OBJECTIVES: This study was carried out to determine nutritional status of elderly patients in a long-term care hospital according to meal type and eating ability. METHODS: Subjects were 47 female patients aged over 65 (79.3 +/- 7.1 years) who resided in a long-term care hospital in Seoul. Thirty seven patients who ate diet orally were grouped according to meal type (27 general diet and 10 soft diet) and eating ability (26 eating by oneself and 11 eaten with help) and 10 were on tube feeding. Nutritional status was determined by food consumption and mid-arm circumference. RESULTS: The mean adequacy ratios (MARs) of 12 nutrients (protein, calcium, phosphorus, zinc, vitamin A, vitamin B1, vitamin B2, vitamin B6, niacin, folic acid, vitamin C) were 0.687 for general diet, 0.565 for soft diet, 0.680 for eating by oneself and 0.677 for eaten with help, which were significantly lower than 0.982 for tube feeding (p < 0.05 or p < 0.01). The patients on tube feeding had significantly lower % arm circumference compared to those who ate general diet (84.0% vs. 95.4%, respectively, p < 0.05). Nutrients intakes, nutrient adequacy ratio (NAR) and index of nutritional quality (INQ) were not different between meal types as well as eating ability. The most insufficiently consumed nutrients by the patients on diet were folic acid, vitamin B2, and calcium (NAR 0.334~0.453, 0.515~0.539, and 0.516~0.533, respectively). CONCLUSIONS: The results suggested that regardless of meal type or eating ability, the subjects who were on diets in this study might have inadequate intake of folic acid as well as vitamin B2, and calcium, which need to be reflected on menu planning. The measurement of mid-arm circumference presented more risk of malnutrition of patients on tube feeding than those on diets, despite apparently better nutrient consumption.
Aged* ; Arm ; Calcium ; Diet ; Eating* ; Enteral Nutrition ; Female ; Folic Acid ; Humans ; Long-Term Care* ; Malnutrition ; Meals* ; Menu Planning ; Niacin ; Nutritional Status* ; Nutritive Value ; Phosphorus ; Riboflavin ; Seoul ; Thiamine ; Vitamin A ; Vitamin B 6 ; Vitamins ; Zinc

BACKGROUND/OBJECTIVES: Chronic colitis is a risk factor for colorectal cancer (CRC) development in both animals and humans. Previously, we reported that a diet rich in protein (with casein as the protein source) significantly increased the risk of mouse CRC development in a dose-dependent manner. In this study, we investigated the effects of different protein sources on the risk of colitis development.MATERIALS/METHODS: Balb/c mice were divided into 7 experimental groups: 20% casein (20C), 20C-dextran sulfate sodium (DSS), 40% casein-DSS (40CD), 40% whey protein-DSS (40WD), 40% soy protein-DSS (40SD), 40% white meat-DSS (40WMD), and 40% red meatDSS (40RMD). Mice were fed an experimental diet for 4 wk and received 3% DSS in their drinking water for 6 days during the 4th wk of the experimental period. RESULTS: Compared to other groups, the 40CD group showed the most aggravated colitis with increased disease activity and inflammatory markers. In the 40RMD group, interleukin (IL)-6 levels were the highest among all the groups. The 40SD group showed conflicting effects, for example, elevated mortality and disease activity but decreased nitric oxide (NO) levels. The 40WD group showed attenuated colitis with increased IL-10 levels and decreased NO levels. The 40WMD group showed conflicting effects, including decreased NO levels and elevated fecal lipocalin-2 and IL-6 levels. CONCLUSIONS These results suggest that, at levels of 40% in the diet, casein and red meat exacerbate colitis, whereas whey protein mitigates it the most effectively.

