BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

No abstract available.
beta-Thalassemia* ; Thalassemia*

Distinction of antemortem changes from postmortem artifacts is of obvious importance in determining the cause of death. Problems in differential diagnosis may occur as a result of faulty autopsy technique, decomposition changes and destructive environmental factors. Recently we experienced a formation of tyrosine crystals on the gastric and esophageal mucosa of decomposed corpse. The tyrosine crystals found on the gastric and esophageal mucosa were very similar and small pin-head sized whitish gray granules. At first we suspected them as a certain drugs or toxic substances. But the granular materials were confirmed as tyrosine crystals by infrared spectrum analysis. So we report here as a first confirmed case in korea. We think the tyrosine crystal is formed by putrefactive processes and consider as one of the putrefactive artifacts.
Artifacts* ; Autopsy ; Cadaver ; Cause of Death ; Diagnosis, Differential ; Gastrointestinal Tract* ; Korea ; Mucous Membrane ; Spectrum Analysis ; Tyrosine*

PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

OBJECTIVES: Although mercury (Hg) exposure is known to be neurotoxic in humans, its effects on liver function have been less often reported. The aim of this study was to investigate whether total Hg exposure in Korean adults was associated with elevated serum levels of the liver enzymes aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT). METHODS: We repeatedly examined the levels of total Hg and liver enzymes in the blood of 508 adults during 2010-2011 and 2014-2015. Cross-sectional associations between levels of blood Hg and liver enzymes were analyzed using a generalized linear model, and nonlinear relationships were analyzed using a generalized additive mixed model. Generalized estimating equations were applied to examine longitudinal associations, considering the correlations of individuals measured repeatedly. RESULTS: GGT increased by 11.0% (95% confidence interval [CI], 4.5 to 18.0%) in women and 8.1% (95% CI, -0.5 to 17.4%) in men per doubling of Hg levels, but AST and ALT were not significantly associated with Hg in either men or women. In women who drank more than 2 or 3 times per week, AST, ALT, and GGT levels increased by 10.6% (95% CI, 4.2 to 17.5%), 7.7% (95% CI, 1.1 to 14.7%), and 37.5% (95% CI,15.2 to 64.3%) per doubling of Hg levels, respectively, showing an interaction between blood Hg levels and drinking. CONCLUSIONS: Hg exposure was associated with an elevated serum concentration of GGT. Especially in women who were frequent drinkers, AST, ALT, and GGT showed a significant increase, with a significant synergistic effect of Hg and alcohol consumption.
Adult* ; Alanine Transaminase ; Alcohol Drinking ; Aspartate Aminotransferases ; Drinking ; Female ; gamma-Glutamyltransferase ; Humans ; Linear Models ; Liver* ; Longitudinal Studies* ; Male

BACKGROUND: With the rapid aging of the Korean population and the steady decrease in the donor population during the past few years, there is a need for measures to ensure balance between blood demand and supply. The trends of the donor population and donor deferral during the past eleven years (1995~2005) were examined to obtain basic data to be used in donor management policy-making. METHODS: Data on the donor population, presenting donors, deferred donors and the reasons for deferral were examined by searching the Blood Information Management System (BIMS) and Annual reports of the Korean Red Cross. RESULTS: The number of presenting donors increased until 2003. However, the actual number of eligible donors has been decreasing since 1999 due to the increase in donor deferral. By enforcing donor eligibility criteria, the donor deferral rate in 1998 increased by 75.2% compared with the previous year, and the deferral rate was 21% in 2005. A low blood specific gravity (SG) was the most common reason for deferral, and more than 90% of those deferred due to a low SG were women. CONCLUSION: In order to assure an adequate donor base, policies should not only target donor recruitment but also the management of deferred donors. The adequacy of currently applied donor eligibility criteria should be reevaluated, and deferred donors should be counseled about their reason for deferral in order to encourage donation. Furthermore, the hemoglobin criteria for women should be reconsidered.
Aging ; Female ; Humans ; Information Management ; Red Cross ; Specific Gravity ; Tissue Donors*

