College and university foodservice dietitians have to be competent for playing a role as the future food service executive as well as the present foodservice administrator in the promising foodservice industry field. The study conducted a survey to examine training needs corresponding to educational contents for the purpose of helping them acquire a new knowledge related to self-development and duty through educational training. The results of this study suggested that training needs were differed by general characteristics of dietitians, operational characteristics of food services, and training subjects. A future study should develop systematic training strategies for dietitians.
Administrative Personnel ; Food Services ; Humans ; Nutritionists*

No abstract available.
Polychondritis, Relapsing*

Neurofibromatosis type 1 (NF1; also known as von Recklinghausen's neurofibromatosis) is inherited in an autosomal dominant fashion, although it can also arise due to spontaneous mutation. Gastrointestinal involvement of NF1 is seen in 10% to 25% and causes symptoms in fewer than 5%. Histologically, the gastro intestinal (GI) manifestation of NF1 occurs in three forms: hyperplasia of the gut neural tissue, stromal tumors, and duodenal or periampullary endocrine tumors. A 31-year-old female, diagnosed with NF1, presented with poor oral intake and vomiting for 10 days prior to admission. Preoperative gastrofiberscopic finding was gastric outlet obstructing polypoid duodenal bulb lesion. The patient underwent hemigastrectomy with antecolic gastrojejunostomy due to gastric outlet obstruction. The final pathologic report was submucosal neurofibromatous proliferation with Brunner's gland hyperplasia located at the duodenal bulb in the NF1 patient. We report this case with a review of literatures.
Adult ; Female ; Gastric Bypass ; Gastric Outlet Obstruction ; Humans ; Hyperplasia ; Neurofibromatoses ; Neurofibromatosis 1 ; Vomiting

PURPOSE: The purpose of this study is to analyze college sudents' attitudes toward people with disabilities, and factors affecting the attitudes, and further to examine possible ways to improve the attitudes. and to furnish guideline of curriculum and practice in rehabilitation nursing on the basis of this analysis. METHOD: A descriptive. relational study design was used. The subjects of this study were 448 college students. A convenient sampling is used. Data were collected through 4 types of previous questionnaires used to examine attitude from May 1 to May 30, 2003. RESULT: 1. The attitude toward people with disabilities whose mean is 3.762 was responded somewhat negatively. Especially, a contact tension whose mean was 4.00 is high. 2. As a result of analyzing the attitudes of college students toward people with disabilities. some factors were statistically significant. They were experience of contact with the disabled. concern toward the disabled, voluntary work related to the disabled, and disability experience education. 3. The more negative experience of people with disabilities and the lower stereotype of disability and the higher effects of parents, teachers, and mass media, then the more positive response of peoples attitude with disabilities. 4. The main factors of determining the attitude of people with disabilities were the stereotype of disability. contact experience concern about disability, voluntary work experience. CONCLUSION: These results suggested that an appropriate educational intervention and strategy is needed in order to change the attitudes of college students toward people with disabilities. Also experimental researches are needed to do it.
Curriculum ; Disabled Persons ; Education ; Humans ; Mass Media ; Parents ; Surveys and Questionnaires ; Rehabilitation Nursing

PURPOSE: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy. Some aspects of POPF management remain controversial. Therefore, the aim of this study was to determine the natural course of POPF and fluid collection after distal pancreatectomy and to reappraise the necessity of intraoperative abdominal drainage insertion. METHODS: For recent 10 years, 264 distal pancreatectomies were performed at Seoul National University Hospital. Clinicopathologic data including POPF and postoperative fluid collection (POFC), and its treatment modality were reviewed retrospectively. During follow-up, the location, size, and clinical impact of the POFC were determined on the basis of CT images. RESULTS: Clinically relevant POPFs were identified in 72 patients (27.3%). Therapeutic interventions were performed in 40 patients (55.6%), and conservative management was successful in 32 patients (44.4%). POFC was detected in 191 cases (72.3%) on the first postoperative CT. During follow-up, spontaneous regressions were observed in 119 cases (93.0%). Only thick pancreatic stump increased the risk of clinically relevant POPF (≥17.3 mm, P = 0.002) and the occurrence of POFC (≥16.0 mm, P < 0.001) in multivariate analysis. CONCLUSION: Intraoperative abdominal drainage insertion could be selectively indwelled in patients with a thickness of pancreas ≥17.3 mm. Since radiologically-proven POFC after distal pancreatecomy showed a 93.0 rate of spontaneous regression, POFC without signs of infection can be safely monitored.
Drainage ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Pancreas ; Pancreatectomy* ; Pancreatic Fistula* ; Retrospective Studies ; Seoul

