Development of Evaluation Indicators for a Children's Dietary Life Safety Index in Korea

This study was performed to develop a children's dietary life safety index required by the Special Act on Safety Management of Children's Dietary Life enacted in 2009. An analytical hierarchy process was used to obtain initial weights of dietary life safety evaluation indicators. The Delphi method was applied to develop the weights along with 98 food and nutrition professionals. Three representative policy indicators, nine strategy indicators, 11 main evaluation indicators, and 20 detailed evaluation indicators were selected for the children's dietary life safety assessment. Three policy indicators and nine strategy indicators were the following: children's food safety indicator (support level of children' safety, safety management level of children's favorite foods, and safety management level of institutional food service), children's nutrition safety indicator (management level of missing meals and obesity, nutrition management level of children's favorite foods, and nutrition management level of institutional food service), and children's perception and practice level indicator ("Dietary Life Law" perception level, perception, and practice level for dietary life safety management, perception, and practice level for nutrition management). Weights of 40%, 40%, and 20% were given for the three representative policy indicators. The relative importance of nine strategic indicators, which were determined by the Delphi method is as follows: For children's food safety, support level of children's safety, safety management level of children's favorite foods, and safety management level of institutional food service were given weights of 12%, 9%, and 19%, respectively. For children's nutrition safety, the missing meals and obesity management level, nutrition management level of children's favorite foods, and the nutrition management level of institutional food service were given weights of 13%, 11%, and 16%, respectively. The "Dietary Life Law" perception level, perception and practice level of dietary life safety management, and perception and practice level of nutrition management were given weights of 4%, 7%, and 9%, respectively.

Statistical Approach to Test Construct Validity and Obtain Weights for the Children's Dietary Life Recognition and Practice Index

Constructs with seven latent evaluation indicators and 18 observable survey questions were developed by food and nutrition experts to calculate a food safety recognition and practice index for children. The purpose of this study was to suggest statistical approaches to test construction validity on the constructs, obtain weights of the evaluation indicators, and develop questionnaires to calculate a children's food recognition and practice index. Survey data of 2,400 elementary fifth grade students were used as empirical results. Test validity was evaluated by exploratory factor analysis and confirmed to be highly significant by confirmatory factor analysis [i.e., linear structural relations (LISREL) analysis]. Standardized path coefficients of the LISREL analysis were suggested based on weights, and the weights were compared using the AHP and Delphi methods.

Selenium Status and Glutathione Peroxidase Activity in Korean Infants

We investigated the selenium (Se) nutrition status in Korean infants. The mean serum Se concentration in infants was 66.9 microg/L, and it increased with increasing in infant age: 57.6 microg/L at 0-5 months, 71.8 microg/L at 6-11 months, and 75.5 microg/L at 12-24 months. Serum glutathione peroxidase (GPx) activity also increased with infant age. Serum Se concentration in infants was positively correlated with serum GPx activity (r = 0.565, p < 0.01). At 0-5 months, human milk-fed infants tended to have higher Se concentrations and GPx activity than those of formula-fed infants, but the result was not significant. With the introduction of supplemental feeding at 6-24 months of age, serum Se concentration was not different between the groups. Therefore, human milk feeding seemed to be more appropriate for infant Se nutrition than infant formula feeding during the first 6 months of life, but supplemental feeding became more important later to maintain good Se nutrition status.

Nutrition Knowledge, Dietary Self-Efficacy and Eating Habits According to Student's Stage of Regular Breakfast or Exercise / 대한지역사회영양학회지

This study has been performed to analyze nutrition knowledge, dietary self-efficacy and eating habits of the elementary- and middle- school students (n = 342) according to student's stage of regular breakfast or exercise. Middle school students had higher nutrition knowledge than primary school students. Total dietary self-efficacy and dietary habit scores were not different by school year and gender. Nutrition knowledge, dietary self-efficacy and dietary habit scores were positively correlated each other. By the stage of regular breakfast, the pre-contemplation stage comprised 13.6%, contemplation 2.1%, preparation 15.7%, action 11.5% and maintenance stage 59.1%. By the stage of regular exercise, the pre-contemplation stage comprised 20.9%, contemplation 7.3%, preparation 45.6%, action 9.8% and maintenance stage 16.4%. According to the stage of change, movement from the pre-contemplation and contemplation to upper stage increased the dietary self-efficacy score. Dietary habit score increased significantly across the five stages of changes. The results of this study indicate differences in stages of changes in breakfast intake and regular exercise and indicate the need for taking these phases of change into account in nutrition education.

