OBJECTIVES: We assessed the public acceptance of a health information exchange (HIE) and examined factors that influenced the acceptance and associations among constructs of the Technology Acceptance Model (TAM). METHODS: We collected data from a survey of 1,000 individuals in Korea, which was administered through a structured questionnaire. We assessed the validity and reliability of the survey instrument with exploratory factor analysis and Cronbach's alpha coefficients. We computed descriptive statistics to assess the acceptance and performed regression analyses with a structural equation model to estimate the magnitude and significance of influences among constructs of TAM. RESULTS: Eighty-seven percent of the respondents were willing to use the technology, and the average level of agreement with the need for the technology was 4.16 on a 5-point Likert scale. The perception of ease of use of the technology significantly influenced perceptions of usefulness and attitudes about the need for HIE. Perceptions of usefulness influenced attitude and behavioral intention to use HIE, and attitude influenced intention. Age showed a wide range of influences throughout the model, and experience with offline-based information exchange and health status also showed noteworthy influences. CONCLUSIONS: The public acceptance of HIE was high, and influences posited by TAM were mostly confirmed by the study results. The study findings indicated a need for an education and communication strategy tailored by population age, health status, and prior experience with offline-based exchange to gain public buy-in for a successful introduction of the technology.
Diffusion of Innovation ; Education ; Health Information Exchange* ; Intention ; Korea* ; Public Opinion ; Reproducibility of Results ; Surveys and Questionnaires

Objectives: The study examined the status on the use of nutrition labeling and nutrition claims among university students as well as the diet quality and nutritional status using the nutrition quotient (NQ) according to the use of nutrition labeling and claims. Methods: A cross-sectional survey was conducted on university students (86 males and 131 females) from March to April in 2019 in Chungbuk area. Results: The percentage of subjects who reported that they recognized nutrition labeling was 80.2% of the total, and 63.8% of them indicated that they used nutrition labeling for their food choices. In addition, 22.6% of the total subjects said that they used nutrition claims. The group of subjects using nutrition labeling showed significantly higher mean scores in balance (P < 0.01), diversity (P < 0.05), moderation (P < 0.01), and dietary behavior (P < 0.001) along with higher mean NQ score (P < 0.001) compared to the group not using nutrition labeling. The group using nutrition claims had significantly higher mean scores in balance (P < 0.001), diversity (P < 0.01), moderation (P < 0.001), and dietary behavior (P < 0.001) as well as total NQ scores (P < 0.001) compared to the group not using nutrition claims. The group of subjects using both nutrition labeling and nutrition claims showed significantly higher mean NQ scores than the group of subjects using either nutrition labeling or nutrition claims (P < 0.05). Conclusions In this study, university students' use of nutrition labeling and nutrition claims appeared to be related to their diet quality and nutritional status.

Parkinson’s disease (PD) is characterized by the presence of α-synuclein (α-syn) inclusions in the brain and the degeneration of dopamine-producing neurons. There is evidence to suggest that the progression of PD may be due to the prion-like spread of α-syn aggregates, so understanding and limiting α-syn propagation is a key area of research for developing PD treatments. Several cellular and animal model systems have been established to monitor α-syn aggregation and propagation. In this study, we developed an in vitro model using A53T α-syn-EGFP overexpressing SH-SY5Y cells and validated its usefulness for high-throughput screening of potential therapeutic targets. Treatment with preformed recombinant α-syn fibrils induced the formation of aggregation puncta of A53T α-syn-EGFP in these cells, which were analyzed using four indices: number of dots per cell, size of dots, intensity of dots, and percentage of cells containing aggregation puncta. Four indices are reliable indicators of the effectiveness of interventions against α-syn propagation in a one-day treatment model to minimize the screening time. This simple and efficient in vitro model system can be used for high-throughput screening to discover new targets for inhibiting α-syn propagation.

