PURPOSE: To investigate nutritional status of inpatients by using subjective. and objective evaluation methods and to find the relationship between them. METHOD: The subjects were 101 inpatients with medical health problems at a university hospital. Nutritional status was evaluated by the Subjective Global Assessment (SGA) and physical assessment including percentage of weight loss, serum albumin, hemogloin, and hematocrit. Data were analyzed using frequency, percentage, mean, Kendall's tau. RESULTS: Grouping by the SGA, 61.4% were classified as severe malnutrition group. When applying the objective methods{physical assessment). 1.9~42.6% were diagnosed as malnutrition each item. The percentage of weight loss during previous 1-6month(r=.43~.54. P=.0001), serum albumin(r=-.26, P=.0003), hemoglobin of male(r=-.38, P=.0001), and hematocrit of male(r=-.34, P=.0001) were significantly correlated with SGA score. The coincidence rate of nutrition evaluation between the objective methods and SGA were 27.7 35.6%, 20.8%, 47.5%, 58.4% in percentage of weight loss, albumin, hemoglobin, and hematocrit. CONCLUSION: These findings showed a majority of inpatients were exposed to the risk of malnutrition. We recommend to evaluate inpatients' nutritional status periodically and to develop nursing intervention to solve their nutritional problems.
Hematocrit ; Humans ; Inpatients* ; Malnutrition ; Nursing ; Nutritional Status* ; Serum Albumin ; Weight Loss

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.
Compartment Syndromes ; Fibrosis ; Ischemia ; Leg ; Necrosis

Diencephalic syndrome is a rare cause of failure to thrive in infancy and early childhood. The syndrome is characterized by profound emaciation with normal appetite, loss of cutaneous adipose tissue, hyperactivity, euphoria, and nystagmus. It commonly occurs in association with chiasmatic and hypothalamic gliomas. It has also been described in association with other histologic types. There is the marked increase of serum growth hormone, which may exhibit an inappropriate, even paradoxical response in stimulation test. A male infant of 12 months of age, showed markedly elevated growth hormone but he had failure to thrive findings. Evenly enhanced round mass was seen at suprasella area in brain CT. Its histological findings was "Desmoplastic infantile ganglioglioma", very rare histologic type. Here we report a case of diencephalic syndrome presented by failure to thrive in association with hypothalamic tumors.
Adipose Tissue ; Appetite ; Brain ; Emaciation ; Euphoria ; Failure to Thrive ; Glioma ; Growth Hormone ; Humans ; Hypothalamic Neoplasms ; Infant ; Male

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy

Objectives: This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility. Methods: Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the “Happy Me” application. The feasibility of using the RE-AIM framework to evaluate it was examined. Results: The review yielded the following evaluation criteria: “reach,” the ratio of participants out of the total target population; “efficacy/effectiveness,” the difference in outcomes between the intervention and control groups, or between a pre- and post-test; “adoption,” the rate of use of the program and participation in the next stage of the program; “implementation,” the progress on the program components; “maintenance,” the participants’ and teachers’ intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested. Conclusions This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.

BACKGROUND/OBJECTIVES: The fruit of Cydonia oblonga Miller (COM) is used traditionally in Mediterranean region medicine to prevent or treat obesity, but its mechanism of action is still unclear. Beyond a demonstrated anti-obesity effect, the fruit was tested for the mechanism of adipogenesis in 3T3-L1 preadipocytes.MATERIALS/METHODS: 3T3-L1 preadipocytes were cultured for 8 days with COM fruit extract (COME) at different concentrations (0–600 µg/mL) with adipocyte differentiation medium. The cell viability was measured using an MTT assay; triglyceride (TG) was stained with Oil Red O. The expression levels of the adipogenesis-related genes and protein expression were analyzed by reverse transcription polymerase chain reaction and Western blotting, respectively. RESULTS: COME inhibited intracellular TG accumulation during adipogenesis. A COME treatment in 3T3-L1 cells induced upregulation of the adenosine monophosphateactivated protein kinase (AMPK)α phosphorylation and downregulation of the adipogenic transcription factors, such as sterol regulatory element-binding protein 1c, peroxisome proliferator-activated receptor γ, and CCAAT/enhancer binding protein α. The COME treatment reduced the mRNA expression of fatty acyl synthetase, adenosine triphosphatecitrate lyase, adipocyte protein 2, and lipoprotein lipase. It increased the mRNA expression of hormone-sensitive lipase and carnitine palmitoyltransferase I in 3T3-L1 cells. CONCLUSIONS COME inhibits adipogenesis via the AMPK signaling pathways. COME may be used to prevent and treat obesity.

