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Aims and objectives To examine the validity of the Morse Fall Scale by analysing the electronic medical records on fall risk during different phases of hospitalisation. Background Regular monitoring on fall risk with a reliable and valid assessment tool is a key element in the fall prevention. In Korea, the Morse Fall Scale is currently being used in numerous medical institutions, yet it has not been comprehensively evaluated whether it is suitable and valid. Design The study design was a retrospective case-control study. Methods The participants included 151 fallers and 694 nonfallers. Data were extracted from a university hospital implementing Morse Fall Scale in the electronic medical records between October 2010 and June 2011. The nonfallers were selected by the stratified random sampling method among the patients who were in the hospital during the same period as the fallers. The Morse Fall Scale scores during three different time periods of hospital stay were used for analysis: the initial assessment score upon admission, the last and the maximum scores recorded from admission to the fall or discharge. Results With the maximum Morse Fall Scale score and the best cut-off point of 51, validity indicators showed the highest performance: 0·72 for sensitivity, 0·91 for specificity, 0·63 for positive predictive value, 0·94 for negative predictive value, 0·63 for Youden Index and 0·77 for the area under the receiver operating characteristic curve. Conclusion The Morse Fall Scale showed relatively high predictive performance for the Korean population. Relevance to clinical practice The study results recommend practice change in fall prevention. As the validity was highest when the patient was first classified into the high-risk group based on the Morse Fall Scale cut-off score 51, patients classified as high risk should be placed under special nursing interventions until the day of their discharge, regardless of change in the patient state. [ABSTRACT FROM AUTHOR]

Background and Aim: New regimens, including those with new fluoroquinolones, have been developed to overcome the antibiotic resistance of Helicobacter pylori. We aimed to assess the antibiotic resistance rates, as well as the molecular mechanisms of fluoroquinolone resistance, of the clinical isolates obtained in Korea. Methods: The minimal inhibitory concentration (MIC) values of ciprofloxacin, amoxicillin, clarithromycin, metronidazole and tetracycline were determined by the agar dilution method for 185 treatment-naïve Helicobacter pylori isolates. The resistant strains were evaluated for the presence of point mutations in the quinolone resistance-determining region (QRDR) of the gyrA and gyrB genes by direct nucleotide sequencing. Results: Twenty-nine (29/185, 15.7%) of the strains were found to be resistant to ciprofloxacin. The resistance rates to amoxicillin, clarithromycin, metronidazole and tetracycline were 2.2% (four of 185), 10.8% (20 of 185), 30.3% (56 of 185) and 0.5% (one of 185), respectively. The most common mutations in the H. pylori gyrA gene were found at codons corresponding to Asp87 (16/29, 55.2%) and Asn91 (10/29, 34.5%). Conclusions: Primary H. pylori resistance to ciprofloxacin occurred at a high frequency. The fluoroquinolone resistance is most likely mediated through amino acid point mutation in the gyrA gene at Asn87 and Asp91. [ABSTRACT FROM AUTHOR]

