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Folate during reproduction: the Canadian experience with folic acid fortification

  • Lindzon, Gillian;O'Connor, Deborah L.
    • Nutrition Research and Practice
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    • v.1 no.3
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    • pp.163-174
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    • 2007
  • Folate has received international attention regarding its role in the risk-reduction of birth defects, specifically neural tube defects (NTDs). In 1998 health officials in Canada, like the United States, mandated the addition of folic acid to white flour and select grain product's to increase the folate intake of reproductive-aged women. Subsequent to this initiative there has been an increase in blood folate concentrations in Canada and a 50% reduction in NTDs. Many countries, including Korea, have not mandated folic acid fortification of their food supply. Reasons vary but often include concern over the masking of vitamin $B_{12}$ deficiency, a belief that folate intakes among womenare adequate, low priority relative to other domestic issues, and the philosophy that individuals have the right not to consume supplemental folic acid if they so choose. Prior to folic acid fortification of the food supply in Canada, the folate intakes of women were low, and their blood folate concentrations while not sufficiently low to produce overt signs of folate deficiency (eg. anemia) were inconsistent with a level known to reduce the risk of an NTD-affected pregnancy. The purpose of this article is to describe the role of folate during the periconceptional period, pregnancy, and during lactation. The rationale for, and history of recommending folic acid-containing supplements during the periconceptional period and pregnancy is described as is folic acid fortification of the food supply. The impact of folic acid fortification in Canada is discussed, and unresolved issues associated with this policy described. While the incidence of NTDs in Canada pre-folic acid fortification were seemingly higherthan that of Korea today, blood folate levels of Korean women are strikingly similar. We will briefly explore these parallels in an attempt to understand whether folic acid fortification of the food supply in Korean might be worth consideration.

Review on Predictors of Weight Loss Maintenance after Successful Weight Loss in Obesity Treatment (비만치료에 있어서 감량 후 체중 유지에 영향을 주는 요인에 관한 고찰)

  • Kwon, Yu-Kyung;Kim, Seo-Young;Lim, Young-Woo;Park, Young-Bae
    • Journal of Korean Medicine for Obesity Research
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    • v.19 no.2
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    • pp.119-136
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    • 2019
  • Objectives: People often fail to maintain their weight even though they have succeeded in weight loss. The purpose of this study was to review previously published study results with regards to the predictive factors associated with weight loss maintenance after successful weight loss. Methods: The authors searched for the articles related to weight loss maintenance after successful weight loss, published up until June 2019 on PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Research Information Sharing Service (RISS), and Koreanstudies Information Service System (KISS). A total of 76 articles were finally selected. From the study results, changeable and unchangeable predictors were extracted, and these predictors were examined according to detailed categories. Results: The changeable predictors of weight loss maintenance included behavioral factors, psychological factors and treatment process-related factors, whereas the unchangeable predictors included genetic and physiological factors, demographic factors, history of treatment on obesity-related factors. The main factors of weight loss maintenance were changeable predictors such as healthy eating habits, dietary intake control, binge eating control, regular exercise and physical activity, depression and stress control, social supports, self-regulation, self-weighing and initial weight loss and unchangeable predictors such as low initial weight and maximum lifetime weight. Conclusions: The results of our review results suggest that changeable and unchangeable predictors of weight loss maintenance should be carefully examined during treatments of obesity.

A Study on the Anorexia and Diet Patterns in Cancer Chemotherapy Patients (항암 화학요법을 받는 환자의 식욕부진 정도와 식이양상에 관한 연구)

  • Choi Eun-Sook;Kim Keum-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.19-35
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    • 1995
  • This study was designed to identify the severity of anorexia and the diet patterns in receiving chemotherapy. The identification of anorexia would provide useful and basic information to oncology nursing care. The subjects of this study were 102 hospitalized chemotherapy patients in a September 10, 1994. The subjects were 20 years old or above and who agreed to participate in this study and could understand the questionnaire. Three-days diet history were collected and analysed. The study subjects change, food aversions, the severity of anorexia. Data related to demographic and other mecdical characteristics such as age, diagnosis, and medication were collected by review of patient medical record. The results of this study were summarized as follows : 1) The score of anorexia was 73.7 in Anorexia Visual Analogue Scales and mean amount of fool intake per a day was 823cc. The larger the anorexia VAS score, the more severe of anorexia. 2) The food preferences of subjects were identified. Those were aversions, or dislikes the meat such as beef, pork, and chicken, and greesy or fried foods. The Caffeinated drinks such as coffee and tea were disgusted, also. The patients preferred vegetables and Korean traditional food especially kimchee and soy bean soap. 3) Those who were administered analgesics and cisplatin suffered more severe in anorexia than those who analgesics and cisplatin was not administarted. The patients with gastrointestinal cancer has more severe anorexia than those who have the other site cancer ; head and neck, genirourinary etc. The result of this study in turn provide valuable nursing practice guidelines for nutritional counseling in cancer chemotherapy patient. Nurses working with chemotherapy ward should identify the severity of anorexia and diet patterns. In conclusion, the severity of anorexia in cancer chemotherapy patients is very important problems. Health care personnels recognize the potential problems of anorexia and encourage the nutritional counseling in cancer chemotherapy patients.

