No abstract available.
Pulmonary Blastoma*

OBJECTIVES: This study was performed to compare health value cognition and health promotion behavior compliance between healthy group and not being healthy group, and to evaluate the difference of health promotion behaviors compliance between high group and low group in health value cognition. METHODS: The subjects of this study were 565 workers, 233 healthy workers, 172 observation cases and 160 disease cases, selected from 4,919 transit coporations workers. RESULTS: In health promoting behavior compliance, not being healthy group showed lower level than healthy group in exercise and showed higher level than healthy group in interpersonal support significantly. A worker who replied on health as the most value in life was consisted in 37.3% of healthy group and 36. 1% of not being healthy group, Health value cognition according to general characteristics showed no significant difference except only variable of age in healthy group. Health promoting behavior compliance according to cognition of health value showed in healthy group that a high level group of health value cognition was more significant difference than a low level group in self actualization and health responsibility of health promoting behavior and didn't show difference significantly in not being healthy group. CONCLUSIONS: In conclusion, the relationship between health value cognition, health promotion behavior compliance and periodic health examination results showed weakly. Therefore, in order to develop and apply spontaneous health promotion program, it was considered that should emphasize compliance than cognition.
Cognition* ; Compliance ; Health Promotion*

Background/Aims: Sarcopenia negatively affects the prognosis of cirrhotic patients, but clinical implications of changes in muscle mass remain unclear. We aimed to elucidate its role in the prognosis of outpatients with cirrhosis. Methods: Patients with cirrhosis who underwent annual abdominal computed tomography (CT) for hepatocellular carcinoma surveillance were included in the prospective cohort. The L3 skeletal muscle index (SMI) was adopted as a proxy for the amount of skeletal muscle, and the rate of SMI change between inclusion and after 1 year (ΔSMI/yr%) was calculated. Results: In total, 595 patients underwent a second CT after 1 year. Among them, 109 and 64 patients had sarcopenia and Child-Pugh class B/C decompensation at inclusion, which changed to 103 and 45 at the 1-year follow-up, respectively. During a median follow-up of 30.1 months after 1 year, 86 patients had at least one cirrhosis complication, and 18 died or received liver transplantation. In the development of cirrhosis complications, ΔSMI/yr% was independently associated, even after adjusting for the Child-Pugh and model for end stage liver disease (MELD)-Na scores. In addition, ΔSMI/yr% showed a good predictive performance for the development of cirrhosis complications within 6 months after 1-year follow-up in all subgroups, with a cut-off of -2.62 (sensitivity, 83.9%; specificity, 74.5%) in the overall population. SMI at 1-year and Child-Pugh score were independent factors associated with survival. In addition, changes in sarcopenia status significantly stratified survival. Conclusion ΔSMI/yr% was a good predictor of the development of cirrhosis complications in outpatients with cirrhosis, independent of Child-Pugh and MELD scores.

Background/Aims: Besifovir dipivoxil maleate (BSV) and tenofovir alafenamide fumarate (TAF) have been recently approved in Korea as the initial antiviral agents for chronic hepatitis B (CHB).However, the real-world outcome data for these drugs remain limited. Therefore, we conducted a noninferiority analysis using real-world data to compare the clinical outcomes of the two nucleotide analogs in treatment-naïve patients with CHB. Methods: We retrospectively investigated a cohort of patients with CHB who received BSV or TAF as first-line antiviral agents. The endpoints were virological response (VR) and liver-related clinical outcomes. Results: A total of 537 patients, consisting of 202 and 335 patients administered BSV and TAF, respectively, were followed up for 42 months. No significant difference was observed between the VRs of the patients from the two groups. The rates of biochemical response, virologic breakthrough, and incidence rates of hepatocellular carcinoma did not differ between the groups. However, the hepatitis B e antigen seroclearance rate was higher and the renal function declined less in the BSV group. Multivariable analysis indicated older age, alcohol abuse, cirrhosis and ascites, and lower serum HBV DNA level to be independently associated with increased hepatocellular carcinoma risk. The 1:1 propensity score-matched analysis with 400 patients showed VR rates of 85.0% and 88.7% in the BSV and TAF group patients, respectively, at 2 years. The absolute value of the 95% confidence interval for the difference (–0.04 to 0.12) satisfied the a priori limit of a noninferiority of 0.15. Conclusions BSV is noninferior to TAF in terms of VR, and their clinical outcomes are comparable to CHB.