Relationships among Personality Preferences, Psychosocial Factors and Dietary Habits of Middle School Students / 대한지역사회영양학회지

The purpose of this study was to obtain an understanding of the association of personality preferences and food behavior factors in middle school students. The subjects were 319 boys and girls in a middle school located in Kyunggi province. A self-administered questionnaire was used to assess demographic factors, dietary habits and psychosocial factors including self-efficacy, perceived benefits and barriers. The MMTIC (Murphy-Meisgeier Type Inventory for Children) test was used to assess the personality preferences of the students. Sixty-seven percent of the subjects were extrovert, 53.9% were the sensing type, 76.8% were the feeling type and 81.8% were the perceiving type in personality preferences. The extrovert had higher self-efficacy than the introvert. The feeling type perceived more benefits and fewer barriers than the thinking type. The education levels of the parents, especially mothers, were positively related with self-efficacy and dietary habit scores of the students. The self-efficacy and perceived benefits and barriers were significantly associated with dietary habits of the students (explained variance: 17.9%). Results of this study presented the relationship of character types and parents' education levels on psychosocial food behavior factors and a need for the development of tailored nutrition education program considering these factors.

Effects of Different Kinds of Korean Soybeans on Body Lipids and Lipid Peroxidation in Rats

This study was conducted to investigate the effect of different kinds of traditional Korean soybeans on blood and liver lipids and lipid peroxidation. SD male rats (n =48 )were assigned to six different groups and provided expe-rimental diets for 28 days. The protein source of the diet was casein, isolated soy protein (ISP ), or casein plus traditional soy powders (yellow bean, huktae, jinuni or seorietae ). The ISP, jinuni and seorietae diet decreased blood triglyceride compared to casein group. The ISP groups had lower hepatic total lipid and triglycerides than casein groups. The yellow bean and seorietae group had hepatic lipid lowering effects, but the effect was not found in huktae and jinuni group. The glutamate-oxaloacetate transaminase activity was significantly decreased in ISP and jinuni groups than in casein group. The glutamate-pyruvate transaminase activity was also decreased in ISP group. The results of this study suggest that jinuni, yellow bean and seorietae groups are more effective in lowering body lipids than huktae group.

Takotsubo, discinesia apical transitoria: presentación de 4 casos y revisión de la literatura / Takotsubo, reversible apical ballooning of the left ventricle: report of 4 cases

A syndrome of apical ballooning, with ECG mimicking acute myocardial infarctation, mild or no enzymatic changes, and normal coronary angiogram was described in 1990. It presents mainly in middle aged and elderly women and it is preceded by stress triggering circumstances. Several mechanisms have been proposed although the precise cause remains unclear. The most accepted theory proposes the interaction of catecholamines and an inadequate inotropic response. We report four cases that presented with chest pain and sudden onset of heart failure, all patients had physical or emotional stress as a triggering factor. On ECG, ST segment elevation and inverted T waves were observed in the acute phase. All patients had typical echocardiogram image and normal coronary angiogram. Both ECG and echocardiogram returned to normal within two weeks.

En 1990 se describió un síndrome caracterizado por discinesia apical transitoria, cambios en el electrocardiograma(ECG), mínima elevación de enzimas cardíacas y arterias coronarias normales. Sepresenta con mayor frecuencia en mujeres añosas y es precedido por un evento de estrés, ya sea físico opsíquico. La fisiopatología aún no está aclarada y se proponen diversas teorías. La de mayor peso es la quepostula una afección secundaria a la descarga de catecolaminas desencadenada por el estrés, sobre un corazón incapaz de mantener una respuesta inotrópica adecuada. Se presentan cuatro casos de pacientes atendidos en nuestro hospital que se manifestaron con síntomas sugerentes de infarto agudo de miocardio asociadosa insuficiencia cardiaca, en el contexto de un episodio estresante. Los síntomas preponderantes fueron dolor precordial opresivo y disnea. En el ECG se evidenciaron tanto supradesnivel del segmento ST, como inversiónde la onda T. Todos los pacientes presentaron la imagen ecocardiográfica típica de discinesia apical, y todos tuvieron en la cinecoronariografía coronarias normales. Cabe destacar que tanto el ECG, como el ecocardiograma volvieron a la normalidad a partir de las dos semanas.

