The occurrence of severe hypotension and bradycardia, following placing to the beach chair position from supine during general anesthesia for repair of tendon injury of the rotator cuff of shoulder in a healthy 50 year-old man was described. The Bezold-Jarisch reflex, which is known to inhibit cardiovascular reflex and composed of three kinds of symptoms such as vasodilation, bradycardia and hypotension, has been reported mainly in peripheral nerve block, and may occur during orthostasis, hypovolemia, hemorrhage, supine inferior vena cava compression in pregnancy, interscalene block for shoulder surgery in the sitting position and so on. The bradycardia and hypotension can be more aggravated when causative elements overlaps each other. Anticholinergics and vasopressor were injected intravenously, and position of the patient was changed to the supine position immediately resulting in a normal vital signs dramatically.
Anesthesia, General ; Arthroscopy ; Bradycardia ; Cholinergic Antagonists ; Dizziness ; Hemorrhage ; Humans ; Hypotension ; Hypovolemia ; Peripheral Nerves ; Pregnancy ; Reflex ; Rotator Cuff ; Shoulder ; Supine Position ; Tendon Injuries ; Vasodilation ; Vena Cava, Inferior ; Vital Signs

The purpose of this study was to investigate the status of children's breakfast skipping and their mothers' needs for breakfast service at child care centers. A survey was conducted with mothers of children aged 3 to 5 years and attending child care centers in Gwanak-gu, Seoul. Out of 960 questionnaires distributed to the caregivers at 32 child care centers, 633 were returned (66% response rate), and 449 were analyzed (47% analysis rate) after excluding data from the respondents not meeting the selection criteria for this study: mothers of children aged 3 to 5 years. Over 2/3 (69%) of children ate breakfast every weekday (Breakfast Eaters) and almost 1/3 (31%) of children skipped breakfast one time or more often on weekdays (Breakfast Skippers). The collected data were compared between Breakfast Eaters and Breakfast Skippers. The average Good Dietary Practice Score of Breakfast Skippers was significantly lower than that of Breakfast Eaters, implying poorer dietary habits. A higher percentage of mothers of Breakfast Skippers (62%) responded that breakfast service was 'necessary' or 'very necessary' at child care centers than those of Breakfast Eaters (27%). A multiple logistic regression analysis was conducted to determine factors affecting mothers' needs for breakfast service at child care centers. The result showed that the children's ages, mothers' occupational status, household monthly income, frequencies of eating breakfast on weekdays and satisfaction level with morning snack provided at child care centers affected mothers' needs for breakfast service at child care centers. In particular, mothers who had a full-time job (OR = 2.06) than housewives, mothers whose children did not eat breakfast at al (OR = 3.54), ate 1~2 times (OR = 5.50) or ate 3~4 times (OR = 3.80) on weekdays than those whose children ate breakfast every weekday were more likely to have needs for breakfast service at child care centers than housewives. In conclusion, Breakfast Skippers tended to have poorer dietary habits than Breakfast Eaters and Full-time working mothers had higher needs for breakfast service at child care centers. This study results suggest that child care centers consider serving breakfast to children as the number of working mothers increases.
Aged ; Breakfast ; Caregivers ; Child ; Child Care ; Surveys and Questionnaires ; Eating ; Employment ; Family Characteristics ; Food Habits ; Humans ; Logistic Models ; Mothers ; Patient Selection ; Snacks

This study was conducted to characterize changes in the meal structure of Korean children in terms of temporal and spatial dimensions. The data of 1,891 and 1,627 school-aged children and adolescents extracted respectively from the 1998 and 2009 Korea National Health and Nutrition Examination Surveys were analyzed by gender, age group, and residential area. From 1998 to 2009, the total eating events increased from 4.3 to 4.6 (p = 0.001); the average number of meal intake decreased from 2.8 to 2.7 (p < 0.001) while that of snack intake increased from 1.5 to 1.9 (p < 0.001). The prevalence of "3 meals a day" pattern tended to decrease while that of "2 meals a day" pattern increased over the years. Especially, the "2 meals a day" pattern with "lunch + dinner" increased from 13% in 1998 to 20% in 2009. The percentage of eating breakfast or dinner at home decreased over the years. These results indicate that over the last decade, "destructuration" occurred in Korean children's meal structure in terms of temporal and spatial dimensions. Especially, such alteration was more distinctive in male than female and in the high school-aged group than the elementary or middle school-aged groups. Overall, the difference of meal structure between genders and residential areas became smaller while the difference among age groups became larger over the years.
Adolescent ; Breakfast ; Child ; Eating ; Female ; Humans ; Korea ; Male ; Meals ; Prevalence ; Snacks

