• Title/Summary/Keyword: Introduction to Medicine

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Socioeconomic Inequalities in Colorectal Cancer Screening in Korea, 2005-2015: After the Introduction of the National Cancer Screening Program

  • Mai, Tran Thi Xuan;Lee, Yoon Young;Suh, Mina;Choi, Eunji;Lee, Eun Young;Ki, Moran;Cho, Hyunsoon;Park, Boyoung;Jun, Jae Kwan;Kim, Yeol;Oh, Jin-Kyoung;Choi, Kui Son
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1034-1040
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    • 2018
  • Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

Parkin Induces MMP-3 Expression in Human Cervical Cancer Cells

  • Lee, Min Ho;Jung, Byung Chul;Jung, Bae Dong;Lee, In-Soo;Rhee, Ki-Jong;Kim, Yoon Suk
    • Biomedical Science Letters
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    • v.19 no.1
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    • pp.1-8
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    • 2013
  • Parkin is known to be a tumor suppressor protein. Previously, we determined that parkin expression restores susceptibility to TNF-${\alpha}$-induced death of HeLa cells, a human cervical cancer cell line resistant to TNF-${\alpha}$-induced cell death. MMP-3 is a zinc-dependent protease recently reported to activate intracellular apoptotic signaling. In this study we examined the regulation of MMP-3 expression by parkin in TNF-${\alpha}$-treated HeLa cells. Furthermore, we investigated the signaling pathway involved in parkin-induced expression of MMP-3. We found that HeLa cells exhibit low levels of MMP-3 but is induced after introduction of the parkin gene into HeLa cells. Furthermore, MMP-3 expression increased further when parkin expressing cells were treated with TNF-${\alpha}$. Using chemical inhibitors of cell signaling pathways, we found that MEK-1 (PD98059), PI3K (LY294002), p38 MAPK (SB203580), and JNK inhibitors alleviated parkin-induced up-regulation of MMP-3. Finally, we show that TNF-${\alpha}$-induced cell death in parkin expressing cells is inhibited by using a MMP-3 inhibitor. These results suggest that parkin expression induces prolonged expression of MMP-3 via MEK-1, PI3K, MAPK, and JNK pathway in HeLa cells allowing the HeLa cells to become sensitive to TNF-${\alpha}$-induced cell death. These results implicate a role of MMP-3 in parkin-induced cell death in TNF-${\alpha}$ treated HeLa cells.

Estimation of the Gastric Cancer Incidence in Tehran by Two-Source Capture-recapture

  • Aghaei, Abbas;Ahmadi-Jouibari, Toraj;Baiki, Omid;Mosavi-Jarrahi, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.673-677
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    • 2013
  • Introduction: Capture-recapture methods have been suggested for reducing costs of disease registration as well as reducing bias in incidence estimations. This study aimed to estimate the gastric cancer incidence in the Tehran metropolis population during 2002-2006. Materials and Methods: We investigated new cases of gastric cancer reported by three sources; death certificates, pathology reports, and medical records to Tehran population-based cancer registry during 2002-2006. $G^2$ statistics and the two-source capture-recapture method were used to select the best-fitted log-linear model and to estimate incidence, respectively. EXCEL software version 2007 and SPSS software version 16 were used for this research. Results: The number of reported cases was 4,463, with an average age of 68.5 (${\pm}12.9$) years. We found the model that combined two sources of data including pathology reports and medical records and furthermore complemented by death certificates as the best model. The reported and the estimated incidences were 11.0 and 27.1 per 100,000 respectively. Conclusions: The incidence estimated by two-source capture-recapture method is about three times higher than the incidence reported by the sources under investigation. It is recommended to move towards the implementation of population-based cancer registration using various sources of data collection to achieve more accurate data.

Development of Indwelling Urinary Catheterization Guideline by Adaptation Process (수용개작방법을 활용한 유치도뇨 간호실무지침 개발)

  • Jeong, Ihn Sook;Jeong, Jae Sim;Seo, Hyun Ju;Lim, Eun Young;Hong, Eun-Young;Park, Kyung Hee;Jung, Young Sun;Choi, Eun Kyoung;Park, Hee Youn;Park, Sun-A
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.1
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    • pp.31-42
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    • 2015
  • Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

Efficacy of sodium bicarbonate buffered versus non-buffered lidocaine with epinephrine in inferior alveolar nerve block: A meta-analysis

