Development and relative validity of semi-quantitative food frequency questionnaire for Korean adults / 한국영양학회지

PURPOSE: This study was implemented to develop and validate the semi-quantitative food frequency questionnaire (SQ-FFQ) to assess energy, carbohydrates, fat, protein, minerals, and vitamins as well as fatty acids and alcohol in Korean adults. METHODS: The SQ-FFQ consisted of 88 food items, and 12 food groups were selected based on information of frequently consumed foods from the Korean Health and Nutrition Examination survey. Each portion size was categorized as one of three amounts: small (0.5 times), medium (1 time), and large (1.5 times). A total of 111 subjects finished 3-day diet records and the SQ-FFQ. The relative validity of SQ-FFQ was assessed by comparison with the 3-day diet records. RESULTS: The mean nutrient intakes obtained from the SQ-FFQ were estimated to be greater than those of the two 3-day dietary records. Spearman's correlation coefficient between the two methods was the highest for energy (r = 0.583; p < 0.001) and lowest for saturated fatty acid (r = 0.121). Correlation coefficients were energy (r = 0.583; p < 0.001), carbohydrates (r = 0.500; p < 0.001), protein (r = 0.466; p < 0.001), fat (r = 0.411; p < 0.001), dietary fiber (r = 0.467; p < 0.001), alcohol (r = 0.527; p < 0.001), calcium (r = 0.409; p < 0.001), phosphorus (r = 0.499; p < 0.001), potassium (r = 0.418; p < 0.001), magnesium (r = 0.427; p < 0.001), and zinc (r = 0.464; p < 0.001), respectively, for all subjects. CONCLUSION: The developed SQ-FFQ in this study seems to be useful for estimating nutritional status, particularly energy, carbohydrates, protein, fat, dietary fiber, alcohol, calcium, phosphorus, potassium, magnesium, and zinc of Korean adults.

The Cut-off Values of Surrogate Measures for Insulin Sensitivity in a Healthy Population in Korea according to the Korean National Health and Nutrition Examination Survey (KNHANES) 2007–2010

BACKGROUND: This study aimed to identify the gender-specific characteristics of the surrogate measures of insulin resistance and to establish valid cut-off values for metabolic abnormalities in a representative sample in Korea. METHODS: Data were collected from the datasets of the Korean National Health and Nutrition Examination Survey between 2007 and 2010. The total number of eligible participants was 10,997. We used three measures of insulin resistance: the homeostasis model assessment-insulin resistance (HOMA-IR), McAuley index, and triglyceride and glucose (TyG) index. The estimated cut-off values were determined using the highest score of the Youden index. RESULTS: The area under the curve (AUC) of the HOMA-IR, McAuley index, and TyG index were 0.737 (95% confidence interval [CI], 0.725–0.750), 0.861 (95% CI, 0.853–0.870), and 0.877 (95% CI, 0.868–0.885), respectively. The cut-off values of the HOMA-IR were 2.20 in men, 2.55 in premenopausal women, and 2.03 in postmenopausal women, and those of the McAuley index were 6.4 in men and 6.6 in premenopausal and postmenopausal women. For the TyG index, the cut-off values were 4.76 in men and 4.71 in premenopausal and postmenopausal women. CONCLUSION: In conclusion, the present study provides the valid cut-off values of the indirect surrogate measures of insulin sensitivity. These values may be used as reference for insulin sensitivity in a clinical setting and may provide a simple and supplementary method for identifying populations at risk of insulin resistance.

Time Measurement Study of Certified Clinical Dietitians from Tertiary Hospital in Seoul and Gyeonggi-do

The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.

Clinical Nutrition Service in Korean Tertiary Hospitals and General Hospitals: Result of Nationwide Cross-Sectional Survey

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.