Background and Aims: Researchers have not clearly described the clinical and pathogenetic features of hypoganglionosis and adult-onset Hirschsprung's disease, which cause pseudo-obstruction or intractable constipation. We conducted this study to explore these features of hypoganglionosis and adult-onset Hirschsprung's disease in Korean patients.Methods: We enrolled 24 patients pathologically confirmed as having hypoganglionosis and 11 as having adult-onset Hirschsprung's disease. We recruited 26 subjects who had undergone operation for nonobstructive colon cancer and 45 healthy volunteers as controls. We described their clinical features, investigated ganglion cells and interstitial cells of Cajal (ICC), and analyzed RET, EDNRB, EDN3, and SOX10 genes.Results: We classified hypoganglionosis patients into two groups: type I (focal type, n = 13), with focally narrowed transition zone (TZ); and type II (diffuse type, n = 11), without transition zone. Hypoganglionosis patients had significantly fewer ganglion cells than the controls, and those cells were scarcer in the transition zone than in the proximal dilated area (P < 0.05). The ICC numbers in both diseases were significantly lower than in controls; however, they were similar between transition zone and the proximal dilated area in hypoganglionosis. In adult-onset Hirschsprung's disease, two significant intronic RET polymorphic variants, IVS14-24G>A and IVS19+47T>C, were significantly associated with adult-onset Hirschsprung's disease (P = 0.0122 and 0.0295, respectively), but not with hypoganglionosis.Conclusions: Hypoganglionosis and adult-onset Hirschsprung's disease have different pathophysiologic characteristics, although their clinical presentations are similar. We suggest that there are two subgroups of hypoganglionosis: those with or without a focally narrowed transition zone with a profoundly diminished number of ganglion cells. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the microbial quality of street‐vended foods in Korea. The microbiological contamination levels of aerobic mesophilic bacteria ranged from 0 to 7.43 log cfu/g with a mean value of 4.71 ± 1.53 log cfu/g, while the level of total coliforms ranged from 0 to 6.86 log cfu/g with a mean value of 3.24 ± 1.40 log cfu/g. Staphylococcus aureus (SA) and Escherichia coli (EC) were detected in 9% (mean value: 3.75 ± 0.56 log cfu/g) and 3% (mean value: 2.33 ± 0.90 log cfu/g) of 326 examined samples, respectively. Vibrio parahaemolyticus, Salmonella spp. and Listeria monocytogenes were not detected. More than 50% of the isolated SA were found to be enterotoxin producers and these organisms primarily possessed type A toxin genes. Conversely, verocytotoxin‐producing EC were not detected. Taken together, these results indicate that consumption of street‐vended foods may pose a risk of foodborne disease and that good hygienic practices should be required to ensure public health. PRACTICAL APPLICATIONS: Accurate and up‐to‐date data for microbiological contamination of ready‐to‐eat foods are necessary for consumer protection to improve sanitary conditions in food processing plants in Korea. Known contamination levels can be used by administrators to establish national regulations for the control of foodborne diseases. [ABSTRACT FROM AUTHOR]

Unlabelled: Mindfulness involves reducing potential influences from aversive cognitions, sensations, and emotions on behavior. Mindfulness may influence the experience of pain-related anxiety, and thereby enhance other aspects of physical and psychosocial functioning. Thus, the purpose of this study was to investigate a potential mediating role of pain-related anxiety between mindfulness and physical and psychosocial functioning in chronic pain patients. This cross-sectional/correlational study used archival data (N = 226) obtained from the larger Korean Pain Study at a university-based pain-management center in Korea. Based on the inclusion criterion for the present study, archival data were analyzed for a final sample of 179 patients with chronic pain. Structural equation analyses showed that both the partial- and full-mediation models had adequate goodness-of-fit indices for physical and psychosocial functioning. Subsequent chi-square tests, however, indicated that the more parsimonious full-mediation model was preferred to the partial-mediation model for physical and psychosocial functioning. Bootstrapping procedures yielded significant mediation effects of pain-related anxiety in the full-mediation models on physical and psychosocial functioning. These findings suggest that being mindful may lead indirectly to a decrease in the disabling influences of pain-related anxiety, thereby contributing to better physical and psychosocial functioning, rather than playing a direct contributing role for better functioning among chronic pain patients in Korea., Perspective: This article examines the mediating role of pain-related anxiety between mindfulness and physical/psychosocial functioning. Results suggest that mindfulness methods may benefit patients having pain-related anxiety and consequent disability. These benefits may derive from the way processes of mindfulness interact with processes of avoidance and with cognitive influences on emotional suffering., (Copyright (c) 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.)

Background: Thyroid cancer incidence in Korean women has increased radically and is the highest in all cancer types. However, the rate of cancer screening among women is very low., Objective: The aim of the study was to determine the risk factors for thyroid cancer and to develop a predictive model based on these risk factors., Methods: The study design comprised a literature review and a case-control study. To construct a predictive model, the participants selected were 260 female outpatients diagnosed with malignant neoplasm of thyroid gland who had undergone thyroid removal surgery. A total of 259 people for the control group were selected by adopting a 5-year age-matching method., Results: From the literature review, 6 categories of risk factors were identified. Nine variables, including occupation, live(d) in coastal region, family history of thyroid cancer, history of benign thyroid tumor, menopause status and weight gain, number of full-term deliveries, abortion, exercise intensity, and stress, remained as statistically significant risk factors in the stepwise regression model. Regarding the predictive power of the model, the area under the receiver operating characteristic curve was .79, accuracy was .77, sensitivity was .89, specificity was .65, positive predictive value was .72, and negative predictive value was .85., Conclusion: The predictive power of the model was relatively good, so it can be used to identify individuals at high risk for thyroid cancer., Implications for Practice: The predictive model can be used in promoting to participate in early cancer-screening tests. Thus, it will be possible to detect thyroid cancer in its earliest stage, diminish mortality, and improve quality of life.

