Epinephrine use and the occurrence of biphasic reaction in patients treated for anaphylaxis in the emergency department

Objective@#Although anaphylaxis can result in poor outcomes, studies on the factors influencing the biphasic reaction of anaphylaxis have been limited. In this study, we evaluated the clinical information of patients at high risk for the biphasic reaction of anaphylaxis. @*Methods@#This retrospective observational study was conducted in the emergency department (ED) of a single tertiary center. We enrolled patients diagnosed with and treated for anaphylaxis from January 2014 to December 2020. We gathered the electronic medical data of the patients who satisfied the diagnostic criteria for anaphylaxis and were treated with epinephrine. The enrolled patients were divided into those showing either a uniphasic reaction or a biphasic reaction depending on the need for multidose epinephrine. @*Results@#The cohort included 255 patients of anaphylaxis (48.6%, male). Of these patients, 59 (23%) showed a biphasic reaction. Patients displaying a biphasic reaction had a longer median time from their ED visit to the administration of the first dose of epinephrine compared to those showing a uniphasic reaction-8 (4-13) vs. 7 (3-12) minutes. Patients showing a biphasic reaction were statistically associated with a longer time from their visit to the ED to epinephrine administration (odds ratio [OR], 1.073; 95% confidence interval [CI], 1.011-1.140; P=0.021), lower mean arterial pressure (OR, 0.971; 95% CI, 0.951-0.991; P=0.006), lower pulse rate (OR, 0.973; 95% CI, 0.954-0.991; P=0.004), and a lower rate of food allergen (OR, 0.406; 95% CI, 0.169-0.976; P=0.044). @*Conclusion@#The delayed administration of epinephrine upon ED arrival was associated with biphasic reactions in addition to lower mean arterial pressure and pulse rate, and exposure to non-food allergen. This study presents evidence supporting the prompt use of epinephrine in patients with anaphylaxis. However, further prospective studies in this regard would be needed.

Effect of the Computerized Emergency Consultation System on Communication Between Medical Staff for Emergency Care / 의료커뮤니케이션

Purpose@#: In emergency department(ED), emergency consultation is often omitted or delayed, resulting in an increase of the length of stay for patients. The present study investigated the emergency consultation computerized system designed for prompt and accurate communication can shorten the time for consultation care. In addition, we tried to confirm how users’ satisfaction with communication for emergency consultation changed before and after using the system. @*Methods@#: We divided the period from arrival to exit of the emergency department into 4 stages, and the time taken for each stage was measured. In addition, the present study conducted a satisfaction survey on the convenience and accuracy of communication among users. @*Results@#: After using the computerized system, the median value of time for emergency consultation treatment decreased significantly from 78 minutes to 39 minutes (p<0.001). In terms of communication convenience, more than two-thirds of the users responded positively. @*Conclusion@#: The system that computerized the initial communication shortened the time required for emergency consultation and increased satisfaction in terms of convenience of communication between medical staff.

Simulation study: the development of a respiratory barrier enclosure with negative pressure and the analysis of its protective effect during intubation

Objective@#Within the last 2 years, coronavirus disease 2019 has spread rapidly across several continents, with 100 million confirmed infected patients. Physical barrier enclosure, also called “aerosol-box,” is a solution for the shortage of protective devices and spaces. In this study, we examined the safety of the novel barrier enclosure. @*Methods@#We simulated droplets by nebulizing 1% glycerol+99% ethanol solution. Two experienced physicians performed intubation under two conditions, such as the isolator condition (applying isolator without negative condition) and the negative pressure condition (applying isolator with the negative condition). We compared two conditions with two control groups, including negative control (room air) and positive control (synthetizing droplet air). During the procedure, particles were counted for 30 seconds, and this was repeated 10 times. At each condition, depending on the result of the normality test (Shapiro-Wilk test), an independent t-test was used when normality was satisfied, and a Mann-Whitney U-test was used when normality was not satisfied. @*Results@#The total number of particles in the positive control was 308,788 (175,936-461,124). The total number of particles for both conditions was significantly less than the positive control. Total number of particles in the isolator condition was 30,952 (27,592-33,244, P=0.001) and that in the negative pressure condition was 27,890 (27,165-29,786, P=0.001). @*Conclusion@#The novel barrier significantly reduces synthetizing droplets exposure during intubation. Application of negative pressure through the isolator results in an additional decrease in particle exposure. Studies involving a larger population of operators and prolonged procedures are required.

