OBJECTIVES: This study examined the status of children's favorite foods intake and the relationship with the policy environment based on the Special Act on Safety Control of Children's Dietary Life for suggesting a supportive policy strategy. METHODS: The subjects were 4th grade students (n=1,638) in elementary school from 45 schools collected from seven areas (Seoul, Daegu, Daejeon, Gyeonggi, Chungnam, Jeonbuk, and Gyeongnam). The children participated in a self-administered questionnaire survey in class under the supervision of the teacher. The questionnaire consisted of items, such as social demographic characteristics, frequency of intake of the children's favorite foods, and policy cognition. A t-test and ANOVA were applied to explore the relationship between the frequency of children's favorite foods intake and policy cognition. The survey was implemented from August 2016 to September 2016. RESULTS: For the boys, the frequency of ‘high-calorie low nutrient foods intake’ (HCLN) was significantly higher than that of the girls (p<0.01). For the children who received information on their favorite foods from the internet, the frequency of HCLN was higher than the other sources (p<0.01). The time of TV viewing and computer usage, and smartphone usage was associated with a higher frequency of HCLN, and a lower healthy favorite food intake (all p<0.001). The intake frequency of healthy favorite foods indicated a positive correlation with the policy cognition, including policy perception, usefulness, necessity and buying intention, and educational experience. CONCLUSIONS: This study showed a correlation with the frequency of children's favorite foods intake and policy. In particular, the frequency of children's healthy favorite foods intake indicated a meaningful relationship with the policy than the frequency of HCLN. This study also found that the consumption of children's healthy favorite foods was positively correlated with the educational experience. To develop a supportive policy for a good dietary environment for children, there is a need to focus on how to collaborate with multiple levels of influences, such as the national level, school level, and family.
Child ; Chungcheongnam-do ; Cognition ; Daegu ; Eating ; Female ; Gyeonggi-do ; Humans ; Intention ; Internet ; Jeollabuk-do ; Organization and Administration ; Smartphone

BACKGROUND: The purpose of this study was to understand the level of successful aging and to analyze the factors that affect successful aging. METHODS: This study was a descriptive study. The data collection of this study using questionnaires was from October 1, 2017 to December 30, 2017, and the 169 elderly people living in Chungcheongnam-do were surveyed. RESULTS: The mean level of successful aging of the subjects was 3.57 (±0.58), which was higher than the median, it was significantly different among the presence of religion, participation in senior facility, regular exercise, pain, and subjective health status. Regression analysis showed that the factors that have the greatest influence on the successful aging of the subjects were the participation in senior facility (β=0.24, P<0.001), self-esteem support (β=0.20, P=0.024), emotional support (β=0.19, P=0.048), regular exercise (β=0.19, P=0.002), and pain (β=−0.14. P=0.029). The explanatory power of these variables on successful aging was 53% (F=20.37, P<0.001). CONCLUSIONS: This study showed that emotional support and support for self-esteem were important in successful aging, and that pain, which was not considered in previous studies, was an important factor.
Aged ; Aging ; Chungcheongnam-do ; Data Collection ; Diagnostic Self Evaluation ; Humans

OBJECTIVES: This study examined the status of children's favorite foods intake and the relationship with the policy environment based on the Special Act on Safety Control of Children's Dietary Life for suggesting a supportive policy strategy. METHODS: The subjects were 4th grade students (n=1,638) in elementary school from 45 schools collected from seven areas (Seoul, Daegu, Daejeon, Gyeonggi, Chungnam, Jeonbuk, and Gyeongnam). The children participated in a self-administered questionnaire survey in class under the supervision of the teacher. The questionnaire consisted of items, such as social demographic characteristics, frequency of intake of the children's favorite foods, and policy cognition. A t-test and ANOVA were applied to explore the relationship between the frequency of children's favorite foods intake and policy cognition. The survey was implemented from August 2016 to September 2016. RESULTS: For the boys, the frequency of ‘high-calorie low nutrient foods intake’ (HCLN) was significantly higher than that of the girls (p<0.01). For the children who received information on their favorite foods from the internet, the frequency of HCLN was higher than the other sources (p<0.01). The time of TV viewing and computer usage, and smartphone usage was associated with a higher frequency of HCLN, and a lower healthy favorite food intake (all p<0.001). The intake frequency of healthy favorite foods indicated a positive correlation with the policy cognition, including policy perception, usefulness, necessity and buying intention, and educational experience. CONCLUSIONS: This study showed a correlation with the frequency of children's favorite foods intake and policy. In particular, the frequency of children's healthy favorite foods intake indicated a meaningful relationship with the policy than the frequency of HCLN. This study also found that the consumption of children's healthy favorite foods was positively correlated with the educational experience. To develop a supportive policy for a good dietary environment for children, there is a need to focus on how to collaborate with multiple levels of influences, such as the national level, school level, and family.
Child ; Chungcheongnam-do ; Cognition ; Daegu ; Eating ; Female ; Gyeonggi-do ; Humans ; Intention ; Internet ; Jeollabuk-do ; Organization and Administration ; Smartphone

