Sukil Kim

Evaluation of a mobile phone-based diet game for weight control.

We developed an interactive mobile-phone based application, SmartDiet, that analyzes daily nutrition intake and patterns of daily exercise. It provides a personalized diet profile and promotes knowledge about nutrition using a diet game. We evaluated the effectiveness of the SmartDiet application in terms of acquiring dietary information, weight control and user satisfaction. A case-control study was conducted over a six-week period, with 19 people in the intervention group and 17 people in the control group. During the study, a total of 235 successful data transmissions were performed from the mobile phones and there was a mean of 12.4 transmissions per participant. The three body composition measures (fat mass, weight and body mass index) decreased significantly after the intervention in the intervention group, but there were no significant changes in the control group. In a questionnaire survey at the end of the study, the majority of the participants responded that the system was useful for obtaining information and managing the diet process. The SmartDiet mobile weight management application appears to contribute to weight loss in obese adults.

Prevalence and Risk Factors Associated with Suicide Ideation and Attempts in Korean College Students

Objective Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. Methods Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscickis suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. Results The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. Conclusion Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.

Modeling the Arden Syntax for medical decisions in XML.

PURPOSE A new model expressing Arden Syntax with the eXtensible Markup Language (XML) was developed to increase its portability. METHODS Every example was manually parsed and reviewed until the schema and the style sheet were considered to be optimized. When the first schema was finished, several MLMs in Arden Syntax Markup Language (ArdenML) were validated against the schema. They were then transformed to HTML formats with the style sheet, during which they were compared to the original text version of their own MLM. When faults were found in the transformed MLM, the schema and/or style sheet was fixed. This cycle continued until all the examples were encoded into XML documents. The original MLMs were encoded in XML according to the proposed XML schema and reverse-parsed MLMs in ArdenML were checked using a public domain Arden Syntax checker. RESULTS Two hundred seventy seven examples of MLMs were successfully transformed into XML documents using the model, and the reverse-parse yielded the original text version of MLMs. Two hundred sixty five of the 277 MLMs showed the same error patterns before and after transformation, and all 11 errors related to statement structure were resolved in XML version. The model uses two syntax checking mechanisms, first an XML validation process, and second, a syntax check using an XSL style sheet. CONCLUSION Now that we have a schema for ArdenML, we can also begin the development of style sheets for transformation ArdenML into other languages.

The effects of an electronic medical record on the completeness of documentation in the anesthesia record

OBJECTIVES The purpose of this study is to evaluate the completeness of anesthesia recording before and after the introduction of an electronic anesthesia record. METHODS The study was conducted in a Korean teaching hospital where the EMR was implemented in October 2008. One hundred paper anesthesia records from July to September 2008 and 150 electronic anesthesia records during the same period in 2009 were randomly sampled. Thirty-four essential items were selected out of all the anesthesia items and grouped into automatically transferred items and manual entry items. 1, .5 and 0 points were given for each item of complete entry, incomplete entry and no entry respectively. The completeness of documentation was defined as the sum of the scores. The influencing factors on the completeness of documentation were evaluated in total and by the groups. RESULTS The average completeness score of the electronic anesthesia records was 3.15% higher than that of the paper records. A multiple regression model showed the type of the anesthesia record was a significant factor on the completeness of anesthesia records in all items (β=.98, p<.05) and automatically transferred items (β=.56, p<.01). The type of the anesthesia records had no influence on the completeness in manual entry items. CONCLUSIONS The completeness of an anesthesia record was improved after the implementation of the electronic anesthesia record. The reuse of the data from the EMR was the main contributor to the improved completeness.

A Study on User Satisfaction regarding the Clinical Decision Support System (CDSS) for Medication

Objectives Many medication errors can occur when ordering and dispensing medicine in hospitals. The clinical decision support system (CDSS) is widely used in an effort to reduce medication errors. This study focused on the evaluation of user satisfaction with the CDSS for medication at a university hospital. Specifically, this study aimed to identify the factors influencing user satisfaction and to examine user requirements in order to further improve user satisfaction and drug safety. Methods The study was based on survey data from 218 users (103 doctors, 103 nurses, and 15 pharmacists) at a university hospital that uses the CDSS. In order to identify the factors influencing user satisfaction with the CDSS, a multiple linear regression was performed. In order to compare the satisfaction level among the professional groups, an analysis of variance (ANOVA) was performed. Results The reliability of information, decision supporting capability, and departmental support were significant factors in influencing user satisfaction. In addition, nurses were the most satisfied group, followed by pharmacists and doctors according to the ANOVA. Areas for further improvement in enhancing drug safety were real time information searching and decision supporting capabilities to prevent adverse drug events (ADE) in a timely manner. Conclusions We found that the CDSS users were generally satisfied with the system and that it complements the nationwide drug utilization review (DUR) system in reducing ADE. Further CDSS evaluation in other hospitals is needed to improve user satisfaction and drug safety.