Background: Reflux esophagitis is inversely associated with the presence of atrophic gastritis, and endoscopic grading of atrophic gastritis correlates with histological evaluation. The aim of this study was to investigate the association of the endoscopic grade of atrophic gastritis with gastroesophageal and gastropharyngeal reflux., Methods: A total of 627 patients, who underwent endoscopy and ambulatory 24-hour dual-probe pH monitoring, were included in this study. The grade of atrophic gastritis was endoscopically classified into 2 types with the atrophic pattern system: the closed-type (C-type) and the open-type (O-type). We compared the findings from endoscopy and ambulatory pH monitoring for these 2 types., Results: The O-type was significantly associated with a lower prevalence of reflux esophagitis (p = 0.001). All variables showing gastroesophageal reflux in the distal probe were significantly lower in the O-type than in the C-type (p < 0.05). Similarly for the proximal probe, all variables, except the supine time of pH < 4, were significantly lower in the O-type than in the C-type (p < 0.05). The frequency of gastroesophageal reflux disease and gastropharyngeal reflux disease was in significantly lower in the O-type than in the C-type (p < 0.001, p = 0.012, respectively)., Conclusions: Endoscopic grading of atrophic gastritis is easy and is inversely associated with gastroesophageal and gastropharyngeal reflux.

Plant roots are associated with diverse communities of endophytic bacteria which do not exert adverse effects. The diversity of bacterial endophytes associated with ginseng roots cultivated in three different areas in Korea was investigated. Sixty-three colonies were isolated from the interior of ginseng roots. Phylogenetic analysis based on 16S rRNA gene sequences showed that the isolates belonged to three major phylogenetic groups: the high G+C Gram-positive bacteria (HGCGPB), low G+C Gram-positive bacteria (LGCGPB), and the Proteobacteria. The dominant species at the three different ginseng growing areas were: HGCGPB at Ganghwa (55.0%), LGCGPB at Geumsan (45.5%), and Proteobacteria at Jinan (61.9%). Most cellulase-, xylanase-, and pectinase-producing colonies among the isolates belong to the LGCGPB group, except for Pectobacterium carotovora which belonged to the Proteobacteria. The 13 isolates belonging to LGCGPB and Proteobacteria were assessed for their antifungal activity against phytopathogenic fungi such as Rhizoctonia solani. Among them, Paenibacillus polymyxa GS01, Bacillus sp. GS07, and Pseudomonas poae JA01 show potential activity as biocontrol agents against phytopathogenic fungi. Finally, most of the low G+C Gram-positive bacteria with antifungal activity against phytopathogenic microorganisms showed cellulolytic enzyme activity while some Proteobacteria with the antifungal activity and the high G+C Gram-positive bacteria did not show any cellulolytic activity.

Korea has National Health Insurance Program operated by the government-owned National Health Insurance Corporation, and diagnostic services are provided every two year for the insured and their family members. Developing a customer relationship management (CRM) system using data mining technology would be useful to improve the performance of diagnostic service programs. Under these circumstances, this study developed a model for diagnostic service management taking into account the characteristics of subjects using a data mining approach. This study could be further used to develop an automated CRM system contributing to the increase in the rate of receiving diagnostic services.

Objectives: We wanted to estimate the annual socioeconomic costs of alcohol drinking in Korea., Methods: The costs were classified as direct costs, indirect costs and the other costs. The direct costs consisted of direct medical costs, indirect medical costs and subsidiary medical costs. Particularly, the medical costs and population attributable fraction for disease were considered to reflect the calculation of the direct medical costs. The indirect costs were computed by the extent to which the loss of productivity and loss of the workforce might have occurred due to changes in mortality and morbidity according to alcohol drinking. The other costs consisted of property loss, administration costs and costs of alcoholic beverage., Results: The annual costs, which seemed to be attributable to alcohol drinking, were estimated to be 149,352 hundred million won (2.86% of GDP). In case of the latter, the amount includes 9,091 hundred million won for direct costs (6.09%), 62,845 hundred million won for the reduction and loss of productivity (42.08%), 44,691 hundred million won for loss of the workforce (29.92%), and the other costs (21.91%)., Conclusions: Our study confirms that compared with the cases of Japan (1.9% of GNP) and the other advanced countries (1.00-1.42% of GDP), alcohol drinking incurs substantial socioeconomic costs to the Korean society. Therefore, this study provides strong support for government interventions to control alcohol drinking in Korea.