La hiperhomocisteinemia como factor de riesgo vascular en hemodializados crónicos / Hyperhomocysteinemia as a vascular risk factor in chronic hemodialysis patients

La homocisteína es un factor de riesgo independiente de enfermedad cardiovascular en la población general, y juega un rol protagónico en el desarrollo de la aterogénesis y las trombosis vasculares, sobre todo en pacientes con insuficiencia renal. Así pues, los pacientes en hemodiálisis están bajo los efectos tóxicos de la hiperhomocisteinemia, presente en cerca del 90% de estos pacientes. En nuestra experiencia hemos encontrado que el ácido fólico es un tratamiento eficaz para disminuir los niveles de homocisteína, y el agregado de metilcobalamina intravenosa potencia este efecto; sin embargo, la metilcobalamina por sí sola fue insuficiente para normalizar la homocisteinemia. A lo largo del tiempo, un grupo de pacientes requirió dosis más elevadas de ácido fólico para corregir la hiperhomocisteinemia. Los pacientes homocigotas y, en menor medida hete-rocigotas para la variante termolábil C677T de la enzima metilentetrahidrofolato reductasa (MTHFR), presentaron una actividad catalítica reducida reflejada en la necesidad de una mayor dosis de ácido fólico para normalizar los niveles de homocisteína. Los efectos trombóticos vasculares fueron similares en todos los pacientes respecto a las variantes genéticas de la enzima metilentetrahidrofolato reductasa, sugiriendo que el tratamiento de la hiperhomocisteinemia es importante para disminuir el riesgo de trombosis. Sin embargo, también la hipoho-mocisteinemia, asociada generalmente a estados de desnutrición, se asocia a mayor mortalidad. Si bien se considera a la hiperhomocisteinemia como un factor de riesgo vascular en los pacientes con insuficiencia renal, aún no se determinó en esta población si su corrección se asocia a una disminución de la tasa de enfermedad vascular y de trombosis. No obstante...

Homocysteine is an independent risk factor for cardiovascular disease in the general population. In addition, it plays a main role in the development of atherogenesis and thrombosis, particularly in end-stage renal disease patients. Therefore, hemodialysis patients are under the burden of homocysteine toxic effects, present in nearly 90% of dialysis patients. Our group found that folic acid is an efficient therapeutic approach to decrease homocysteine levels, and the addition of intravenous methylcobalamin potentiates this effect; however, methylcobalamin alone was unsuccessful to normalize homocysteine levels. With time a group of patients required a higher dose of folic acid to reduce hyperhomocysteinemia. Patients homozygous and, to a lesser extent heterozygous, to the C677T thermolabile variant of methylenetetrahydrofolate reductase (MTHFR) presented a reduced catalytic activity and required a higher folic acid dose. Vascular-access thrombotic events were similar in all patients according to the variants of the enzyme, suggesting that treating hyperhomocysteinemia was the key to lower the risk of thromboses. Noteworthy, hypohomocysteinemia, generally acompanying malnourishment, is associated to higher mortality. Albeit hyper-homocysteinemia is considered a vascular risk factor in renal failure patients, it has not yet been established in this population if its correction is associated with a decrease in the rate of vascular disease and thrombosis. However, given the mentioned evidence about the low risk and good tolerance of vitamin therapy, we believe it useful to know folate, cobalamin and homocysteine blood levels in chronic renal patients and start a prompt treatment, which may proof adequate to maintain homocysteine levels of 10 +/- 5 micromol/l.

Estado inmunitario de 4 grupos de edad de población chilena contra sarampión y rubeola / Immune status against measles and rubella among chilean subjects of different ages

Background: Results of clinical and epidemiological studies confirm that no cases of measles have occurred in Chile since 1993. However, since covering of vaccination programs do not exceed 95 percent, an immunological surveillance for this disease is warranted. Aim: To know the immune status against measles and rubella in the Chilean population. Material and methods: A serological census of a representative sample of communities with high (90 percent or more) or low immunization coverings was performed. Four sub samples along the country were selected: 122 children aged 18 months of age (stratum A), 1,276 children attending the first year of basic school (stratum B), 899 teenagers in their last high school year (stratum C) and 399 women attending a family planning clinic (stratum D). IgG antibodies against measles and rubella were measured using ELISA and hemagglutination inhibition techniques, respectively. Results: Antibodies against measles and rubella were found in 96 percent and 94 percent of study subjects. No differences in these titres were found between different strata or communities with high or low vaccination covering. There is a high percentage of positive antibodies against measles among children of 18 months of age and a high percentage of antibodies against rubella among teenagers and women in family planning. Only 3 percent of the sample had not received any vaccine at the moment of the study. Conclusions: The high prevalence of antibodies against rubella allows to conclude that it is not necessary to consider this antigen in the next vaccination campaign. Due to the high prevalence of antibodies against measles, only the population older than 20 years old should be affected by the disease if this virus enters the country

