BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

Real-time data reporting in clinical research networks can provide network members through interim analyses of the registered data, which can facilitate further studies and quality improvement activities. The aim of this report was to describe the building process of the data display system (DDS) of the Korean Neonatal Network (KNN) and its basic structure. After member verification at the KNN member's site, users can choose a variable of interest that is listed in the in-hospital data statistics (for 90 variables) or in the follow-up data statistics (for 54 variables). The statistical results of the outcome variables are displayed on the HyperText Markup Language 5-based chart graphs and tables. Participating hospitals can compare their performance to those of KNN as a whole and identify the trends over time. Ranking of each participating hospital is also displayed in terms of key outcome variables such as mortality and major neonatal morbidities with the names of other centers blinded. The most powerful function of the DDS is the ability to perform 'conditional filtering' which allows users to exclusively review the records of interest. Further collaboration is needed to upgrade the DDS to a more sophisticated analytical system and to provide a more user-friendly interface.
Data Display/*utilization ; Humans ; Internet ; Quality Improvement ; Registries ; Republic of Korea ; Societies, Medical/*organization & administration ; User-Computer Interface

PURPOSE: This study investigated the current trends and changes in the field of cataract surgery in Korea. METHODS: The members of the Korean Society of Cataract and Refractive Surgery (KSCRS) and the members of the Korean Ophthalmological Society (KOS) participated in a survey on cataract surgery in 2012, the 16th survey, consisting of 108 multiple-choice questions, mailed in July 2013 to 301 KSCRS and KOS members. Sixty two (20.6%) members answered the questions. Current data were compared with previous surveys performed in 2006 and 2009. RESULTS: Most of the respondents (46%) were in the fourth decade, 43% in the fifth decade and 10% in the sixth decade of life. The duration of hospital stay had decreased annually and the use of topical anesthesia (69%) was the most preferred. Self-sealing wound construction was the main wound closure technique in phacoemulsification (72%). The most preferred intraocular lens (IOL) for cataract surgery was hydrophobic acrylic (76%) which showed an increasing trend. The implantation of phakic IOL was performed by 41% of the respondents and interest in the value added IOLs such as presbyopia IOL and toric IOL had increased annually. In addition, to minimize astigmatism following cataract surgery, several methods were performed according to the degree of astigmatism. However, there was little interest in new cataract surgery techniques such as femtosecond laser and many respondents were skeptical whether to adopt the femtosecond laser cataract surgery system. CONCLUSIONS: This survey summarized current trends and changes in the field of cataract surgery in Korea.
Anesthesia ; Astigmatism ; Cataract* ; Surveys and Questionnaires ; Korea* ; Length of Stay ; Lenses, Intraocular ; Phacoemulsification ; Postal Service ; Presbyopia ; Refractive Surgical Procedures ; Wound Closure Techniques ; Wounds and Injuries

BACKGROUND: To assess the effect and toxicity of low-dose paclitaxel in patients with metastatic or recurrent gastric cancer with measurable lesions as first-line chemotherapy. METHODS: Patients with measurable metastatic or recurrent gastric cancer were eligible in this study. Paclitaxel and cisplatin were intravenously infused for 3h, at a dose of each 135 mg/m2 and 60 mg/m2, every 3 weeks and then this regimen was repeated until intolerable toxicity or disease progression. Objective tumor responses, duration of response, time to disease progression, and toxicity profile were evaluated in this study. RESULTS: Total 31 patients were enrolled in this study between May 2001 and January 2004. Sixteen patients had ECOG performance status (PS) 1, eleven had PS 2 and four had PS 3. A total of 122 cycles (median 3, range 1~12) were administered. Eleven (35%, 11/31) objective partial responses (PR) were observed and the remaining 19 patients showed stable (9 patients, 30%) and progressive disease (11 patients, 35%). The response rate was 35% (95% confidence interval, 18~51%). The estimated median survival was 8.1 months, median response duration was 5.3 months and median progression-free survival was 3.3 months. Severe toxicities were uncommon. There were 14 episodes (11.5%) of grade 3-4 neutropenia. Grade 3 nausea and vomiting occurred in 4%. Grade 3 peripheral neuropathy occurred in 3.3%. CONCLUSION: This low dose paclitaxel regimen (135 mg/m2) showed comparable results with previously published high-dose paclitaxel regimen (175~250 mg/m2) used in metastatic or recurrent gastric cancer and the toxicity was minimal.
Cisplatin ; Disease Progression ; Disease-Free Survival ; Drug Therapy* ; Humans ; Nausea ; Neutropenia ; Paclitaxel* ; Peripheral Nervous System Diseases ; Stomach Neoplasms* ; Vomiting

