Street vended food (SVF) includes food and beverages prepared and sold outdoors or in public areas by street merchants for consumption on the scene or later without further preparation. Due to its low price and convenience, SVF has been popular in Korea for a long time, particularly with high school students. Beyond Korea, SVF is also popular in southeast Asia and southern Africa in the form of ready-to-eat food. This study on high school students, who are main consumers of SVF in Korea, focused on the factors that affect consumer loyalty. The study was performed by questionnaire and used AMOS software to develop a structural equation model. The results of verifying the model's fidelity were chi2 = 685.989, df = 261, GFI = 0.851, AGFI = 0.814, NFI = 0.901, CFI = 0.907, RMR = 0.048, indicating a satisfying structural model. SVF quality and service, emotional response, and the physical environment had a statistically significant effect on consumer loyalty. In contrast, SVF sanitation had no statistically significant effect on consumer loyalty. Based on these results, the sanitary management of SVF needs to be addressed immediately combined with education for SVF providers to maintain a clean environment.
Africa, Southern ; Aminopeptidases ; Asia, Southeastern ; Food and Beverages ; Humans ; Korea ; Models, Structural ; Surveys and Questionnaires ; Sanitation

PURPOSE: Not many studies have evaluated the adoption and dissemination of evidence-based medicine in rectal cancer radiotherapy (RT). We aimed to analyze the differences by institutional characteristics and geography in adopting evidence-based care for rectal cancer RT and factors affecting the adoption in Korea. MATERIALS AND METHODS: Korean National Health Insurance Service claims database was used. All rectal cancer patients treated with radical surgery and adjuvant RT at the same institution in 2005-2016 were included in this study. RT within 3 months before and after surgery was regarded as preoperative and postoperative RT, respectively. RESULTS: A total of 16,827 patients treated in 83 institutions were included in the analysis. The use of preoperative RT has substantially increased over time, from 40.6% in 2005 to 84.2% in 2016 all over the nation. The proportion of preoperative RT (54.8%) exceeded that of postoperative RT (45.2%) in 2006. However, a wide range of institutional and regional variation was observed. Compared to high-volume institutions, low-volume institutions showed late adoption and variable dissemination patterns of preoperative RT. Busan–Ulsan–Gyeongsangnam-do and Gangwon-do showed slower adoption and less use of preoperative RT than other region. CONCLUSION: We demonstrated gradual and steady increase in adoption of preoperative RT in rectal cancer treatment nationally from 2005 to 2016. Institutional variations between high- and low-volume institutions were observed.
Evidence-Based Medicine* ; Gangwon-do ; Geography ; Humans ; Korea ; National Health Programs ; Radiotherapy* ; Rectal Neoplasms*

Purpose: The purpose of this study was to investigate the influence and relationship among anxiety, depression, self-esteem, and quality of life, along with factors affecting quality of life, on patients with rheumatoid arthritis. Methods: This study was a cross-sectional descriptive study, and 200 individuals with rheumatoid arthritis who visited a single university hospital as outpatients were recruited through convenience sampling. Using a structured questionnaire, a survey was conducted regarding the general characteristics, anxiety, depression, self-esteem, and quality of life. Collected data were analyzed using t-test, ANOVA, and regression analysis. Results: Results showed that lower levels of anxiety or depression and higher levels of self-esteem were associated with improved quality of life. Depression was identified as the main factor affecting quality of life, followed by anxiety, glucocorticoid treatment, time elapsed after diagnosis, and occupational status. Conclusion These findings confirmed that depression, anxiety, and glucocorticoid medication are factors influencing quality of life in patients with rheumatoid arthritis, Duration since diagnosis, and occupation should be considered in order to improve the quality of life of these patients with rheumatoid arthritis. The occupation and treatment-related characteristics of the patients must be considered, with particular focus on depression and anxiety.

Cervicogenic vertigo was known as Bow hunter's syndrome. Occlusion of vertebral artery causes vertebrobasilar insufficiency and we reported cervicogenic vertigo case which was treated by simple decompression of transverse foramen of C1. The patient was 48 years old female who had left side dominant vertebral artery and vertigo was provoked when she rotated her head to right side. Angiography showed complete obliteration of blood flow of left vertebral artery when her head was rotated to right side. The operation was decompression of left vertebral artery at C1 level. Posterior wall of transverse foramen was resected and vertebral artery was exposed and decompressed. After surgery, vertigo of the patient was disappeared, and angiography showed patent left vertebral artery when her head was rotated to right side. Vertigo caused by compression of cervical vertebral artery could be treated by decompression without fusion or instrumentation, especially in C1 transverse foramen.
Angiography ; Decompression* ; Female ; Head ; Humans ; Mucopolysaccharidosis II ; Vertebral Artery ; Vertebrobasilar Insufficiency ; Vertigo*

OBJECTIVES: The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. METHODS: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). RESULTS: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. CONCLUSIONS: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.
Classification ; Health Policy ; Humans ; Inpatients ; National Health Programs ; Seoul ; Tertiary Care Centers