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A Study for Suggestion of Quantitative Scale for Dysmenorrhea in Clinics (한의원에서 사용 가능한 정량적인 월경곤란증 평가지표 개발)

  • Park, Jeong-Su;Park, Sun-Ju;Gim, Gyeong-Hun;Kim, Woon-Ji;Choi, Hyeong-Sim;Choi, Han-Seok;Choi, Youn-Kyung;Cho, Jung-Hoon;Shin, Young-Chul;Ko, Seong-Gyu
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.1
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    • pp.144-161
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    • 2011
  • Objectives: Oriental Medicine has thousands years of history. But this era, every medical decision should be based on scientific evidence, that is evidence-based medicine (EBM). This study is to suggest quantitative case report form for dysmenorrhea that can be easily used in clinics. Methods: First, to search published papers in Korea and overseas, OASIS, KISS and NCBI(pubmed) database. Second, to search clinical trials in clinical trial register website, ISRCTN and clinicaltrials.gov. Result: Visual Analogue Scale(VAS) is the most commonly used scale. Conclusion: The main scales for dysmenorrhea are Visual Analogue Scale(VAS), Multidimensional verbal Rating scale(MVRS), pain-killer intake amount and restriction of daily life activities. To measure the effect of herbal medicine, more than 2 menstrual cycle is recommended.

Curating the Korean Medical Classics Curriculum with a Focus on Its Introductory Role to Clinical Korean Medicine (임상한의학입문 역할을 반영한 원전학 수업 설계)

  • Jo, Na-young;Jo, Hak-jun
    • Journal of Korean Medical classics
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    • v.34 no.2
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    • pp.1-22
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    • 2021
  • Objectives : A transition course of 'Introduction to Clinical Korean Medicine' was developed to meet the demands for better preparation for clinical application of Korean Medicine within the curriculum. A Korean Medical Classics curriculum reflecting such demands was newly designed. Methods : Based on the 'Introduction to Clinical Medicine(ICM)' course of the Medical School curriculum that follows the medical education guideline, the 'Introduction to Clinical Korean Medicine(ICKM)' course was designed and developed. The role of Korean Medical Classics was suggested in the process. Results : In the following course, Korean Medical diagnosis, diagnostics, patient intake methods reflecting the Korean Medical diagnostic system, clinical skills, basic skills, treatment planning, patient education, etc. are included. Faculty members of the basic sectors of the Korean Medical school will participate in this curriculum, of which a head will be appointed to overlook the curriculum. In the case of Korean Medical Classics, previous learning outcomes need to be reorganized based on clinical expression while clinical case studies need to be added to course material. A more active approach utilizing new pedagogic strategies and teaching methods should be taken. Conclusions : The Korean Medical Classics curriculum could effectively take on the introductory role to clinical Korean Medicine, successfully strengthening the connection between the basic and clinical Korean Medicine to improve learners' satisfaction.

Trend of Domestic Fig Industry and its Implications

  • Lim, Jeeyoung;You, Jihye;Park, Junhong;Moon, Junghoon
    • Agribusiness and Information Management
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    • v.10 no.1
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    • pp.16-25
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    • 2018
  • Fig is a fruit of which the flesh is very sweet, and it is a tree which has been grown for fruit in Korea since long time ago. However, since the flesh of fig tends to be easily softened, commercial cultivation of this fruit began later than that of other fruit trees grown for profit, however, the cultivation and demand of fig tend to be increased steadily due to the development of technology for storage and distribution since the 2000s. In addition, as the domestic dining culture is getting diversified, the dishes cooked by using fig as a food material are introduced through diverse foods including dessert, and it is possible to intake fig in diverse ways, but not through the traditional processed food. Therefore, it is necessary to establish a measure of expanding the consumption of fig as a processed food, and it will be possible to overcome the limitation of short storage period, while securing the competitiveness of the fig industry. In this research, we have studied the history of domestic fig cultivation, current status of it and status of processed foods through related documents and materials, and the characteristics of the consumers who purchase figs. Fig is a traditional fruit, however, we could find out the fact that the consumers tend not to recognize it as a traditional one. Therefore, if we could add fig to various processed foods utilizing its sweet taste, rather than increasing the consumption of fresh fruits, it may increase the consumption of it.