BACKGROUND: The management of blood program is difficult, because there is no comprehensive data collection system in place that gathers data about blood and blood components (blood) usage in Korea. To provide basic data for estimating future blood needs and thereby adjusting the blood program to those needs, data of blood usage in ten Korean university hospitals was analyzed. METHODS: The amount of blood used in Korea from 1995 to 2004 was estimated from the data of the Korean Red Cross Blood Centers (KRCBC) and from blood collection data of hospitals. Ten top ranking hospitals regarding blood usage were selected based on a previous report, and the data for blood usage in these hospitals were evaluated. RESULTS: About 20% of red blood cells (RBC) including whole blood > or =40% of platelets (PLT), > or =30% of plasma products (Plasma), and > or =70% of single donor apheresis platelets (SDP) transfused in Korea were used in ten University hospitals. The pattern of blood utilization in ten hospitals was different from that in total hospitals in Korea. The mean units of blood transfused per 1000 admitted patients in these ten hospitals increased steadily until 2000, but from 2001 the amount of blood transfused reached a plateau until 2004, although variations between hospitals is noticed, it seems to be stabilized. About 35% of RBC, 33% of Plasma and 27% of PLT were transfused for patients aged 60 years or more, and the transfusion rate for RBC was between 5% and 17% showing an increasing tendency proportional to patients age in two hospitals. CONCLUSION: This study provides baseline data for planning a blood program, and for a blood monitoring program a continuous and comprehensive data collection system for blood supply and blood demand needs to be established at a National level.
Blood Component Removal ; Data Collection ; Erythrocytes ; Hospitals, University* ; Humans ; Korea* ; Plasma ; Red Cross ; Tissue Donors

PURPOSE: The purpose of this study is to investigate the dosimetric and clinical influence of computed tomography-based (3-dimensional [3D]) simulation versus conventional 2-dimensional (2D)-based simulation in postoperative chemoradiotherapy (CRT) for patients with advanced gastric cancer in terms of parallel opposed anteroposterior-posteroanterior field arrangement. MATERIALS AND METHODS: A retrospective stage-matched cohort study was conducted in 158 patients treated with adjuvant CRT following curative surgery and D2 dissection from 2006 to 2008 at Samsung Medical Center: 98 patients in the 3D group; and 60 patients in the 2D group. For comparison of the dosimetric parameters between 3D plan and 2D plan, second sets of radiation treatment plans were generated according to the same target delineation method used in the 2D group for each patient in the 3D group (V2D). Acute toxicity, recurrence, and survival were analyzed. The median follow-up period was 28 months (range, 5 to 51 months). RESULTS: The 3D group showed better dose-volume histogram (DVH) profiles than the V2D group for all dosimetric parameters, including the kidneys, liver, spinal cord, duodenum, pancreas, and bowel. However, no difference in acute gastrointestinal toxicity and survival outcomes was observed between the 3D group and the 2D group. CONCLUSION: The 3D plan enabled precise delineation of the target volume and organs at risk by visualization of geometric changes in the internal organs after surgery. The DVH of normal tissues in the 3D plan was superior to that of the V2D plan, but similar clinical features were observed between the 3D group and the 2D group.
Chemoradiotherapy ; Cohort Studies ; Duodenum ; Follow-Up Studies ; Humans ; Kidney ; Liver ; Organs at Risk ; Pancreas ; Radiotherapy ; Radiotherapy Planning, Computer-Assisted ; Recurrence ; Retrospective Studies ; Spinal Cord ; Stomach Neoplasms*

No abstract available.
Humans* ; Hybridomas*

BACKGROUND: There is a need to prepare an adequate blood supply because of the imbalance between the blood supply and demand and the advent of an aging society. This paper presents the basic data for the blood supply and demand through an estimation of the blood donation and blood usage over the next ten years. METHODS: Data analysis was carried out using time-series methods. The data for the monthly blood donation from the Korean Red Cross from 1992 to 2004 was used to estimate the blood donation, and data of the blood supply from the Korean Red Cross and hospitals from 2000 to 2004 for the estimation of the blood supply for transfusion. In order to overcome the limits of the time-series methods, one prospect excluding the data from the year 2004 and the other prospect including the data from the year 2004 were analyzed simultaneously. RESULTS: According to the analysis performed with data from the year 2004 excluded, blood donation rate is expected to decrease to 2.5% in 2015 and the total blood demand (1,435,903 units), which is composed of RBC and single donor platelet, is expected to exceed the total blood donation (1,408,244 donors) by 2015. According to the analysis performed with the data from the year 2004 included, the blood donation rate is expected to decrease to 1.3% in 2015 and the total blood demand (1,760,219 units) is expected to exceed the total blood donation (1,639,042 donors) in 2009. CONCLUSION: A shortage of blood supply is expected to occur during the next ten years. In order to eliminate this blood shortage, a national data management system for blood collection and usage will be needed. In addition, adequate donor resources as well as a monitoring system will be needed to improve the efficiency of blood usage.
Aging ; Blood Donors ; Blood Platelets ; Humans ; Red Cross ; Statistics as Topic ; Tissue Donors