Objective: We used paclitaxel and cisplatin, known to be effective in intraperitoneal chemotherapy, in a novel prototype of rotational intraperitoneal pressurized aerosol chemotherapy (RIPAC) and evaluated the pharmacokinetics, tissue concentrations, and toxicities in a pig model. Methods: We developed RIPAC, including the nozzle with the conical pendulum motion, and used 10% of intravenous doses of paclitaxel and cisplatin. We used high-performance liquid chromatography followed by tandem mass spectrometry to analyze serum and tissue concentrations. We applied a non-compartment model to study pharmacokinetics to analyze the time-dependent serum concentrations measured before RIPAC to 48 hours. We evaluated the difference in tissue concentrations between twelve peritoneal regions by the modified peritoneal cancer index. For evaluating toxicities, we observed hepatic and renal function until 4 days after RIPAC. Results: Six pigs underwent RIPAC using paclitaxel (n=3) and cisplatin (n=3). The peak serum concentration (Cmax) and the area under the curve were higher for cisplatin, while the time to the peak serum concentration (Tmax) was longer for paclitaxel. Moreover, the parietal peritoneum showed higher tissue concentrations than the visceral peritoneum, and the ratio of tissue to serum concentrations using Cmax was higher for paclitaxel (172.2–6,237.9) than for cisplatin (0.1–9.3). However, there were no renal and hepatic toxicities after RIPAC with paclitaxel or cisplatin. Conclusion Delayed absorption of paclitaxel sprayed by RIPAC into the peritoneum to the bloodstream may lead to higher tissue concentrations at different regions and lower serum concentrations than cisplatin.

Objectives: This paper aimed to provide an in-depth analysis of the factors influencing the dietary habits of male and female workers at a facility in Gwangju and their awareness of the same. Methods: A total of 32 workers were divided into eight groups based on work type, gender, and age, and focus group interviews (FGIs) were conducted. The FGIs included cognitive, behavioral, and environmental questionnaires based on dietary habits and the social cognitive theory. The interviews were analyzed by subject and sub-subject using audio recordings and transcriptions. Results: Male workers in the concerned company favored meat while female workers preferred vegetables, yet by and large, the preferences were irregular. Male workers living alone frequently ate ready meals and female workers often skipped meals. An analysis of the factors influencing the study subjects’ dietary habits from the cognitive, behavioral, and environmental perspectives showed that the main factors negatively affecting their dietary habits were shiftwork, living alone, and drinking. Workers were unaware of these factors and their poor eating habits. Instead, male workers complained of poor cooking skills, while female workers complained of loneliness. Workers thus appeared to need the support of nutrition education and a counseling assistant to cope with this situation. Conclusions The study identified the fact that the absence of nutrition education left the workers unaware of their poor eating habits. The workers would need counseling and support to help them build healthy dietary habits. It would also be necessary to focus on raising the workers’ cognitive awareness of dietary habits and enhancing their behavioral ability to cope with bad eating habits through nutrition education that reflects the reality of their situation.

Purpose: This study examined the factors influencing Nutrition Quotient for adults (NQ-A), focusing on workers in the manufacturing industry. Methods: The participants were 738 industrial workers in Gwangju. Their dietary information was analyzed using a questionnaire of NQ-A, which consisted of 21 checklist items and the general characteristics of the subjects. The scores of NQ-A and its 4 factors (balance, moderation, diversity, and dietary behavior) were calculated according to the general characteristics of subjects. The data were analyzed using a χ2 test, t-test, correlation, and multiple regression using SPSS 21.0 program. Results: The mean NQ-A score was 45.3 for the total subjects, indicating a low grade. Non-shift workers showed significantly higher scores for balance, diversity, and moderation factors than shift workers. Forty-three (8.7%) shift workers and 123 (50.8%) non-shift workers had good NQ-A scores, whereas 453 (91.3%) shift workers and 119 (49.2%) non-shift workers required monitoring for nutrition. The significant influencing factors of NQ-A were the working pattern (p < 0.001), gender (p < 0.001), family composition (p < 0.001), age (p < 0.001), and household income (p < 0.001). As a result of multiple regression analysis, there was a significant difference in the NQ-A score for moderation (F = 141.930, p < 0.001), diversity (F = 98.998, p < 0.001), balance (F = 52.329, p < 0.001), and dietary behavior (F = 12.895, p < 0.001). As a result, shift work and gender had the greatest influence on the balance (β = −0.372, p < 0.001), diversity (β = −0.316, p < 0.001), and moderation (β = −0.507, p < 0.001) factors in NQ-A. Gender had the most influence on the dietary behavior in NQ-A. Conclusion Shift work and gender were significant factors affecting NQ-A. To manage workers' health better, it will be necessary to prepare a nutrition education program according to the type of working pattern and gender.