BACKGROUND: Tumor growth and metastasis depend on angiogenesis. Angiogenesis correlates with the expression of vascular endothelial growth factor (VEGF) and with the prognosis in some cancers. Angiogenesis may also play an important role in the growth and the metastasis of thyroid cancer. We determine whether the expression of VEGF and its receptors (flk-1/KDR, flt-1) correlates with vascularity, invasion to adjacent structure and lymph node metastasis of thyroid cancers. METHODS: Sixty-five specimens obtained from patients with benign thyroid disease and thyroid cancers investigated by immunohistochemical staining for factor VIII, VEGF, flk-1/KDR and flt-1. Vessels were counted by light microscopy (x200), and the intensity of staining for VEGF and receptors was assessed on a scale of 1 to 4 . Correlations between the expression of VEGF, microvessel density and various clinicopathologic factors were analyzed. RESULTS: 1) There were no differences in microvessel counts and expressions of VEGF and its receptors among sex, age and tumor size. 2) Microvessel counts in thyroid cancers (mean SD: 91.1+/-30.4, x200), especially anaplastic cancers (159.0+/-14.1) were higher than in follicular adenomas (56.3 13.6). 3) The expressions of VEGF, flk-1/KDR and flt-1 were higher in thyroid cancers (2.7+/-1.0, 2.1+/-0.9, 2.2+/-0.9) than in follicular adenomas (1.4+/-0.5, 1.4+/-0.5, 1.4+/-0.5), the expressions of VEGF, flk-1/KDR and flt-1 in anaplastic cancers (3.8+/-0.5, 3.8+/-0.5, 3.5+/-0.6) were higher than in differentiated cancers (papillary and follicular). But there were no differences of microvessel density and the intensity of VEGF, flk-1/KDR and flt-1 expression between absence and presence of the invasion to adjacent structure and lymph node metastasis in cancers. 4) The intensity of VEGF expression correlated with microvessel densities and that of its receptors. CONCLUSION: Angiogenesis and VEGF expression in thyroid cancer correlated with the grade of differentiation. But we did not found any differences in angiogenesis and VEGF expression with or without invasion to adjacent structures and lymph node metastasis in differentiated thyroid cancer. In the future, further study, including recurrent and distant metastatic thyroid cancers, will be needed.
Adenoma ; Factor VIII ; Humans ; Lymph Nodes ; Microscopy ; Microvessels* ; Neoplasm Metastasis ; Prognosis ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms* ; Vascular Endothelial Growth Factor A*

The aim of this study was to investigate respondents' satisfaction with smart device-based testing (SBT), as well as its convenience and advantages, in order to improve its implementation. The survey was conducted among 108 junior medical students at Kyungpook National University School of Medicine, Korea, who took a practice licensing examination using SBT in September 2015. The survey contained 28 items scored using a 5-point Likert scale. The items were divided into the following three categories: satisfaction with SBT administration, convenience of SBT features, and advantages of SBT compared to paper-and-pencil testing or computer-based testing. The reliability of the survey was 0.95. Of the three categories, the convenience of the SBT features received the highest mean (M) score (M= 3.75, standard deviation [SD]= 0.69), while the category of satisfaction with SBT received the lowest (M= 3.13, SD= 1.07). No statistically significant differences across these categories with respect to sex, age, or experience were observed. These results indicate that SBT was practical and effective to take and to administer.
Gyeongsangbuk-do ; Humans ; Korea* ; Licensure ; Personal Satisfaction ; Republic of Korea ; Students, Medical* ; Tablets

The global burden of hepatitis B virus (HBV) infection is profound, and represents a public health threat as chronic infection can lead to liver cirrhosis, hepatocellular carcinoma, and death. The risk factors for chronic hepatitis B-related liver disease differ according to HBV endemicity, hepatitis B e-antigen seropositivity, and viral load. It is important to identify these risk factors and start antiviral treatment at an appropriate time according to current guidelines. The most crucial step in reducing HBV infection is prevention in infancy or early childhood, as infection at an early stage may lead to chronicity. South Korea was formerly an HBV-endemic area, but the epidemiology of HBV infection was changed by the introduction of vaccination in 1983 and nationwide immunization in 1995. The government and the private sector made efforts to reduce the prevalence of HBV infection, and Korea is on target to meet the World Health Organization goal of eliminating viral hepatitis by 2030. To eliminate hepatitis worldwide, the costs of antiviral treatment to prevent perinatal HBV transmission in pregnant women with high viremia should be covered by a national program, and strategies to reduce the prevalence of HBV infection in immigrant populations are needed.

