Patients' Perception of and Satisfaction on Therapeutic-diets at Hospitals in Busan

The purpose of this study was to investigate the inpatients' perception of therapeutic-diets and of explanation about those diets provided by hospitals and satisfaction on therapeutic-diets at hospitals in Busan. The subjects consisted of 155 inpatients at five hospitals, which all had over 400 beds. The research was performed through the interviewing process using questionnaires. Seventy five percent of patients had received an explanation for their therapeutic-diet and 57.4% of respondents were given a manual that explained the reason for the therapeutic-diet. The professionals who explained the therapeutic-diet was 61.7% dietitians and 25.6% doctors. 59.4% of the patients considered the dietitian to be suitable for explaining the diet and 25.6% patients believed the doctor to be suitable for explaining the diet. In terms of the patients' perception of the therapeutic-diet explanation, 74.5% of the patients understood very well, 78.9% of them perceived this explanation as very important, and 67.5% of them were satisfied. On a scale of 5.00 for therapeutic-diet satisfaction, the average scores were 2.95 for meal characteristics and 3.06 for service characteristics. The items that scored low in therapeutic-diet satisfaction were taste, seasoning and appearance of meals, provision of selective menu and consideration of personal preference. In terms of the perception of understanding the therapeutic-diet, patients who were provided a manual and an explanation gave high scores to 'taste', 'variety of diet', 'meeting opportunity with dietitians', and 'prompt dealing with meal complications'. There was a significant (p<0.05) positive correlation between satisfaction for the explanation of the therapeutic-diet and the degree of perceived benefits of the explanation to the nutrition-management and the satisfaction on the therapeutic-diet satisfaction. Therefore, the results of this study suggest that hospitals should increase support for explaining the therapeutic-diet by dietitians and develop menus based on the patients' preference and the taste of the meal.

Modified Double Tension Band Wiring for Reattaching the Greater Trochanter When Performing Hemiarthroplasty for Intertrochanteric Fracture in Elderly Patients

PURPOSE: We wanted to evaluate the clinical and radiological results after performing arthroplasty for an intertrochanteric fracture in patients 70 years of age or older, and we used a new fixation technique of the greater trochanter. MATERIAL AND METHODS: From January, 2004 to August 2007, we treated 21 cases (M/F: 3/18) of intertrochanteric fracture with hemiarthroplasty with modified double tension band wiring. All the cases were above type 2 (AO/OTA A1.3) according to the Jensen modification of the Evans classification, and all the patients were elderly. The fractures were evaluated for the fracture pattern by using simple radiography and 3D computed tomography. We analyzed the clinical and radiological results at a minimum of 12 months (range: 12~36 months). RESULTS: We performed hemiarthroplasty with modified double tension band wiring. Two cases (9.5%) among the 21 cases developed loss of reduction due to an additional injury and one of them underwent reoperation using a greater trochanter reattachment device (GTRD). The greater trochanters were well maintained without displacement and excellent union was seen at the fracture site of 19 cases. CONCLUSION: The modified double tension band wiring technique, along with several other fixation methods, should be considered to easily obtain rigid fixation in an unstable intertrochanteric fracture.

Mothers' Perceptions on Nutrition Education for Elementary School Students in the Busan Area I: A Demographical Factor Approach

This study examined mothers' perceptions on nutrition education for elementary school students according to demographical factors. Questionnaires were distributed to the mothers of 511 elementary school students in the Busan area. According to the results, 50% of the respondents felt that the preschool years or the lower elementary grades were proper times to start nutrition education. Furthermore, they preferred school dietitians (55.4%), outside professional dietitians (16.3%), nurse teachers (13.8%), class room teachers (11.7%), and parents (2.8%) as nutrition educators. The mothers who were college and university graduates had significantly (p<0.001) higher scores regarding the necessity of nutrition education for student growth when compared to mothers who were high schools graduates. However, the high school graduates had significantly (p<0.001) higher scores than the college and university graduates with respect to nutrition education for correcting obesity. The order of importance for nutrition education curriculum content was as follows: eating habits, food safety, health and disease, maintaining ideal body weight, food waste and environment, basic food knowledge, and traditional foods. The college and university graduates, and those of 'A' group schools, had significantly (p<0.001) higher importance scores for proper eating habits. Mothers having experience with nutrition education comprised 43.9% of the subjects, and there was a significantly (p<0.05) higher percentage of employed mothers as compared to unemployed. Eighty-six percent of the respondents wanted to receive nutrition education. For more effective learning, they preferred in-person group education rather than correspondence education using e-mails or printed materials from schools.

