The purpose of this study was to investigate teacher's perceptions about the nutrition education of elementary schools. A total of 226 elementary school teachers within Changwon and Milyang city participated in this study. The results of this study were as follows. 90.8% of the teachers responded that nutrition education is necessaty in the elementary schools, and positive responses in the Milyang urban area were higher than that of the Changwon rural area(p<0.001). The main reason for the necessity of nutrition education was for proper growth and good table manners and the Milyang urban city was significantly higher than three other classes in 'for proper growth'(p<0.05). The starting period for nutrition education was supported by 72.1% of the teachers as beging when the children are in kindergarten, proving that this early nutrition education is supported. Especially in the Changwon urban support was higher than in the three other classes(p<0.01). The perceptions about a suitable person to teach nutrition indicated parents(39.6%), dietitions(35.5%), class teachers(24.9%), and the beliefs about nutrition specialists or dietitions was very low. 53.6% of the teachers responded that they would not teach nutrition education themselves and the main reason for this was that believed the teacher's work would be too hard(32.0%), lack of nutrition knowledge(29.4%), and that such courses should be taught courses by specialists(29.4%). However, 51.6% of the teachers disagreed with having a separate course for nutrition education. Proper eating habits(62.7%) and growth and nutrition(28.6%) were the main categories within nutrition education. The teacher recognized that elementary students' nutrition problem is to eat too much processed and instant foods(39.1%), deviated foods(36.9%), and lack of table manners(19.4%). The most effect method was to link the subject matter with the parents(38.7%), use of audio visuals and education materials(28.3%), and need of nutrition education teachers(10.1%) was low.
Child ; Eating ; Education* ; Gyeongsangnam-do* ; Humans ; Specialization

Infective endocarditis is a dreaded complication in dialysis or kidney transplantation patients, with high morbidity and mortality. Despite the improved early survival of the transplanted kidney with new immunosuppressive agents, the number of patients returning to dialysis after a failed renal allograft is increasing. There is no consensus on the optimal management of immunosuppression in patients with a failed allograft. Continued immunosuppression is associated with infection, and the rapid discontinuation of immunosuppression may lead to acute rejection. Therefore, it is important to taper the immunosuppression properly in patients with a failed renal allograft. We report on a hemodialysis patient with a failed renal allograft who had a cerebral infarction following infective endocarditis. The patient was treated successfully with antibiotics and valve replacement.
Anti-Bacterial Agents ; Cerebral Infarction ; Consensus ; Dialysis ; Endocarditis ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Renal Dialysis ; Transplantation, Homologous ; Transplants

Retrohepatic caval injuries are a difficult problem to surgeons as its mortality approaching 50~80%. Several bypass techniques was advocated to reduce operative bleeding and to improve the prognosis of the traumatized patients. We successfully managed a case of retro hepatic caval injury using venovenous bypass and total hepatic vascular isolation. A 28 year old female patients was admitted to Cheju Medical Center injured in a traffic accident. At exploration, a retrohepatic caval injury was suspected. So patient was emergently transferred to Seoul National University Hospital, after gauze packing. On arrival, vital signs were stable. Reexploration was undertaken. There was gush out of blood from retrohepatic space. After clamping suprahepatic and infrahepatic vena cava, venovenous bypass was introduced to left axillary vein and left femoral vein using Biomedicus pump. Systemic heparinization was not used. Avulsion between vena cava and common trunk of left and middle hepatic veins was repaired and left hepatectomy was done. Gauze packing was done due to ongoing oozing by coagulopathy from massive transfusion. Total venovenous bypass time was 30 min. On 10th operative day, reexploration was undertaken to assure hemostasis and to remove packed gauze. On 54th postoperative day patient discharged without any morbidity.
Accidents, Traffic ; Adult ; Axillary Vein ; Constriction ; Female ; Femoral Vein ; Hemorrhage ; Hemostasis ; Heparin ; Hepatectomy ; Hepatic Veins ; Humans ; Jeju-do ; Mortality ; Prognosis ; Seoul ; Vital Signs

Background/Aims: Calcium channel blockers (CCBs) are the most widely prescribed medication for patients with vasospastic angina (VA). However, few studies have compared the prognosis of VA patients who are prescribed different CCBs. Methods: We enrolled 2,960 patients who received provocation test prospectively in 11 university hospitals in Korea. We divided 1,586 patients received four major CCBs into two groups: a first generation CCB (diltiazem and nifedipine) group and a second generation CCB (amlodipine and benidipine) group. Primary outcome was time to events of composite of death from any cause, acute coronary syndrome (ACS) and symptomatic arrhythmia during 3-year follow-up. We also compared the effect of each CCB on the control of angina symptoms. Results: There was no difference of the primary outcome among the two groups with a cumulative incidence rate of 5.4%, 2.9%, and a person-month incidence rate of 2.33 and 1.26, respectively (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.25 to 1.17; p = 0.120, as reference with the 1st generation CCBs). The incidence of ACS was significantly lower in 2nd generation CCBs group with a person-month incidence rate of 1.66 vs. 0.35 (HR, 0.22; 95% CI, 0.05 to 0.89; p = 0.034). Use of benidipine showed a significant better control of angina symptom compared with diltiazem for 3 years (odds ratio, 0.17; 95% CI, 0.09 to 0.32; p < 0.0001 at 3rd year). Conclusions The first and second generation CCB groups did not differ in terms of composite outcome occurrence. However, the ACS incidence rate was significantly lower in the users of the 2nd generation CCBs.

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.