The effect of paramedic’s emergency patient simulation training - course using standardized communication tools and simulation / 의료커뮤니케이션

Background@#: Since primary emergency treatment should be performed appropriately and promptly, efficient and accurate communication between paramedics and medical staff is paramount to a successful primary emergency treatment and patient handover. The problem of the training program in Korea is that it concentrates more on in-class lectures, often delivered by non-medical specialists, who may lack in practical experience and without proper communication training. To solve this problem, we have devised a simulation based training that focuses on event debriefings and two-way communication. @*Methods@#: 62 paramedics from 3 stations enrolled in the study. 4 different courses with different emergency situations were created and each course was taken twice resulting in a total of 8 classes. All courses were based on actual cases. The curriculum consisted of subject lectures with guidelines, skill practice courses, and simulation courses based on hands-on method. In simulation courses, paramedics use standardized check list to communicate with medical specialists. All curriculums except subject lectures include debriefing, which allows free talking with educators comprised of medical specialists. In order to measure the educational impact, all students performed self-assessment through a structured questionnaire before and after the training. @*Results@#: Regardless different situations and paramedics’ education level, their performance and communication skills have improved after simulation training course. Paramedics mentioned learning skills in simulation course through communication with medical staffs as the biggest advantage. @*Conclusion@#: Receiving the simulation training with standardized communication tools is effective at enhancing the communication between the paramedics and medical staff.

High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy. MATERIALS AND METHODS: Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy₁₀ (range, 51.75 to 150 Gy₁₀), and the median re-RT dose was 68.8 Gy₁₀ (range, 43.2 to 132 Gy₁₀). RESULTS: Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED₁₀) doses were the most significant prognostic factors. Cumulative BED₁₀ ≥145 Gy₁₀ and re-RT BED₁₀≥68.7 Gy₁₀ were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred. CONCLUSION: Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.

The experience of remote videoconferencing to enhance emergency resident education using Google Hangouts

OBJECTIVE: It is difficult for emergency residents to attend all the lectures that are required because of the limited labor time. The Google Hangouts program for has been used as a remote videoconference to overcome the limit to provide equal opportunities and reduce the time and costs since 2015. This article reports the authors' experiences of running a residency education program using Google Hangouts. METHODS: From 2015, topics on the emergency radiology were lectured to emergency residents in three different hospitals connected by Google Hangouts. From 2017, electrocardiography analysis, emergency radiology, ventilator application, and journal review were selected for the remote videoconference. The residents' self-assessment score, and a posteducation satisfaction questionnaire were surveyed. RESULTS: Twenty-nine emergency residents responded to the questionnaire after using the Google Hangouts. The number of participants before and after Hangout increased significantly in other two hospitals. All the residents answered that the score on achieving the learning goal increased before and after the videoconference lectures. All the residents answered that the training program is more satisfactory after using the Google Hangouts than before. CONCLUSION: All emergency residents were satisfied and were more confident after the remote videoconference education using the Google Hangouts than before.

Preliminary results of entire pleural intensity-modulated radiotherapy in a neoadjuvant setting for resectable malignant mesothelioma