Slow overmethylation of housekeeping genes in the body mucosa is associated with the risk for gastric cancer

Helicobacter pylori infection increases age-related diverse overmethylation in gene-control regions, which increases the risk of gastric cancer. The H. pylori-associated overmethylation changes subsequently disappear when gastric atrophy and cancer develop. To identify cancer-risk epigenotypes, we traced dynamic methylation changes in the background mucosa of the stomach depending on the extent of gastric atrophy. Paired biopsy specimens were obtained from the noncancerous antrum and body mucosa of 102 patients with cancer and 114 H. pylori–positive and 112 H. pylori–negative controls. The grade of gastric atrophy was evaluated using the endoscopic atrophic border score. The methylation-variable sites at the CpG-island margins and near the transcriptional start sites lacking CpG islands were semiquantitatively analyzed by radioisotope-labeling methylation-specific PCR. We selected eight housekeeping genes adjacent to Alu (CDH1, ARRDC4, PPARG, and TRAPPC2L) or LTR retroelements (MMP2, CDKN2A, RUNX2, and RUNX3) and eight stomach-specific genes (TFF2, PGC, ATP4B, TFF1, TFF3, GHRL, PGA, and ATP4A). Analysis of age-related methylation in the H. pylori–positive controls revealed slow overmethylation in the body and in the LTR-adjacent genes. A high-frequency overmethylation defined based on the slowly overmethylated genes was frequently observed in the body of patients with gastric cancer with open-type atrophy (OR, 12.7; 95% confidence interval, 3.2–49.8). The rapidly changing methylation of Alu-adjacent genes was barely increased in the antrum of patients with gastric cancer. Among diverse methylation changes associated with H. pylori infection, an increase in slowly changing methylation could serve as a cancer-risk marker. Cancer Prev Res; 7(6); 585–95. ©2014 AACR.

Characteristics of primary cutaneous lymphoma according to WHO‐EORTC classification in Korea

Background. Primary cutaneous lymphoma (PCL) is an extranodal non‐Hodgkin lymphoma with primary involvement of the skin. Epidemiological data on PCLs according to the World Health Organization/European Organization for Research and Treatment of Cancer classification (WHO‐EORTC) has not been investigated in Korea to date.

Upregulation of Krüppel-like factor 6 in the mouse hippocampus after pilocarpine-induced status epilepticus

Krüppel-like factor 6 (KLF6) is a transcriptional regulator involved in a broad range of cellular processes. To date, however, the expression of KLF6 in brains with pathophysiological conditions, such as epilepsy, has not been reported. Therefore, the present study investigated the temporal pattern of KLF6 expression in the mouse hippocampus and identified cell types expressing KLF6 after pilocarpine-induced status epilepticus (SE). Seizures were induced by administrating pilocarpine hydrochloride (280 mg/kg, i.p.) 30 min after an injection of atropine methyl nitrate (3 mg/kg, i.p.). Pilocarpine- and saline-injected animals were sacrificed 1, 3, 7, 14, or 28 days after the onset of SE. Immunohistochemistry showed that the proportion of KLF6-positive cells increased in the hippocampus 1 day after SE onset, peaked at 3 days after SE, and then gradually decreased until 28 days after SE, consistent with the results from our immunoblot analysis. Cells expressing increased levels of KLF6 following pilocarpine-induced SE also expressed GFAP and Ox-42, markers for astrocytes and microglia, respectively. Quantitative analysis revealed that astrocytes were the major type of KLF6-expressing glial cells. These cells also expressed heat shock protein 47 (HSP47), a collagen-specific molecular chaperone. This is the first report showing that KLF6 is inducible in the hippocampus and may be associated with glial responses, especially HSP47-related tissue remodeling after pilocarpine-induced SE.

Extensive partial unilateral lentiginosis

JEADV 2006, 20, 461–488

Development of Ontology for the Diseases of Spine

KISTI is carrying out an e-Spine project for spinal diseases to prepare for the aged society, so called NAP.