PURPOSE: Although the prevalence rate of chronic diseases is rapidly increasing due to an unhealthy diet in Korea, nurses may not have enough nutritional knowledge to educate their patients. This study investigated the level of nurses' nutritional knowledge for chronic diseases as well as for strokes, and the needs for nurses' nutritional education. METHODS: This research is a descriptive research conducted from April to August of 2014, on 242 nurses who work with stroke patients, in two tertiary general hospitals in the city of Seoul, South Korea. RESULTS: The average nutritional knowledge score of our subjects was 19.9+/-2.51 (range 12-24). The correct response rate was 83% which was higher than expected. However, many nurses (31-66%) answered incorrectly on items such as 'Drinking low-fat milk is better than whole milk', and 'Seasoning with a large amount of soy sauce instead of salt can reduce sodium consumption'. We also found that nurses who received continuing education regarding nutrition scored higher than those who did not (p=.020). There was no correlation between nutritional knowledge and the need for nutritional education (r=.034, p=.601). CONCLUSION: The level of nutritional knowledge of the nurses was relatively low and irrelevant to the completion of nutrition courses during university or duration of experience. Rather, the relevance was higher when the nurse received nutrition-related training after graduating from university. Our results imply that continuous nutritional education is necessary for hospital nurses.
Chronic Disease ; Diet* ; Education ; Education, Continuing ; Hospitals, General ; Humans ; Korea ; Milk ; Prevalence ; Seoul ; Sodium ; Soy Foods ; Stroke*

To study the histopathologic effects and possible collagen fiber alterations in corneal opacification after repeated photorefractive keratectomy(PRK) in human. PRK had been performed five times for 2 and 2/3 years using excimer laser. One year and ten months after last PRK, partial penetrating keratoplasty was performed. The cornea was stained with PAS, Alcian blue, Masson`s trichrome, Congo red. Oil red. O and stained immunohistochemically for collagens type III, IV, VI, VII. It was observed under light microscope(LM) and transmission electron microscope(TEM). LM findings showed thickening of epithelial layers, proliferation of subepithelial fibroblasts and absence of Bowman`s membrane. By TEM, disarray of collagen lamellae and electron dense deposits to adjacent keratocyte were observed. Histochemically, positive staining in Alcian blue, while negative in others. In immunohistochemistry, positive staining for type IV and VI collagens were noted. Corneal opacity after repeated PRK is due to deposits of type IV and VI collagens and acidic mucoprotein in extracelluar matrix, which is positive in Alcian blue stain.
Alcian Blue ; Collagen ; Congo Red ; Cornea ; Corneal Opacity* ; Fibroblasts ; Humans ; Immunohistochemistry ; Keratoplasty, Penetrating ; Lasers, Excimer ; Membranes ; Photorefractive Keratectomy*

Familial adenomatous polyposis (FAP) includes early development of up to thousands of colorectal adenoma and of colonic adenocarcinoma in all untreated cases. Moreover, a variety of extracolonic manifestation are seen. Several reports have demontrated a high incidence of papillry carcinoma of thyroid. We experienced a case of familial adenomatous polyposis, presenting with thyoid papillry carcinoma, and reported with a brief review of literatures.
Adenocarcinoma ; Adenoma ; Adenomatous Polyposis Coli* ; Carcinoma, Papillary* ; Colon ; Incidence ; Thyroid Gland* ; Thyroid Neoplasms

PURPOSE: Recently, social interest in an organized trauma system for the treatment of patients has been increasing in government and academia and the establishment of trauma center is being considered across the country. However, establishing such a system has not been easy in Korea, because enormous experiences and resources are necessary. The objectives of this study were (1) to estimate a trauma patient's demands during the course of treatment and (2) to provide appropriate direction for trauma centers to be established in Korea. METHODS: The records of 207 patients who were admitted to the Department of Trauma Surgery in Ajou University Medical Center due to trauma were retrospectively reviewed for a 1 year period from March 2010 to February 2011. Patients were reviewed for general characteristics, number of hospital days, numbers and kinds of surgeries, numbers and kinds of consultations, ISS (Injury Severity Score) and number of patients with ISS more than 15. RESULTS: All 207 patients were enrolled. The average number of hospital days was 36.7 days. The ICU stay was 15.9 days, and the general ward stay was 20.8 days. Admitted patients occupied 9.02 beds in ICU and 11.80 beds in the general ward per day. The average number of surgeries per patient was 1.4, and surgery at the Department of Trauma Surgery was most common. Number of consultations per patient was 14.23, and consultations with orthopedic surgeons were most common. The average ISS was 18.6. The number of patients with ISS more than 15 was 141 (61.8%) and the average number of patients treated per trauma surgeon as a major trauma patient was 94.3. The number of mortalities was 20, and the mortality rate was 9.7%. CONCLUSION: To reduce mortality and to provide proper treatment of patients with major trauma, hospitals need some number of beds, especially in the ICU, to treat patients and to prepare them for emergent surgery. An appropriate number of trauma surgeons and various specialists for consultation are also needed.
Academic Medical Centers ; Emergencies ; Humans ; Korea ; Orthopedics ; Patients' Rooms ; Referral and Consultation ; Retrospective Studies ; Specialization ; Trauma Centers

