Noise and Room Acoustic Conditions in a Tertiary Referral Hospital, Seoul National University Hospital

BACKGROUND AND OBJECTIVES: Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. MATERIALS AND METHODS: Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. RESULTS: The A-weighted equivalent noise level, L(Aeq), ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. CONCLUSIONS: At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.

Nutrition Diagnostic Analysis for Nutrition Care Process Model in Adults of a Health Screening & Promotion Center / 대한지역사회영양학회지

OBJECTIVES: This study was performed to examine nutrition problems and causes/contributing risk factors. METHODS: This study was conducted using data 1,863 adults visited Asan health screening & promotion center located in Seoul, Korea during May to June of 2013. We used Nutrition Care Process Model developed by the International Dietetics & Nutrition Terminology (IDNT). RESULTS: The most frequent nutrition problem in male subjects was excessive alcohol intake. Men in fifties showed the highest rate of excessive alcohol intake among the age groups examined (22.4%). By comparison, the most frequent nutrition problem in women was inadequate protein intake. Women in fifties exhibited the highest rate of inadequate protein intake (22.5%). The most common contributing factors for these observations were a low preference for dairy products followed by high preference for alcohol and a deficit in food-and nutrition-related knowledge, regardless of the sex and age. The most common nutrition problem observed among the group diagnosed with hyperglycemia or hypertriglyceridemia or hyperuricemia or fatty liver was excessive alcohol intake (p<0.001), whereas the group diagnosed with hyperglycemia or hypercholesterolemia showed significantly higher rate of inappropriate intake of carbohydrate (fructose) compared to the group not diagnosed with such disease conditions (p<0.05). The group diagnosed with hypercholesterolemia, hyperuricemia and fatty liver showed significantly higher occurrence of inappropriate intake of fat (saturated fat) than the group free of such diseases (p< 0.001). The osteopenia group showed higher rate of inadequate protein intake (p<0.001) and the fatty liver group with excessive energy intake (p<0.001). Overall, the results suggest that there is a significant relationship between nutrition problems and health conditions found in groups diagnosed with a diverse array of medical conditions. CONCLUSIONS: Therefore, we strongly suggest that dieticians should implement nutrition interventions with people visiting health screening & promotion center based on nutrition problems and the contributing factors diagnosed by dietitions in order to prevent chronic diseases in this population.

A study on dietary habits, nutrient intakes and dietary quality in adults of a health screening and promotion center according to non-alcoholic fatty liver disease / 한국영양학회지

PURPOSE: The purpose of this study was to evaluate dietary habits, food intakes, nutrient intakes, and diet quality of non-alcoholic fatty liver disease in a health screening and promotion center. METHODS: The total number of study subjects was 10,111 adults, where 3087 subjects (30.5%) were diagnosed as NAFLD. The dietary intakes were obtained using a food frequency questionnaire. They were then compared with the dietary reference intakes could be used in the future for development of diet and nutrition guidelines s (KDRIs). RESULTS: Mean age of subjects in the normal group was 52.9+/-10.3 yrs and body mass index (BMI) was 22.4 +/- 2.6 kg/m2, and those of the NAFLD group were 55.1 +/- 9.2 yrs and 25.4 +/- 2.9 kg/m2. BMI, blood pressure of the NAFLD group were significantly higher than those of the normal group. The rates of skipping breakfast, overeating, and eating out were significantly could be used in the future for development of diet and nutrition guidelines er in the NAFLD group (p < 0.05, p < 0.000, p < 0.000 respectively). The speed of eating was fast in the NAFLD group (p < 0.000). The NAFLD group consumed significantly higher amounts of grains, meats, fish, seaweeds, kimchies, sugars, sweets, coffee, teas, and oils compared to the normal group (p < 0.05). Meanwhile, intakes of starch products, fruits, milk, and milk products were significantly lower in the NAFLD group compared with those of the normal group (p < 0.05). Riboflavin, calcium, and dietary fiber nutrient adequacy ratio (NAR) of the NAFLD group were significantly lower than those of the normal group. The Korean's dietary diversity score (KDDS) of the NAFLD group was lower than that of the normal group. CONCLUSION: In conclusion, we suggest that diet guidelines, such as increasing the intake of calcium and dietary fiber, reducing the intake of energy, fat, and simple carbohydrates, are necessary to improvement of NAFLD. The results could be used in the future for development of diet and nutrition guidelines for NAFLD.

