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This study investigates the effect of working hours on the dietary behaviors and dietary quality of male industrial workers employed in rotating shifts. The survey was conducted from February to March 2022, enrolling 209 male workers operating in rotational shifts at industries in the Chungcheongnam-do region. Eating behavior and health awareness were investigated during the morning shift, afternoon shift, and night shift for the same subjects. The shift timings were found to be associated with dietary behavior, which had an impact on the dietary quality of workers. Negative effects of shift timings on diet and health were also perceived by the shift workers. The frequency of alcohol consumption was high during the morning shift, and the frequency of night time snack intake was high during the afternoon shift. During the night shift, there was decreased vegetable intake and increased ramyeon intake. Compared to the morning shift, a significant decrease in dietary quality scores was found during the night shift. The workers recognized that rotating shift work negatively affected health, eating habits and sleep. There was a high demand for providing a variety of menus and healthy night snacks in the company cafeteria. When nutritional counseling and educational health services were provided, the willingness to participate was high. Therefore, to improve the health and dietary quality of shift workers, there is a need to provide diets suitable for the working environment and the characteristics, and to provide nutrition management services.
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Objectives@# Bone health in early adulthood, as individuals approach peak bone mass, plays a critical role in preventing osteoporosis later in life. This study aimed to investigate the associations between lifestyle and dietary factors, anthropometric measurements, and urinary bone resorption markers in young adults. @*Methods@# A cross-sectional study was conducted with 100 healthy Korean adults (50 men and 50 women) in their 20s and early 30s. Bone mineral density (BMD), anthropometric measurements, dietary intake (24-hour recall), and urinary bone resorption indicators (deoxypyridinoline and N-terminal telopeptide of type I collagen) were analyzed. Variables were compared between the osteopenia and osteoporosis groups (OSTEO group: 30% men and 60% women) and the healthy control group. @*Results@# Men in the OSTEO group were significantly taller than those in the control group (P < 0.05). Women in the OSTEO group had significantly lower body weight and body composition (muscle and body fat) than those in the normal group (P< 0.01). Men in the OSTEO group had a significantly higher intake of animal calcium (Ca) than those in the normal group (P < 0.05). Women in the OSTEO group had significantly higher dietary fiber, vitamin A, Ca, plant Ca, and potassium intake than did those in the normal group (P < 0.05). There were no significant differences in caffeinated beverage consumption, eating habits, or urinary bone resorption indicators between the OSTEO and control groups of either sex. @*Conclusions@# In our study of young South Korean adults, we observed low bone density levels, with particularly low BMD in taller men and underweight women. We found a higher nutrient intake in the OSTEO group, indicating the possibility of reverse causality, a phenomenon often found in cross-sectional studies. Therefore, there is a need to further elucidate dietary factors related to osteoporosis in young adults through prospective cohort studies involving a larger population.
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Purpose@#The purpose of this study was to evaluate the nutritional quality of complementary baby food products sold in Korea according to the baby food stages and food composition. @*Methods@#A total of 1,587 complementary food products sold online and offline between March and December 2021 were investigated. They ranged from liquid meals to solid rice for babies aged 5 to 36 months. @*Results@#The number of intakes per packaged volume was 2.8 in Stage 1, 1.9 in Stage 2, 1.4 in Stage 3, and 1.1 in Stage 4 (p < 0.0001). The dietary variety scores (DVS) of the complementary baby food products were 3.4 in Stage 1, 5.5 in Stage 2, 7.1 in Stage 3, and 9.7 in Stage 4 (p < 0.0001) and showed a significant increase in the later stages. The Korean dietary diversity score (KDDS) significantly increased from 2.3 in Stage 1, to 2.8 in Stage 2, 3.0 in Stage 3, and 3.4 in Stage 4 (p < 0.0001). The higher the baby food stage, the higher the proportion of grains/meat/vegetable ingredients. The ratio of protein intake to Adequate Intake (AI) or Recommended Nutrition Intake (RNI) was higher in products with a KDDS of 3 points or more, or in products with 2 points or fewer in Stages 1 and 2 (p < 0.0001, respectively). The ratio of protein intake to RNI increased as the KDDS score increased in Stages 3 and 4 (p < 0.0001, respectively). For all stages of baby foods, the ratio of protein intake to AI or RNI was high in products that included the meat group (beans, nuts, meat, eggs, fish, and shellfish) (p < 0.0001, respectively). @*Conclusion@#Continuous research and nutritional evaluation are required for establishing nutrient content standards for commercially available baby foods, considering breast milk intake.