PURPOSE: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. METHODS: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. RESULTS: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. CONCLUSIONS: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.
Child ; Chungcheongnam-do ; Disease Transmission, Infectious ; Education ; Exanthema ; Fatigue ; Humans ; Latent Tuberculosis ; Mass Screening ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. METHODS: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for β-lactams and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. RESULTS: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. CONCLUSIONS: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.
Amoxicillin ; Anti-Bacterial Agents ; Cefotaxime ; Child ; Child, Hospitalized ; Chungcheongnam-do ; Erythromycin ; Humans ; Penicillins ; Pneumococcal Infections ; Retrospective Studies ; Streptococcus pneumoniae ; Streptococcus ; Vaccination

BACKGROUND/AIMS: Behavioral factors, such as smoking and heavy alcohol consumption, increase the risk of gastric cancer (GC), but their effects on survival are not clear. We examined associations between prediagnostic smoking and alcohol drinking behavior and GC death by long-term follow-up. METHODS: The participants were 508 GC patients enrolled at Chungnam University Hospital and Hanyang University Guri Hospital from 2001 to 2006. Information on clinicopathologic and behavioral risk factors was collected, and patient survival was prospectively followed until 2016 by medical chart review and telephone survey. RESULTS: During above 10 years follow-up period, overall death was 46.2% (n=226) and GC deaths was 38.2% (n=187) among the 489 GC patients included in the analysis. No significant association was found between smoking habits and overall or GC survival. However, after stratification by histological type, the hazard ratio (HR) of GC death for current smokers tended to be higher for the diffuse type (HR 1.61, 95% CI 0.57–4.59 for current vs. never) rather than for the intestinal type (HR 0.78, 95% CI 0.28–2.19 for current vs. never). Light alcohol consumption was found to be associated with a significantly lower risk of GC death (HR 0.52, 95% CI 0.36–0.75 for <20 g/day for women or <40 g/day for men vs. never and past), and the effects of alcohol drinking habits had similar effects on GC death for the intestinal and diffuse types. CONCLUSIONS: These results suggest smoking and alcohol drinking behaviors before a diagnosis of GC are weakly associated with GC survival. Nevertheless, the effect of smoking behavior on prognosis appears to depend on the histological type of GC.
Alcohol Drinking ; Chungcheongnam-do ; Cohort Studies ; Diagnosis ; Drinking ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Stomach Neoplasms ; Telephone

BACKGROUND: The primary goal of this study was to characterize the clinical outcomes of adult patients with hematologic malignancies (HM) who were treated with extracorporeal membrane oxygenation (ECMO) support when conventional treatments failed. METHODS: In this retrospective, observational study at a tertiary medical center, we reviewed the clinical course of 23 consecutive patients with HM requiring ECMO who were admitted to the intensive care unit at Asan Medical Center from March 2010 to April 2015. RESULTS: A total of 23 patients (8 female; median age, 44 years; range, 29–51 years) with HM and severe acute circulatory and/or respiratory failure received ECMO therapy during the study period. Fourteen patients received veno-arterial ECMO, while 9 patients received veno-venous ECMO. The median ECMO duration was 104.7 hours (range, 37.1–221 hours). Nine patients were successfully weaned from ECMO. The in-hospital mortality rate was 91.1% (21 of 23). There were complications in 3 patients (cannulation site bleeding, limb ischemia, and gastrointestinal bleeding). CONCLUSION: ECMO is a useful treatment for patients with circulatory and/or pulmonary failure. However, in patients with HM, the outcomes of ECMO treatment results were very poor, so it is advisable to carefully decide whether to apply ECMO to these patients.
Adult ; Chungcheongnam-do ; Extracorporeal Membrane Oxygenation ; Extremities ; Female ; Hematologic Neoplasms ; Hemorrhage ; Hospital Mortality ; Humans ; Intensive Care Units ; Ischemia ; Mortality ; Observational Study ; Respiratory Insufficiency ; Retrospective Studies