The purpose of this study was to investigate the perception of foodservice managers in childcare centers and kindergartens for identifying the vulnerable areas of safety management. The foodservice managers in 1,144 of nationwide childcare centers and kindergartens were surveyed from May to October 2007 to answer a total 72 questions in areas of general characteristics, actual practice of foodservice management and safety management perception. Meals were served in 97.7% of surveyed facilities and 91.0% among them were self-operated. The hiring rate (27.8%) of dietitians in childcare centers was significantly lower than the rate (82.0%) of kindergartens. The needs of dietitian employment between childcare centers and kindergartens differed as 44.9% and 87.5%, respectively. In knowledge on food-borne illnesses, they have the wrong information in the field of season for frequent outbreak, major pathogens and foods causing food-borne illnesses. The food-borne illnesses (36.2%) were indicated as the major problem in foodservice facilities and the degree of risk exposure was considered as safe (70.1%). More than 70% of both facilities answered as sanitary in the status of personal hygiene. Only 38.0% recognized the Facility and Equipment Standard in the Childcare Law and Early Childhood Education Law. In preparation of meals and management of cooking processes, kindergarten scored significantly high compared to childcare centers (p < 0.05 or p < 0.01) while the necessity of standards was not different in both facilities. Among managers surveyed, 28.8% had taken food safety education from professional institutions and more than 80% in both facilities indicated the need of professional educations. These results suggest that it is necessary for the systematic sanitary education of foodservice managers by developing the sanitary management standard as well as the amendment of laws related foodservice in childcare centers and kindergartens.
Cooking ; Employment ; Food Safety ; Foodborne Diseases ; Humans ; Hygiene ; Jurisprudence ; Meals ; Safety Management ; Seasons

Airway stenting has become a common treatment for malignant central airway obstruction. Most airway stents are well tolerated, and life-threatening complications are very rare. Here we describe the case of a life-threatening obstruction due to accumulated respiratory secretions. A 33-year-old man had a massive large cell neuroendocrine carcinoma in the anterior mediastinum, which caused extensive extrinsic compression of the whole trachea. Airway stents were successfully inserted into the whole trachea but 1 week after the procedure, the patient complained of worsening dyspnea due to sticky respiratory secretions accumulated inside the stents. Because the patient could not expectorate a large amount of sticky secretions, frequent bronchoscopic toiletings were performed for 2 months. The stent was well maintained for 7 months till the enlarged tumor causes extrinsic compression because stent revision was performed. About 1 year after the first stent insertion, the patient was admitted to the intensive care unit and intubated because of obstruction of the stent by organized secretions. Fortunately, these secretions were successfully removed and the patient was discharged without any sequelae. Thus, respiratory secretions can cause life-threatening complications after airway stent insertion. Clinicians should be aware of this, and careful examination and close follow-up of such patients are needed.
Adult ; Airway Obstruction ; Carcinoma, Neuroendocrine ; Dyspnea ; Follow-Up Studies ; Humans ; Intensive Care Units ; Mediastinum ; Self Expandable Metallic Stents ; Sputum ; Stents* ; Trachea

