Bone Health-Related Nutritional Knowledge and its Association with Calcium-Related Dietary Behaviors and Nutrition Education of Women in their 20s and 30s

Osteoporosis is a major health problem confronting middle-aged women today. Enhancing calcium intake in early adulthood can increase the rate of calcium gain in bone. In this study, we investigated the association of bone health-related nutritional knowledge levels with calcium-related dietary behavior and nutrition education among women. Data were collected using questionnaires from 347 women aged 20∼30 residing in Gyeonggi-do. Subjects were categorized into two groups according to their bone health-related nutritional knowledge (high or low-knowledge group). Knowledge related to bone health and calcium, and dietary habits was assessed, and the preference for and intake frequency of calcium-rich food were collected and analyzed using food frequency questionnaires. The high-knowledge group showed a significantly higher rate of nutritional education experience (33.9%) when compared with the low-knowledge group (18.9%). Not only were the perceptions regarding milk and dairy products more positive in the high-knowledge group (P＜0.05), but the intake frequency of calcium-rich foods, such as tofu, soybean, and anchovies, was also higher in this group compared to the low-knowledge group (P＜0.05). Overall, the preference for all calcium-rich foods was positively correlated to their intake frequency (P＜0.05). Nutrition education experience and the recognition of the need for such education were positively correlated with the bone health-related nutrition knowledge score (P＜0.05). In conclusion, bone health-related nutritional knowledge can affect calcium-related dietary behavior and increase the intake of calcium-rich food of 20∼30-year-old women and this can contribute to the prevention of osteoporosis. To improve bone health-related nutritional knowledge among young women, it may be important to provide nutrition education.

Chronological Outcomes and Learning Curve of Endoscopic Submucosal Dissection for Colorectal Tumors / 대한소화기학회지

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors. METHODS: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. RESULTS: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm2). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). CONCLUSIONS: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation.

Is the Environment of the Endoscopy Unit a Reservoir of Pathogens?

BACKGROUND/AIMS: Given the characteristic procedures involved in the endoscopy unit, the spread of pathogens is much more frequent in this unit than in other environments. However, there is a lack of data elucidating the existence of pathogens in the endoscopy unit. The aim of this study was to detect the presence of possible pathogens in the endoscopy unit. METHODS: We performed environmental culture using samples from the endoscopy rooms of 2 tertiary hospitals. We used sterile cotton-tipped swabs moistened with sterile saline to swab the surfaces of 197 samples. Then, we cultured the swab in blood agar plate. Samples from the colonoscopy room were placed in thioglycollate broth to detect the presence of anaerobes. After 2 weeks of culture period, we counted the colony numbers. RESULTS: The most commonly contaminated spots were the doctor's keyboard, nurse's cart, and nurse's mouse. The common organisms found were non-pathogenic bacterial microorganisms Staphylococcus, Micrococcus, and Streptococcus spp.. No definite anaerobe organism was detected in the colonoscopy room. CONCLUSIONS: Although the organisms detected in the endoscopy unit were mainly non-pathogenic organisms, they might cause opportunistic infections in immunocompromised patients. Therefore, the environment of the endoscopy room should be managed appropriately; moreover, individual hand hygiene is important for preventing possible hospital-acquired infections.

Effects of a Face-to-face Self-management Program on Knowledge, Self-care Practice and Kidney Function in Patients with Chronic Kidney Disease before the Renal Replacement Therapy

PURPOSE: The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy. METHODS: This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks. RESULTS: Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group. CONCLUSION: Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.

Breast Abscess due to Mycobacterium Fortuitum: A Case Report / 대한내과학회지

The rapidly growing nontuberculous mycobacterium, Mycobacterium fortuitum, is of increasing clinical importance. The ubiquitous M. fortuitum has been isolated from water, soil, and dust. M. fortuitum usually causes skin or soft-tissue infection following trauma or surgery, but may also infect a wide variety of tissues, including the lungs, lymph nodes, bones, joints, and meninges. We believe this is the first report of a breast abscess due to M. fortuitum, which presented in an immunocompetent woman in Korea after nipple piercing. A 26-year-old non-pregnant female presented with a 5-month history of a tender right breast lump that gradually increased in size. Pus from the right breast supported the growth of M. fortuitum. Mycobacterial infection should be considered in cases of recurrent breast abscess with sterile bacterial cultures, particularly when there is a history of nipple piercing procedures.

Meningitis Associated Dengue Fever Imported from Vietnam

Dengue fever is an acute febrile disease caused by the dengue virus, which belongs to the family Flaviviridae. The increasing number of people traveling abroad has increased the number of cases of imported dengue fever in Korea. The most common symptoms in patients with dengue fever are malaise, fever, musculoskeletal pain, headache, nausea, vomiting, and abdominal pain. Neurological manifestations such as myelitis, encephalitis, and cranial nerve palsies have been recognized as clinical consequences of dengue infection, but meningitis is a rare complication. We report the case of a 38-year-old man who presented with fever, headache, and nuchal rigidity while traveling in Vietnam. The etiology of meningitis was confirmed by the presence of dengue IgM antibody in his serum. This case report highlights the potential of dengue infection as a cause of meningitis.

Yellow Fever Vaccine-associated Viscerotropic Disease / 대한내과학회지

This report describes a case of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) that occurred after vaccination in a 23-year-old male. Seven days after vaccination, our patient presented with fever, myalgia, and nausea. The IgM enzyme-linked immunosorbent assay (ELISA) for yellow fever virus was positive. After a 24 day hospitalization, he recovered and was discharged. Yellow fever is a viral hemorrhagic febrile illness caused by a flavivirus and transmitted by mosquitoes. The clinical presentation ranges from a mild febrile illness to a serious infection, leading to hepatic and renal failure, myocardial injury, hemorrhage, and shock, with a case fatality rate of 20-30%. Because yellow fever is a potentially fatal disease, vaccination is encouraged for people traveling to high-risk areas. Although considered a safe vaccine, severe adverse reactions have been reported. In 2001, rare, but severe, acute viscerotropic disease following vaccination was first described. We report the case of a 23-year-old male with fever and hepatitis following vaccination with 17D yellow fever vaccine.