  • Guo, Jing;Yin, Kaifeng;Roges, Rafael;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.3
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    • pp.129-142
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    • 2018
  • Introduction: This systematic review evaluated the use of buffered versus non-buffered lidocaine to increase the efficacy of inferior alveolar nerve block (IANB). Materials and Methods: Randomized, double-blinded studies from PubMed, Web of Science, Cochrane Library, Embase, and ProQuest were identified. Two of the authors assessed the studies for risk of bias. Outcomes included onset time, injection pain on a visual analog scale (VAS), percentage of painless injections, and anesthetic success rate of IANB. Results: The search strategy yielded 19 references. Eleven could be included in meta-analyses. Risk of bias was unclear in ten and high in one study. Buffered lidocaine showed 48 seconds faster onset time (95% confidence interval [CI], -42.06 to -54.40; P < 0.001) and 5.0 units lower (on a scale 0-100) VAS injection pain (95% CI, -9.13 to -0.77; P=0.02) than non-buffered. No significant difference was found on percentage of people with painless injection (P = 0.059), nor success rate (P = 0.290). Conclusion: Buffered lidocaine significantly decreased onset time and injection pain (VAS) compared with non-buffered lidocaine in IANB. However due to statistical heterogeneity and low sample size, quality of the evidence was low to moderate, additional studies with larger numbers of participants and low risk of bias are needed to confirm these results.

A study on Medical servicer satisfaction of Emergency Department patient (응급실 내원자의 의료서비스 만족에 관한 연구)

  • Kwon, Seon Suk;Yoo, In Soo;Jung, Ha Sook
    • The Korean Journal of Emergency Medical Services
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    • v.1 no.1
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    • pp.42-53
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    • 1997
  • To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

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Fundamental Study Related to the Addition of Clinical Laboratory Science in the Qualifications of Health Research Officer (Public Health Job Serial) (보건연구사(공중보건 직류) 응시자격에 임상병리학(임상검사과학) 추가와 관련된 기초조사)

  • Bon-Kyeong KOO;Myungsuk JI
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.288-293
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    • 2024
  • A basic investigation was conducted to evaluate whether a degree or certification in clinical laboratory science should be included as a necessary qualification for the job of a health research officer (public health job serial). Currently, in Korea, 26 graduate schools offer clinical laboratory science programs. The field of clinical laboratory science is expected to play an important role in promoting public health, and can also play an important role in the fields of public health and genetic analysis. The 4th Industrial Revolution has opened up an era of technology and innovation. As a result, there have been innovations in healthcare through the introduction of new technologies and approaches. Clinical laboratory science plays an important role in medicine and research, and the expertise and skills imparted by its study can provide great value to the field of healthcare. To improve public health, we propose adding the clinical laboratory science major to the qualifications required for applying for the job of a health research officer.

Expression of Human Leukocyte Antigen DQB1*0602 in Korean Patients with Narcolepsy (한국인 기면병 환자의 Human Leukocyte Antigen(HLA) DQB1*0602 발현 빈도)

  • Hong, Seung-Chul;Woo, Young-Sub;Park, Soo-A;Jeong, Jong-Hyun;Han, Jin-Hee;Kim, Leen;Lee, Sung-Pil
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.107-112
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    • 2001
  • Introduction: Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, is known to be closely associated with the human leukocyte antigen (HLA) DQB1*0602. Several studies have suggested that HLA-DQB1*0602 is strongly linked with narcolepsy-cataplexy. However, no studies have yet been made on whether HLA DQB1*0602 is associated with Korean patients with narcolepsy. This study was designed to investigate the frequency of HLA-DQB1*0602 of Korean patients with narcolepsy. Methods: Twenty patients were selected (mean age: $28.2{\pm}3.0$, 11 men and 9 women). The patients were confirmed to have narcolepsy by the overnight polysomnography and multiple sleep latency test (MSLT) in addition to their clinical history and symptoms at St. Vincent's Hospital and Korea University Hospital Sleep Disorders Clinic. Any subjects co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep were excluded. Clinical data was collected through a semi-structured interview for narcoleptic patients. All patients and 21 control did HLA typing for the presence of DQB1*0602. Results Obtained were as Follows: 1) Mean sleep latency was 2.4 (${\pm}2.0$ minutes) and mean frequency of sleep-onset REM period was 3.0 (${\pm}1.6$) by MSLT. 2) Characteristic symptoms of narcolepsy investigated were as follows: excessive daytime sleepiness (100%), cataplexy (100%), sleep paralysis (60%), hypnagogic hallucination (70%) and disrupted nocturnal sleep (75%). 3) Strong emotional expression such as laughing (80%) and joking (70%) triggered cataplexy which affects the knee and leg region (80%) and jaw region (30%). 4) HLA-DR2 was found in 90% of patients and 35% in controls. The frequency of HLA-DQB1*0602 in patients and controls was 90%, and 24%, respectively. Conclusions: These results, which exhibit high HLA-DQB1*0602 expression in Korean patients with narcolepsy, suggest that HLADQB1*0602 could be a strong genetic marker in narcolepsy.

