Purpose: There is an increasing number of colorectal cancer survivors in South Korea. However, no research has identified supportive care needs of survivors of colorectal cancer in South Korea. Thus, the purpose of this study was to determine the level of supportive care needs and effects of emotional state and quality of life (QoL) on supportive care needs of colorectal cancer survivors. Methods: This cross-sectional study was conducted among 115 survivors of colorectal cancer in South Korean who had primary treatment of surgery for colorectal cancer. Data were collected from April to September 2016. Participants responded to self-reported questionnaires assessing supportive care needs, emotional state (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Colorectal scale). Results: The overall score of supportive care needs for colorectal cancer survivors was 1.22 ± 0.61 (full score: 3 points), with health care staff and social support needs garnering highest scores. Approximately, 20.0% and 21.7% of patients had anxiety and depression, respectively. The mean QoL score was 2.90 ± 0.53, with social and family status having the lowest QoL score. Multiple regression analysis showed that both the period after treatment and anxiety significantly influenced supportive care needs. Conclusion Appropriate interventions should be used immediately after completion of treatment to help reduce anxiety and meet supportive care needs of colorectal cancer survivors.

Purpose: There is an increasing number of colorectal cancer survivors in South Korea. However, no research has identified supportive care needs of survivors of colorectal cancer in South Korea. Thus, the purpose of this study was to determine the level of supportive care needs and effects of emotional state and quality of life (QoL) on supportive care needs of colorectal cancer survivors. Methods: This cross-sectional study was conducted among 115 survivors of colorectal cancer in South Korean who had primary treatment of surgery for colorectal cancer. Data were collected from April to September 2016. Participants responded to self-reported questionnaires assessing supportive care needs, emotional state (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Colorectal scale). Results: The overall score of supportive care needs for colorectal cancer survivors was 1.22 ± 0.61 (full score: 3 points), with health care staff and social support needs garnering highest scores. Approximately, 20.0% and 21.7% of patients had anxiety and depression, respectively. The mean QoL score was 2.90 ± 0.53, with social and family status having the lowest QoL score. Multiple regression analysis showed that both the period after treatment and anxiety significantly influenced supportive care needs. Conclusion Appropriate interventions should be used immediately after completion of treatment to help reduce anxiety and meet supportive care needs of colorectal cancer survivors.

Nonalcoholic fatty liver disease (NAFLD) is more prevalent in diabetic patients than in non-diabetic subjects, because the two diseases share a common pathophysiological mechanism. Associated abnormalities can be observed from the pre-diabetic stage. Lifestyle intervention, including diet, exercise, and weight loss, is the primary recommended therapy for NAFLD. Among the therapeutic drugs for NAFLD treatment, anti-diabetic agents are aimed at improving or slowing the progression of NAFLD in addition to lowering blood glucose. In this paper, we systemically review the evidence surrounding antidiabetic medications and their ability to improve disease progression in patients with NAFLD.
Blood Glucose ; Diabetes Mellitus ; Diet ; Disease Progression ; Humans ; Incretins ; Life Style ; Non-alcoholic Fatty Liver Disease* ; Sodium-Glucose Transporter 2 ; Thiazolidinediones ; Weight Loss

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in both developed and developing countries and is an important risk factor for both hepatic and cardiometabolic mortality. Despite decades of clinical trials, effective treatment options for NAFLD are limited, requiring novel therapeutic approaches to prevent disease development and progression to cirrhosis and cancer. Recently, bile acids have emerged as signaling molecules and metabolic regulators that can activate signaling mediated by nuclear receptors and G protein-coupled receptors to regulate hepatic lipid, glucose, and energy homeostasis, as well as its own synthesis and transport in the liver and intestine. Many recent studies have reported that the activation or modulation of bile acid signaling mediated by bile acid receptors favorably affects both insulin sensitivity and NAFLD pathogenesis at multiple levels, suggesting that these approaches hold promise as novel therapies. In this review, we provide an overview of the role of bile acids, in particular, their signaling related to the nuclear receptor farnesoid X receptor in NAFLD and new insights into the possible approach of targeting bile acid-related pathways in the treatment of this serious disease.
Bile Acids and Salts ; Bile ; Developing Countries ; Fibrosis ; Gastrointestinal Microbiome ; Glucose ; Homeostasis ; Insulin Resistance ; Intestines ; Liver ; Liver Diseases ; Metabolism ; Mortality ; Non-alcoholic Fatty Liver Disease ; Receptors, Cytoplasmic and Nuclear ; Risk Factors

