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

The purpose of this study was to investigate the effect of manganese (Mn) supplementation on bone status and calcium balance in ovariectomized rats according to the calcium intake levels. Total of 50 Sprague Dawley female rats (6 weeks) were divided into 5 groups and bred for 12 weeks: sham operated control group (SACa), OVX Ca deficiency group (OLCa) with Ca deficiency diet (0.1% Ca modified AIN-93N diet), OVX Ca deficiency & Mn supplement group (OLCaMn), OVX adequate Ca group (OACa; 0.5% Ca AIN-93N diet) and OVX adequate Ca & Mn supplement group (OACaMn). BMD (bone mineral density) of the femur was increased by Mn supplementation in OVX adequate Ca group. However, BMDs of spine, femur and tibia were lowered in OLCa compared to the OLCaMn group. Bone strength of tibia in OLCaMn group was significantly lower than OLCa group. Serum ALP (alkaline phosphatase) and CTx (C-telopeptide of collagen cross-links) levels were significantly higher in ovariectomized rats than those in the sham group, but they were not changed by Mn supplementation. Ca retention rate and Ca absorption rate did not differ among the experimental groups. Urinary Ca excretion was increased by Mn supplementation in Ca deficiency rats. In summary, Mn supplementation resulted in positive effects on bone mineral density ovariectomized rats with which intake adequate Ca. However, Mn supplementation on Ca deficiency ovariectomized rats resulted in decrement of BMD and bone strength by increasing Ca excretion. Therefore, it is encouraged to consider calcium intake levels in supplementation of manganese in order to prevent postmenopausal osteoporosis and to keep bone healthy.
Absorption ; Animals ; Bone Density ; Calcium ; Collagen ; Diet ; Female ; Femur ; Humans ; Manganese ; Osteoporosis, Postmenopausal ; Ovariectomy ; Rats ; Retention (Psychology) ; Salicylamides ; Spine ; Tibia

We report our experience of a concurrent robot assisted distal gastrectomy and partial nephrectomy for synchronous early gastric cancer and renal cell carcinoma. A 55-year-old female patient was diagnosed with early gastric cancer on screening endoscopy. Abdominal computed tomography showed an incidental right renal cell carcinoma. Robot assisted distal gastrectomy was performed, followed by partial nephrectomy. The final pathological examination showed signet ring cell carcinoma within the lamina propria and renal cell carcinoma with negative resection margins. The patient showed no evidence of recurrence at 6-months. A robot-assisted combined operation could be a treatment option for early stages of synchronous malignancies.
Carcinoma, Renal Cell* ; Carcinoma, Signet Ring Cell ; Endoscopy ; Female ; Gastrectomy* ; Humans ; Mass Screening ; Middle Aged ; Mucous Membrane ; Nephrectomy* ; Recurrence ; Robotics ; Stomach Neoplasms* ; Surgical Procedures, Minimally Invasive

PURPOSE: This study aims to investigate how variability of bystander cardiopulmonary resuscitation (CPR) willingness may change depending on special situations and to find out factors that enhance CPR willingness in each situation and ways to increase the ratio of bystander CPR. METHODS: A population-based, nationwide study using a structured questionnaire via telephone survey regarding CPR was done in 2015 (n=1,000). A stratified cluster sampling was conducted to assess the impact of age and gender on CPR willingness. The contents of the questionnaire consisted of basic characteristics, CPR training experience, and status. Additionally, respondents were presented with five hypothetical scenarios of cardiopulmonary arrest; family member, stranger, elderly person, preschool child, and pregnant woman. RESULTS: Willingness to perform CPR was low for pregnant women (52.1%) or elders (59.3%), moderate for strangers (73.3%) or children (71.3%), but high for a family members (90.4%). Age, awareness of CPR, training experience of CPR, CPR training by manikin practice, recent CPR training (≤2 years), experience of bystander CPR, family history of severe illness, and awareness of Good Samaritan law all influenced the willingness to perform CPR on bystander in each scenario. CONCLUSION: The willingness of bystander CPR decreased in special situations, especially for elderly and pregnant woman. However, recent CPR training group were more willing in the elderly, and CPR experienced group also showed increased tendency in pregnant woman. It is expected that the rate of bystander CPR can be increased by emphasizing that performing bystander CPR for children, pregnant women, and elders is not different from the general population.
Aged ; Attitude to Health ; Cardiopulmonary Resuscitation* ; Child ; Child, Preschool ; Female ; Heart Arrest ; Humans ; Jurisprudence ; Manikins ; Pregnant Women ; Surveys and Questionnaires ; Telephone