OBJECTIVES: The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. METHODS: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). RESULTS: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. CONCLUSIONS The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

A 71-year-old woman presented with an enlarging mass in the right buttock, with pain and tingling sensation in sitting position. Five years ago, she was diagnosed with acute limb ischemia due to acute thrombosis of right persistent sciatic artery (PSA), and she underwent successful thromboembolectomy and femoro-tibioperoneal trunk bypass. Computed tomography angiography revealed a huge PSA aneurysm (PSAA). During the previous bypass, the distal popliteal artery was ligated just above the distal anastomosis to exclude the PSAA, whose proximal end was already thrombosed. However, PSAA has grown to cause compression symptoms, and the mechanism of aneurysm growth can be ascribed to type 1a or type 2 endoleak. In order to relieve the compression symptoms, aneurysm excision was performed without any injury to the sciatic nerve. A postoperative tingling sensation due to sciatic-nerve stimulation in the supine position resolved spontaneously one month after surgery.
Aged ; Aneurysm* ; Angiography ; Arteries* ; Buttocks ; Congenital Abnormalities ; Endoleak ; Extremities ; Female ; Humans ; Ischemia ; Popliteal Artery ; Sciatic Nerve ; Sciatica ; Sensation ; Supine Position ; Thrombosis

Phytochemicals were isolated from leaves of the fiber crop, ramie (Boehmeria nivea, Bn), using open column chromatography and medium pressure liquid chromatography. Their structures were identified as β-sitosterol, (-)-loliolide, rutin, and pyrimidinedione by MS, ¹H-, and ¹³C-NMR spectroscopic analysis. Among them, (-)-loliolide was isolated for the first time from B. nivea. A content analysis of (-)-loliolide in B. nivea collected from different regions and harvest times was conducted by HPLC. The highest content of (-)-loliolide was found in Bn-23 harvested in September. These results will be helpful to use the plant which harvest in September as a high content phytochemical additive in food, health supplements, and medicinal products.
Boehmeria* ; Chromatography ; Chromatography, High Pressure Liquid* ; Chromatography, Liquid ; Phytochemicals ; Plants ; Rutin ; Urticaceae

A germacrane-type sesquiterpenoid was isolated and purified from a methanol extract of the roots of Valeriana fauriei (RVF) through open column chromatography using silica gel. This compound was verified to be heishuixiecaoline A by spectroscopic analysis. This compound was isolated for the first time from RVF.Quantitative analysis of heishuixiecaoline A from RVF cultivated from three different regions (Eumseong, Jinbu, and Jinan regions) was performed by combining high-performance liquid chromatography with a photodiode array detector. The extract of RVF cultivated in the Jinbu region showed the highest content (9.23 mg/g). In addition, a significant amount of the compound was detected in all RVF samples, which could be expected since it is a characteristic compound of RVF. The sesquiterpenoid group heishuixiecaoline A was isolated from RVF, a resource for various pharmacological substances, and quantitative analysis of RVF cultivated from three different regions was performed. As a result of these experiments, basic data on RVF that can be used in the development and application of pharmaceuticals and health functional foods in the future were obtained.

Background: Mechanical failures of tumor endoprosthesis in the distal femur usually require revision surgery. We investigated if the proximal femur host bone can be salvaged by onlay and overlapping allograft in revision surgeries due to aseptic loosening and stem fractures. Methods: We retrospectively reviewed 18 patients (7 men and 11 women) with osteosarcoma around the knee. The entire cohort was classified into three subgroups (no bone graft: 6, onlay allograft: 7, and overlapping allograft: 5) according to our treatment strategy. Results: The median interval from the initial surgery to the revision was 94.5 months (range, 21–219 months), and the median follow-up period from the revision surgery was 88.0 months (range, 24–179 months). At the last follow-up, 9 of the 18 patients maintained their endoprostheses, and the 5-year prosthesis survival rate was 57.9%. Limb survival was 100%. Five-year prosthesis survival rate was 66.7% in the no bone graft group, 85.7% in the onlay allograft group while 30.0% in the overlapping allograft group. In the no bone graft group and onlay allograft group, 66.7% (4/6) and 57.1% (4/7) maintained their revision prostheses while no prostheses survived in the overlapping allograft group. Recurrent stem loosening was observed in 14.2% (1/7) and 60.0% (3/5) of the onlay allograft and overlapping allograft groups, respectively, despite allograft bone union. The complication rate was 66.7% (12/18) in the entire cohort. The most common type of complication was infection (n = 6), followed by aseptic loosening (n = 4) and mechanical failure (n = 2). Conclusions This study indicates that onlay allograft can be used as a supportive method in revising failed endoprosthesis if the extent of host bone destruction is extensive. However, applying overlapping allograft to secure bone stock showed a high rate of mechanical failures and infection in the long term. Future studies with a larger cohort are necessary to assess the prognostic factors for the higher complication rate in overlapping allograft and the need for overlapping allograft. Surveillance with consideration of the risk of anteromedial osteolysis in allograft and efforts for prevention of periprosthetic infection are essential.