PURPOSE: Smart device-based testing (SBT) is being introduced into the Republic of Korea’s high-stakes examination system, starting with the Korean Emergency Medicine Technician Licensing Examination (KEMTLE) in December 2017. In order to minimize the effects of variation in examinees’ environment on test scores, this study aimed to identify any associations of variables related to examinees’ individual characteristics and their perceived acceptability of SBT with their SBT practice test scores. METHODS: Of the 569 candidate students who took the KEMTLE on September 12, 2015, 560 responded to a survey questionnaire on the acceptability of SBT after the examination. The questionnaire addressed 8 individual characteristics and contained 2 satisfaction, 9 convenience, and 9 preference items. A comparative analysis according to individual variables was performed. Furthermore, a generalized linear model (GLM) analysis was conducted to identify the effects of individual characteristics and perceived acceptability of SBT on test scores. RESULTS: Among those who preferred SBT over paper-and-pencil testing, test scores were higher for male participants (mean± standard deviation [SD], 4.36± 0.72) than for female participants (mean± SD, 4.21± 0.73). According to the GLM, no variables evaluated— including gender and experience with computer-based testing, SBT, or using a tablet PC—showed a statistically significant relationship with the total score, scores on multimedia items, or scores on text items. CONCLUSION: Individual characteristics and perceived acceptability of SBT did not affect the SBT practice test scores of emergency medicine technician students in Korea. It should be possible to adopt SBT for the KEMTLE without interference from the variables examined in this study.
Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Female ; Humans ; Korea ; Licensure ; Linear Models ; Male ; Multimedia ; Personal Satisfaction ; Republic of Korea

The pathogenesis of hepatocellular carcinoma (HCC) is a complex process. During the last decade, advances in genomic technologies enabled delineation of the genomic landscape of HCC, resulting in the identification of the common underlying molecular alterations. The tumor microenvironment, regulated by inflammatory cells, including cancer cells, stromal tissues, and the surrounding extracellular matrix, has been extensively studied using molecular data. The integration of molecular, immunological, histopathological, and clinical findings has provided clues to uncover predictive biomarkers to enhance responses to novel therapies. Herein, we provide an overview of the current HCC genomic landscape, previously identified gene signatures that are used routinely to predict prognosis, and an immune-specific class of HCC. Since biomarker-driven treatment is still an unmet need in HCC management, translation of these discoveries into clinical practice will lead to personalized therapies and improve patient care, especially in the era of targeted and immunotherapies.
Biomarkers ; Carcinoma, Hepatocellular ; Extracellular Matrix ; Humans ; Immunotherapy ; Pancreatic Pseudocyst ; Pancreatitis ; Patient Care ; Prognosis ; Stromal Cells ; Tumor Microenvironment

PURPOSE: Smart device-based testing (SBT) is being introduced into the Republic of Korea’s high-stakes examination system, starting with the Korean Emergency Medicine Technician Licensing Examination (KEMTLE) in December 2017. In order to minimize the effects of variation in examinees’ environment on test scores, this study aimed to identify any associations of variables related to examinees’ individual characteristics and their perceived acceptability of SBT with their SBT practice test scores. METHODS: Of the 569 candidate students who took the KEMTLE on September 12, 2015, 560 responded to a survey questionnaire on the acceptability of SBT after the examination. The questionnaire addressed 8 individual characteristics and contained 2 satisfaction, 9 convenience, and 9 preference items. A comparative analysis according to individual variables was performed. Furthermore, a generalized linear model (GLM) analysis was conducted to identify the effects of individual characteristics and perceived acceptability of SBT on test scores. RESULTS: Among those who preferred SBT over paper-and-pencil testing, test scores were higher for male participants (mean± standard deviation [SD], 4.36± 0.72) than for female participants (mean± SD, 4.21± 0.73). According to the GLM, no variables evaluated— including gender and experience with computer-based testing, SBT, or using a tablet PC—showed a statistically significant relationship with the total score, scores on multimedia items, or scores on text items. CONCLUSION Individual characteristics and perceived acceptability of SBT did not affect the SBT practice test scores of emergency medicine technician students in Korea. It should be possible to adopt SBT for the KEMTLE without interference from the variables examined in this study.