Yoon-Hyung Park

Comparison of Quality of Life and Nutritional Status in Gastric Cancer Patients Undergoing Gastrectomies

The aim of this study was to compare the quality of life (QoL) depending on the postoperative survival period or nutritional status in gastric cancer patients. Surviving gastric cancer patients (n = 222) after the gastrectomy were included in the study at Soonchunhyang University Bucheon Hospital from April 2010 to August 2012. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and a gastric cancer-specific module, the EORTC QLQ-STO22, were used to assess the QoL. The postoperative survival period of the patients fell into two groups; the less-than-1-year group or the more-than-1-year group, and the nutritional status of the patients fell into three groups by a score of patient generated-subjective global assessment (SGA)-A, B, and C. As a result, the rate of malnutrition was 34.5% in the less-than-1-year group and 19.8% in the more-than-1-year group, respectively. Score for the fatigue (p = 0.006), loss of appetite (p = 0.002), reflux (p = 0.027) and body image (p = 0.004) in which the QoL was significantly lower in the less-than-1-year group than in the more-than-1-year group. The score of QoL according to the nutritional status of all subjects, overall health status (p = 0.043), physical functioning (p = 0.016), fatigue (p = 0.006), pain (p = 0.028), loss of appetite (p = 0.017), reflux (p = 0.003), eating restriction (p = 0.002), anxiety (p = 0.010), and body image (p = 0.001) was significantly lower in the SGA-C group than in other SGA groups. These results suggest that the nutritional status of the gastrectomy patients with stomach cancer may impact on their QoL. It is necessary to to develop nutritional intervention to improve QoL in gastric cancer patients with postoperative malnutrition.

Hypertension and age at onset of natural menopause in Korean postmenopausal women: Results from the Korea National Health and Nutrition Examination Survey (2008-2013).

OBJECTIVES Menopause is a natural phenomenon of aging, although the timing and management of menopause can significantly affect a womans quality of life. It is therefore important to identify measures to ensure a healthy menopause. We set out to investigate the association between hypertension and early menopause in Korean women. STUDY DESIGN This cross-sectional study was based on 2008-2013 data from the Korea National Health and Nutrition Examination Survey (KNHANES). Of the 53,829 participants surveyed, 13,584 women were selected. We analyzed the contents of the health interview, health examination, and nutrition survey. MAIN OUTCOME MEASURE The main outcome was defined based on hazard ratios (HR) to identify the effects of hypertension on age at onset of menopause. RESULTS Among postmenopausal women (n=6650), the mean age at onset of menopause was 50.4 years. Premenopausal hypertension was statistically significantly associated with age at menopause, oral contraceptive usage, household income, education level, occupation, marital status and smoking and drinking habits. With lower age at diagnosis of hypertension, HRs for menopause tended to be higher, and hypertension diagnosed before age 40 years conferred a statistically significantly higher HR (Model 1, HR=2.32, 95% CI=1.87-2.88; Model 2, HR=2.31, 95% CI=1.86-2.86; Model 3, HR=2.23, 95% CI=1.80-2.77; Model 4, HR=2.00, 95% CI=1.52-2.63). CONCLUSION Premature menopause is strongly associated with lifestyle factors, in combination with incomplete management of chronic diseases. Our findings support the hypothesis that younger age at diagnosis of hypertension is associated with younger age at onset of menopause in Korean women.

A 9-year Trend in the Prevalence of Allergic Disease Based on National Health Insurance Data

Objectives: To investigate trends in the prevalence of allergic disease over a 9-year period. Methods: Using National Health Insurance Service (NHIS) data, the annual number of patients with allergic disease was obtained for each regional subdivisions (small cities, counties, and districts) from 2003 to 2011. Annual populations for each sub-region were obtained and used to calculate the standardized prevalence. To compare prevalence within the study period, data was standardized spatially and temporally. For standardization, demographic data was used to obtain the registered population and demographic structure for 2010, which was used to perform direct standardization of previous years. In addition, a geographic information system (GIS) was used to visualize prevalence for individual sub-regions, and allergic diseases were categorized into five groups according to prevalence. Results: The nationwide outpatient prevalence of allergic rhinitis increased approximately 2.3-fold, from 1.27% in 2003 to 2.97% in 2013, while inpatient prevalence also increased approximately 2.4-fold,. The outpatient prevalence of asthma increased 1.2-fold, and inpatient prevalence increased 1.3-fold. The outpatient prevalence of atopic dermatitis decreased approximately 12%, and inpatient prevalence decreased 5%. Conclusions: There was a large difference between prevalence estimated from actual treatment data and prevalence based on patients’ self-reported data, particularly for allergic rhinitis. Prevalence must continually be calculated and trends should be analyzed for the efficient management of allergic diseases. To this end, prevalence studies using NHIS claims data may be useful.