BACKGROUND: We studied the association between the triglyceride to high-density lipoprotein cholesterol ratio and computed tomography-measured visceral fat as well as cardiovascular risk factors among Korean male adults. METHODS: We measured triglycerides, high density lipoprotein cholesterol, body mass, waist circumference, fasting plasma glucose, hemoglobin A1c, systolic blood pressure, diastolic blood pressure, visceral fat, and subcutaneous fat among 372 Korean men. The visceral fat and subcutaneous fat areas were measured by computed tomography using a single computed tomography slice at the L4-5 lumbar level. We analyzed the association between the triglyceride to high density lipoprotein cholesterol ratio and visceral fat as well as cardiovascular risk factors. RESULTS: A positive correlation was found between the triglyceride to high density lipoprotein cholesterol ratio and variables such as body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, visceral fat, and the visceral-subcutaneous fat ratio. However, there was no significant correlation between the triglyceride to high density lipoprotein cholesterol ratio and subcutaneous fat or blood pressure. Multiple logistic regression analyses revealed significant associations between a triglyceride to high density lipoprotein cholesterol ratio > or =3 and diabetes, a body mass index > or =25 kg/m2, a waist circumference > or =90 cm, and a visceral fat area > or =100 cm2. The triglyceride to high density lipoprotein cholesterol ratio was not significantly associated with hypertension. CONCLUSION: There were significant associations between the triglyceride to high density lipoprotein cholesterol ratio and body mass, waist circumference, diabetes, and visceral fat among a clinical sample of Korean men. In the clinical setting, the triglyceride to high density lipoprotein cholesterol ratio may be a simple and useful indicator for visceral obesity and cardiovascular disease.
Adult* ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Cholesterol, HDL* ; Fasting ; Humans ; Hypertension ; Intra-Abdominal Fat* ; Lipoproteins ; Logistic Models ; Male* ; Obesity, Abdominal ; Risk Factors* ; Subcutaneous Fat ; Triglycerides* ; Waist Circumference

BACKGROUND: Intraductal papillary mucinous tumor (IPMT) of the pancreas is a rare tumor arising in the main pancreatic duct or its subbranches. It is characterized by a diffusely or focally dilated main pancreatic duct filled with mucus and a mucus secretion through a patulous duodenal papilla. METHODS: The clinicopathologic characteristics of eight IPMT cases which were resected surgically from January 1994 to August 1998 at Seoul National University Hospital were reviewed to consider the optimal surgical treatment. RESULTS: The range of ages was from 49 to 70 years with a mean age of 59.3. Five were men and three were women. The prominent symptom was upper abdominal pain. Seven patients had been treated for pancreatitis before. Tumor markers didn't correlate with the pathologic status. In all the cases, a dilated pancreatic duct with secretion of mucin was found in the radiologic studies. Four lesions were located in the uncinate process, 3 in the body, and 1 diffusely. One total pancreatectomy, 1 Whipple's procedure, 3 pylorus-preserving pancreatoduodenectomies, 1 duodenum-preserving resection of the head of the pancreas, and 2 subtotal pancreatectomies were performed. Three lesions were malignant, another three were borderline malignant, and the remaining two were benign. Three were multiple lesions. Lesions for which the main pancreatic duct was dilated more than 0.5 cm, lesions greater than 2.5 cm, lesions with a mural nodule greater than 1.0 cm, or type 1, 2, 3 lesions were borderline malignant or malignant. There was no lymphatic metastasis. After a follow-up duration from 1 month to 56months, all patients are alive at the time of study and have experienced no locoregional recurrence or distant metastasis. CONCLUSIONS: In the radiologic studies, an IPMT should be considered in a multilobulating cystic lesion with the dilated main pancreatic duct. The lesions are variable from benign to malignant and often spread intraductally. When the lesion seems to be malignant, an aggressive resection is recommended.
Abdominal Pain ; Biomarkers, Tumor ; Female ; Follow-Up Studies ; Head ; Humans ; Lymphatic Metastasis ; Male ; Mucins* ; Mucus ; Neoplasm Metastasis ; Pancreas* ; Pancreatectomy ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pancreatitis ; Recurrence ; Seoul

PURPOSE: This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain. METHODS: Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast. RESULTS: One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified. CONCLUSIONS: In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups.
Appendectomy ; Appendicitis ; Colitis ; Diagnosis, Differential ; Diverticulitis ; Enteritis ; Female ; Humans ; Ovary ; Urinary Calculi

PURPOSE: We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory. METHODS: One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program. RESULTS: The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363. CONCLUSION: The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
Checklist ; Clinical Competence ; Decision Making ; Diagnosis, Oral ; Educational Measurement ; Ethics, Medical ; Humans ; Mental Competency ; Pilot Projects ; Statistics as Topic ; Students, Medical

No abstract available.
Humans ; Infarction ; Skin Temperature ; Skin