BACKGROUND: Hypoglycemia is the most common therapeutic complication of diabetes mellitus and especially in elderly diabetic patients with diminished cardiac and cerebral circulation can cause serious tissue damage. Though many studies have attempted to evaluate hypoglycemia in IDDM or adult diabetic patients, few studies in the elderly. We have compared clinical characteristics of severe hypoglycemia in elderly diabetes with adult diabetes. METHODS: This study include 56 severe hypoglycemic patients who have admitted to emergency department of National Medical Center from march 1, 1992 to december 31, 1997. they are divided two group (adult group; 21, elderly group; 35) and authors investigate the cause, the symptom, the time of severe hypoglycemia, degree of education, treatment method in each group. RESULTS: 1) DM education was not well done in severe hypoglycemic patients. 2) The frequency of severe hypoglycemia in the elderly was more than adult (adult: 21 (38%), elderly 35 (62%)). 3) In both population, the most common symptom of severe hypoglycemia was neuroglycopenic symptom, especially in the elderly (adult: 57%, elderly: 77%). 4) Decreased food intake (49%) in the elderly and overdose of insulin (38%) in the adult were the most common cause of severe hypoglycemia. 5) Severe hypoglycemia occurred more often between midnight and 6 AM in the adult, between noon and 6 PM in the elderly. 6) The treatment of diabetes mellitus is insulin (71%) and oral hypoglycemic agent (29%) in the adult, oral hypoglycemic agent (51%) and insulin (49%) in the elderly. CONCLUSION: For prevention of severe hypoglycemia, we should emphasize the importance of DM education and especially elderly diabetic patients should be educated about the symptoms of hypoglycemia, the self-management of hypoglycemia, the need for a regular carbohydrate intake and more easy and effective diet program is require in elderly diabetes.
Adult ; Aged* ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diet ; Eating ; Education ; Emergency Service, Hospital ; Humans ; Hypoglycemia* ; Insulin ; Self Care

The aim of this study was to estimate internal radiation doses and lifetime cancer risk from food ingestion. Radiation doses from food intake were calculated using the Korea National Health and Nutrition Examination Survey and the measured radioactivity of 134Cs, 137Cs, and 131I from the Ministry of Food and Drug Safety in Korea. Total number of measured data was 8,496 (3,643 for agricultural products, 644 for livestock products, 43 for milk products, 3,193 for marine products, and 973 for processed food). Cancer risk was calculated by multiplying the estimated committed effective dose and the detriment adjusted nominal risk coefficients recommended by the International Commission on Radiation Protection. The lifetime committed effective doses from the daily diet are ranged 2.957-3.710 mSv. Excess lifetime cancer risks are 14.4-18.1, 0.4-0.5, and 1.8-2.3 per 100,000 for all solid cancers combined, thyroid cancer, and leukemia, respectively.
Adolescent ; Adult ; Cesium Radioisotopes/chemistry ; Child ; Child, Preschool ; *Eating ; Food Contamination, Radioactive/*analysis ; Humans ; Infant ; Infant, Newborn ; Iodine Radioisotopes/chemistry ; Neoplasms, Radiation-Induced/*etiology ; Nutrition Surveys ; Radiation Dosage ; Republic of Korea ; Young Adult

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 microg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.
Adult ; Blood Glucose ; Deamino Arginine Vasopressin ; Diabetes Insipidus, Neurogenic ; Diabetes Mellitus, Type 2 ; Diet ; Fasting ; Humans ; Hyperglycemia ; Metformin ; Polydipsia ; Polyuria ; Sodium ; Thirst ; Valproic Acid ; Water Deprivation