PURPOSE: The purpose of this study is to evaluate the safety and efficacy of the multimodality treatment with neoadjuvant intensity-modulated radiotherapy (IMRT) for resectable clinical T1-3N0-1M0 malignant pleural mesothelioma (MPM). MATERIALS AND METHODS: A total of eleven patients who received neoadjuvant chemotherapy and radiotherapy between March 2016 and June 2018 were reviewed. Patients received 25 Gy in 5 fractions to entire ipsilateral hemithorax with helical tomotherapy. RESULTS: All of patients were men with a median age of 56 years. Epithelioid subtype was found in 10 patients. All patients received neoadjuvant chemotherapy with pemetrexed-cisplatin regimen. Ten patients (90.9%) completed 25 Gy/5 fractions and one (9.0%) completed 20 Gy/4 fractions of radiotherapy. IMRT was well tolerated with only one acute grade 3 radiation pneumonitis. Surgery was performed 1 week (median, 8 days; range, 1 to 15 days) after completing IMRT. Extrapleural pneumonectomy was performed in 4 patients (36.3%), extended pleurectomy/decortication in 2 (18.2%) and pleurectomy/decortications in 5 (63.6%). There was no grade 3+ surgical complication except two deaths after EPP in 1 month. Based on operative findings and pathologic staging, adjuvant chemotherapy was delivered in 7 patients (63.6%), and 2 (18.2%) were decided to add adjuvant radiotherapy. After a median follow-up of 14.6 months (range, 2.8 to 30 months), there were 3 local recurrence (33.3%) and 1 distant metastasis (11.1%). CONCLUSION: Neoadjuvant entire pleural IMRT can be delivered with a favorable radiation complication. An optimal strategy has to be made in resectable MPM patients who would benefit from neoadjuvant radiation and surgery. Further studies are needed to look at long-term outcomes.

Prognostic Factor Analysis Including Electrocardiogram Change in Patientss with Subarachnoid Hemorrhage

PURPOSE: The prognostic factors of subarachnoid hemorrhage (SAH) are still not completely known. Several studies suggested that electrocardiogram (ECG) changes can act as a predictor of outcome in SAH patients. The purpose of this study was to describe the prognostic factors, including ECG changes, which are predictive of unfavorable outcome in non-traumatic SAH patients. METHODS: We retrospectively selected patients from our prospectively collected database of 202 SAH patients who visited the emergency medical center. The outcome was assessed using the Glasgow Coma Scale at six months after the occurrence of SAH. RESULTS: In the univariate analysis, a high score in one of the conventional systems (Hunt and Hess system, World Federation of Neurosurgical Societies [WFNS] scale, and Fisher grade), advanced age, accompanying intracranial hemorrhage or intraventricular hemorrhage, ECG changes (ST depression or Tall T), and a history of hypertension were associated with unfavorable outcome. The multivariate analysis showed three prognostic factors (ECG changes, age and high score in the conventional system) for unfavorable outcome. Using this result, three novel models corresponding to the three conventional systems were constructed to predict an unfavorable outcome in such patients. The area under the curve for model 1 (containing the WFNS scale) was 0.912, that of model 2 (containing the HH system) was 0.913, and that of model 3 (containing the Fisher system) was 0.885. Compared with the WFNS, HH or Fisher grade alone, each model exhibited superior accuracy. CONCLUSION: ECG can be described as an independent predictor of poor outcome, and the novel models which contain the ECG changes were found to be more accurate in predicting an unfavorable outcome in SAH patients compared with the conventional scoring system.

Chronic hepatitis C healed by peginterferon-α and rivabirin treatment after kidney transplantation / 영남의대학술지

Hepatitis C virus (HCV) infection is present in a high proportion of patients with kidney transplantation. Compared with uninfected kidney transplant recipients, HCV infected kidney recipient have higher prevalence of liver disease and worse allograft survival after transplantation. Interferon monotherapy before transplantation is standard therapy for HCV-infected kidney transplant candidates. If HCV infection is discovered after transplantation, interferon monotherapy is considered due to the limited critical situation. However, in this patient, who was a kidney recipient, HCV infection was treated after kidney transplantation with peginterferon-α and rivabirin. As a result, the patient achieved sustained virologic response.

Effects of Short-Term Exenatide Treatment on Regional Fat Distribution, Glycated Hemoglobin Levels, and Aortic Pulse Wave Velocity of Obese Type 2 Diabetes Mellitus Patients