BACKGROUND/AIMS: In addition to the globally endorsed Barcelona Clinic Liver Cancer (BCLC) staging system, other algorithms or staging systems have been developed, including the Hong Kong Liver Cancer (HKLC) staging system. This study aimed to validate the HKLC staging system relative to the BCLC staging system for predicting survival for hepatocellular carcinoma (HCC) patients in Korea. METHODS: From 2004 to 2013, 2,571 patients newly diagnosed with HCC were consecutively enrolled at three Korea University medical centers. RESULTS: Both staging systems differentiated survival well (p < 0.001). However, 1-year and 3-year survival were predicted better using the HKLC system than the BCLC system (area under the receiver operating characteristic curve: 0.869 vs 0.856 for 1 year, p=0.002; 0.841 vs 0.827 for 3 years, p=0.010). In hypothetical survival curves, the HKLC system exhibited better median overall survival than the BCLC system (33.1 months vs 19.2 months). In evaluations of prognosis according to either BCLC or HKLC treatment guidelines, risk of death was reduced in the group following only HKLC guidelines compared with the group following only BCLC guidelines (hazard ratio, 0.601; 95% confidence interval, 0.443 to 0.816; p=0.001). CONCLUSIONS: Although both staging systems predicted and discriminated HCC prognoses well, the HKLC system showed more encouraging survival benefits than the BCLC system.
Academic Medical Centers ; Carcinoma, Hepatocellular ; Hong Kong ; Humans ; Korea ; Liver Neoplasms ; Liver ; Neoplasm Staging ; Prognosis ; ROC Curve

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate

Since sorafenib was introduced in 2007 for treating advanced hepatocellular carcinoma (HCC), 15 patients have achieved a complete response (CR) in advanced HCC. However, only four of these reports can be regarded as real CRs involving adequate assessments including imaging, serum tumor markers, and histologic examinations of completely resected specimens. A 54-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (LC) presented to our unit. A CT scan demonstrated a 3.8-cm arterial hypervascular/portal-washout mass in the right lobe and invasion in the right portal vein. Twelve weeks after beginning sorafenib therapy, the AFP level was normalized and a CT scan showed a prominent decrease in the hepatic mass and a significant decrease in the volume of portal vein thrombosis (PVT). The patient received a right liver hemihepatectomy after 12 months. No viable tumor cells were found in the resected specimen, and there was no thrombotic obstruction of the portal vein. Twelve months later the patient showed no clinical evidence of HCC recurrence. This is the first case of CR in HCC treatment following sorafenib with histologically confirmed HCV-related HCC without LC evidence, HCC with PVT, and a follow-up of longer than 12 months. This case seems to be an extremely unusual clinical outcome in advanced HCC.
Biomarkers, Tumor ; Carcinoma, Hepatocellular* ; Follow-Up Studies ; Hepacivirus ; Hepatitis C ; Humans ; Liver ; Liver Cirrhosis ; Middle Aged ; Portal Vein ; Recurrence ; Response Evaluation Criteria in Solid Tumors ; Tomography, X-Ray Computed ; Venous Thrombosis

PURPOSE: This study was conducted to investigate and analyze the association between stress from shift and non-shift work as well as the effects living habits have on eating habits in order to identify why and how workers can improve their health and form proper eating habits for higher working efficiency. METHODS: The subjects of this study were 361 workers from K manufacturing company from April 7 to 11, 2014 and they were surveyed using a questionnaire. The subjects were divided into two groups according to working pattern: shift workers (n = 216) and non-shift workers (n = 110). RESULTS: In the general characteristics, there were significant differences in age, work career, work time, marriage, monthly income, and education levels between the two groups. For healthy behaviors, significant differences in subjective health status, moderate physical activity, drinking, smoking, and sleep time were observed between shift workers and non-shift workers. For eating habits, scores of non-shift workers having a regular mealtime, balanced meal composition, and vegetable and seaweed intakes were significantly higher than those of shift workers. The sum score of dietary habits in non-shift workers was also significantly lower than that in shift workers (p < 0.05). Total job stress score did not significantly differ between the two groups. CONCLUSION: The sum of eating habit scores according to work types was 16.1 ± 0.6 in non-shift workers and 14.0 ± 0.3 in shift workers. These results suggest that it is necessary to provide food suitable to characteristics of different workers according to work type which should be provided along with daily nutrition counseling to help subjects recognize their status.
Counseling ; Diagnostic Self Evaluation ; Drinking ; Eating* ; Education ; Food Habits ; Gwangju* ; Marriage ; Meals ; Motor Activity ; Seaweed ; Smoke ; Smoking ; Vegetables