BACKGROUND: Antiphospholipid antibody syndrome (APS), an important cause of acquired thrombophilia, is diagnosed when vascular thrombosis or pregnancy morbidity occurs with persistently positive antiphospholipid antibodies (aPL). APS is a risk factor for unprovoked recurrence of pulmonary embolism (PE). Performing laboratory testing for aPL after a first unprovoked acute PE is controversial. We investigated if a specific phenotype existed in patients with unprovoked with acute PE, suggesting the need to evaluate them for APS. METHODS: We retrospectively reviewed patients with PE and APS (n=24) and those with unprovoked PE with aPL negative (n=44), evaluated 2006–2016 at the Asan Medical Center. We compared patient demographics, clinical manifestations, laboratory findings, and radiological findings between the groups. RESULTS: On multivariate logistic regression analysis, two models of independent risk factors for APS-PE were suggested. Model I included hemoptysis (odds ratio [OR], 12.897; 95% confidence interval [CI], 1.025–162.343), low PE severity index (OR, 0.948; 95% CI, 0.917–0.979), and activated partial thromboplastin time (aPTT; OR, 1.166; 95% CI, 1.040–1.307). Model II included age (OR, 0.930; 95% CI, 0.893–0.969) and aPTT (OR, 1.104; 95% CI, 1.000–1.217). CONCLUSION: We conclude that patients with first unprovoked PE with hemoptysis and are age <40; have a low pulmonary embolism severity index, especially in risk class I–II; and/or prolonged aPTT (above 75th percentile of the reference interval), should be suspected of having APS, and undergo laboratory testing for aPL.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome* ; Chungcheongnam-do ; Demography ; Hemoptysis ; Humans ; Logistic Models ; Partial Thromboplastin Time ; Phenotype* ; Pregnancy ; Pulmonary Embolism* ; Recurrence ; Retrospective Studies ; Risk Factors ; Thrombophilia ; Thrombosis

OBJECTIVE: To compare the reliability and validity of the Korean range of motion standard protocol (KRSP) for measuring joint range of motion (ROM) with those of the conventional ROM measurement using a goniometer.METHODS: We conducted a randomized controlled trial involving 91 healthy elderly individuals. We compared two strategies of measuring joint ROM to evaluate the reliability and validity of each standardized protocol: first, the KRSP based on the Chungnam National University guidelines and second, handheld goniometric measurement. In the first strategy, 3 examiners (1 rehabilitation doctor, 1 physical therapist, and 1 physical therapy student) independently measured joint ROM in 46 randomly selected subjects; in the second strategy, another 3 examiners (1 rehabilitation doctor, 1 physical therapist, and 1 physical therapy student) measured joint ROM in 45 randomly selected subjects. The reliability of each protocol was calculated using intraclass correlation coefficient, ICC(2,1), and root mean square error (RMSE).RESULTS: Both protocols showed good to excellent intra-rater reliability. With goniometer use, the inter-rater reliability was low—ICC(2,1), 95% confidence interval ranged from 0.643 (0.486–0.783) to -0.078 (-0.296–0.494)— and RMSE was high. With the KRSP, the inter-rater reliability ranged from 0.846 (0.686–0.931) to 0.986 (0.972–0.994) and RMSE was low.CONCLUSION: ROM measurements using the KRSP showed excellent reliability. These results indicate that this protocol can be the reference standard for measuring ROM in clinical settings as an alternative to goniometers.
Aged ; Chungcheongnam-do ; Humans ; Joints ; Methods ; Physical Therapists ; Range of Motion, Articular ; Rehabilitation ; Reproducibility of Results

PURPOSE: Although an increased incidence of gallbladder (GB) stone formation after gastrectomy has been reported, its etiology remains uncertain. The goal of this study was to explore the incidence of gallstone formation after gastrectomy in gastric cancer patients and investigate the risk factors therein.MATERIALS AND METHODS: Medical records of patients who underwent curative gastrectomy, performed by a single surgeon between August 2012 and December 2015 at the Asan Medical Center, were retrospectively reviewed. Baseline characteristics and surgical outcomes, including GB stone gallstone formation after gastrectomy, were analyzed.RESULTS: Of 561 patients included in the study, 36 presented with GB stone formation after gastrectomy for gastric cancer. The incidence of gallstone formation was 6.4%. The mean interval between gallstone formation and gastrectomy was 21.9 months. In multivariate analyses, the incidence of gallstone formation increased in patients 63 years or older, with greater than 6.2 kg weight loss in the first 6 months after the procedure, a preoperative serum total bilirubin level greater than 0.5 mg/dL, and in patients who did not receive adjuvant chemotherapy.CONCLUSIONS: This study presented risk factors for GB stone formation after gastric cancer surgery, and special attention should be afforded to patients with such risk factors.
Bilirubin ; Chemotherapy, Adjuvant ; Cholecystolithiasis ; Chungcheongnam-do ; Gallbladder ; Gallstones ; Gastrectomy ; Humans ; Incidence ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; Weight Loss