Nurses' Perception on Clinical Nutrition Services by Types of Medical Institution and Area

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

Job Satisfaction Level and Related Factors among Korean Hospital Dietitians

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability.vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

The intake of food and nutrient by the elderly with chronic disease in the Seoul area

This study was carried out in order to investigate the status of food and nutrient intakes depending on the types of chronic disease of the elderly at welfare centers in Seoul. The total number of subjects was 299 elderly over the age of 60 (82 men and 217 women); they were grouped by the disease status: normal, cardiovascular disease (CVD), diabetes mellitus (DM) and arthritis patients groups. The dietary intakes were obtained by a 24-hour recall and analyzed by CAN-Pro 4.0; they were then compared with the dietary reference intakes for the Korean (KDRIs). In the results of anthropometric data according to chronic disease, the waist circumference of the normal group in males and females was lower than the other groups; in particular, the normal female group showed a lower level of waist-hip ratio, body mass index (BMI) and body fat % than those of the other groups. The arthritis group showed a higher intake of milk products than the other groups (p < 0.05); consequently, calcium intake was significantly higher than that of the other groups (p < 0.001). Vitamin A intake in the arthritis group was significantly higher than the intake in the normal and DM groups (p < 0.01). Normal and arthritis groups showed significantly higher intake of zinc and copper than the CVD group (p < 0.01). In general, about 80% of the subjects in this study revealed insufficient intakes of riboflavin, vitamin C, calcium, dietary fiber, vitamin D, biotin and potassium, compared with the estimated average requirement (EAR) or adequate intake (AI). However, sodium intake of all groups was higher than the AI of KDRIs. In conclusion, nutrient intake, according to the chronic disease, showed significant difference in some of the micronutrients, vitamin A, Ca, Zn and Cu. Therefore, we suggest that dietary guidelines, such as reducing the intake of salty foods and sweet drinks and increasing the intake of foods with sufficient calcium, vitamin D and vitamin C, are necessary to the improvement of eating habits for the elderly.

A case of granulocytic sarcoma of the pancreas and kidney in a patient presenting with jaundice / 대한내과학회지

Granulocytic sarcoma is an extramedullary tumor composed of immature cells of the granulocytic series known to occur in patients with myelodysplastic syndrome, chronic myeloid leukemia, or acute myeloid leukemia. and occasionally it has been presented without overt leukemia. Involvement of pancreas and kidney is relatively rare in granulocytic sarcoma. We present an extremely rare case of granulocytic sarcoma of pancreas and kidney in a 56-year-old male patient of acute myeloid leukemia presenting with obstructive jaundice due to a pancreatic mass and peri-lymphadenopathy consisting of myeloblast and review the literatures. It should be kept in mind that granulocytic sarcoma is a possible cause of obstructive jaundice in patient with acute myeloid leukemia.

Effects of Topically Applied 0.1%Dexamethasone on Endothelial Healing and Aqueous Composition Following Experimental Corneal Alkali Wounds

The effects of topical dexamethasone on the endothelial healing and the change of aqueous composition were examined in the repair process of experimental corneal alkali wounds. Corneal alkali wounds were induced, then the eyes were treated topically with either 0.1%dexamethasone or abalanced salt solution[BSS]4 times per day for 8 weeks. Endothelial wound morphometry was performed after alizarin red and trypan blue staining. The concentrations of ascorbic acid, glucose, and the ions, Na, K , Ca2 and Mg2 , were measured in the aqueous humor. Endothelial healing in control corneas showed a biphasic pattern of healing:an initial short-term healing for the first week and then a late long-term healing following a secondary endothelial breakdown. Topical administration of 0.1%dexamethasone deterred endothelial healing during the early period and prevented secondary endothelial breakdown. Total repair process of endothelium was accelerated by the dexamethasone treatment. Among the various components of the aqueous humor examined, ascorbic acid seemed most sensitive to change caused by the alkali injury and dexametha-sone treatment. The present data indicate that dexamethasone may have a therapeutic potential in the management of endothelial healing after corneal alkali injury.

Effects of Topically Applied Na-Hya luronan on Stromal and Endothelial Healing in Experimental Corneal Alkali Wounds

The effects of topical sodium-hyaluronan on the stromal and endothelial healing were examined in the repair process of experimental corneal alkali wounds. Corneal alkali wounds were produced in one eye of each rabbit by applying a 5.5 mm round filter paper soaked in 1N NaOH onto the central cornea for 60 seconds. Then the eyes were treated topically with either 1% Na-HA(the treatment group)or a phosphate buffered saline(PBS)(the con-trol group)4 times per day for 3 weeks. Endothelial wound morphometry was performed after alizarin red and trypan blue staining. The stromal healing was assessed by counting polymorphonuclear leukocytes(PMNs)and keratocytes in the central and marginal wounds areas. The stroma treated with Na-HA had less PMNs than that of the control group during the early healing period. The defect area of the endothelium was significantly smaller in the Na-HA treated group than in the control corneas. The present findings indicate that topically applied 1%Na-HA affects stromal and endothelial healing during the early repair process after corneal alkali wounds.

