The purpose of this study was to the relationship between powerlessness, self-efficacy and quality of life in hemodialysis patients. The subjects were compromised of 198 hemodialysis patients from Pusan, Kyung-Sang Namdo and Kyung-Sang Bukdo 6 hemodialysis clinics. There were significant positive correlation between self-efficacy and quality of life(r= .512, p .00l). Data were collected by questionnaires from Sep. 19 to Oct. 27, 2001. The instrument used for study were the Powerlessness Behavioral Assessment Tool (Miller, 1983) and self-efficacy developed by Kim, Ju-Hyun(1995) and quality of life developed by Kim, Ok-Soo(1993). Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, pearson correlation The results were as follows. 1. The mean score of powerlessness was 52.41+/-.93, mean mark 3.28+/-.43, and the mea score of self-efficacy was 45.44+/-.75, mean mark 2.87+/-.49, and the mea score of quality of life was 121.27+/-3.81. mean mark 2.96+/-.58. 2. There were significant differences in the level of powerlessness according to sex (1,=2.148, p= .033), occupation(t=3.682, p=.000), economic status(F=3.094, p=.048), experience of hospitalization (1,=-2.002. p= .047). 3. There were significant differences in the level of self-efficacy according to age(F=3.271. p=.013), economic status (F=5.759, p=.004), religion(F=2.667, p= .048), hemodialysis period(F=2.991. p =.032), hemodialysis frequency(t = 9.045, p = .003), experience of hospitalization (1,=4.40, p=.037). 4. There were significant differences in the level of quality of life according to occupation(t=3.796, p=.053), economic status(F=11.478, p=.000), hemodialysis frequency(t=7.573, p=.006). 5 There were significant negative correlation between powerlessness and self-efficacy (r=- .401. p .001), powerlessness and quality of .life(r=- .562, p .001),
Busan ; Hospitalization ; Humans ; Quality of Life* ; Surveys and Questionnaires ; Renal Dialysis*

In order to investigate the cumulative incidence and risk factors for diabetic retinopathy among non-insulin dependent diabetes mellitus, 116 patients which given diagnosis of diabetes at age 30 years or older who had been followed-up for more than 10 years and were initially free from retinopathy were analysed retrospectively. Several risk factors for retinopathy were analysed at the initial examinations: sex, age at the onset, age at the initial examination, duration, fasting plasma glucose(FPG), two-hour postpradial plasma glucose(pp2), blood pressure, hypertension status, therapeutic regimen, total cholesterol, HDL-cholesterol, triglyceride, body mass index. After a mean follow-up time of 11.7 years. The cumulative incidence was 31.0%. By univariate analysis. Significant risk factors of retinopathy were age at the onset, age at the initial examination. FPG, PP2, therapeutic regimen. However, By using multivariate analysis. Independent risk factors were not found.
Blood Pressure ; Body Mass Index ; Cholesterol ; Diabetes Mellitus ; Diabetic Retinopathy* ; Diagnosis ; Fasting ; Follow-Up Studies ; Humans ; Hypertension ; Incidence* ; Multivariate Analysis ; Plasma ; Retrospective Studies ; Risk Factors* ; Triglycerides

In order to evaluate the ocular autonomic dysfunction in diabetics, pupil cycle time(PCT) was assessed in 201diabetics and 33controls. PCT was significantly different between the diabetics and controls and prolonged in diabetics in regard to the severity of retinopathy(p<0.05). PCT was significantly prolonged in diabetics in regard to the diabetic peripheral neuropathy and nephropathy(p<0.05). PCT was significantly different among the diabetic groups in regard to the duration of diabetes(p<0.05). Sustainde PCT was unmeasurable in 56.7% of diabetics and in 72.3% of proliferative diabetic retinopathy compared with 28.8% of controls(p<0.05). Ocular autonomic dysfunction in diabetics correlated closely with the severity of the diabetic retinopathy, diabetic petiphetal neuropathy and nephropathy, diabetic duration.
Diabetic Nephropathies ; Diabetic Retinopathy ; Peripheral Nervous System Diseases ; Pupil*

PURPOSE: Food protein-induced enterocolitis syndrome (FPIES) is a symptom complex of vomiting and diarrhea caused by non-IgE mediated allergy to cow's milk and/or soy in young infants. Transforming growth factor (TGF)-beta has been reported to protect the epithelial barrier of the gut from foreign antigens. We studied the expression of type 1 and 2 TGF-beta receptors in the mucosa of small intestine to investigate their roles in the pathogenesis of FPIES. METHODS: Twenty-eight patients, aged 7 to 120 days (mean 49 days) who were diagnosed with FPIES by clinical criteria and challenge tests were included. Immunohistochemical stainings for type 1 and 2 TGF-beta receptors were performed on endoscopic duodenal biopsy specimens. RESULTS: Type 1 and 2 TGF-beta receptors were expressed in the villous and crypt epithelial cells but nearly absent in the lamina propria in both patients and controls. Type 1 TGF-beta receptor expression was significantly lower in the patients who had villous atrophy than in the patients who had not and in controls. The expression of type 1 TGF-beta receptor was negatively correlated with the severity of villous atrophy. Type 2 TGF-beta receptor expression showed no significant difference between the patients and controls. CONCLUSION: Our results suggests that the decreased activity of type 1 TGF-beta receptor is implicated in the pathogenesis of FPIES in young infants.
Atrophy ; Biopsy ; Diarrhea ; Enterocolitis* ; Epithelial Cells ; Humans ; Hypersensitivity ; Infant ; Intestine, Small ; Milk ; Mucous Membrane ; Receptors, Transforming Growth Factor beta ; Transforming Growth Factors ; Vomiting

Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.
Cardiovascular Diseases ; Curriculum ; Dyslipidemias* ; Humans ; Job Description ; Nutrition Therapy* ; Nutritionists ; Professional Practice

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring . evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring . evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.
Diabetes Mellitus ; Diagnosis ; Education ; Humans ; Job Description ; Nutrition Assessment ; Nutrition Therapy* ; Nutritionists*

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring.evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.
Curriculum ; Diagnosis ; Humans ; Nutrition Assessment ; Nutrition Therapy* ; Nutritionists* ; Referral and Consultation

PURPOSE:Vascular endothelial growth factor (VEGF) is known to play an important role in the process of angiogenesis and chronic inflammation. Plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (tPA) are main regulators of the plasmin system. The functions of these components are shown to be closely associated and recent studies have reported their potential roles in the asthmatic airways. We determined plasma levels of soluble VEGF (sVEGF), PAI-1, tPA and endothelin (ET)-1 in children with recurrent early wheeze. Our purpose was to examine whether there would be any difference in these biomarkers in relation to the relapse rate of wheezing. METHODS:Fifty-eight children aged 2-6 years who were admitted with acute wheezing were enrolled. They were divided into two groups: patients with more than three relapses of wheezing (group 1, n=34) and those with less than one relapse (group 2, n=24). Plasma levels of sVEGF, PAI-1, ET-1 and tPA on admission were measured using ELISA in the two patient groups and controls (n=16). RESULTS:PAI-1, sVEGF and tPA significantly increased during acute wheezing episode. The levels of these biomarkers were significantly higher in group 1 than in group 2 (P<0.01). ET-1 showed no significant difference between the patient groups and controls. CONCLUSION:Our study showed significantly elevated plasma levels of sVEGF and plasmin system regulators in children with recurrent early wheeze, which was even higher in the group with more frequent relapses. Our results suggest that these biomarkers may be associated with airway inflammation and may contribute to the later development of asthma in these children.
Asthma ; Biomarkers ; Child ; Endothelial Growth Factors ; Endothelins ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysin* ; Humans ; Inflammation ; Plasma* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Recurrence ; Respiratory Sounds ; Tissue Plasminogen Activator ; Vascular Endothelial Growth Factor A*

PURPOSE:Vascular endothelial growth factor (VEGF) is known to play an important role in the process of angiogenesis and chronic inflammation. Plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (tPA) are main regulators of the plasmin system. The functions of these components are shown to be closely associated and recent studies have reported their potential roles in the asthmatic airways. We determined plasma levels of soluble VEGF (sVEGF), PAI-1, tPA and endothelin (ET)-1 in children with recurrent early wheeze. Our purpose was to examine whether there would be any difference in these biomarkers in relation to the relapse rate of wheezing. METHODS:Fifty-eight children aged 2-6 years who were admitted with acute wheezing were enrolled. They were divided into two groups: patients with more than three relapses of wheezing (group 1, n=34) and those with less than one relapse (group 2, n=24). Plasma levels of sVEGF, PAI-1, ET-1 and tPA on admission were measured using ELISA in the two patient groups and controls (n=16). RESULTS:PAI-1, sVEGF and tPA significantly increased during acute wheezing episode. The levels of these biomarkers were significantly higher in group 1 than in group 2 (P<0.01). ET-1 showed no significant difference between the patient groups and controls. CONCLUSION:Our study showed significantly elevated plasma levels of sVEGF and plasmin system regulators in children with recurrent early wheeze, which was even higher in the group with more frequent relapses. Our results suggest that these biomarkers may be associated with airway inflammation and may contribute to the later development of asthma in these children.
Asthma ; Biomarkers ; Child ; Endothelial Growth Factors ; Endothelins ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysin* ; Humans ; Inflammation ; Plasma* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Recurrence ; Respiratory Sounds ; Tissue Plasminogen Activator ; Vascular Endothelial Growth Factor A*

We report here on a case of a spinal extradural leiomyoma in a 67-year-old woman, and this tumor was in a very unusual location for a leiomyoma. Because the patient underwent hysterectomy for a uterine leiomyoma 20 years ago, we can speculate that the spinal lesion was a metastatic leiomyoma.
Aged ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Spinal Cord