Association between Pollen Risk Indexes, Air Pollutants, and Allergic Diseases in Korea

Objectives This study, different from the past researches, has been conducted in all age groups to understand the association between air pollutants, pollen risk indexes, and outpatients with allergic rhinitis (AR), asthma, and atopic dermatitis (AD). Methods Data on air pollutants, pollen risk indexes, and outpatients with each disease were collected from 2003 through 2011 to verify the association between them. All data are time-series materials that have been observed by time (day) and region, and are in a nonlinear shape. In particular, the total number of outpatients per day is a count data that had a Poisson distribution as the response variable. SAS 9.3 was used to make a statistical model, generalized additive model, with lag effects for the analysis. Results For allergic diseases during spring (April–May) and fall (September-October), a significant association was shown between the variables of air pollutants, pollens, and the number of outpatients. Especially, the estimates of NO2 [AR (43.00967 ± 0.11284), asthma (52.01837 ± 0.06452), AD (52.01837 ± 0.06452), p < 0.001] in spring and SO2 [AR (43.00967 ± 0.11284), asthma (52.01837 ± 0.06452), AD (52.01837 ± 0.06452), p < 0.001] in fall were highly significant and showed a positive association with all diseases. Conclusion Domestically and even internationally, various studies on the allergic diseases are being conducted. However, not many studies related to similar studies. In the need of creating grounds to back up these efforts, additional studies on allergic diseases, as well as researches utilizing pollen data, air pollution data, and claims data provided by the Health Insurance Corporation that has no problem in the representativeness of the data that have close relationships to the allergic disease will be needed.

Relationship between Serum 25-hydroxy-vitamin D Concentration and Risk of Metabolic Syndrome in Patients with Fatty Liver

Background The vitamin D deficiency rate in Koreans is still high and dietary intake is insufficient. The purpose of this study was to provide basic data for the management of metabolic syndrome (MetS) by analyzing the effect of vitamin D levels on the MetS in patients with fatty liver. Methods We analyzed the MetS ratio and serum 25-hydroxy-vitamin D (25[OH]D) concentration in 151 adults diagnosed with fatty liver by using obesity index and blood profiles. We collected data on demographic factors, nutrient intake, and lifestyle habits. Results The mean 25(OH)D concentration of all subjects was 14 ng/mL and the insufficiency and deficiency rates were 40.4% and 29.8%. The proportion of MetS was 38.4% and the mean 25(OH)D level of MetS group was 12.1 ng/mL. Low-density lipoprotein cholesterol, triglyceride, and blood glucose were higher in the MetS group than in the normal group, and the waist circumference of the male was significantly higher than that of the normal group. The results showed that the lower the vitamin D concentration, the higher the risk of MetS (odds ratio, 1.47, 95% confidence interval, 0.98–2.81; P=0.043). Conclusions These results suggest that serum 25(OH)D levels may be a risk factor for MetS in patients with fatty liver.

Association between Nutrient Intake and Metabolic Syndrome in Patients with Colorectal Cancer

The purpose of this study was to investigate the difference of nutritional status according to metabolic syndrome in colorectal cancer patients. The subjects were divided into 2 groups (metabolic syndrome group and normal group) according to the presence or absence of metabolic syndrome in 143 patients diagnosed with colorectal cancer, and their lifestyle and nutritional status were analyzed. Recall method was used for the dietary survey, and metabolic syndrome was defined as the presence of 3 or more of waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein (HDL)-cholesterol, and blood pressure. This study showed that the metabolic syndrome group had a low age, a high body mass index (BMI), and a high drinking rate. The intake of energy, protein, fat, calcium, and phosphorus was significantly higher in the metabolic syndrome group than in the normal group, and the intake of β-carotene, vitamin C, and folic acid was significantly low. The intake of cholesterol, fatty acid, saturated fatty acid, and polyunsaturated fatty acid was also higher in the metabolic syndrome group. Higher BMI, alcohol consumption, intake of fat, total fatty acid or saturated fatty acid increased the risk of metabolic syndrome, but fiber, vitamin C, or folic acid intake lowered the risk.Weight management and balanced nutritional intake should be emphasized to prevent metabolic syndrome and to improve the condition in patients with colorectal cancer.