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Bacterial meningitis in children experienced at a university hospital, 1993-2006 (서울의 한 대학병원에서 경험한 소아의 세균성 수막염: 1993-2006)

  • Cho, Sung Yoon;Kim, Tae Yeon;Lee, Hyunju;Kim, Kyung Hyo;Yoo, Eun Sun;Kim, Hae Soon;Park, Eun Ae;Ryu, Kyung Ha;Sohn, Sejung;Seo, Jeong Wan;Lee, Seung Joo
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1077-1084
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    • 2008
  • Purpose : Despite the seriousness of bacterial meningitis in children, there is little information on the incidence, causative organisms, mortality rate and age distribution. We studied the frequency by age group and causal pathogens, and clinical characteristics in children with bacterial meningitis in the private sector in Korea. Methods : The medical records containing the data on bacterial meningitis patients under 18 years of age confirmed by cerebrospinal fluid (CSF) findings were retrospectively analyzed from September, 1993 to August, 2006 at Ewha Womans University Mokdong Hospital. Results : Eighty-one cases of bacterial meningitis were observed. Overall the most common organism was Streptococcus agalactiae (group B streptococcus, GBS) (30 cases, 37.0%) followed by Haemophilus influenzae (22 cases, 27.2%), Streptococcus pneumoniae (12 cases, 14.8%), Escherichia coli (3 cases, 3.7%), Neisseria meningitidis (1 case, 1.2%) and others (13 cases, 16.0%). In neonates and young infants under 2 months, the most common organism was GBS. In children between 3 months, and 5 years, the most common organism was H. influenzae. S. pneumoniae was the most common organism in children over 5 years of age. Thirty-one patients (38.3%) had complications. Of all ages, the mortality rate of bacterial meningitis markedly decreased compared with the previously reported rate. Conclusion : In neonates, GBS meningitis was most common. The frequency of H. influenzae meningitis decreased after the introduction of H. influenzae type b vaccination. A strategy for the prevention of GBS meningitis in neonates should be established. The influence of the pneumococcal conjugate vaccine on S. pneumoniae meningitis should be studied.

Etiological Classification and Developmental Outcomes in Floppy Infants: A Single Tertiary Center Experience (늘어지는 영아 증후군의 진단적 분류와 발달 예후: 단일 3차 병원에서의 연구)

  • Park, Jung Min;Choi, Young Ha;Lee, Ha Neul;Chung, Hee Jung
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.189-196
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    • 2018
  • Purpose: Floppy infants or congenital hypotonia indicates decreased muscle tone in infants secondary to abnormalities of the central or the peripheral nervous system, or both. Previous literature classified its causes as those attributable to a central vs. peripheral origin; however, recent studies have introduced a newer classification describing a combined origin. We invenstigated floppy infants by applying the new etiological classification and reviewed the most common etiologies based on the age of presentation. We additionally reviewed the clinical characteristics, diagnoses, and the developmental outcomes in these infants. Methods: We retrospectively reviewed the electronic medical charts and recruited 116 infants diagnosed with floppy infant syndrome between January 2005 and December 2016 at Severance Children's Hospital. Among these infants, 66 with a confirmed diagnosis were reviewed for the etiological classification. Information regarding developmental outcomes was obtained via phone interviews with the infants' families. Results: Based on the new etiological classification, among 69 infants with a confirmed diagnosis, in 40 (34.5%) this syndrome was of central origin, in 19 (16.4%) of peripheral origin, and in 10 (8.6%) of combined origin. Prader-Willi syndrome, myotonic dystrophy, and spinal muscular atrophy were the most common disorders observed and combined hypotonia showed the poorest developmental outcome. Conclusion: The study states the importance of proper evaluation of etiological diagnosis and optimal intervention for developmental prognosis. The introduction of a new etiological group of combined hypotonia especially emphasizes regular monitoring and timely rehabilitative intervention in patients for the better quality of life in them as well as their caregivers.