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

Foot-and-mouth disease (FMD) is an acute epidemic that spreads rapidly among cattle and pigs. In 2014, in Korea, despite enforced vaccination, the type O Southeast Asia (SEA) topotype viruses (Mya-98 lineage) infected mainly cattle and pigs simultaneously, thereby causing enormous damage. If a vaccine that is completely protective against this FMD virus is developed and used, it can become a very important preventive measure in Asia, which is where this type of virus mainly circulates. The SEA topotype has been steadily evolving and transforming into new variations since it became epidemic in Asia. Therefore, it became necessary to develop a new vaccine that could provide protection against the FMD virus strain that was responsible for the 2014–2015 outbreak in Korea. This study aimed to develop a vaccine that would provide complete protection against the SEA topotype FMD virus to control sporadic FMD outbreaks, which occur despite the enforcement of vaccination, and to completely prevent virus shedding, thereby preventing the virus from spreading. The vaccine candidate virus developed in this study showed low pathogenicity and can be distinguished from the wild-type FMD virus strain. The developed vaccine was able to protect mice from SEA and Middle East–South Asia topotype virus strains and induced high titers of antibodies against both virus strains in pigs, thereby confirming the sufficiency of its protective function. In particular, the results of the SEA topotype virus challenge test in pigs revealed that perfect immunity was created in the vaccinated pigs, without virus shedding and viremia.
Animals ; Antibodies ; Asia ; Asia, Southeastern ; Cattle ; Disease Outbreaks ; Foot-and-Mouth Disease ; Korea ; Mice ; Swine ; Vaccination ; Viremia ; Virulence ; Virus Shedding

PURPOSE: The purpose of this study was to examine the relationships of authentic leadership and nursing organizational culture to the intention of hospital nurses to stay in their current position. METHODS: The participants of this study were 503 nurses in 8 hospitals. We collected data using questionnaires for assessing authentic leadership, nursing organization culture and intention to stay. For data analysis, t-test, ANOVA, Cronbach's α, Pearson's correlation coefficient, Tukey test, Multiple regression were performed using SAS ver.9.4 (SAS Institute Inc., Cary, NC, USA). RESULTS: Authentic leadership (β=.12, p=.008) and relation-oriented culture (β=.13, p=.009) affected the intention of the hospital nurses to stay. These variables accounted for 29% of the variance in the intention to stay among hospital nurses. CONCLUSION: The finding of this study shows that the authentic leadership and nursing organizational culture especially relation-focused can influence nurses' intention to stay in their current position. For retaining nurses, it is suggested to use an authentic leadership training program for nursing leaders and to make efforts to establish a relation-focused culture in the hospital.
Education ; Intention ; Leadership ; Nursing ; Organizational Culture ; Statistics as Topic

BACKGROUND/OBJECTIVES: The International Agency for Research on Cancer defined alcohol beverages and acetaldehyde derived from alcoholic beverages as a Group 1 carcinogen to humans. However, the association between alcohol consumption and gastric cancer risk has been controversial in Korean. We assessed the relationship between alcohol consumption and gastric cancer risk in Korea through a case-control study. SUBJECTS/METHODS: From 2 hospitals, a total of 316 cases with gastric cancer (208 men, 108 women) were selected and matched to 316 controls by sex and age (± 5 years) during the same duration. The current status, frequency, and amount of alcohol consumption for a year three years ago were assessed by trained interviewers. RESULTS: Alcohol consumption status and frequency did not show any significant association with gastric cancer risk. However, high alcohol consumption (≥ 20 g/day for women or ≥ 40 g/day for men) significantly increased the risk of gastric cancer (odds ratio (OR) 1.73; 95% confidence interval (CI) 1.05–2.85). Gastric cancer risk was strongly positively associated with alcohol consumption of ≥ 20 g/day, especially in women (OR 5.62; 95% CI 1.32–23.81). CONCLUSION: The results from this study suggest that excessive alcohol consumption rather than the current status or frequency of alcohol consumption contributes to the increased risk of gastric cancer, especially in women.

PURPOSE: This study aims to identify the relationship between person-centered critical care nursing (PCCN) and family satisfaction for intensive care unit (ICU) nurses.METHODS: This research used a cross-sectional survey. The participants were 142 nurses and 121 family members from 8 ICUs in 4 hospitals in B city. The questionnaire survey was conducted between December 2018 and March 2019. The eight ICUs were divided into those that scored high and those that scored low for person-centered care relative to the average score for PCCN, and the difference in family satisfaction between the ICUs with high and low scores was compared using t-test.RESULTS: The mean score of PCCN was 3.68±0.40 out of 5. In the subcategories of PCCN, “comfort”was the highest at 3.95±0.49, followed by “respect” at 3.73±0.57, “compassion” at 3.59±0.57, and “individuality” at 3.47±0.54. The average score of family satisfaction with the ICUs was 3.45±0.67 out of 5. In its subcategories, “emotion” was the highest at 3.69±0.72, followed by “information” at 3.61±0.75, “participation” at 3.30±0.79, and ”resources‘ at 3.20±0.80. The family satisfaction (3.75±0.54) with the ICU of the highest-scoring PCCN was significantly higher than the family satisfaction (3.25±0.53) with the ICU with the lowest-scoring PCCN (t=4.97, p<.001).CONCLUSION: The results suggest that the PCCN scores of ICU nurses should be promoted to improve family satisfaction. It is necessary to pursue a variety of ways to secure the provision of person-centered nursing practice in ICUs.
Critical Care Nursing ; Cross-Sectional Studies ; Humans ; Intensive Care Units ; Nursing ; Patient-Centered Care