Isotretinoin exposure in pregnant women in Korea

  • Kim, Nae Ry;Yoon, So Ra;Choi, June Seek;Ahn, Hyun Kyong;Lee, So-Young;Hong, Dal Soo;Yun, Jeong Sup;Hong, Seong Yeon;Kim, Yoon Ha;Han, Jung Yeol
    • Obstetrics & gynecology science
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    • v.61 no.6
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    • pp.649-654
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    • 2018
  • Objective Isotretinoin is a notorious teratogen otherwise used for the treatment of acne vulgaris. Some countries, including those in North America and the European Union, implemented the pregnancy prevention program (PPP); however, no PPP has yet been established in South Korea. So the aim of this study was to evaluate the rate of pregnant women exposed to isotretinoin among the callers of the Korean Mother Safe Counseling Center. Methods This is a prospective cohort study. We evaluated the demographic characteristics, obstetric history, and isotretinoin exposure of pregnant women based on the mother safe registry from April 2010 to July 2016. Results Among 22,374 callers, 650 (2.9%) pregnant women were exposed to isotretinoin. The mean age was $29.0{\pm}4.4$ years in the isotretinoin-exposed group and $32.0{\pm}4.2$ years in the unexposed group (P<0.001). Moreover, the incidence of pregnancies within 30 days after isotretinoin discontinuation or during isotretinoin intake was 78.9% (513/650). The median duration of isotretinoin exposure was 18 (1-4,231) days. Furthermore, from 2011 to 2015, the incidence of isotretinoin exposure was $2.9{\pm}1.2$ pregnancies per 10,000 births in South Korea. Conclusion Approximately 80% of pregnant women are exposed to isotretinoin within the recommended 30 days of contraception or during pregnancy. Therefore, the PPP has to be established in South Korea.

Complementary health education and clinical guidance for treating women experiencing infertility along with unexplained resistant hyperprolactinemia

  • Atef M.M. Darwish;Dina A.M. Darwish
    • Journal of Medicine and Life Science
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    • v.20 no.4
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    • pp.158-165
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    • 2023
  • This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

A Web-based Internet Program for Nutritional Assessment and Diet Prescription by Renal Diseases (웹기반의 신장질환별 영양평가 밑 식사처방 프로그램)

  • 한지숙;김종경;전영수
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.847-885
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    • 2002
  • The purpose of this study was to develop a web-based internet program for nutritional assessment and diet Prescription by renal diseases. Renal diseases were classified by nephrotic syndrome, renal failure, hemodialysis and peritoneal dialysis. The system consisted of five parts according to their functions and contents. The first part is to assess the general health status such as body weight, obesity index, basal metabolic rate and total energy requirement by the input of age, sex, height, weight and degree of activity. The second part was designed to investigate dietary history of patient, that is, to find out his inappropriate dietary habit and give him some suggestions for appropriate dietary behavior by investigating his dietary history. This part also offers the diet and nutrition management by personal status with renal disease, and the information for food selection, snacks, convenience foods, dine-out, behavioral modification, cooking methods, food exchange lists and terms. The third part is evaluating their energy and nutrients intake by comparing with recommended dietary allowance for Koreans or standardized data for patient with renal disease. In this part, it is also analyzing energy and nutrients of food consumed by food group and meals, and evaluating the status of nutrient intake. The fort]1 one, a major part of the system, is implementing the diet and menu planning by using food exchange lists. This Part Provides the patient with menus lists and I day menu suitable to his weight, activity and the status of renal disease. The fifth part is providing information on energy and nutrients of foods and drinks, and top 20 foods classified by nutrients. These results are finally displayed as tabular forms and graphical forms on the computer screen.

A Cohort Study on Risk Factors for Chronic Liver Disease: Analytic Strategies Excluding Potentially Incident Subjects (만성간질환 위험요인에 대한 코호트연구: 잠재적 발병자 집단을 감안한 분석전략)

  • Kim, Dae-Sung;Kim, Dong-Hyun;Bae, Jong-Myun;Shin, Myung-Hee;Ahn, Yoon-Ok;Lee, Moo-Song
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.452-458
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    • 1999
  • Objectives: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. Methods: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox's model were used for potentially diseased group, other members, and total subjects, respectively. Results: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk. while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. Conclusions: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.

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