ON and OFF Responses of the Electroretinogram in Patients with Glaucoma

PURPOSE: To investigate whether there is a difference in ON- and OFF-responses of the photopic electroretinogram (ERG) in glaucomatous eyes. METHODS: Photopic ERG and optical coherence tomography were performed in 15 normal, 13 glaucoma suspect, and 22 glaucoma subjects. Amplitudes and implicit times for a, b, d, i, photopic negative response (PhNR), and retinal nerve fiber layer thickness were compared among the three groups. RESULTS: The PhNROFF amplitude (microV) was 19.05 +/- 11.41 in the glaucoma group, 14.24 +/- 10.37 in the glaucoma suspect group, and 2.69 +/- 12.16 in the normal group, demonstrating a significant difference among the three groups (p < 0.01). The PhNRON amplitude (microV) was 20.15 +/- 13.99 in the glaucoma group, 31.49 +/- 17.09 in the glaucoma suspect group, and 37.59 +/- 9.53 in the normal group, a significant difference (p < 0.01). However, there was no significant difference between the three groups. The ON-OFF response PhNR amplitude was correlated with retinal nerve fiber thickness (r = 0.481, r = -0.480, respectively), and areas under the receiver operating characteristic curve were 0.782, and 0.718, respectively. CONCLUSIONS: There is a potential role for the ON-OFF response PhNR in early detection of glaucomatous damage.

Effects of soybean supplementation on blood glucose, plasma lipid levels, and erythrocyte antioxidant enzyme activity in type 2 diabetes mellitus patients

The purpose of this study was to investigate the effect of soybean on blood glucose and lipid concentrations, and antioxidant enzyme activity in type 2 diabetes mellitus (DM) patients. We divided patients into two groups and fed them, respectively, a basal diet (control group) and a basal diet with 69 g/d of soybean (soybean group) for 4 weeks. Pills with roasted soybean powder were provided to the soybean supplementation group three times a day. Macronutrients intake except dietary fiber was similar between the two groups. No significant differences were observed in dietary intakes or body weight before and after the supplementation. Energy composition ratio of C:F:P was 65:19:16 in the control group, 64:20:16 in the soybean group. The blood parameters of subjects before supplementation, such as fasting blood glucose, postprandial glucose level, total cholesterol, triglyceride, LDL-cholesterol and HbA1C were not different between the two groups. After supplementation, fasting blood glucose (p<0.001), postprandial glucose level (p<0.001) and serum triglyceride level (p<0.05) were significantly reduced in the soybean group in comparison with the control group. The total cholesterol level was not significantly different between the control and the supplemented group after 4 weeks of treatment. TBARS levels of the soybean group were not significantly different from those of the control group. The activities of catalase (p<0.01) and glutathione peroxidase (p<0.05) were significantly higher in the soybean group compared to the control group. The results of this study suggest that soybean supplementation would be helpful to control blood glucose and serum lipid in diabetic patients. Also, soybean showed an antioxidant activity that may contribute to enhance the effect of antioxidant defense. This activity contributes to protection against oxidative damage in type 2 DM patients. Soybean may have potential use in the disease management of patients with DM.

A Study on the Situation and Demand with Nutrition Service in Health Promotion Center

This study was done to analyze nutrition counseling services in health promotion center and to investigate demands of subjects for nutrition services. Data was collected through the survey of 90 subjects. The results were as follows. The results of people receiving nutrition services showed that 58.5% of the counseling group and 46.4% of the noncounseling group answered having experience with nutrition services. And 50% of them received nutrition counseling through individual counseling. Diet therapy with health check-up results also appeared the highest in contents of nutrition counseling. As a source of nutrition information and health knowledge, subjects relied heavily or most on the TV, internet, books, magazines, and newspapers. On the other hand, they relied much less on advice from dietitians, nutritionists, medical doctors and nurses. The experience of receiving nutrition services and thinking about nutrition education related positively. It showed that the counseling group (95.1%) was significantly higher than the non-counseling group (80.5%) in necessity of nutrition assessment. But, necessity of nutrition counseling wasn't significantly different between the two groups. The method of nutrition counseling subjects preferred was individual consultation. The subjects answered to having need of analysis and evaluation of nutrient intake and calorie prescription in nutrition assessment and individual nutritional status results explanation in nutrition counseling. In conclusion all people visiting health promotion centers need nutrition service of some kind.