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Purpose@#Epidermal growth factor receptor (EGFR) T790M mutations have been detected in the second or third rebiopsy, even if the T790M mutation was not identified in the first rebiopsy. This meta-analysis investigated the EGFR T790M mutation detection rates and its additional advantages with repeated rebiopsies. @*Materials and Methods@#We searched through the PubMed and EMBASE databases up to June 2022. Studies reporting rebiopsy to identify the EGFR T790M mutation in case of disease progression among patients with advanced non-small cell lung cancer and multiple rebiopsies were included. The quality of the included studies was checked using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. @*Results@#Eight studies meeting the eligibility criteria, reporting 1,031 EGFR mutation–positive patients were selected. The pooled EGFR T790M mutation detection rate of the first and repeated rebiopsies were 0.442 (95% confidence interval [CI], 0.411 to 0.473; I2=84%; p < 0.01) and 0.465 (95% CI, 0.400 to 0.530; I2=69%; p < 0.01), respectively. Overall, the pooled detection rate of EGFR T790M mutation was 0.545 (95% CI, 0.513 to 0.576), which increased by 10.3% with repeated rebiopsies. @*Conclusion@#This meta-analysis identified that repeated rebiopsy increases the detection rate of EGFR T790M mutation by 10.3%, even if EGFR T790M mutation is not detected in the first rebiopsy. Our results indicate that the spatiotemporal T790M heterogeneity can be overcome with repeated rebiopsy.
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Purpose@#This study aimed to report the final analysis of time-on-treatment (TOT) and overall survival (OS) in patients with advanced-stage epidermal growth factor receptor (EGFR)+ non–small cell lung cancer (NSCLC) who received sequential afatinib and osimertinib and to compare the outcomes with other second-line regimens (comparator group). @*Materials and Methods@#In this updated report, the existing medical records were reviewed and rechecked. TOT and OS were updated and analyzed according to clinical features using the Kaplan-Meier method and log-rank test. TOT and OS were compared with those of the comparator group, in which most patients received pemetrexed-based treatments. A multivariable Cox proportional hazard model was used to evaluate features that could affect survival outcomes. @*Results@#The median observation time was 31.0 months. The follow-up period was extended to 20 months. A total of 401 patients who received first-line afatinib were analyzed (166 with T790M+ and second-line osimertinib, and 235 with unproven T790M and other second-line agents). Median TOTs on afatinib and osimertinib were 15.0 months (95% confidence interval [CI], 14.0 to 16.1) and 11.9 months (95% CI, 8.9 to 14.6), respectively. The median OS in the osimertinib group was 54.3 months (95% CI, 46.7 to 61.9), much longer than that in the comparator group. In patients who received osimertinib, the OS was longest with Del19+ (median, 59.1; 95% CI, 48.7 to 69.5). @*Conclusion@#This is one of the largest real-world studies reporting the encouraging activity of sequential afatinib and osimertinib in Asian patients with EGFR+ NSCLC who acquired the T790M mutation, particularly Del19+.
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Since the introduction of low-dose computed tomography (CT) screening for patients at high risk of lung cancer, the detection rate of suspicious lung cancer has increased. In addition, there have been many advances in therapeutics targeting oncogenic drivers in non-small cell lung cancer. Therefore, accurate pathological diagnosis of lung cancer, including molecular diagnosis, is increasingly important. This review examines the problems in the pathological diagnosis of suspected lung cancer. For successful pathological diagnosis of lung cancer, clinicians should determine the appropriate modality of the diagnostic procedure, considering individual patient characteristics, CT findings, and the possibility of complications. Furthermore, clinicians should make efforts to obtain a sufficient amount of tissue sample using non- or less-invasive procedures for pathological diagnosis and biomarker analysis.
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Purpose@#The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs). @*Materials and Methods@#From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022. @*Results@#The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm2) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm2, p < 0.001) and 1.9-mm forceps (3.7 mm2, p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications. @*Conclusion@#Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.
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Background@#The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. @*Methods@#Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. @*Results@#The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden’s index). @*Conclusion@#Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.