BACKGROUND: Most type 2 diabetes mellitus patients are obese and have obesity related vascular complications. Exenatide treatment is well known for both decreasing glycated hemoglobin levels and reduction in body weight. So, this study aimed to determine the effects of exenatide on body composition, glycated hemoglobin levels, and vascular stiffness in obese type 2 diabetes mellitus patients. METHODS: For 1 month, 32 obese type 2 diabetes mellitus patients were administered 5 µg of exenatide twice daily. The dosage was then increased to 10 µg. Patients' height, body weight, glycated hemoglobin levels, lipid profile, pulse wave velocity (PWV), body mass index, fat mass, and muscle mass were measured by using Inbody at baseline and after 3 months of treatment. RESULTS: After 3 months of treatment, glycated hemoglobin levels decreased significantly (P=0.007). Triglyceride, total cholesterol, and low density lipoprotein levels decreased, while aspartate aminotransferase and alanine aminotransferase levels were no change. Body weight, and fat mass decreased significantly (P=0.002 and P=0.001, respectively), while interestingly, muscle mass did not decrease (P=0.289). In addition to, Waist-to-hip ratio and aortic PWV decreased significantly (P=0.006 and P=0.001, respectively). CONCLUSION: Effects of short term exenatide use in obese type 2 diabetes mellitus with cardiometabolic high risk patients not only reduced body weight without muscle mass loss, body fat mass, and glycated hemoglobin levels but also improved aortic PWV in accordance with waist to hip ratio.

Omega-3 Polyunsaturated Fatty Acids May Attenuate Streptozotocin-Induced Pancreatic beta-Cell Death via Autophagy Activation in Fat1 Transgenic Mice

BACKGROUND: Inflammatory factors and beta-cell dysfunction due to high-fat diets aggravate chronic diseases and their complications. However, omega-3 dietary fats have anti-inflammatory effects, and the involvement of autophagy in the etiology of diabetes has been reported. Therefore, we examined the protective effects of autophagy on diabetes using fat-1 transgenic mice with omega-3 self-synthesis capability. METHODS: Streptozotocin (STZ) administration induced beta-cell dysfunction in mice; blood glucose levels and water consumption were subsequently measured. Using hematoxylin and eosin (H&E) and Masson's trichrome staining, we quantitatively assessed STZ-induced changes in the number, mass, and fibrosis of pancreatic islets in fat-1 and control mice. We identified the microtubule-associated protein 1A/1B light chain 3-immunoreactive puncta in beta-cells and quantified p62 levels in the pancreas of fat-1 and control mice. RESULTS: STZ-induced diabetic phenotypes, including hyperglycemia and polydipsia, were attenuated in fat-1 mice. Histological determination using H&E and Masson's trichrome staining revealed the protective effects of the fat-1 expression on cell death and the scarring of pancreatic islets after STZ injection. In the beta-cells of control mice, autophagy was abruptly activated after STZ treatment. Basal autophagy levels were elevated in fat-1 mice beta-cells, and this persisted after STZ treatment. Together with autophagosome detection, these results revealed that n-3 polyunsaturated fatty acid (PUFA) enrichment might partly prevent the STZ-related pancreatic islet damage by upregulating the basal activity of autophagy and improving autophagic flux disturbance. CONCLUSION: Fat-1 transgenic mice with a n-3 PUFA self-synthesis capability exert protective effects against STZ-induced beta-cell death by activating autophagy in beta-cells.

Adrenocortical Insufficiency due to Spontaneous Bilateral Adrenal Hemorrhage Presented as Acute Abdominal Pain / 이화의대지

Adrenocortical insufficiency is the clinical manifestation of deficient production or action of glucocorticoids. It is a life-threatening disorder that can result from primary adrenal failure or secondary adrenal failure due to impairment of the hypothalamic-pituitary axis. Primary adrenocortical insufficiency can be caused by autoimmune adrenalitis, infection (especially, tuberculosis), metastatic cancer, lymphoma, adrenal hemorrhage, infarction or drugs. Among these, adrenal hemorrhage may be caused by anticoagulant drug or heparin therapy, thromboembolic disease, hypercoagulable states such as antiphospholipid syndrome, physical trauma, postoperative state, sepsis and severe stress from any cause. However, even fewer reports exist of adrenocortical insufficiency due to spontaneous bilateral adrenal hemorrhage. We report a rare case of acute adrenocortical insufficiency due to spontaneous bilateral adrenal hemorrhage presenting as acute abdominal pain.