Effects of Mushroom Supplementation on Blood Glucose Concentration, Lipid Profile, and Antioxidant Enzyme Activities in Patients with Type 2 Diabetes Mellitus

The present study was carried out to evaluate the physiological effects of mushroom supplementation on blood glucose levels, lipid profile, and antioxidant enzyme activities in subjects with type 2 diabetes mellitus. Subjects were randomized into either a control group or mushroom supplementation group. Mushroom supplementation was provided 3 times a day for 4 weeks. We found that total dietary fiber intake was about 2.5 times higher (30.3 g vs. 12.3 g) in subjects receiving mushroom supplementation than in the control group. Two groups maintained the same food intake and amount of activity, exercise during the supplementation. We observed no difference in age, height, weight, BMI (body mass index), blood pressure between the groups. Nutrient intake did not differ appreciably between the two groups, except for fiber intake, during the supplementation. Fasting blood glucose levels and 2-hour postprandial blood glucose levels were significantly lower in those ingesting mushroom than in controls. Furthermore, the concentrations of low-density lipoprotein cholesterol were decreased significantly in the mushroom supplementation group. Small changes were observed in the concentration of total cholesterol, triglyceride, high-density lipoprotein cholesterol of those supplemented with mushroom, but these changes were not statistically significant. Activities of superoxide dismutase and catalase with mushroom supplementation were higher than in controls, but and glutathione peroxidase activity was not affected. The levels of thiobarbituric acid reactive substance of mushroom group were lower than control group, but were not siginificant. We conclude that addition of mushroom influences glycemic control and may be effective in lowering blood lipids and improving antioxidant enzyme activities. Accordingly, such effects may reduce risk factors for cardiovascular disease in patients with type 2 diabetes. However, to confirm these effects and to make dietary recommendations for patients with type 2 diabetes, further studies are necessary.

Correlation between Optokinetic Nystagmus Response and Visual Acuity

PURPOSE: The purpose of this paper was to determine the correlation between optokinetic nytagmus and grating and Snellen visual acuity charts and the validity of this correlation as an index. METHODS: Diffusion blur was used to cause visual decrease in 24 patients with normal eyes. Vision was measured using 3 different methods. To compare the central and peripheral vision, visiual acuity was measured using a macula occluder. RESULTS: Twenty four patients had an average uncorrected vision of 1.0 and showed regular visual acuity decrease using diffusion blur. Grating visual acuity showed correlation with the Snellen visual acuity but OKN visual acuity showed low correlation (p<0.05, ANOVA with repeated measure trend). OKN visual acuity showed low correlation with grating acuity when central visual acuity was occluded and only peripheral acuity was taken into consideration. CONCLUSIONS: Visual acuity measured using Snellen or grating acuity had little correlation with OKN visual acuity, and visual acuity measured using OKN was unable to indicate visual acuity in a quantitative manner.

Clinical Manifestations and Surgical Outcome of Infantile Esotropia

PURPOSE: To study the clinical manifestations and surgical outcome of infantile esotropia. METHODS: This review retrospectively examined 165 patients of infantile esotropia who had undergone recession of bilateral medial rectus muscles from April 1991 to September 2001 at our institute. We measured the binocular alignment and analyzed the long term surgical outcome. RESULTS: The average angle of deviation of 165 patients was 45.9 +/- 13.99PD (25 ~ 90PD) and the average refractive error was +sph 1.18 +/- 2.25D (-sph 7.00 ~ +sph 6.00D). Amblyopia was found in 48.4% of the patients, DVD in 12.7%, IOOA in 11.3%, and manifest latent nystagmus in 6.0%. A binocular alignment within 10 PD was achieved in 73.9% and 57.9% at the 2nd and 4th post-operative year respectively. CONCLUSIONS: The surgical outcome of bimedial rectus muscle recession in infantile esotropia was satisfactory in 74%, and 58% of the patients at the 2nd and 4th post-operative year respectively.