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Background/Aims@#Despite the obvious benefits of adding immune checkpoint inhibitors to platinum-etoposide chemotherapy in patients with extensive-stage small-cell lung cancer (ES-SCLC), real-world data remain scarce. @*Methods@#This retrospective study included 89 patients with ES-SCLC treated with platinum-etoposide chemotherapy alone (chemo-only group; n = 48) or in combination with atezolizumab (atezolizumab group; n = 41) and compared the survival outcomes between these two groups. @*Results@#Overall survival (OS) was significantly longer in the atezolizumab group than in the chemo-only group (15.2 months vs. 8.5 months; p = 0.047), whereas the median progression-free survival was almost the same (5.1 months vs. 5.0 months) in both groups (p = 0.754). Subsequent multivariate analysis revealed that thoracic radiation (hazard ratio [HR], 0.223; 95% confidence interval [CI], 0.092–0.537; p = 0.001) and atezolizumab administration (HR, 0.350; 95% CI, 0.184–0.668; p = 0.001) were favorable prognostic factors for OS. In the thoracic radiation subgroup, patients who received atezolizumab demonstrated favorable survival outcomes and no grade 3–4 adverse events (AEs). @*Conclusions@#The addition of atezolizumab to platinum-etoposide resulted in favorable outcomes in this real-world study. Thoracic radiation was associated with improved OS and acceptable AE risk in combination with immunotherapy in patients with ES-SCLC.
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In the current years, it has now become necessary to establish standards for micronutrient intake based on scientific evidence. This review discusses issues related to the development of the 2020 Dietary Reference Intakes for Koreans (KDRI) for magnesium (Mg), zinc (Zn), and copper (Cu), and future research directions. Following issues were encountered when establishing the KDRI for these minerals. First, characteristics of Korean subjects need to be applied to estimate nutrient requirements. When calculating the estimated average requirement (EAR), the KDRI used the results of balance studies for Mg absorption and factorial analysis for Zn, which is defined as the minimum amount to offset endogenous losses for Zn and Mg. For Cu, a combination of indicators, such as depletion/repletion studies, were applied, wherein all reference values were based on data obtained from other countries. Second, there was a limitation in that it was difficult to determine whether reference values of Mg, Zn, and Cu intakes in the 2020 KDRI were achievable. This might be due to the lack of representative previous studies on intakes of these nutrients, and an insufficient database for Mg, Zn, and Cu contents in foods. This lack of database for mineral content in food poses a problem when evaluating the appropriateness of intake. Third, data was insufficient to assess the adequacy of Mg, Zn, and Cu intakes from supplements when calculating reference values, considering the rise in both demand and intake of mineral supplements. Mg is more likely to be consumed as a multi-nutrient supplement in combination with other minerals than as a single supplement. Moreover, Zn-Cu interactions in the body need to be considered when determining the reference intake values of Zn and Cu. It is recommended to discuss these issues present in the 2020 KDRI development for Mg, Zn, and Cu intakes in a systematic way, and to find relevant solutions.
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This study was undertaken to investigate the association between maternal nutrition knowledge, dietary attitudes, and behaviors related to sugar intake and sugar intake reduction in preschool children. Eighty-three children aged 5 to 6 years attending kindergartens in Hongseong and their mothers participated in this study from October 2020 to February 2021. The average age of the mothers was 38.7 years, and 53.0% of the children were male. As child age increased, nutrition knowledge of sugar intake reduction increased, but no relation was found between age and, dietary behavior and preference related to sugar intake reduction. For children whose mothers perceived that their child’s sugar preference was high, the behavioral score of sugar intake reduction was low. The more mothers allowed their children to eat sweet food; the higher was their child’s preference for sweet food, which was also significantly associated with an increased risk of high sugar intake. When mothers were provided education that encouraged reducing children’s sugar intakes, knowledge about reducing sugar intake in children was significantly increased. The study emphasizes the importance of the roles of mothers and primary caregivers regarding reducing the sugar intakes of preschool children.