Factors related to Patients with Fatty Liver

BACKGROUND: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnoimal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management. METHODS: We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultrasound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was derivated from Food Composition Table, and we analyzed several biochemical variables. RESULTS: There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertriglyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8%, in patients, 7.4% in controls(p<0.05). There were no significant statistical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient gr oup or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patients, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0,05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and excercise between patients and controls. CONCLUSIONS: The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.

Effect of weight control on hepatic abnormalities in obese patients with fatty liver

This study was aimed at finding out whether weight reduction alone can improve liver function in obese patients with fatty liver. We did a longitudinal, clinical intervention study on weight reduction by behavior modification, diet and exercise. The study subjects were 25 patients referred to an obesity clinic in whom obesity is the sole factor causing abnormal liver function and fatty liver. Patients were weighed about one year later. We compared the degree of improvement in hepatic function between Group I that showed weight reduction and Group II that showed no-weight reduction. Group I (13) showed dramatic improvement in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, nearly all down to within normal levels. AST showed statistically significant improvement from 74 +/- 36 IU/l to 25 +/- 7 IU/l. ALT also showed statistically significant improvement from 109 +/- 67 IU/l to 30 +/- 14 IU/l. Group II (12) showed higher AST and ALT levels on follow-up visit than initial visit. AST showed statistically significant elevation from 43 +/- 11 IU/l to 59 +/- 23 IU/l. ALT also showed statistically significant elevation from 64 +/- 21 IU/l to 97 +/- 33 IU/l. If we can rule the other causes of hepatic abnormalities in obese patients with fatty liver, we suggest these patients would benefit by weight reduction.

Validation of a Semi-Quantitative Food Frequency Questionnaire / 한국역학회지

The relationships between diet and the occurence of the major diseases of our civilization are of both epidemiological and practical importance to public health problems. Diseases associated with dietary factors rank among the leading causes of illness and death in Korea. Not only for assessment for clinical evaluation, but also for epidemiological concern, we need for rapid and inexpensive methods to assess dietary intake in relating nutrition to health. The validity of a self-administered semi-quantitative food frequency questionnaire was evaluated for a group of 103 men and women aged 26 to 65. Intakes of 8 nutrients computed from the questionnaire were compared with those derived from 3-months diet record. The questionnaire estimates of mean nutrient intake were within about 10% of the mean diet record measurements for nutrients evaluated but iron and vitamin A. The correlation coefficients comparing unadjusted nutrient intakes measured by two methods ranged from 0.27(iron) to 0.57(fat). The correlation coefficients comparing nutrient intakes measured by two methods adjusted for age and sex ranged from 0.26(iron) to 0.50(calories). After adjusted for age and sex or caloric intake, the intakes in iron did not show correlation measured by two methods. A simple and relatively inexpensive questionnaire could be useful information on dietary intake for macronutrients. The modification and revision would be required for assessments of intakes in micronutrients.

Efficacy of Diet Therapy in Korea Hypercholesterolemic Patients

BACKGROUND: Although diet therapy is the standard initial treatment for hypercholesterolemia, the efficacy of diet therapy in Korean hypercholesterolemic patients never been investigated . This study was designed to evaluate the efficacy of diet therapy for hypercholesterolemia. METHODS: One hundred seventeen outpatients with hypercholesterolemia were educated individualized diet therapy which is low in fat, cholesterol and high fiber. After three and six month, we assessed the changes of plasma lipids, apolipoproteins, body weight and the adherence to diet therapy. RESULTS: After 3 months of the diet therapy, there were significant reductions in total cholesterol(-11.8%), LDL-C(-14.5%), HDL-C(-3.9%), Apo(-5.4%), TC/HDL-C(-7.3%), Apo B /Apo A1(-7.7%) and weight(-3.1%). After 6 months of the diet therapy, there were significant reductions in total cholesterol(-10.7%), LDL-C(-14.0%), TC/HDL-C(-9.1%), Apo B/Apo A1(-7.7%) and weight(-2.3%). In this study 77% of the subjects had experienced improvement in their plasma LDL-C. Nonrespondents were older and had more female patients than respondents significantly. CONCLUSION: Diet therapy in Korean hypercholesterolemic patients is effective for reductions of total cholesterol and LDL-C.