6 months and 5 years of age and the mean age was 1 year 11 months old. There were 10 cases of mixed infection with another pathogen. Clinical diagnosis were pneumonia(88%), acute broncholitis(5.4%), acute tracheobronchitis(5.4%), croup(1.3%). The clinical features of adenoviral lower respiratory infection were severe especially in type 3 and 7 infections in aspect of fever duration, ventilator care. Extrapulmonary manifestations were gastrointestinal symptoms in 23 cases(31%), hepatomegaly in 36 cases(53%), seizure and mental alteration in 13 cases(20.3%). In chest radiographic findings, parahilar and peribronchial infiltration were in 49 cases(67%), hyperaeration in 21 cases(29%), atelectasis in 14 cases(19%), consolidation in 39 cases(53%) and bilateral pneumonic infiltration in 28 cases(38%). Among thirty six adenovirus type 7 LRTI, 15 patients(41.6%) had pleural effusion and 3 patients had chest tube insertion. Number of fetal cases related to adenovirus were 9 cases(12%) and fetal cases due to ventilatory failure were 7(11%). Conclusion : During 7 year period of studying adenoviral lower respiratory infection, we identified the serotypes of adenovirus. Among the serotypes, adenovirus type 7 were epidemically isolated. Adenovirus were isolated in severe lower respiratory infection of young children aged between 6 months and 5 years and related to death of the patients, especially when the patients had underlyng diseases or were infected by adenovirus type 7.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.5
• /
• pp.495-500
• /
• 1993

Background: For the relief of the occlusion of major bronchi, laser therapy, radiation therapy or combined therapy is generally used. But the effect of radiation therapy is very slow and not consistent and laser therapy requires expensive equipments and technical expertise with occasional serious side effects. Direct ethanol injection has been widely used for the control of bleeding in gastrointestinal lesion, esophageal varices or renal cell carcinoma with good results. So we tried direct injection of ethanol into the tumor to relieve the obstruction of major bronchus in 11 patients. Method: All procedures were done under the fiberoptic bronchoscopy with continuous oxygen supplement and aliquoted 0.5-1.0 ml of absolute ethanol directly into the tumor through the endobronchial aspiration needle. The tumor was endoscopically removed with a biopsy forceps immediately after ethanol injection. The whole procedure was repeated 3-4 days interval until the lumen opens. Usually after 2-3 trials of ethanol injection, the lumen opened up. Results: The immediate effect of ethanol injection was whitening of the mucosa and prompt cessation of bleeding. The late effect was necrosis of the tumor. The final results of this procedure were improvement of symptoms and reexpnasion of the lung in all patients. $FEV_{1.0}$ and FVC were improved and $PaO_2$ was increased from $68.1{\pm}9.2$ mmHg to $83.9{\pm}8.1$ mmHg, $SaO_2$: from $94{\pm}8.5%$ to $96.6{\pm}1.1%$, and $AaDO_2$ was reduced from $26.5{\pm}8.5$ mmHg to $10.9{\pm}9.1$ mmHg. Conclusion: Direct ethanol injection into the tumor tissue is a rapid, cheap and relatively safe method of relieving the complete occlusion of major bronchus.

• Journal of Korean Academy of Nursing
• /
• v.22 no.2
• /
• pp.207-226
• /
• 1992

This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.