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Purpose@#In this study, the serving size of home meal replacement (HMR)-soups (Guk, Tang) and stews (Jjigae) available in the Korean market was investigated, and an evaluation of the nutrition per serving was conducted based on the nutrition labeling. @*Methods@#The market research was conducted from March to August 2021 on products sold on the internet, convenience stores, supermarkets, and hypermarkets. A total of 370 products were investigated and classified into 3 types: Guk (n = 129), Tang (n = 132), and Jjigae (n = 109). @*Results@#An analysis of the survey revealed that 72.9% of Guk, 71.2% of Tang, and 79.8% of Jjigae had labels with servings per container, and 89.2% of Guk, 91.7% of Tang, and 99.1% of Jjigae had labels with nutrition facts. The nutritional evaluation per serving of Guk, Tang, and Jjigae was conducted for 259 products (87 Guk, 86 Tang, and 86 Jjigae) having labels containing both the servings per container and nutrition facts. The average serving size of Tang was 367.6 g, which was significantly higher than Guk (325.3 g) and Jjigae (305.1 g) (p < 0.001). The calorie content of Jjigae (171.4 kcal) and Tang (162.3 kcal) was significantly higher than Guk (90.8 kcal) (p < 0.001), and the protein content was the highest in Tang (16.3 g) (p < 0.001). The sodium content per serving of Jjigae (1,479.0 mg) was significantly higher than Guk (1,073.3 mg) and Tang (959.8 mg) (p < 0.001). The percent daily value per serving of all three types was less than 10% on average for calories and 15–30% for protein, whereas for sodium showed an average of around 50% (48–74%). @*Conclusion@#The serving size and nutritional value per serving of the HMR-soups and stews found in this study can be used as basic data to establish the reference serving size.
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Background@#This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public–private mix (PPM). Factors affecting treatment success were also investigated. @*Methods@#Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. @*Results@#A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m2, previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. @*Conclusion@#The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.
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Objective@#To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). @*Materials and Methods@#This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. @*Results@#Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI.Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). @*Conclusion@#A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.
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This study compared the job satisfaction and job importance of school dietitians according to various school types in Sejong. One hundred and twenty-six school dietitians working in kindergartens (n=36), elementary schools (n=42), middle schools (n=22), and high schools (n=26) participated in this questionnaire survey. The subjects were divided into four groups according to the school types. Half of the subjects were over 41 years of age, with 64.3% graduating from graduate school. The percentage of nutrition teachers was the highest in middle schools at 95.4%, followed by the elementary school at 90.5% and high school at 73.1%, whereas 100% of the kindergarten dietitians were not nutrition teachers (P＜0.001). The percentage of the running status of nutrition education classes/activities was lowest in kindergartens (P＜0.001). The job satisfaction score in the job itself area was significantly lower in kindergartens and high schools than in middle schools (P＜0.01). The satisfaction scores of human relationships, working environment, personnel evaluation, and welfare did not differ significantly among the schools. As for the Job importance, the scores of nutrition counseling were significantly lower in middle school than in elementary and high schools (P＜0.05). In cooking and distribution management, high schools were less important than other school levels (P＜0.05). These findings highlight the need for the placement of nutrition teachers in kindergarten to promote nutrition education, the reduction of workload for school dietitiansutrition teachers and additional placement of dietitians by the appropriate workload such as the number of people and meals to serve.
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Purpose@#This study investigated the association between the mothers' use of home meal replacement (HMR) in their children's meals and the diet quality of their young children. @*Methods@#Three hundred and thirty-seven mothers with five-year-old kindergartners in Sejong city participated in the survey from June to July 2020. The questionnaire consisted of the status of HMR use in children's meals and questions for assessing the nutrition quotient for preschoolers (NQ-P). The subjects were classified into three groups according to the frequency of HMR use in children's meals: using HMR more than three times a week (high-frequency group; [HG], n = 65), one–two times a week (moderate-frequency group; [MG], n = 145), and less than once a week (low-frequency group; [LG], n = 130). @*Results@#The mothers' mean age was 38.3 years. The average monthly cost of purchasing HMRs was highest at 200,000–300,000 won in HG, 50,000–100,000 won in MG, and less than 50,000 won in LG (p < 0.001). The consumption frequency of processed meats, fast foods, processed beverages, and sweet & fatty snacks was significantly higher in the HG group than the other groups. The mean NQ-P score was 60.5 in HG, 63.0 in MG, and 64.5 in LG, showing a significant difference (p < 0.01). In the sub-score according to the three areas, there were no significant differences in balance and environment among the three groups. In the moderation area, however, the score was 44.1 in HG, 51.3 in MG, and 57.5 in LG Group, showing a significant difference (p < 0.001). @*Conclusion@#The increase in HMR use was related to the decreased diet quality in the overall and moderation areas of children's diet. These results support the importance of nutrition education for mothers, which aims to reduce their children's access and exposure to processed foods, such as HMR.