OBJECTIVE: The effect of cognitive-behavioral therapy on the delusion in schizophrenic patients was evaluated. METHOD: The patients admitted to a psychiatric ward from September 1999 to June 2000 and diagnosed as schizophrenia, schizophreniform disorder, and schizoaffective disorder by DSM-IV were randomly assigned to cognitive-behavioral therapy(CBT) group(n=9) and supportive psychotherapy (ST) group(n=8). During the 10 weeks' treatment period, conviction, preoccupation, and anxiety on delusion, mode of explanation about symptom, and recovery style were regularly measured and compared between groups. RESULTS: 1) As for conviction and anxiety on delusion, the patients from both groups showed gradual reduction over time, but there was no significant difference between groups. 2) As for preoccupation of delusion, patients from both groups showed gradual reduction over time, and the patients on CBT group had a significantly more reduction than ST group. 3) As for mode of explanation and recovery style, CBT group had more marked positive changes than ST group did. CONCLUSION: Cognitive-behavioral therapy is more effective on preoccupation of delusion, explanatory mode about symptom, and recovery style than supportive psychotherapy.
Anxiety ; Delusions* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychotherapy ; Psychotic Disorders ; Schizophrenia

BACKGROUND: Although current dietary guidelines recommend to increase the consumption of whole grain, these recommendations are mainly derived from the belief that replacing fats with carbohydrate may reduce risk of coronary artery disease (CAD) by improving serum lipids. Our objective was to evaluate whether the isocalorical replacement of refined rice with whole grain reduce CAD risk factors such as insulin demand and lipid peroxidation in CAD patients. METHODS: Thirty-eight male patients with CAD were provided with 70 g powder of whole grain (220 kcal) for 16 weeks, replacing cooked refined rice as a carbohydrate source of breakfast. An oral glucose tolerance test (OGTT) was performed in all subjects to determine the effect of whole grain consumption on serum concentrations of insulin and glucose in CAD patients with different degree of glucose tolerance. RESULTS: With the substitution of whole grain for refined rice, serum glucose concentrations decreased by 24% without altering body weight and energy intake. Estimates of daily fiber and vitamin E intakes increased by 24% and 50%, respectively. Whole grain consumption in CAD patients without diabetes decreased fasting glucose (22%) and the area under the curve (AUC) for insulin (26%) and glucose (19%) during an OGTT. CAD patients with diabetes also showed reductions in fasting glucose (27%) and AUC for glucose (25%) during the OGTT, compared with baseline values. Whole grain consumption reduced plasma malondialdehyde and homocysteine and urinary 8-epi-prostaglandin F 2alpha concentrations by about 30%. Lipid-corrected concentrations of alpha-carotene, retinol, alpha- and gamma-tocopherol and lycopene increased by 22-46%, compared with baseline values. Whole grain consumption decreased the percentage composition of w6 fatty acids of serum phospholipid increased by 14%. CONCLUSION: The replacement of refined rice with whole grain as a carbohydrate source of a meal showed significant beneficial effects on glucose, insulin and homocysteine concentrations and lipid peroxidation in CAD patients. These effects are likely to substantially reduce the risk factors of CAD and diabetes in CAD patients.
Area Under Curve ; Blood Glucose ; Body Weight ; Breakfast ; Edible Grain* ; Coronary Artery Disease* ; Coronary Vessels* ; Energy Intake ; Fasting ; Fats ; Fatty Acids ; gamma-Tocopherol ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Insulin* ; Lipid Peroxidation* ; Male ; Malondialdehyde ; Meals ; Nutrition Policy ; Plasma* ; Risk Factors ; Vitamin A ; Vitamin E ; Vitamins

OBJECTIVES: This study was conducted to investigate providers' perspectives on current challenges in implementing a program for prevention and management of childhood obesity and adoption of mobile phone as a potential solution of leveraging multimodal delivery and support in a school setting. METHODS: The qualitative data were collected through face-to-face in-depth interviews with 23 elementary-school teachers, 6 pediatricians, and 6 dieticians from community health centers and analyzed using a qualitative research methodology. RESULTS: Current challenges and potential solutions of obesity-prevention and -management program for obesity program for elementary school children were deduced as two themes each. Lack of tailored intervention due to limited recipient motivation, lack of individualized behavioral intervention, and different environmental conditions can be solvable by mobile technology-based personalized intervention which brings about interactive recipient participation, customized behavioral intervention, and ubiquitous accessibility. Lack of sustainable management due to stigmatization, limited interactions between program providers and inconsistent administrative support can be handled by multimodal support based on school setting using mobile platform providing education of health promoting behaviors toward larger scale and interactive networking between program participants, and minimizing administrative burden. CONCLUSIONS: Adoption of mobile-based health management program may overcome current limitations of child obesity program such as lack of tailored intervention and sustainable management via personalized intervention and multimodal supports although some concerns such as increased screen time need to be carefully considered in a further study.
Cell Phones* ; Child* ; Community Health Centers ; Education ; Humans ; Motivation ; Nutritionists ; Obesity* ; Pediatric Obesity ; Qualitative Research ; Stereotyping