PURPOSE: The consumers' preferences are not considered in developing or implementing new medical technologies. Furthermore, little efforts are made to investigate their demands. Therefore, their preferred surgical method and the factors affecting that preference were investigated in pancreatic surgery. METHODS: Six-hundred subjects including 100 medical personnel (MP) and 500 lay persons (LP) were surveyed. Questionnaire included basic information on different methods of distal pancreatectomy; open surgery (OS), laparoscopic surgery (LS), and robotic surgery (RS). Assuming they required the operation, participants were told to indicate their preferred method along with a reason and an acceptable cost for both benign and malignant conditions. RESULTS: For benign disease, the most preferred method was LS. Limiting the choice to LS and RS, LS was preferred for cost and well-established safety and efficacy. OS was favored in malignant disease for the concern for radicality. Limiting the choice to LS and RS, LS was favored for its better-established safety and efficacy. The majority thought that LS and RS were both overpriced. Comparing MP and LP responses, both groups preferred LS in benign and OS in malignant conditions. However, LP more than MP tended to prefer RS under both benign and malignant conditions. LP thought that LS was expensive whereas MP thought the cost reasonable. Both groups felt that RS was too expensive. CONCLUSION: Though efforts for development of novel techniques and broadening indication should be encouraged, still more investments and research should focus on LS and OS to provide optimal management and satisfaction to the patients.
Consumer Satisfaction ; Humans ; Investments ; Laparoscopy ; Methods ; Pancreas ; Pancreatectomy ; Surveys and Questionnaires

PURPOSE: Treatment of hepatolithiasis is difficult because of the high recurrence rate, and the long-term outcome is not satisfactory. We reviewed clinical outcomes to determine the optimal treatment modalities for hepatolithiasis. METHODS: Between 1981 and 2005, 648 patients with hepatolithiasis were treated at our institute. Changing patterns of treatment modalities and outcomes were analyzed for the periods: 1st (1981~1985; n=159), 2nd (1986~1990; n=100), 3rd (1991~1995; n=111), 4th (1996~2000; n=141), and 5th (2001~2005; n=137). Clearance and recurrence rates according to the treatment modalities and associated malignancies were analyzed in patients for the most recent 10 years. RESULTS: During the past 25 years, hepatectomy as a treatment for hepatholithiasis has increased in frequency and become the major treatment modality in the recent 10 years, while choledocholithotomy and drainage procedures have decreased in frequency. With improvement in operative clearance and post-operative lithotripsy, the final clearance rate improved from 79.0% to 91.3%. In the most recent 10 years, the final clearance rate of hepatectomy, choledocholithotomy, cholangioenterostomy, and PTCS was 97.1%, 82.0%, 78.8%, and 100%, respectively, and the recurrence rate was 34.7%, 15.4%, 17.0%, and 42.9%, respectively. Twenty-six patients (47.2%) had recurrences within 2 years, and 12 patients (21.8%) had recurrences after 5 years. Cholangiocarcinomas occurred in 10 patients (3.6%). The diagnosis of cholangiocarcinoma was established pre-operatively in 2 patients, post-operatively in 4 patients, and during the follow-up period in 4 patients. CONCLUSION: In the treatment of hepatolithiasis, hepatectomy has a high clearance rate and a low recurrence rate. To reduce the recurrence rate, complete stone clearance without residual stones seems to be of utmost importance. Suspicion of malignancy and long-term follow-up are needed in the management of patients with hepatolithiasis.
Cholangiocarcinoma ; Drainage ; Factor IX ; Follow-Up Studies ; Hepatectomy ; Humans ; Lithotripsy ; Recurrence

OBJECTIVES: Metabolic syndrome components, insulin resistance and central obesity cause type 2 diabetes and hypertension. This will increase the risk of cardiovascular disease. Women after menopause are at increased risk of metabolic syndrome. Several researchers studied that in menopause, metabolic syndrome increased cardiovascular mortality. We studied the impact on cardiovascular mortality of postmenopausal women with metabolic syndrome in the Republic of Korea. METHODS: Twenty four thousand nine hundred forty nine postmenopausal women aged 40 years or older were enrolled at health promotion centers of national university hospital located in 18 regions during 1994-2004. Age, weights, height, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), cholesterol, triglyceride (TG), high-density lipoprotein were evaluated and history taking about alcohol consumption, smoking, and exercise was performed. In addition, subjects who died of cardiac disease were analyzed from January 1995 to December 2009. RESULTS: Metabolic syndrome was higher in postmenopausal women with increased in age, BMI, blood pressure (BP), FBG, cholesterol, TG. Thirty cardiac deaths occurred during the observation period. Factors affecting cardiac death were age, smoking, FBG and when age and smoking were controlled. FBG was an important factor affecting cardiovascular mortality in our study. When controlling age, smoking, and alcohol consumption, metabolic syndrome caused an increased relative risk of cardiovascular mortality. Survival rate was much lower in postmenopausal women with metabolic syndrome than those without metabolic syndrome. CONCLUSION: Metabolic syndrome in Korean postmenopausal women increased cardiovascular mortality.
Aged ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Height ; Cardiovascular Diseases ; Cholesterol ; Death ; Fasting ; Female ; Health Promotion ; Heart Diseases ; Humans ; Hypertension ; Insulin Resistance ; Lipoproteins ; Menopause ; Obesity, Abdominal ; Postmenopause ; Smoke ; Smoking ; Survival Rate ; Weights and Measures