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Purpose@#The purpose of this study was to evaluate the change in the use of home meal replacement (HMR) and delivered foods and food habits of college students due to coronavirus disease 2019 (COVID-19). @*Methods@#A survey was conducted on 460 male and female college students in Chungcheong province in December 2020. @*Results@#The methods of participation in classes in the 2nd semester of 2020 were 40.2% for ‘100% non-face-to-face’ and 40.4% for ‘more than 70.0% of non-face-to-face classes’. 52.8% of the subjects responded that their physical activity had decreased, while 36.1% of the subjects responded that their body weight had increased over the past 6 months. Regarding the use of HMR, 62.7% of the male students and 69.6% of the female students responded with ‘1–2 times a week or less’ before the outbreak of COVID-19. After the outbreak, 57.4% of males and 46.7% of females responded with ‘3–4 times a week or more’ (p < 0.05, p < 0.001). As for the use of delivered food, 58.3% of the females responded with '2–3 times a month or less' before the outbreak, whereas the rate of responding with ‘1 or more times a week’ after the outbreak was 64.6% (p < 0.001). Negative changes in food habits caused by COVID-19 were in the order of irregular meals (56.7%), increased intake of delivered food (42.2%), increased intake of snacks (33.3%), and increased intake of processed foods such as HMR (30.4%). @*Conclusion@#As mentioned above, many college students had non-face-to-face classes due to COVID-19. During this period, they experienced decreased physical activity, weight gain, and undesirable eating habits such as irregular meal time, and increased intake of processed foods, delivery foods, and snacks. Therefore, there is a high need for nutrition education and policy support for the prevention and management of health and nutrition problems of college students, which can be caused due to the COVID-19 pandemic.
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Objective@#To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). @*Materials and Methods@#This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. @*Results@#Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI.Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). @*Conclusion@#A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.
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This study compared the job satisfaction and job importance of school dietitians according to various school types in Sejong. One hundred and twenty-six school dietitians working in kindergartens (n=36), elementary schools (n=42), middle schools (n=22), and high schools (n=26) participated in this questionnaire survey. The subjects were divided into four groups according to the school types. Half of the subjects were over 41 years of age, with 64.3% graduating from graduate school. The percentage of nutrition teachers was the highest in middle schools at 95.4%, followed by the elementary school at 90.5% and high school at 73.1%, whereas 100% of the kindergarten dietitians were not nutrition teachers (P＜0.001). The percentage of the running status of nutrition education classes/activities was lowest in kindergartens (P＜0.001). The job satisfaction score in the job itself area was significantly lower in kindergartens and high schools than in middle schools (P＜0.01). The satisfaction scores of human relationships, working environment, personnel evaluation, and welfare did not differ significantly among the schools. As for the Job importance, the scores of nutrition counseling were significantly lower in middle school than in elementary and high schools (P＜0.05). In cooking and distribution management, high schools were less important than other school levels (P＜0.05). These findings highlight the need for the placement of nutrition teachers in kindergarten to promote nutrition education, the reduction of workload for school dietitiansutrition teachers and additional placement of dietitians by the appropriate workload such as the number of people and meals to serve.
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Purpose@#This study investigated the association between the mothers' use of home meal replacement (HMR) in their children's meals and the diet quality of their young children. @*Methods@#Three hundred and thirty-seven mothers with five-year-old kindergartners in Sejong city participated in the survey from June to July 2020. The questionnaire consisted of the status of HMR use in children's meals and questions for assessing the nutrition quotient for preschoolers (NQ-P). The subjects were classified into three groups according to the frequency of HMR use in children's meals: using HMR more than three times a week (high-frequency group; [HG], n = 65), one–two times a week (moderate-frequency group; [MG], n = 145), and less than once a week (low-frequency group; [LG], n = 130). @*Results@#The mothers' mean age was 38.3 years. The average monthly cost of purchasing HMRs was highest at 200,000–300,000 won in HG, 50,000–100,000 won in MG, and less than 50,000 won in LG (p < 0.001). The consumption frequency of processed meats, fast foods, processed beverages, and sweet & fatty snacks was significantly higher in the HG group than the other groups. The mean NQ-P score was 60.5 in HG, 63.0 in MG, and 64.5 in LG, showing a significant difference (p < 0.01). In the sub-score according to the three areas, there were no significant differences in balance and environment among the three groups. In the moderation area, however, the score was 44.1 in HG, 51.3 in MG, and 57.5 in LG Group, showing a significant difference (p < 0.001). @*Conclusion@#The increase in HMR use was related to the decreased diet quality in the overall and moderation areas of children's diet. These results support the importance of nutrition education for mothers, which aims to reduce their children's access and exposure to processed foods, such as HMR.