Trichofolliculoma in External Auditory Canal / 대한이비인후과학회지

Trichofolliculoma is an uncommon follicular hamartoma of hair follicle tissue, typically occurring on the face and skin of the head and neck and appearing as papules or nodules. Dents in the central portion and immature white hair may be observed. Asymptomatically, trichofolliculoma occurs at any age but rather frequently in adults in many cases. A 47-year-old man presented a right ear canal mass, which had not been treated for 12 years. The tumor began to increase its size 4 years ago. A little red bump blocked the entrance of the right external auditory canal and there was a little dinge at the center of bump with growing black hair. This case was first reported in our country. Thus, we report this rare case with a review of the literature.

Clinical Reasons for Returning Hearing Aids

BACKGROUND AND OBJECTIVES: Increases in older aged populations and exposure to complicated noise environments have increased the number of hearing-impaired patients, creating greater demands for hearing aids. We have assessed the reasons that individuals rejected wearing and returned properly prescribed hearing aids, as well as differences in individual factors between younger and elderly adults. SUBJECTS AND METHODS: Of 1138 patients for whom hearing aids were prescribed at Kyung Hee University Medical Center Hearing Aid Clinic, 81 (6.14%) returned their hearing aids, including 36 patients aged or =65 years. Patient-related, hearing-related, and hearing aid-related factors were assessed by retrospective chart analysis and phone survey and compared in the two groups. RESULTS: The primary symptoms reported by the 81 patients who returned their hearing aids were hearing disturbance, ringing, and fullness in the ear, in that order and in both groups. The rate of hearing aid return was similar in elderly females and males (p=0.288). The spondee recognition threshold was significantly higher in younger than in elderly adults (63.3+/-14.0 dB vs. 55.6+/-14.74 dB, p=0.019), but the hearing aid return rate was highest in patients with moderate hearing loss in both groups. In evaluating the reasons for return of hearing aids, we found that ineffectiveness of the device was the most frequent reason, accounting for 32.0% of returns, the highest percentage in both groups, with the most frequent patient problem caused by management difficulty in elderly and financial difficulty in younger adults. CONCLUSIONS: The reasons for hearing aid return were different in two groups. Financial considerations were cited more by younger adults, while difficulties in managing hearing aids were cited more frequently by elderly adults. Patients in both groups, however, reported that the most frequent reasons for return were inadequate hearing improvement and inconvenience wearing the hearing aid due to noise amplification.

A Study on Image Reconstruction for Seed Localization for Permanent Prostate Brachytherapy / 대한방사선종양학회지

PURPOSE: This study was to design and fabricate a phantom for prostate cancer brachytherapy to validate a developed program applying a 3-film technique, and to compare it with the conventional 2-film technique for determining the location of an implanted seed. MATERIALS AND METHODS: The images were obtained from overlapped seeds by randomly placing a maximum of 63 seeds in the anterior-posterior (AP) position and at -30degrees to 30degrees at 15degrees intervals. Images obtained by use of the phantom were applied to the image processing procedure, and were then processed into the development program for seed localization. In this study, cases were set where one seed overlapped, where two seeds overlapped and where none of the three views resolved all seeds. The distance between the centers of each seed to the reference seed was calculated in a prescribed region. This distance determined the location of each seed in a given band. The location of the overlapped seeds was compared with that of the 2-film technique. RESULTS: With this program, the detection rate was 92.2% (at +/-15degrees), 94.1% (at +/-30degrees) and 70.6% (compared to the use of the 2-film technique). The overlaps were caused by one or more than two seeds that overlapped; the developed program can identify the location of each seed perfectly. However, for the third case the program was not able to resolve the overlap of the seeds. CONCLUSION: This program can be used to improve treatment outcome for the brachytherapy of prostate cancer by reducing the number of errors in the process of reconstructing the locations of perfectly overlapped seeds.

Evaluation of the Long-Term Stability for the Cylindrical Ionization Chambers / 대한방사선종양학회지

PURPOSE: To analyze the long-term stability of Farmer-type cylindrical ionization chambers by calibration factor provided from the KFDA (Korea Food Drug Administration) MATERIALS AND METHODS: The cylindrical ionization chambers used in this study were the PTW 30001 (30006), 30013, 30002, 30004, 23333, the Capintec PR06C, the NE 2571, the Exradin A12 and the Wellhofer FC65G (IC70). We were analyzed that the N(k) and N(D,W) calibration factor for the cylindrical chambers and compared between the measured N(D,W) and calculated N(D,W) calibration factor. RESULTS: We have observed that the long-term stability of the PTW 30013 (30006), the Wellhofer FC65G (IC70) and the NE 2571 has varied within 0.2%. The measured N(D,W) calibration factor was about 1.0% higher than the calculated N(D,W) that determined by the N(k) calibration factor. CONCLUSION: The study has evaluated that the long-term stability of the cylindrical chambers through analysis for the Nk and N(D,W) calibration factor. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.

