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Background: To investigate the characteristics of cancer survivors and the effects of the services of the Korean Cancer Survivorship Center Pilot Project launched by the South Korean government on distress.Methods: A prospective observational cohort study was performed in cancer survivors who completed primary treatment. Cancer survivors’ distress and symptoms such as fatigue, pain, depressive mood, anxiety, and insomnia were evaluated by well-trained nurses. Regarding to their needs, medical and psychosocial support services were provided. Results: This study included 1,921 cancer survivors, with a mean age of 57.3 years (68.7% females). The breast cancer was most common, followed by stomach and colorectal cancer. Psychosocial and medical support decreased the percentage of the high-distress group from 50.9% to 30.5% and decreased the percentage of cancer survivors with high scores in fatigue, pain, anxiety, depressive mood, and insomnia. The independent predictors of a low distress level after the use of the services were older age, the relief of fatigue, pain, and insomnia.Conclusions: This study showed that psychosocial and medical support is associated with the lower distress and physical and mental symptoms of cancer survivors. Psychosocial and medical support could contribute to distress relief in cancer survivors. Further management strategies for fatigue, pain, and insomnia are required.

Purpose: The purpose of this study was to investigate the relationship between sleep timing and depressive mood in Korean adolescents. Methods: The study analyzed the data from the 2007~2015 Korea Youth Risk Behavior Web-based Survey. A total of 541,693 students in grades 7~12 were included in the final analysis. Multivariable logistic regression was used to examine their sleep timing and depressive mood, adjusted for sex, grade, region, socioeconomic status, academic performance, alcohol, smoking and physical activity. Sleep duration and sleep quality were also included in our model to identify whether or not the effect of sleep timing on depression is mediated by sleep duration or sleep quality. Results: The prevalence of depressive mood was 32.7% and the mean sleep timing was 12:13 AM. After adjustment for eligible covariates, the association between sleep timing and depressive mood showed a J-shaped curve. Adolescents who slept at 8 pm~10 pm were 39% more likely to be depressive (OR = 1.39, 95% CI 1.30~1.40) and at 3 am~ 4 am were 67% more likely to be depressive (OR=1.67, 95% CI 1.64~1.70) than adolescents who slept at 11 pm~12 am. These associations persisted after being adjusted for sleep duration and sleep quality. Conclusion: Sleep timing was related to depression in adolescents, independent of sleep duration and sleep quality. It appears that there is a certain sleep timing beneficial to mental health of adolescents.

The principle purpose of this research is to figure out whether the inhalation of Wood Essential oil (Chamaecyparis obtusa) affect not only human beings' concentration for surroundings but also change as to status of feelings. total number of subjects for this experimental are determined to be 66 (men 44 and women 22) among 85 adults who agreed to participate in this experiment after excluding 19 participants who were not able to smell scent due to flu and nasal inflammation. After both experimental group and control group being measured referring to their status of mood such as concentration, depression, vigor, fatigue, confusion, tension and anger, the experimental group is offered to get a piece of cotton that includes Wood Essential oil and they are asked to inhale it for 5 min. On the other hand, control group is offered to wait for the experimental group finishing inhaling wood Essential oil for 5 min. After 5 min, the status of mood from both groups were measured again. simultaneously, I conducted a survey targeting experimental group to see what their preferences are like regarding scent of wood essential oil. The experiment shows that the status of experimental group's concentration is improved about 0.94 point when compared to control group's. Moreover, Total mood disturbance is lower than control group's. Therefore it is proved that the inhalation of wood Essential oil alleviates overall status of mood. according to the analyses result of favor to scent for wood essential oil from experimental group, some of them who were positive got much better improvement when it comes to concentration and far more relieved on their feelings than those who weren't. Based from this result, it is definitely confirmed that there is a Phytoncide‘s psychophysiological effect which transcends the Placebo Effect generated by Phytoncide’s positive image.