PURPOSE: The objective of this study was to investigate the effects of a high fructose and fat diet on bone growth and maturation in growing female rats. METHODS: Three-week-old female SD rats were randomly assigned to four experimental groups; the control group (CON: fed control diet based on AIN-93G, n = 8); the high-fructose diet group (HFrc: fed control diet with 30% fructose, n = 8); the high-fat diet group (Hfat: fed control diet with 45 kcal% fat, n = 8); and the high-fat diet plus high fructose group (HFrc + HFat: fed diets 45 kcal% fat with 30% fructose, n = 8). Each group was assigned their respective diets for the remaining eight weeks. Bone-related parameters (bone mineral density (BMD) and structural parameters, osteocalcin (OC), deoxypyridinoline (DPD)) and morphologic changes of kidney were analyzed at the end of the experiment. RESULTS: Final body weights and weight gain were higher in the HFat and HFrc + HFat groups and showed higher tendency in the HFrc group compared with those of the CON group (p < 0.05); however, no significant difference in caloric intake was observed among the four experimental groups. The serum OC levels of the HFrc and HFrc + HFat groups were lower than those of the CON and HFat groups (p < 0.05). Urinary levels of DPD did not differ among the experimental groups. BV/TV and Tb.N of trabecular bone were higher in the HFrc + HFat group and showed a higher tendency in the HFrc group than those of the CON and HFat groups (p < 0.05). Tb.Pf of trabecular bone were lower in the HFrc + HFat group than those in the CON and HFat groups (p < 0.05). However, no difference in trabecular BMD was observed among the experimental groups. Cortical bone volume was higher in the HFat and HFrc + HFat groups than in the CON and HFrc groups (p < 0.05). No morphology change in kidney was observed among the experimental groups. CONCLUSION: Our study suggests that 8 weeks of high-fructose and high fat intake could improve the bone quality (Structural parameters) of trabecular and cortical bone of tibia in growing female rats.
Animals ; Body Weight ; Bone Development ; Diet ; Diet, High-Fat* ; Energy Intake ; Female* ; Fructose* ; Humans ; Kidney ; Osteocalcin ; Rats* ; Tibia ; Weight Gain

Coronary stent loss is a rare but serious complication during interventional cardiology. This complication occurs not only in the intracoronary area but also in the extracoronary area, such as the aortic root or the left ventricle. An 83-year-old man with stable angina had a stent inserted into a heavy calcific left anterior descending artery. The stent was lost twice during the procedure. The first stent was dislodged from the left main coronary artery to the proximal left anterior descending artery, and the second stent migrated to the aortic root following separation from the balloon. We successfully redeployed the first stent at the dislodged site and retrieved the second stent using a goose-neck snare after moving the stent to the descending aorta. These steps circumvented the need for the patient to undergo emergency cardiovascular surgery.
Angina, Stable ; Aorta, Thoracic ; Arteries ; Cardiology ; Coronary Vessels ; Emergencies ; Heart Ventricles ; Humans ; Percutaneous Coronary Intervention ; SNARE Proteins ; Stents

Purpose: A systematic review and meta-analysis of nutrition educational intervention studies was performed to assess the association between nutrition education intervention and fruit & vegetable (F&V) preferences and nutrition knowledge in preschool children. Methods: The relevant studies of nutrition education intervention and F&V preferences and nutrition knowledge published from January 2000 to June 2020 were located using PubMed, Web of Science, Cochrane Library, Research Information Sharing Service, Korean Studies Information Service System databases, and lists of references. A random-effects metaanalysis was conducted to estimate the standardized mean difference with a 95% confidence interval (CI). Subgroup analyses were performed to identify the association between nutrition education and F&V preferences and nutrition knowledge. Results: The results show that the effect sizes (ES) of F&V preferences and nutrition knowledge of preschool children were 0.31(95% CI, 0.23, 0.39), and 1.69(95% CI, 1.27, 2.12), respectively. The result of subgroup analysis, nutrition education focused on F&V (F&V preferences, ES: 0.32; nutrition knowledge, ES: 2.09) presented a slightly larger effect than general nutrition education (F&V preferences, ES: 0.26; nutrition knowledge, ES: 1.62). As for the type of exposure to F&V, direct exposure education (F&V preferences, ES: 0.40) had a greater effect than indirect exposure (F&V preferences, ES: 0.26). This meta-analysis showed that nutrition education intervention had positive effects on the F&V preferences and nutrition knowledge in preschool children. Conclusion In conclusion, from the meta-analysis and subsequent subgroup analysis, we found that varied types of nutrition education intervention had varying effects on F&V preferences and nutrition knowledge in preschool children.