PURPOSE: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. METHODS: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. RESULTS: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. CONCLUSION: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.
Advanced Trauma Life Support Care ; Emergencies ; Humans ; Injury Severity Score ; Korea ; Magnetic Resonance Imaging ; Medical Records ; Multiple Trauma ; Porphyrins ; Primary Health Care ; Resuscitation

Promoter CpG island hypermethylation has become recognized as an important mechanism for inactivating tumor suppressor genes or tumor-related genes in human cancers of various tissues. Gene inactivation in association with promoter CpG island hypermethylation has been reported to be four times more frequent than genetic changes in human colorectal cancers. Hepatocellular carcinoma is also one of the human cancer types in which aberrant promoter CpG island hypermethylation is frequently found. However, the number of genes identified to date as hypermethylated for hepatocellular carcinoma (HCC) is fewer than that for colorectal cancer or gastric cancer, which can be attributed to fewer attempts to perform genome-wide methylation profiling for HCC. In the present study, we used bead-array technology and coupled methylation-specific PCR to identify new genes showing cancer-specific methylation in HCC. Twenty-four new genes have been identified as hypermethylated at their promoter CpG island loci in a cancer-specific manner. Of these, TNFRSF10C, HOXA9, NPY, and IRF5 were frequently hypermethylated in hepatocellular carcinoma tissue samples and their methylation was found to be closely associated with inactivation of gene expression. Further study will be required to elucidate the clinicopathological implications of these newly found DNA methylation markers in hepatocellular carcinoma.
Antimetabolites, Antineoplastic/therapeutic use ; Azacitidine/analogs & derivatives/therapeutic use ; Carcinoma, Hepatocellular/drug therapy/*genetics ; Cell Line, Tumor ; CpG Islands ; *DNA Methylation ; GPI-Linked Proteins/genetics ; Gene Expression Profiling ; Homeodomain Proteins/genetics ; Humans ; Interferon Regulatory Factors/genetics ; Liver Neoplasms/drug therapy/*genetics ; Neuropeptide Y/genetics ; Oligonucleotide Array Sequence Analysis ; Promoter Regions, Genetic ; Tumor Necrosis Factor Decoy Receptors/genetics

OBJECTIVE: The objective of this study was to elucidate the relationship between job stress and pulse wave velocity (PWV) as a cardiovascular risk factor. METHOD: The study design was cross-sectional, and a total of 234 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude) using a modified Karasek model. Cuffs were applied to the extremities and a microphone for phonocardiography was placed at the second intercostal space at the margin of the sternum. The subjects rested in a supine position for 5 min, and PWV was measured using a VP-1000(Colin Waveform analyzer). RESULTS: There were significant correlations between blood pressure, glucose, total cholesterol, coagulation factor and PWV. The group with low decision latitude and high decision latitude showed higher levels of PWV, but the differences were not significan. The PWV (left) was significantly higher in the high strain group than in the lower strain group. After adjustment for age and cardiovascular risk factors, job strain was still associated with PWV. CONCLUSION: These result suggest that the high strain group among workers is related to an increased risk of PWV as a marker of atherosclerosis.
Atherosclerosis ; Blood Coagulation Factors ; Blood Pressure ; Cholesterol ; Extremities ; Glucose ; Phonocardiography ; Pulse Wave Analysis* ; Risk Factors* ; Sternum ; Supine Position