Technetium-99m methoxyisobutylisonitrile(99m-Tc MIBI), a new myocardial imaging agent, was used in myocardial perfusion scan in 23 patients who had been diagnosed as myocardial infarction to assess its usefulness in elvaluation of coronary artery disease. All patients undertook left ventriculography (LVG) and coronary arteriography (CAG). Gated blood pool scan, plannar scintigraphy and SPECT were also done using 99m-Tc MIBI. After then SPECT image was reconstructed to short axis view of the heart at the level of the base, mid and apex. The data from these studies were compared with the results of EKG, LVG and CAG. Diagnostic sensitivity of myocardial scan using 99m-Tc MIBI was 91.3%. In localization of infarction site and evaluation of its extent, myocardial scan was superior to EKG. CAG revealed significant stenosis at the arteries supplying the area in which the scan showed perfusion defect. In detecting abnormal wall motion, the sensitivity and the specificity were 81.9% and 93.7% respectively. Perfusion defect were found in 75%, 82.5%, and 100% of hypokinetic, akinetic, and dyskinetic segments, respectively. Myocardial perfusion scan using 99m-Tc MIBI was an useful noninvasive test in localizing the site and the extent of infarct and detecting the abnormal left ventricular wall motion.
Angiography ; Arteries ; Axis, Cervical Vertebra ; Constriction, Pathologic ; Coronary Artery Disease ; Electrocardiography ; Heart ; Humans ; Infarction ; Myocardial Infarction* ; Myocardial Perfusion Imaging* ; Perfusion ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon

In Sasang constitutional medicine, both disease susceptibility and drug response are considered to be related to the characteristics of an individual's physiology and psychology: a theory which is central to traditional Korean medicine. Based on such observable characteristics, Sasang constitutional medicine classifies people into four constitutional types. Genetic studies of Sasang constitution would help reveal the inheritance patterns and models of the typological traits and, moreover, help with traditional medical diagnosis and treatment. To investigate the heritable aspect of Sasang constitution, we collected various pedigrees from South Korea. The study population has 101 pedigrees composed of 593 individuals. The determination of the Sasang constitution type of each individual was performed by doctors who diagnose the Sasang constitutional type of individuals as part of their professional practice. We calculated estimates of familial correlation and heritability. Parent-Offspring pairs showed the strongest familial correlation of Sasang constitutional type, with the correlation values of 0.21 and 0.28, followed by sibling pairs with the value ranging between 0.14 and 0.25. From the heritability analysis conducted with the Variance-Component method, the heritability of TE (Tae-Eum) type, SY (So-Yang) type, and SE (So-Eum) type were 55%, 41%, and 47%, respectively. This pattern of heritability was consistent with different set of analyses, which suggest the robustness of our result. Our result clearly shows that the Sasang constitution type is heritable, and further genetic analysis based on our result will shed light on the biological mechanism of Sasang constitution.
Constitution and Bylaws ; Disease Susceptibility ; Humans ; Inheritance Patterns ; Light ; Professional Practice ; Republic of Korea ; Siblings

After bone marrow transplantation (BMT), recipients can be complicated by infectious or non-infectious chest lesions such as mycobacterial infections or post- transplant lymphoproliferative disorders (PTLDs). BMT recipients usually face a lot of risks of mycobacterial infection because they have severely impaired cell- mediated immunity as a result of their underlying disease, chemotherapy, radiotherapy, acute or chronic graft-versus-host diesase (GVHD) and their treatment. We report a case of mediastinal tuberculous abscess and lymphadenitis after BMT, which mimicks PTLDs. 20 months before admission, BMT was performed on a 41 year-old woman who was diagnosed as chronic myelocytic leukemia. She showed acute and chronic GVHD with several infections of bacteria or viruses after BMT. In endemic area of tuberculosis such as Korea, PTLDs should be differentiated from pulmonary tuberculosis and tuberculous lymphadenitis.
Abscess* ; Adult ; Bacteria ; Bone Marrow Transplantation* ; Bone Marrow* ; Drug Therapy ; Female ; Humans ; Korea ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Lymphadenitis* ; Lymphoproliferative Disorders ; Radiotherapy ; Thorax ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: To prevent the transmission of pathogens by endoscopes, following established reprocessing guidelines is critical. An ideal reprocessing step is simple, fast, and inexpensive. Here, we evaluated and compared the efficacy and safety of two disinfectants, a tertiary amine compound (TAC) and ortho-phthalaldehyde (OPA). METHODS: A total of 100 colonoscopes were randomly reprocessed using two same automated endoscope reprocessors, according to disinfectant. The exposure time was 10 minutes for 0.55% OPA (Cidex® OPA, Johnson & Johnson) and 5 minutes for 4% TAC (Sencron2®, Bab Gencel Pharma & Chemical Ind. Co.). Three culture samples were obtained from each colonoscope after reprocessing. RESULTS: A total of nine samples were positive among the 300 culture samples. The positive culture rate was not statistically different between the two groups (4% for OPA and 2% for TAC, P=0.501). There were no incidents related to safety during the study period. CONCLUSIONS: TAC was non-inferior in terms of reprocessing efficacy to OPA and was safe to use. Therefore, TAC seems to be a good alternative disinfectant with a relatively short exposure time and is also less expensive than OPA.
Colonoscopes* ; Disinfectants* ; Endoscopes* ; o-Phthalaldehyde*