Antigenic analysis of dengue virus using monoclonal antibodies.

Dengue viruses are classified as a separate antigenic group within the Flaviviridae on the basis of cross-reactivity in neutralization assays employing polyclonal sera. Additional serological relationships defining group, complex and type specificity between members of the various antigenic groups have also been identified with polyclonal sera in analyses using hemagglutination inhibition (HI) and complement fixation (CF) tests. With the advent of monoclonal antibodies, however, this picture has become far more complex. While the basic framework of serological relationships has been confirmed, a large number of additional cross-reactivities have been identified that suggest a much greater degree of antigenic diversity and/or relatedness than previously imagined. Monoclonal antibodies have not only been used to dissect the antigenic relatedness between flaviviruses but also in studies aimed at defining epitopes on viral proteins involved in a range of biological activities from protection to antibody-dependent enhancement (ADE) of infection. Of the ten proteins encoded by the dengue virus genome, monoclonal antibodies have been raised to six, including each of the structural proteins (C, prM, E) and three of the non-structural proteins (NS1, NS3, NS5). These antibodies have been applied to the construction of functional maps and in particular to the definition of antigenic determinants involved in protection.

Integracao ensino/servico numa disciplina clinica. / Teaching and assistence integracion in a clinical discipline.

A avaliacao da integracao estudante/paciente, em uma disciplina clinica, demonstrou uma aprendizagem insuficiente de habilidades basicas que todo medico deve necessariamente dominar, bem como um impacto negativo na qualidade da assistencia. Embora existissem parcos recursos, o problema principal era a utilizacao inadequada dos disponiveis. Com a assessoria pedagogica, exame de literatura e criatividade pessoal, montou-se um sistema para integrar o ensino ao servico de forma que a aprendizagem dos estudantes pudesse ter um impacto mensuravel assistencia aos pacientes. Com este objetivo, varias medidas foram tomadas: o delineamento de um conteudo minimo mais adequado para a formacao geral o aumento dos recursos da disciplina, e principalmente a utilizacao racional do tempo dos professores e alunos.Sao mostrados o planejamento do novo sistema, sua aplicacao durante um ano escolar, a avaliacao da aprendizagem e seu impacto na assistencia.}

Maffucci's Sundrome ( Dyschondroplasia with Hemangiomata ) / 대한피부과학회지

A case of Maffucci's syndrome, which was considered to be a first case reported in Korean literature, was presented with review of literatures. The patient, 17 years old Korean girl, had muliple cutaneous cavernous type hemangioma on the right foot and ankle area with an enchondroma in the third toe which showed slight shortening of length and abnormality on bone X-ray study. Authors presented this case with the results of histopathological examination of the skin and bones and right side femoral angiography for establishment of the diagnosis.

Hyperlipoproteinimia Type III ( Broad Beta disease, Floating beta lipoproteins ) with Review of Literatures of Primary Hyperlippoproteinemias / 대한피부과학회지

A stout and obese fourty five year-old Korean man was affected with hyperlipoproteinemia type III. His skin lesion showed yellowish papular eruptive xanthomas with erythematous halo located chiefly on the trunk and extensor aspects of the extremities including both palms. In addition to the skin lesion he showed pea-sized cervical lymphnode swellings, slightly tessellated fundi and, on ECG, premature ventricular contraction. Otherwise no specific findings were seen. The laboratory examinations showed increases of both serum cholesterol and triglycerides, increased fasting blood sugar level and abnormal glucose tolerance curve with turbid color of fasting blood serum which had been kept standing at 4C for 24 hours. On the paper electrophoresis "broad beta band" blending with the pre-beta area was noted. The authors discussed laboratory characteristics, clinical manifestations and differential diagnosis of primary hyperlipoproteinemia on each type with review of the literatures of the disease.