BACKGROUND: In management of osteoporosis, several concerns here have been raised. The current issue included the utilization of dual energy X-ray absorptiometry (DXA) and fracture-risk assessment (FRAX), screening of vitamin D deficiency and secondary osteoporosis, and long-term use of bisphosphonate and calcium supplements. There was no study on physicians' attitude on these current issues in Korea. Therefore, we investigated the physicians' attitude on these issues by survey. METHODS: We administered a 30-item questionnaire to all members of Korean Society for Bone and Mineral Research by email survey form. One hundred participants answered the questionnaire. The questionnaire included the questions about the physicians' attitude to current issues and the barriers to osteoporosis treatment in Korea. RESULTS: Most physicians used bone densitometry devices (99%) and, central DXA was the most accessible device (95%). Eighty-eight percent were aware of FRAX(R), but among them, only 19.3% used it. The main reason for not using FRAX(R) was the lack of time in their proactive (76%). Screening for vitamin D status and secondary osteoporosis was performed by 59% and 52% of the respondents, respectively. The lack of awareness among patients and high costs of medication were perceived as the most important barriers to osteoporosis management in Korea. CONCLUSIONS: This study provides physicians' perspective to the current issue for diagnostic and treatment of osteoporosis in Korea. To further improve osteoporosis management, educational programs for patients and doctors, and the improvement of reimbursement system should be considered in Korea.
Absorptiometry, Photon ; Calcium ; Surveys and Questionnaires ; Densitometry ; Electronic Mail ; Humans ; Korea ; Mass Screening ; Osteoporosis* ; Vitamin D ; Vitamin D Deficiency

BACKGROUND: Recently the Korean society has been challenged with the rapid growth of obese population due to the improved socioeconomic status and lifestyle changes over the past decades. Not only has obesity been known as one of major risk factors for various diseases including cardiovascular diseases(e.g. hypertension, coronary heart disease and stroke) and diabetes mellitus, but it has also increased the death from obesity-related diseases. It has been required, however, to establish our own obesity criteria adjusted for Korean since much difference is expected to exist in the degree of obesity between white and Asian people. Therefore, this study was designed to provide with primary data to help establish new criteria through identifying the distribution of Body Mass Index(BMI), and then analysing its relatian with some obesity-related diseases. METHODS: This study calculated BMI and related it to some obesity-related diseases by analysing data from 1995 National Health Interview Surveys, in which a random sample of 5,750 Korean at the age of 15-69 had self-reported their heights, body weights and diagnoses with obesity-related diseases by physicians. Variables under consideration include potential risk factors(e.g. alcohol intakes, smoking, exercise, etc.) as well as demographics of the sample population. RESULTS: Average BMI(kg/m(2)) were 21.6+/- 2.6 for male and 21.7+/-4.8 for female(mean+/-SD), which increased in direct proportion to the increase of age until the age reached the group of 40-59, and then followed by the inverse in its relation with the age at 60 and over. It was revealed, however, that prevalences of obesity-related diseases such as hypertension, diabetes mellitus etc. were the highest among the population group with their BMI of 23.8~35.6. In short, this study identified the proportional relation of BMI with the prevalence of obesity-related diseases. CONCLUSIONS: In this study, the prevalence for hypertension and diabetes mellitus was shown to be higher than the average among population with their BMI of 21.9~238, whose figure is much lower than both 26.4, the value of the 90th percentile proposed in MONICA prot and 25, the current WHO criteria of obesity. However, a Japanese study reported that the health risk began to increase at the BMI of 23 with risks for obesity-related diseases dramatically increased at the BMI of 26-27 and over, and concluded that because Asian has more body fats accumulated within the upper body part compared with the white, the Asian persons are more obese, though less in terms of BMI, than the white. Therefore, future works should be focused on establishing our own criteria for obesity with health risks through determining the association of BMI with prevalence of various diseases in Korea.
Adipose Tissue ; Asian Continental Ancestry Group ; Body Height ; Coronary Disease ; Demography ; Diabetes Mellitus* ; Diagnosis ; Humans ; Hypertension* ; Korea ; Life Style ; Male ; Obesity ; Population Groups ; Prevalence* ; Risk Factors ; Smoke ; Smoking ; Social Class ; Weights and Measures