PURPOSE: The AFX2 endograft is a unibody, bifurcated stent graft that can be used to lower complications in certain patients. In this study, we retrospectively reviewed consecutive cases in which the AFX2 system was used to overcome the challenges of narrow distal aorta, as well as to reduce procedure time and contrast medium dose. Furthermore, we compared the results with matched patients treated using the Endurant II endograft system.MATERIALS AND METHODS: This was a retrospective observational study of nine patients with abdominal aortic aneurysm (AAA) who underwent endovascular aneurysm repair (EVAR) using the AFX2 device between June 2017 and April 2018 at Seoul National University Hospital. The patients had narrow distal aorta (n=3), reversed tapered neck (n=1), iliac artery aneurysm (n=2), chronic kidney disease patients (n=2), and impending rupture (n=1). Seven matched patients were treated using the Endurant II graft.RESULTS: In the AFX2 group, the mean procedure time was 87.2 minutes, mean blood loss volume was 157.7 mL, and mean volume of contrast medium used was 48.3 mL. In the Endurant II group, the mean procedure time was 140.0 minutes, mean blood loss volume was 175.0 mL, and mean volume of contrast medium used was 119.3 mL.CONCLUSION: Our preliminary experiences with selected AAA patients treated using the AFX2 endovascular repair system showed good outcomes compared with similar patients treated using the Endurant II system. Therefore, the AFX2 may be a good option to perform EVAR in patients of advanced age who have chronic kidney failure or narrow distal aorta.
Aneurysm ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Blood Vessel Prosthesis ; Humans ; Iliac Artery ; Kidney Failure, Chronic ; Neck ; Observational Study ; Renal Insufficiency, Chronic ; Retrospective Studies ; Rupture ; Seoul ; Transplants

Objective: The Block Design Test (BDT) is known to be an effective measure in diagnosing age-related cognitive decline of visuospatial function. The goal of this study is to investigate the effects of age, education years, and gender on the performance of the BDT and to provide normative data in Korean community-dwelling participants who are 55 to 90 years old. Methods: The participants were 432 non-demented adults aging from 55 to 90 years old. The BDT was administered to participants according to its manual. Multiple linear regressions and analyses of variance were conducted, including age, gender, and educations were used as covariates. Results: Age, educational years, and gender were found to be significantly associated with performance on the BDT. As age increased, BDT performance decreased. Educational years were associated with BDT performance. Men showed higher performance (29.9±10.3) compare to women (26.1±8.7). The BDT is influenced by age, educational years, and gender. Conclusion Unlike the previous study, the current study shows that gender has a significant influence in visuospatial ability in the old population. Present normative data will be useful for clinicians in evaluating aging participants with cognitive impairment.

Objective: The Block Design Test (BDT) is known to be an effective measure in diagnosing age-related cognitive decline of visuospatial function. The goal of this study is to investigate the effects of age, education years, and gender on the performance of the BDT and to provide normative data in Korean community-dwelling participants who are 55 to 90 years old. Methods: The participants were 432 non-demented adults aging from 55 to 90 years old. The BDT was administered to participants according to its manual. Multiple linear regressions and analyses of variance were conducted, including age, gender, and educations were used as covariates. Results: Age, educational years, and gender were found to be significantly associated with performance on the BDT. As age increased, BDT performance decreased. Educational years were associated with BDT performance. Men showed higher performance (29.9±10.3) compare to women (26.1±8.7). The BDT is influenced by age, educational years, and gender. Conclusion Unlike the previous study, the current study shows that gender has a significant influence in visuospatial ability in the old population. Present normative data will be useful for clinicians in evaluating aging participants with cognitive impairment.