Smoking cessation leads to both beneficial and harmful changes in cardiovascular disease (CVD) risk factors. The basis of the harmful changes, however, is unknown. Our objective was to determine whether they are associated with the weight gain that accompanies smoking cessation.Study subjects were male cigarette smokers aged at least 30 years who visited the Health Promotion Center of Seoul National University Hospital between 1995 and 2007 repeatedly with a 1- to 3-year interval between first and second visit. Self-reporting questionnaires gathered clinical and socio-economic characteristics on the initial visit, and CVD risk factors (blood pressure, fasting blood glucose, and serum lipid profile) were measured on both the visits.We compared the CVD risk factors between smoking quitters and smoking continuers. The quitters were more likely than the continuers to have harmful health changes such as increase in body weight (P0.01), in systolic blood pressure, and in serum levels of total cholesterol, LDL-cholesterol, and non-HDL cholesterol (P0.05). When stratified by body weight change, quitters who had gained more than the median (1.3 kg) were more likely than those who had not to have increase in blood pressure (P0.01) and in serum levels of total cholesterol, triglycerides, non-HDL cholesterol, and fasting glucose (P0.05).Harmful changes in CVD risk factors associated with smoking cessation were mainly secondary to weight gain. To reduce the risk of cardiovascular disease in quitters, therefore, more attention should be focused on preventing weight gain.

Background: High-sensitivity C-reactive protein (hs-CRP) is an important inflammatory marker, and inflammation is known to be involved in the initiation and progression of cancer. We investigated the association between serum hs-CRP levels and all-cause mortality, cancer mortality, and site-specific cancer mortality in apparently cancer-free Koreans. Methods: A total of 33,567 participants who underwent routine check-ups at a single tertiary hospital health-screening center between May 1995 and December 2006, and whose serum hs-CRP level data were available, were included in the study. Baseline serum hs-CRP levels were obtained and subjects were followed up for mortality from baseline examination until December 31, 2008. Results: During an average follow-up of 9.4 years, 1,054 deaths, including 506 cancer deaths, were recorded. The adjusted HRs (aHR; 95% confidence interval [CI]) of subjects with hs-CRP ≥3 mg/L for all-cause and cancer-related mortality were 1.38 (1.15–1.66) and 1.61 (1.25–2.07) in men, and 1.29 (0.94–1.77) and 1.24 (0.75–2.06) in women, respectively, compared with subjects with hs-CRP ≤1 mg/L. Elevated hs-CRP was also associated with an increased risk of site-specific mortality from lung cancer for sexes combined (2.53 [1.57–4.06]). Conclusions: This study suggests that elevated levels of hs-CRP in apparently cancer-free individuals may be associated with increased mortality from all-causes and cancer, in particular, lung cancer in men, but not in women. Impact: As a marker for chronic inflammation, hs-CRP assists in the identification of subjects with an increased risk of cancer death. Cancer Epidemiol Biomarkers Prev; 21(11); 2076–86. ©2012 AACR.

Background Participants9 understanding of clinical trials is important in informed consent. However, little is known about what information participants really want to know. Aims To demonstrate the existence of a discrepancy between participants9 understanding and their desire to know. Methods The participants in clinical trials at Seoul National University Hospital were surveyed. The survey consisted of 11 statements based on the essential elements of informed consent. The participants gave two responses to each statement on a five-point Likert scale to rate their subjective understanding and desire to know, respectively. Information discrepancy was defined as the difference between these two ratings: if understanding exceeded desire to know for a particular item, it was defined as ‘over-informed’; if desire to know exceeded understanding for a particular item, it was defined as ‘under-informed’. Results Participants reported good understanding of ‘voluntariness’, ‘duration’, ‘study involves research’ and poor understanding of ‘confidentiality’, ‘compensation’, ‘benefits’, ‘procedures’ and ‘risks or discomforts’. For ‘risks or discomforts’, ‘who to contact’, ‘voluntariness’, ‘duration’ and ‘procedures’, participants reported high desire to know compared with ‘confidentiality’, ‘purpose’, ‘study involves research’ and ‘benefits’. The elements ‘study involves research’, ‘voluntariness’, ‘duration’, ‘purpose’ and ‘who to contact’ were over-informed, while ‘compensation’, ‘risks or discomforts’, ‘procedures’, ‘confidentiality’ and ‘benefits’ were under-informed. Participants over 50 years of age, those without a college education and those whose participation was less voluntary were relatively less informed about the clinical trials. Conclusions An information discrepancy was observed between the participants9 understanding and their desire to know. By putting more emphasis on under-informed elements, the quality of informed consent could be improved.