Comparison of Calcium Intake Status by Region and Socioeconomic Status in Korea: The 2011-2013 Korea National Health and Nutrition Examination Survey

Background Calcium is an essential element nutrient in our body, and insufficient calcium intake is very common in Korean. Socioeconomic status (SES) is known to be associated with quality of diet and health. The purpose of this study was to compare between calcium intake by region and SES. Methods This study used data from a nationally represented sample of Koreans (n=19,249) from 2011 to 2013 Korea National Health and Nutrition Examination Survey. We were divided into six regions: Seoul and Gyeonggi-do, Gangwon-do, Chungcheong-do, Jeolla-do, Gyeongsang-do, and Jeju-do. Daily calcium intake and dietary quality based on 24 hr recall data was calculated and analyzed by the sex, age, SES. Results The regions with the highest calcium intakes in both males and females were Seoul and Gyeonggi-do. The age groups with a significant difference in calcium intake, nutrient adequacy ratio, and nutrient density by region were 14 to 19, 20 to 29, and ≥65 years. Calcium intake and dietary quality were lowest in the low household income group. In terms of being a recipient of the dietary life supply, the calcium intake and dietary quality of the recipient group was low. Conclusions We found that daily calcium intake was very different by region and was significantly lower in region with lower SES. The findings of this study suggest social inequalities in calcium intake by region can be addressed in the development and implementation of tailored nutritional interventions to promote calcium nutritional status of Koreans.

Clinical outcome of acute intoxication due to ingestion of auxin-like herbicides

Background. The human toxicity of synthetic auxin analogue herbicides has not been extensively studied. Methods. Clinical outcome was assessed from medical records of 17 patients who had intentionally ingested auxin pesticides with active ingredients like dicamba, triclopyr, MCPA or mecoprop. The patients were interviewed after discharge to follow outcome (interval 2 to 56 months). Result. One patient who had ingested 500 mL of a mecoprop product died of hypotension and respiratory failure 36 hours after hospital admission. The other 16 patients recovered and were discharged by hospital day 28. After discharge, four patients died from causes not related to herbicide intoxication. In the 12 surviving patients, no long-term effects were reported. Conclusion. Human toxicity of synthetic auxins appears relatively benign with conservative treatment. However, when the amount ingested is above several hundred milliliters of commercial product, especially in combination of mecoprop with other intoxicants (e.g. alcohol), shock with respiratory failure may develop and lead to death.

Annual prevalence and economic burden of genital warts in Korea: Health Insurance Review and Assessment (HIRA) service data from 2007 to 2015

This study evaluated the annual prevalence of anogenital warts (AGW) caused by human papillomavirus (HPV) and analysed the trend in annual per cent changes (APC) by using national claims data from the Health Insurance Review and Assessment of Korea, 2007-2015. We also estimated the socio-economic burden and co-morbidities of AGW. All analyses were performed based on data for primary A63.0, the specific diagnosis code for AGW. The socio-economic cost of AGW was calculated based on the direct medical cost, direct non-medical cost and indirect cost. The overall AGW prevalence and socio-economic burden has increased during the last 9 years. However, the prevalence of AGW differed significantly by sex. The female prevalence increased until 2012, and decreased thereafter (APC + 3·6%). It would fall after the introduction of routine HPV vaccination, principally for females, in Korea. The male prevalence increased continuously over time (APC + 11·6%), especially in those aged 20-49 years. Referring to the increasing AGW prevalence and its disease burden, active HPV infection control surveillance and prevention in males are worth consideration.

Factors Affecting Smoking Cessation Success of Heavy Smokers Registered in the Intensive Care Smoking Cessation Camp (Data from the National Tobacco Control Center)

Objectives The purpose of this study was to investigate the factors involved in the success of smoking cessation in heavy smokers enrolled in an intensive care smoking cessation camp program. Methods Heavy smokers enrolled in the program were classified into a success (n = 69) or failure (n = 29) group, according to whether they maintained smoking cessation for 6 months after the end of the program. Demographics, smoking behaviors, and smoking cessation-related characteristics were analyzed. Results Statistically significantly more participants in the success group had a spouse (98.6%; p = 0.008) compared with participants in the failure group (82.8%). However, multivariate logistic regression analysis indicated that having a spouse was not an independent factor in smoking cessation (p = 0.349). A significant difference in the frequency of counseling between the success and failure groups was observed (p = 0.001), with 72.5% of those who received counseling on 3–5 occasions for 6 months after the end of program successfully quit smoking, indicating that those who received more counseling had a higher likelihood of smoking cessation success. This was confirmed as an independent factor by multivariate logistic regression (p < 0.005). Furthermore, a graduate school level of education or higher, indicated a statistically greater success rate compared to those that were less well educated (p = 0.043). This was also observed as a significant independent factor using multivariate logistic regression (p = 0.046). Conclusion Education level, marital status, and the number of counseling sessions were significant factors contributing to smoking cessation success.