The aim of this study is to determine whether the 65 competencies, defined in “the role of Korean doctor, 2014”, are suitable for basic medical education phase in Korea. It seeks to analyze the gap among the educational reality and expectation, assessment situation of the competencies above. We also try to define issues of the development, application and assessment phases of competency-based medical education (CBME) at individual medical schools. We designed survey tools based on the Miller's assessment pyramid (knowledge, explanation, demonstration, and performance) for each of the 65 competencies. The survey distributed to 41 medical schools in April 2015 and 38 replies were received (92.7%). Competencies that matched both the educational reality and expectation were numbers 1 (patient care), 33 (social accountability), and 49 (professionalism). However, all the other competencies ranked lower in current status than that of desirable level. 54 out of 65 competencies (83.07%) remained at the knowledge and explanation level when each competence were assessed. In the development, application, and assessment phases of CBME, common issues that medical schools commonly noted were difficulty linking competencies to curriculum preparation and student assessment, the lack of faculty's understanding, difficulty to reach consensus among faculties, and absence of teaching and learning methods and assessment tools that fits CBME. For the successful settle down of CBME, there is a need for efforts to develop the model of graduate outcomes, to share information and experience, and to operate faculty development program by the medical education communities.
Consensus ; Curriculum ; Education, Medical ; Humans ; Korea ; Learning ; Mental Competency ; Needs Assessment ; Schools, Medical

No abstract available.
Adiponectin ; Cardiovascular Diseases

BACKGROUND: Childhood cancer survivors have been reported to have an increased risk of prevalence of metabolic syndrome compared to the normal population. The purpose of this study was to investigate the prevalence of the components of metabolic syndrome in childhood cancer survivors in a single institute.METHODS: The study included survivors who had survived for at least 5 years after off chemotherapy without evidence of recurrence. We measured body mass index (BMI), triglycerides (TG), high-density lipoprotein (HDL)-cholesterol, systolic and diastolic blood pressure, and fasting glucose.RESULTS: We investigated 58 childhood cancer survivors, median age 5.4 years (range, 0.1-17.2 years) at diagnosis and median follow-up time elapsed after off chemotherapy 7.4 years (range, 4.7-18.6 years). The frequency of metabolic syndrome was 3.4%. The prevalence of each component was: obesity, 17.2%; elevated TG level, 46.6%; low HDL cholesterol, 34.5%; elevated blood pressure, 1.7%; and elevated fasting glucose, 9.3%, respectively. Sixty nine percentage of survivors had at least 1 abnormal component of metabolic syndrome. The increased TG level was found more frequently in obese subjects than normal weight subjects.CONCLUSION: We observed the high incidence of increased TG level in childhood cancer survivors. It is necessary to be closely monitored the components of metabolic syndrome in childhood cancer survivors, in order to prevent them from cardiovascular diseases and improve their health outcomes.
Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol, HDL ; Diagnosis ; Drug Therapy ; Fasting ; Follow-Up Studies ; Glucose ; Humans ; Incidence ; Lipoproteins ; Obesity ; Prevalence ; Recurrence ; Survivors ; Triglycerides

Objectives: We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK). Methods: This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic. Results: TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003). Conclusion TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.

BACKGROUND: Previously, cutaneous lymphomas were classified according to either the European Organization for the Research and Treatment of Cancer (EORTC) or the World Health Organization (WHO) classification paradigms. The aim of this study was to determine the relative frequency of Korean cutaneous lymphoma according to the new WHO-EORTC classification system. METHODS: A total of 517 patients were recruited during a recent 5 year-period (2006-2010) from 21 institutes and classified according to the WHO-EORTC criteria. RESULTS: The patients included 298 males and 219 females, and the mean age at diagnosis was 49 years. The lesions preferentially affected the trunk area (40.2%). The most frequent subtypes in order of decreasing prevalence were mycosis fungoides (22.2%), peripheral T-cell lymphoma (17.2%), CD30+ T-cell lymphoproliferative disorder (13.7%), and extranodal natural killer/T (NK/T) cell lymphoma, nasal type (12.0%). Diffuse large B-cell lymphoma accounted for 11.2% of cases, half of which were secondary cutaneous involvement; other types of B-cell lymphoma accounted for less than 1% of cases. CONCLUSIONS: In comparison with data from Western countries, this study revealed relatively lower rates of mycosis fungoides and B-cell lymphoma in Korean patients, as well as higher rates of subcutaneous panniculitis-like T-cell lymphoma and NK/T cell lymphoma.
Academies and Institutes ; Classification* ; Diagnosis ; Female ; Humans ; Korea ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphoproliferative Disorders ; Male ; Mycosis Fungoides ; Prevalence ; T-Lymphocytes ; World Health Organization