The aims of this study were to assess the quality of breakfast intake and to examine the relation of breakfast intake to the quality of daily diet in Korean school-aged children. The one day 24-hour recall data from the 2001 National Health and Nutrition Survey were analyzed. The sample of this study consisted of 1,600 children aged 7 to 18 years attending elementary, middle, or high schools. By calorie level of breakfast intake, the children were grouped into Breakfast Skippers (0 kcal; n = 268, 17%), Low Calorie Breakfast Eaters (0 kcal < and < 10% of Estimated Energy Requirement (EER); n = 190, 12%), Moderate Calorie Breakfast Eaters (10% < or = and < 25% of EER; n = 861, 54%), or Sufficient Calorie Breakfast Eaters (> or = 25% of EER; n = 281, 17%). General characteristics including weight status and nutritional quality of breakfast and daily diet were compared among the four groups. The average daily calorie intake of Breakfast Skippers, Low, Moderate, and Sufficient Breakfast Eaters were 1,771 kcal, 1,719 kcal, 1,902 kcal, and 2,349 kcal, respectively; they were 86.3%, 85.9%, 98.0%, and 124.9% of EER, respectively. The percentages of students consuming daily diet with protein, vitamin A, B1, B2, niacin, vitamin C, calcium, phosphorus, or iron less than Estimated Average Requirement decreased in the breakfast groups with the higher calorie level of breakfast intake. The Dietary Variety Score of daily diet significantly increased by increasing the calorie level of breakfast intake. The results indicated the quality of daily diet was positively related to the level of calorie intake from breakfast.
Aged ; Ascorbic Acid ; Breakfast ; Calcium ; Child ; Diet ; Humans ; Iron ; Niacin ; Nutrition Surveys ; Nutritive Value ; Phosphorus ; Vitamin A

The purpose of this study was to investigate the current status of foodservice management in organizations delivering meal boxes for low-income children during summer vacation. A survey was conducted with persons in charge of meal box production and service of these organizations via mail. Out of 114 questionnaires distributed nationwide, 100 were analyzed (87.8% analysis rate). Over half (53%) of the organizations delivered meal boxes consisting of rice and side dishes while the rest delivered side dishes only. About 81% of the organizations received KRW 3,000 per meal from their local governments and the rest received KRW 3,500. Only 28% of organizations had employed a dietitian. Over one-third (38%) of the respondents were unaware of the official nutritional standard of the foodservice program for low-income children during vacation. Most of the organizations (94%) had menu planned in advance. The average percentage of food cost was 84.1%. Over 40% of the organizations did not keep food samples for sanitation test (43%) and did not take any measures for keeping food temperature during delivery (45%). The organizations delivering rice and side dishes were more likely to be located in cities rather than rural areas and received higher reimbursement rate. The organizations receiving reimbursement of KRW 3,500 or hiring a dietitian were more likely to use standardized recipes, keep food samples for sanitation test, or take measures for keeping food temperature during delivery compared to the counterparts. Respondents reported that increasing reimbursement rate was the most necessary for improving the quality of meal box. This study results showed that the meal box delivery service for low-income children was not properly managed during the vacation, with regards to menu planning and food production. It is recommended that reimbursement rate for meal boxes should be adjusted depending on meal box types and local conditions.
Child ; Surveys and Questionnaires ; Fees and Charges ; Humans ; Meals ; Menu Planning ; Postal Service ; Sanitation