Participation in a screening program by itself may not improve clinical outcomes. Treatment gaps in the program may limit its full benefit. We evaluated statin prescription rates for subjects with sustained hypercholesterolemia to assess the treatment gaps in the National Health Screening Program (NHSP) in Korea. A retrospective, random cohort was established among National Health Insurance Corporation (NHIC) members. Finally, we examined 465,499 individuals who attended the NHSP from 2003 to 2010 without any history of dyslipidemia, statin prescription, or hospitalization for cardiovascular events until the end of 2002. The subsequent statin prescription rates were identified from the NHIC medical service claim database from 2003 to 2011. Descriptive data and odds ratio from multivariate logistic analyses on statin prescription rates and the corresponding correlations were evaluated. The NHSP detected 114,085 (24.5%) cases of newly diagnosed hypercholesterolemia. However, only 8.6% of these received statin prescription within 6 months of diagnosis. For cases of sustained hypercholesterolemia determined in the next screening visit by the NHSP, the statin prescription rate increased, but only to 12.2%. Statin prescriptions were more common among females, older individuals, and hypertension or diabetes patients. Furthermore, the statin prescription rates had increased over the study period. The NHSP exhibited low statin prescription rate which has been improving. For the NHSP to be effective, it would be worthwhile to decrease the gap between the diagnosis of hypercholesterolemia and the following treatment.
Adult ; Chronic Disease ; Drug Prescriptions/statistics & numerical data ; Female ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities/*statistics & numerical data ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use ; Hypercholesterolemia/*diagnosis/epidemiology/*prevention & control ; Insurance Claim Reporting/statistics & numerical data ; Male ; Mass Screening/*utilization ; Middle Aged ; National Health Programs/*utilization ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; Treatment Outcome ; Young Adult

In order to increase inhaled corticosteroid (ICS) use and to reduce hospitalization, emergency department visits and ultimately the economic burden of asthma, "Korean Asthma Management Guideline for Adults 2007" was developed. To assess the guideline effects on physician's ICS prescription for asthma, we conducted segmented regression and multilevel logistic regression using National Health Insurance claims database of outpatient visits from 2003 to 2010. We set each quarter of a year as a time unit and compared ICS prescription between before and after guideline dissemination. A total of 624,309 quarterly visits for asthma was observed. The ICS prescription rate before and after guideline dissemination was 13.3% and 16.4% respectively (P < 0.001). In the segmented regression, there was no significant guideline effect on overall ICS prescription rate. In multilevel logistic regression analyses, the effect of guideline on overall ICS prescription was not significant (odds ratio, 1.03; 95% CI, 1.00-1.06). In subgroup analysis, ICS prescription increased in secondary care hospitals (odds ratio, 1.15; 95% CI, 1.02-1.30) and in general hospitals (odds ratio, 1.10; 95% CI, 1.04-1.16). However, in primary clinics, which covered 81.7% of asthma cases, there was no significant change (odds ratio, 0.98; 95% CI, 0.94-1.02). From the in-depth interview, we could identify that the reimbursement criteria of the Health Insurance Review and Assessment Service and patient's preference for oral drug were barriers for the ICS prescription. The domestic asthma clinical guideline have no significant effect on ICS prescription, especially in primary clinics.
Administration, Inhalation ; Adrenal Cortex Hormones/*administration & dosage ; Allergy and Immunology/standards ; Anti-Inflammatory Agents/administration & dosage ; Asthma/*drug therapy/*epidemiology ; Drug Prescriptions/*statistics & numerical data ; Guideline Adherence/*utilization ; Humans ; *Practice Guidelines as Topic ; Prevalence ; Pulmonary Medicine/standards ; Republic of Korea/epidemiology ; Treatment Outcome