DNA methylation is one of the main epigenetic mechanisms and hypermethylation of CpG islands at tumor suppressor genes switches off these genes. To find novel DNA methylation markers in hepatocellular carcinoma (HCC), we performed pharmacological unmasking (treatment with 5-aza-2'-deoxycytidine or trichostatin A) followed by microarray analysis in HCC cell lines. Of the 239 promoter CpG island loci hypermethylated in HCC cell lines (as revealed by methylation-specific PCR), 221 loci were found to be hypermethylated in HCC or nonneoplastic liver tissues. Thirty-three loci showed a 20% higher methylation frequency in tumors than in adjacent nonneoplastic tissues. Correlation of individual cancer-related methylation markers with clinicopathological features of HCC patients (n = 95) revealed that the number of hypermethylated genes in HCC tumors was higher in older than in younger patients. Univariate and multivariate survival analysis revealed that the HIST1H2AE methylation status is closely correlated with the patient's overall survival (P = 0.022 and P = 0.010, respectively). In conclusion, we identified 221 novel DNA methylation markers for HCC. One promising prognostic marker, HIST1H2AE, should be further validated in the prognostication of HCC patients.
Azacitidine/analogs & derivatives/pharmacology ; Carcinoma, Hepatocellular/*genetics/mortality ; Cell Line, Tumor ; CpG Islands ; DNA Methylation/*drug effects ; Down-Regulation ; Female ; Hep G2 Cells ; Humans ; Hydroxamic Acids/pharmacology ; Liver/metabolism ; Liver Neoplasms/*genetics/mortality ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Promoter Regions, Genetic ; Survival Analysis ; Tumor Markers, Biological/*genetics

Purpose: Our study aimed to evaluate the predictive value of multiparametric magnetic resonance imaging (mpMRI)to assess the capsular extension of prostate cancer. Risk factors for extraprostatic invasion or microscopic invasionof bladder neck (pT3a stage) in the cases showing localized disease findings on MRI scan were also identified. Materials and Methods: We identified 198 patients who underwent robot-assisted or conventional laparoscopicradical prostatectomy in our institute between June, 2016 and May, 2018. Altogether, 170 patients withpreoperational mpMRI scans and complete pathologic data were included. Positive and negative predictive valuesof mpMRI to detect capsular extension were estimated. Chi-square test was performed for ratio variables. Logisticregression analysis was performed to identify capsular invasion risk factors. Results: Median age and prostate-specific antigen level were 68 years and 7.5 ng/mL, respectively. Based onfindings, 16 patients (9.4%) were identified as cT3a stage (unilateral or bilateral extraprostatic extension), whereas37 patients (21.8%) as pT3a stage. Positive and negative predictive values of mpMRI to detect capsular extensionwere 75.0% and 73.9%, respectively. In the logistic regression analysis, positive biopsy core rate was the significantpredictor for pT3a disease in the patients with negative capsular invasion findings on mpMRI (p<0.001). Accordingto receiver-operating characteristic curve (area under the curve=0.691, p=0.001), the positive biopsy core rateof 0.275 was the best threshold. Conclusions Multiparametric MRI is an appropriate test to predict pT3a disease preoperatively. The patients withpositive core rate over 0.275 may have pT3a diseases despite negative image findings.

Background: Programmed death ligand 1 (PD-L1) expression cannot currently be predicted through radiological findings. This study aimed to develop a prediction model capable of differentiating between positive and negative PD-L1 expression through a radiomics-based investigation of computed tomography (CT) images in patients with urothelial carcinoma. Methods: Sixty-four patients with urothelial carcinoma who underwent immunohistochemical testing for PD-L1 were retrospectively reviewed. The number of patients in the positive and negative PD-L1 groups (PD-L1 expression >5%) was 14 and 50, respectively. CT images obtained 90 seconds after contrast medium administration were selected for radiomic extraction. For all tumors, 1,691 radiomic features were extracted from CT using a manually segmented three-dimensional volume of interest. Univariate and multivariate logistic regression analyses were performed to identify radiomic features that were significant predictors of PD-L1 expression. For the radiomics-based model, a receiver operating characteristic (ROC) analysis was performed. Results: Among 64 patients, 14 were included in the PD-L1 positive group. Logistic regression analysis found that the following radiomic features significantly predicted PD-L1 expression: wavelet-low-pass, low-pass, and high-pass filters (LLH)_gray-level size-zone matrix (GLSZM)_SmallAreaEmphasis, wavelet-LLH_firstorder_Energy, log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis, original_shape_Maximum2DDiameterColumn, wavelet-low-pass, low-pass, and low-pass filters (LLL)_gray-level run-length matrix (GLRLM)_ShortRunEmphasis, and exponential_firstorder_Kurtosis. The radiomics signature was –4.0934+21.6224 (wavelet-LLH_GLSZM_SmallAreaEmphasis)+0.0044 (wavelet-LLH_firstorder_Energy)–4.7389 (log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis)+0.0573 (original_shape_Maximum2DDiameterColumn)–29.5892 (wavelet-LLL_GLRLM_ShortRunEmphasis)–0.4324 (exponential_firstorder_Kurtosis). The area under the ROC curve model representing the radiomics signature for differentiating cases that were deemed PD-L1 positive based on immunohistochemistry was 0.96. Conclusions This preliminary radiomics model derived from contrast-enhanced CT predicted PD-L1 positivity in patients with urothelial cancer.