Background/Aims: There is no clear consensus on the relative ranking of interventional and radiation techniques with indications similar to those of radiofrequency ablation (RFA) for the treatment of early hepatocellular carcinoma (HCC). We used a network meta-analysis to compare the efficacy of non-surgical treatments for early HCC. Methods: We searched databases for randomized trials assessing the efficacy of loco-regional treatments for HCCs ≤5 cm with no extrahepatic spread or portal invasion. The primary outcome was the pooled hazard ratio (HR) for overall survival (OS), and secondary outcomes included overall and local progression-free survival (PFS). A frequentist network meta-analysis was performed, and the relative ranking of therapies was assessed with P-scores. Results: Nineteen studies comparing 11 different strategies in 2,793 patients were included. Chemoembolization plus RFA improved OS better than RFA alone (HR 0.52, 95% confidence interval [CI] 0.33–0.82; P-score=0.951). Cryoablation, microwave ablation, laser ablation, and proton beam therapy had similar effects on OS compared with RFA. For overall PFS, but not local PFS, only chemoembolization plus RFA performed significantly better than RFA (HR 0.61, 95% CI 0.42–0.88; P-score=0.964). Injection of percutaneous ethanol or acetic acid was significantly less effective than RFA for all measured outcomes, while no differences in progression outcomes were identified for other therapies included in the network. Conclusions Our results suggest that chemoembolization combined with RFA is the best option for local treatment of early HCC. Cases with potential contraindications for RFA may benefit from a tailored approach using thermal or radiation modalities.

PURPOSE: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. METHODS: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were ‘nurse’ related factors, ‘patient’ related factors, ‘resource’ related factors. The nine categories were ‘unpreparedness’, ‘nursing barriers due to stigma’, ‘undervaluing and avoidance of psychiatric nursing’, ‘eroding into the trap of a vicious cycle’, ‘facing unapproachable patients’, ‘dealing with unhelpful family members’, ‘burdening already overburdened staff’, ‘obstructive environment’, and ‘isolation of staff with heavy responsibilities’. CONCLUSION: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.
Education ; Focus Groups ; Humans ; Korea ; Medical-Surgical Nursing ; Mental Disorders ; Mental Health ; Psychiatric Nursing ; Qualitative Research ; Seoul

No abstract available.
Adult ; Diagnosis, Differential ; Female ; Humans ; Liver/pathology/radiography/ultrasonography ; Peliosis Hepatis/pathology/*radiography ; Tomography, X-Ray Computed

The purpose of this study was to compare the nutritional status of children aged 5 or under and women aged 20 to 34 years between the Republic of Korea (South Korea) and the Democratic Peoples' Republic of Korea (DPRK: North Korea). For the source of nutritional status of North Koreans, the DPRK 2004 Nutrition Assessment-Report of Survey Results was used. As the comparable data of South Koreans, the anthropometric data for children and women were obtained from the reports of the Korean Pediatric Society and the Korean Agency for Technology and Standards, respectively. The blood hemoglobin data of South Korean women were obtained from the data file of the 2001 National Health and Nutrition Survey and analyzed. In regard to the North Korea, the prevalence of underweight (weight for age Z-score <-2.0) in children under 12 months was about 10~15%, and thereafter progressively increased until 30 to 35 months reaching 30%. In South Korea, the prevalence of underweight was less than 3% in most age groups both in boys and girls. In North Korea, the prevalence of stunting (height for age Z-score <-2.0) reached 20% in children under 12 months and increased with age over the level of 50% in children aged 54 to 59 months. In South Korea, the prevalence of stunting was less than 3% in children under 12 months and was less than 10% throughout the age groups. Maternal protein-energy malnutrition and anemia were assessed for the women aged 20 to 34 years using mid-upper arm circumference (< 22.5 cm) and blood hemoglobin level (< 12 g/DL), respectively. The prevalence of protein-energy malnutrition was 39.6%, 30.7%, 31.7% in North Korea and 12.5%, 5.0%, 1.5% in South Korea for the women in 20~24, 25~29, 30~34 years, respectively. The prevalence of anemia in the North Korean women was about 34~36% while that in the South Korean women was 15~18%. In conclusion, the disparity of nutritional status in early childhood and maternity between South Korea and North Korea is so huge that active and well-planned nutrition support policy and programs for women and children in North Korea is imperative to prepare for the future unified nation.
Anemia ; Arm ; Information Storage and Retrieval ; Child ; Democratic People's Republic of Korea* ; Female ; Humans ; Korea* ; Nutrition Surveys ; Nutritional Status ; Prevalence ; Protein-Energy Malnutrition ; Republic of Korea ; Thinness