Effects of Topically Applied Na-Hyaluronan on Epithelial Healing and Aqueous Composition in Experimental Corneal Alkali Wounds

The effects of topical sodium-hyaluronan (Na-HA)on the epithelial healing and aqueous compositions were examined in the repair process of experimen-tal corneal alkali wounds.Corneal alkali wounds were produced in one eye of each rabbit by applying a 5.5 mmround filter paper soaked in 1N NaOH onto the central cornea for 60 seconds.Then the eyes were treated topically with either 1%Na-HA (the treatment group)or a phosphate buffered saline (PBS) (the control group)4 times per day.The epithelial healing was assessed using a quantitative method and the changes of the concentration of ascorbic acid and glucose in aqueous were evaluated.The initial epithelial healing rate was similar between 1%Na-HA treated and control groups and the later healing was enhanced in the treated group but statistically insignificant.The concentrations of ascorbic acid and glucose in aqueous humor are not statistically different in the early phase, but ascorbic acid concentration in later healing phase was higher in the treated group when compared with the control group.The present findings in dicate that topical-ly applied 1%Na-HA affects late epithelial healing and ascorbic acid concentration in aqueous humor during the repair process after corneal alkali wounds.

A Case of Optic Nerve Infiltration of Acute Lymphocytic Leukemia

Leukemia is a common malignancy in childhood and has various associated ocular manifestations. Clinically, retina is the most commonly involved site and papilledema may be observed due to either direct infiltration or CNS involvement of leukemia. We have experienced a case of mass-like leukemic infiltration in retina and optic nerve in a 16-year-old ALL patient who presented with sudden reduction of visual acuity. With systemic chemotherapy, intrathecal methotrexate and radiotherapy, visual acuity and fundus findings improved. We report this unusual condition with a review of previous report.

Incidence and Complications of Obesity in Pubescent School Children

PURPOSE: In recent years, obesity in children has become one of the major nutritional problems, and the trend is that number of obese children is increasing. The purpose of this research is to examine the incidence of obesity in pubescent school children in Seoul and Cheju, and to analyze body fat component, complications and eating habits of those obese children in order to obtain basic information for prevention of obesity in children in the future. METHODS: The total number of 4,555 junior high school students from 4 schools consisting of 1,234 boys and 3,321 girls were examined based on their height and weight. For those children, obesity index was calculated based on the 50th percentile obtained from standard weight for height of children proposed by the Korean Pediatric Association in 1985. The body fat component was measured and compared between 275 children of 530 obese children(11.6%) and 275 children from the control group by Futrex-5000 A body fat and fitness computer. Of those children, oral glucose tolerance test, blood pressure, and biochemical studies were performed on 31 children whose follow-up was possible, and their exercise load and eating habits were examined. RESULTS: It was found that 11.6% of the subject children were obese, which consisted of 12.4% in boys and 11.4% in girls. The study showed 11.4% obesity ratio in Seoul and 13.2% obesity ratio in Cheju, but the difference was insignificant. Percents of bodyfat was 25.3+/-5.7% (mean+/-SD) for control group, 32.9+/-4.8% for mild obesity group, 35.6% for moderate obesity group, and 37.2+/-4.0% for severe obesity group. The morbidity of complications of those 31 children whose follow-up was possible showed the highest percentage of 29.0% in hyperlipidemia, and lower percentage in hypertension, elevated AST and/or ALT, glucose intolerance, diabetes, respectively. The eating habit analysis showed the total calorie intake/total energy expenditure ratio of 1.10 which is higher in calories than energy consumption, and the food intake evaluation showed that 23.3% of fat was contained in total calorie intake. CONCLUSIONS: The childhood obesity becomes the primary cause of adult obesity, hypertension and diabetes, and therefore, eating habits and exercise load should be carefully observed in order to prevent childhood obesity. In addition to the health care provided currently by schools, regular physical check-up should undertaken for early diagnosis to conduct appropriate tests and treatment.

Hereditary influence in determinig peak bone mass / 대한내분비학회지

No abstract available.