BACKGROUND: Double balloon enteroscopy was developed to improve access to the small intestine. The aim of this study was to evaluate the efficacy of double balloon enteroscopy in patients with obscure gastrointestinal bleeding. METHODS: From November 2004 through August 2005, 24 consecutuve patients (14 males, 10 females; mean age 48+/-15.1 years, range 2181 years) with gastrointestinal bleeding of an obscure origin were enrolled in this study. The patients underwent enteroscopy using the double balloon technique for the following indications: (1) clinical evidence of gastrointestinal bleeding such as melena and hematochezia (the Hb levels ranged from 5.9 g/dL to 11.9 g/dL, mean 9.0+/-2.3 g/dL) (2) no site and cause of blood loss detected by upper endoscopy and colonoscopy. RESULTS: Of 24 patients that underwent a double balloon enteroscopy, bleeding points were identified in 22 patients. The causes of bleeding were nine small bowel ulcera, six angiodysplasiaa, three cases of Crohn's disease, two gastrointestinal stromal tumors, one Meckel's diverticulum and one cecal diverticular ulcer. However, two cases showed negative findings. No patient suffered from procedure related complication. CONCLUSIONS: Double balloon enteroscopy is a safe and useful diagnostic tool for obscure gastrointestinal bleeding.
Colonoscopy ; Crohn Disease ; Double-Balloon Enteroscopy* ; Endoscopy ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Hemorrhage* ; Humans ; Intestine, Small ; Male ; Meckel Diverticulum ; Melena ; Ulcer

BACKGROUND/AIMS: The ability to visualize the small bowel mucosa by capsule endoscopy is limited. Moreover, studies involving small-bowel preparation with purgative drugs have failed to establish which preparations produce better images and higher diagnostic yields. The aim of this study was to evaluate the efficacies and diagnostic yields of different bowel preparations. METHODS: A cohort of 134 patients with suspected small bowel disease was randomly assigned to 3 groups. Patients in group A (n=44) fasted for 12 h before being administered an M2A capsule (Given Imaging, Yoqneam, Israel). Patients in group B (n=45) were asked to drink two doses of 45 mL of sodium phosphate (NaP) with water during the afternoon and evening on the day before the procedure and to drink at least 2 L of water thereafter. Patients in group C (n=45) drank 2 L of a polyethylene glycol (PEG) lavage solution the evening before the procedure. RESULTS: Overall cleansing of the small bowel was adequate in 43% of patients in group A, 77% of those in group B, and 56% of those in group C (group A vs group B, p=0.001). Diagnoses for obscure gastrointestinal bleeding were established in 9 patients (39%) in group A, 16 patients (69%) in group B, and 14 patients (50%) in group C. No significant difference in diagnostic yield was observed between groups. CONCLUSIONS: Bowel preparation with NaP for capsule endoscopy improved small-bowel mucosal visualization when compared to 12-h overnight fasting.
Capsule Endoscopy ; Cohort Studies ; Hemorrhage ; Humans ; Mucous Membrane ; Phosphates ; Polyethylene Glycols ; Prospective Studies ; Sodium ; Therapeutic Irrigation ; Water

BACKGROUND/AIMS: Capsule endoscopy is an effective diagnostic tool for detecting small bowel disease. However, the method of bowel preparation for capsule endoscopy has not been standardized. The aim of this study was to evaluate the efficacy of oral sodium phosphate as a preparation for capsule endoscopy. METHODS: A total of 129 cases who underwent capsule endoscopy from Mar. 2003 to Sep. 2004 were analyzed retrospectively. Eighty- eight cases were prepared with sennosides (Alaxyl(R)) and 41 cases were prepared with sodium phosphate. The intestinal mucosa was defined as being unclean if the intestinal content, food materials, and bubbles covered more than 25% of the mucosal surface. Using a stopwatch, the exact time of the unclean image was recorded. The percentage of the unclean image for the small intestinal transit time (SITT) was calculated as an objective score. Small bowel cleansing was considered 'adequate' if the objective score was <10% and 'inadequate' if the objective score was 10% or greater. RESULTS: 35 cases (40%) showed an adequate image in the sennosides and simethicone group and 26 cases (63%) showed an adequate image in the sodium phosphate and simethicone group. The adequacy rate was significantly higher in the sodium phosphate group than in the sennosides group (p<0.05). CONCLUSIONS: Capsule endoscopy prepared by sodium phosphate and simethicone produced a better visual image than sennosides and simethicone.
Capsule Endoscopy* ; Gastrointestinal Contents ; Intestinal Mucosa ; Retrospective Studies ; Senna Extract ; Simethicone ; Sodium*