Attending conferences is important for doctors and residents in family medicine. Nevertheless, departments of family medicine at many hospitals find it difficult to hold regular conferences. Holding joint videoconferences between Family Medicine Departments of several hospitals through a videoconferencing system could solve this problem. Therefore, Family Medicine Departments of Seoul National University Hospital, Seoul National University Bundang Hospital, and Kangwon National University Hospital decided to hold regular joint videoconferences via a videoconferencing system. Eighty-one joint videoconferences were held from April 1 to October 29, 2010. PowerPoint slideshows were transferred to the other two locations in the same resolution as presenter's monitor. Image and voice of the speaker were transferred in real time and in acceptable quality. Joint videoconferences are feasible, satisfactory and useful for medical education, especially when individual family medicine departments are small and lack resources to hold face-to-face conferences. We expect that more family medicine departments will choose to participate in implementing similar joint videoconferencing systems in the future.

Yu-Il Kim, MD·Jee Young Hong, MD·Kyoungwoo Kim, MD·Eurah Goh, MD·Nak-Jin Sung, MD Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Department of Family Medicine, Inje University Seoul Paik Hospital, Seoul, Department of Family Medicine, Kangwon National University Postgraduate College of Medicine, Chuncheon, Korea

Background: Diet pattern of regular and three meals per day is commonly recommended. Studies investigated the health effect of gorging pattern of diet using meal frequency and meal skipping, but the health effect of meal calorie variation between three regular meals has never been investigated. In this study, maximum meal calorie variation was defined as subtraction calorie for a meal with minimum energy intake from calories for a meal with maximum energy intake between three meals and examined the effect of maximum meal calorie variation between three regular meals a day on cardiovascular risk factors. Methods: A total of 4,680 healthy subjects aged 20-87 years who underwent medical screening examination, at one tertiary hospital health screening center and completed 24-hour dietary recall was included. Serum cholesterol subfractions, fasting glucose and blood pressure were measured. Results: Maximum meal calorie variation was significantly related to serum concentration of total cholesterol (β = 1.77; 95% confidence interval [CI], 0.36 to 3.18) and low density lipoprotein-cholesterol (LDL-C) (β = 1.64; 95% CI, 0.37 to 2.91), body mass index (β = 0.24; 95% CI, 0.12 to 0.37) and waist circumference (β = 0.66; 95% CI, 0.34 to 0.98) after adjustment for potential confounders. Conclusion: This study suggests the notion that concentration of total cholesterol and LDL-C and obesity indices are related to maximum meal calorie variation between three meals, independently of energy intake and other confounding factors in free-living population.

Results: The mean follow-up duration was 112 months and the mean age of the first visit was 47.9 years. The median maximum duration of abstinence was 5.50 years, and the annual hazard ratio of relapse was about 2.5-4.2% from two to seven years of duration of abstinence. Mean age of smoking onset was 22.9 years, the mean smoking duration was 24.5 years, and the mean smoking amount per a day was 20.0 cigarettes. In single-variate analysis, the total number of cessation success, the age of smoking onset, the mean smoking duration, the mean smoking amount per day, the cessation method, the reason for trying cessation were related with the long-term cessation maintenance. In multivariate analysis, the total number of success for cesstion, the reason for trying cessation, the cessation method, the mean number of cigarettes per day were related. Conclusion: The experience of relapse, the motive of cessation and self-willingness were shown to be important for longterm maintenance of smoking cessation.