PURPOSE: This study analyzed the degree of job stress and caffeine intake in workers in industrial positions in order to determine the relationships between job stress and caffeine intake. METHODS: For this purpose, this study conducted a survey targeting 361 blue collar workers working for K manufacturing company, Gwangju. RESULTS: The total score for job stress in subjects was 72.7 ± 6.8 points/100 points. According to job stress, subjects were categorized as follows: Q1 for the group who had the least stress; Q2 for the group who had little stress; Q3 for the group who had a lot of stress, and Q4 for the group who had the most stress. As for the effects of caffeine on health, 57.1% thought that caffeine is helpful and not harmful if taken properly while 17.3% responded that less caffeine consumption is better. Daily intake of caffeine according to stress was presented as: 172.0 ± 85.3 mg in Q1, 179.0 ± 83.7 mg in Q2, 187.9 ± 81.4 mg in Q3, and 214.2 ± 147.3 mg in Q4 (p < 0.05). The percentages of caffeine consumption compared to the daily safe limit in subjects were: 43.0 ± 21.3, 44.8 ± 20.9, 47.1 ± 20.4, and 53.6 ± 36.8% in Q1, Q2, Q3, and Q4, respectively (p < 0.05). Adverse effects such as nausea or vomiting from caffeine were most common in Q4 (p < 0.05) CONCLUSION: As a result, higher stress in blue collar workers working for K manufacturing company was associated with more caffeine consumption. Groups with a lot of stress (Q4) consumed approximately 50% of daily safe limit of caffeine. Considering the results above, this study suggests that further research on more precise caffeine intake and its effects is needed.
Caffeine* ; Gwangju ; Nausea ; Vomiting

Aspergillus tracheobronchitis (AT), an unusual form of invasive pulmonary aspergillosis (IPA), is characterized by pseudomembrane formation, ulcer or obstruction that is predominantly confined to tracheobronchial tree. Hematologic malignancies, neutropenia, solid organ transplantation, chronic corticosteroid therapy and acquired immunodeficiency syndrome (AIDS) are known to be major predisposing conditions. However, since the introduction of highly active antiretroviral therapy, there is only one reported case of AT in AIDS patient. After pandemic of influenza A/H1N1 2009, there are several reports of IPA in patient with influenza and most of them received corticosteroid or immunosuppressive therapy before the development of IPA. We present a 45 year-old AIDS patient with influenza A infection who developed pseudomembranous AT without corticosteroid use or immunosuppressive therapy.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Aspergillus* ; Bronchitis ; Coinfection* ; Hematologic Neoplasms ; Humans ; Influenza, Human* ; Invasive Pulmonary Aspergillosis ; Neutropenia* ; Organ Transplantation ; Pandemics ; Transplants ; Ulcer

BACKGROUND/AIMS: Waist circumference (WC) is a risk factor for metabolic syndrome and is related to insulin resistance (IR) and nonalcoholic fatty liver disease (NAFLD). The purpose of this study was to determine the association between WC and IR and NAFLD in apparently healthy Korean adults. METHODS: The volunteers included in this cross-sectional study comprised 9,159 adults (5,052 men, 4,107 women) who participated in a comprehensive health checkup program. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR) and was considered to be present when the HOMA-IR score was >2. NAFLD was evaluated by ultrasound examination. Elevated alanine aminotransferase (ALT) was defined as >40 IU/L in men and >35 IU/L in women. Logistic regression was performed to determine the odds ratios (ORs) and 95% confidence intervals (95% CIs) for NAFLD, IR, and ALT according to categorized levels of WC. RESULTS: NAFLD was found in 2,553 (27.9%) of the participants (82.6% men, 17.4% women), while IR and elevated ALT were found in 17.2% (68.1% men, 31.9% women) and 10% (83% men, 17% women), respectively. After adjusting for confounding factors, the prevalence of NAFLD, IR, and elevated ALT was significantly associated with increases in WC quartile: highest quartile for NAFLD in men, OR=15.539, 95% CI=12.687-19.033; highest quartile for NAFLD in women, OR=48.732, 95% CI=23.918-99.288 (P<0.001); and highest quartile for IR in men, OR=17.576, 95% CI=13.283-23.255; highest quartile for IR in women, OR=11.078, 95% CI=7.813-15.708 (P<0.001); highest quartile for elevated ALT in men, OR=7.952, 95% CI=6.046-10.459; and highest quartile for elevated ALT in women, OR=8.487, 95% CI=4.679-15.395 (P<0.001). CONCLUSIONS: WC contributes to IR and NAFLD in apparently healthy Korean adults, and thus may be an important factor in the development of IR and NAFLD.
Adult ; Alanine Transaminase/blood ; Area Under Curve ; Asian Continental Ancestry Group ; Body Mass Index ; Cross-Sectional Studies ; Fatty Liver/*diagnosis ; Female ; Humans ; *Insulin Resistance ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Risk Factors ; *Waist Circumference