Benzalkonium chloride, diazolidinyl urea, and imidazolidinyl urea are commonly used preservatives in cosmetics. Recent reports suggested that these compounds may have cellular and systemic toxicity in high concentration. In addition, diazolidinyl urea and imidazolidinyl urea are known formaldehyde (FA) releasers, raising concerns for these cosmetic preservatives. In this study, we investigated the effects of benzalkonium chloride, diazolidinyl urea, and imidazolidinyl urea on ROS-dependent apoptosis of rat neural progenitor cells (NPCs) in vitro. Cells were isolated and cultured from embryonic day 14 rat cortices. Cultured cells were treated with 1–1,000 nM benzalkonium chloride, and 1–50 μM diazolidinyl urea or imidazolidinyl urea at various time points to measure the reactive oxygen species (ROS). PI staining, MTT assay, and live-cell imaging were used for cell viability measurements. Western blot was carried out for cleaved caspase-3 and cleaved caspase-8 as apoptotic protein markers. In rat NPCs, ROS production and cleaved caspase-8 expression were increased while the cell viability was decreased in high concentrations of these substances. These results suggest that several cosmetic preservatives at high concentrations can induce neural toxicity in rat brains through ROS induction and apoptosis.
Animals ; Apoptosis* ; Benzalkonium Compounds ; Blotting, Western ; Brain ; Caspase 3 ; Caspase 8 ; Cell Survival ; Cells, Cultured ; Formaldehyde ; In Vitro Techniques ; Rats* ; Reactive Oxygen Species ; Stem Cells* ; Urea

PURPOSE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. MATERIALS AND METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups. RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI. CONCLUSION: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.
Breast Neoplasms* ; Breast* ; Case-Control Studies* ; Disease-Free Survival ; Drug Therapy* ; Humans ; Lymph Nodes ; Lymphatic Irradiation ; Lymphedema ; Mastectomy, Segmental* ; Neoplasm Metastasis ; Propensity Score ; Radiation Pneumonitis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence

PURPOSE: The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010. RESULTS: We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081). CONCLUSION: PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Radiotherapy* ; Recurrence ; Retrospective Studies*

Infections of Toxoplasma gondii and Babesia microti are reported in many wild animals worldwide, but information on their incidence and molecular detection in Korean wild fields is limited. In this study, the prevalence of T. gondii and B. microti infection in blood samples of 5 animal species (37 Chinese water deer, 23 raccoon dogs, 6 roe deer, 1 wild boar, and 3 Eurasian badgers) was examined during 2008–2009 in Gangwon-do (Province), the Republic of Korea (=Korea) by using serological and molecular tests. The overall seropositivity of T. gondii was 8.6% (6/70); 10.8% in Chinese water deer, 4.3% in raccoon dogs, and 16.7% in roe deer. PCR revealed only 1 case of T. gondii infection in Chinese water deer, and phylogenic analysis showed that the positive isolate was practically identical to the highly pathogenetic strain type I. In B. microti PCR, the positive rate was 5.7% (4/70), including 2 Chinese water deer and 2 Eurasian badgers. Phylogenetic analysis results of 18S rRNA and the β-tubulin gene showed that all positive isolates were US-type B. microti. To our knowledge, this is the first report of B. microti detected in Chinese water deer and Eurasian badger from Korea. These results indicate a potentially high prevalence of T. gondii and B. microti in wild animals of Gangwon-do, Korea. Furthermore, Chinese water deer might act as a reservoir for parasite infections of domestic animals.
Animals ; Animals, Domestic ; Animals, Wild* ; Asian Continental Ancestry Group ; Babesia microti* ; Babesia* ; Deer ; Gangwon-do* ; Humans ; Incidence ; Korea* ; Mustelidae ; Parasites ; Polymerase Chain Reaction ; Prevalence ; Raccoon Dogs ; Republic of Korea ; Sus scrofa ; Toxoplasma* ; Water

BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea. METHODS: Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed. RESULTS: Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN), 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%. CONCLUSIONS: More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.
Academies and Institutes ; Biopsy, Fine-Needle ; Data Collection ; Follow-Up Studies ; Humans ; Incidence ; Korea* ; Thyroid Gland* ; Thyroid Nodule