A Study of Health Professionals Awareness, Satisfaction and Desirable Nutrition Labeling of Foods for Special Dietary Uses / 대한지역사회영양학회지

This survey was conducted to evaluate with 457 health professionals from July, 1999 to September, 1999 the awareness of and satisfaction with the nutrition labeling system in Korea and to determine a desirable labeling system. Professors of food and nutrition and nutrition researchers in the food industry had the hightest scores on awareness of the nutrition labeling system(75.6% and 73.4%, respectively), which was significantly different from each other by occupation(p<0.01). Frequently checked labeling information were expiration date, production date, price, and company respectively. Special nutrient food producers(56.9%), dietitians(49.3%), nurses(48.1%), researchers(42.3%) answered moderately on satisfaction with nutrition information for products, which was statistically significant(p<0.01). This suggests that health professionals were unsatisfied with the present nutrition labeling system. In nutrition focusing statements, nutrient content claims, health claims, and working periods were significantly related with nutrition focusing statements and health claims, but not with nutrient content claims : the subject who had been working for more than 10 years and less than 5 years had positive thoughts or those matters while the subjects whose working periods were between 10 and 5 years had the lowest score. The most desirable labeling units were serving size(65.1%). Ninety two percent of the subjects wanted absolute nutrient contents in food and their percentage of the KRDA. Eight nine percent of health professionals agreed that the health claims should be used only with scientific approval by the government or food research institutions. Only 4.4% of subjects were satisfied with current regulations of health claims(p<0.001). More studies regarding labeling units, their range and nutrient reference values are needed. The opinions of health professionals in nutrition labeling system should discussed to establish a desirable nutrition labeling system.

The Health and Nutritional Status of Urban Area Workers in Korea

This study was conducted to evaluate the workers' health conditions, nutritional status, food habits, and their needs for the nutrition programs at the worksite. Three hundred and fifty one(men 260, women 91) employees from 11 companies in urban area were recruited for the study. The results of this study were as follows : The average consumption of nutrients in the subjects' diets were found to be deficient such as total energy, calcium, iron, vitamin A and B2. More than 42% of the subjects have at least one of the chronic diseases like obesity, diabetes mellitus, anemia, hypercholesterolemia, liver disease, and hypertension. Most subjects did not recognize their own blood cholesterol levels, blood pressure, or blood sugar level. Nutrition knowledge scores of the subjects were very low, which was only 52.4%. It should be noted that weight problems and other health problems of the employees at the worksite were frequently found among the employees who had relatively low nutrition knowledge scores. The nutrition programs for prevention of the obeses, hypercholesterolemia, diabetes mellitus, stress, and smoking were urgently needed by the subjects. Many subjects also wanted the nutrition education programs for their family.

The Analysis of the Difference between Interviewers and the Days of the Week using the 24-Hour Dietary Recall Method

The purpose of the study is to evaluate the differential effects caused by the interviewers and the days of the week using the 24-hour dietary recall method on the dietary evaluation of nutrient intakes. Thirteen subjects were interviewed by three trained interviewers on a Monday, Wednesday, and Friday. The consumption of nutrients by the subjects during each day was assessed. The average intake of nutrients was found to be sufficient except in calcium, iron, and vitamin A. there was a significant difference between the food intake on the weekdays and that o the weekend. However, the were no significant differences between the interviewers assessments on the intake of nutrients consumed by the subjects. The standardization of the portion size, interview skill and experience may be a few of the reasons explaining the elimination of the potential error created by variations among the interviewers. This study suggests that repeated 24-hour recalls during weekdays and weekends may be a better method for estimating the nutrients consumed by the subjects.

The Changes of Dietary Intakes in the Defectors from North Korea / 대한지역사회영양학회지

No abstract available.