OBJECTIVES: The purpose of this study was to investigate recognition, dietary attitude and education needs for reducing sodium intakes of dietitian at customized home visiting health service (CHVHS). METHODS: The subjects were 75 dietitian at CHVHS. We investigated several variables (recognition, dietary attitude, education needs for reducing sodium intakes) and determined sodium intakes level of subjects as 'low', 'middle' and 'high' by Dish Frequency Questionnaire 25 (DFQ 25). Also, we assessed the differences in recognition, dietary attitude, sodium intake level and education needs by dietitian career period (under 3 yrs vs. over 3 yrs) at CHVHS. RESULTS: In recognition related reducing sodium intake, they showed 'checking a sodium content in nutrition labeling' score 2.5/4.0 and 'perception difference between sodium and salt' score 3.1/4.0. There was no difference in the recognition between under 3yrs' group and over 3yrs' group. In dietary attitude related reducing sodium intake, they showed 'palatability for salty taste' score 0.8/1.0, 'attitude in related soups' 0.7/1.0, 'attitude in related using natural spice' 0.6/1.0. There was a difference in 'attitude in related soups' between under 3yrs' group and over 3yrs' group (0.6 vs. 0.7). In sodium intake level by DFQ 25, they showed 'low group' 41.3%, 'middle group' 41.3% and 'high group' 17.3%. There was no difference in the distribution of sodium intake level by the career. In education needs related reducing sodium intakes, there were 'teaching experience' 93.3%, 'have a difficulty in teaching about reducing sodium intakes' 86.6%, and 'necessity of education for CHVHS dietitians' 100.0%. 'Needed education contents for CHVHS dietitians' were ranked as 'cooking way to reduce sodium intake' 58.7%, 'relation between hypertension and sodium' 17.3%, 'composing way to reduce sodium intake' 17.3%. There was a difference in needed education contents 'relationship between hypertension and sodium' (33.3% vs. 2.6%) and 'The cooking way to reduce sodium intake' (38.9% vs. 76.9%) by the career. CONCLUSIONS: The results suggested that a capacity training program for reducing sodium intake may be needed for dietitians at CHVHS to improve health of the community elderly. For effective training program related reducing sodium intake for dietitians at CHVHS, it may be necessary to consider the career period as dietitians at CHVHS.
Aged ; Cooking ; Education* ; Health Services* ; House Calls* ; Humans ; Hypertension ; Nutritionists* ; Surveys and Questionnaires ; Sodium*

BACKGROUND: Diabetic ketoacidosis(DKA) is serious acute metabolic complication and the most important cause of high morbidity and mortality of diabetes. The object of this study is to examine the clinical characteristics of patients with DKA who had a prior history of diabetes or not. METHOD: Authors reviewed retrospectively the medical records of 49 cases adimitted to Kyungpook National University Hospital from January 1991 to June 1997 with a diagnosis of DKA and classified cases as type I, type II and newly diagnosed diabetics according to prior history of diabetes. RESULTS: 1. Of 49 cases of DKA, 24(49%) were classified as type I, 17(35%) as type II from data available in the medical records, and 8(16%) had DKA as the initial manifestation of the disease. 2. The male to female ratio was 0.5 : 1 in type I, 1.1 : 1 in type II and 1.7 : 1 in newly diagnosed diabetics, and the mean age was 24.4 in type I, 57.9 in type II and 23.9 years old in newly diagnosed diabetics. 3. The mean duration between initial diagnosis of diabetes and the occurrence of DKA was 2.6 in type I and 6.9 years in type II diabetes. The occurrence of DKA within 2 years of initial diagnosis of diabetes was 54% in type I and 18% in type II diabetes, but the occurrence of DKA after 5 years of initial diagnosis of diabetes was 17% in type I and 47% in type II diabetes. 4. The precipitating factors of DKA were identified in 88% in type I, 76% in type II and 38% in newly diagnosed diabetics, and the most common precipitating factor was omission of treatment in both type I and type II(type I: 56%, type II: 35%). 5. The altered mental status was correlated with increased osmolality (p<0.05), but not with other laboratory values such as pH, bicabonate, glucose, anion gap and dehydration status(p>0.05). CONCLUSION: It is necessary to conduct early aggressive evaluation for early diagnosis and proper treatment of DKA, because DKA occurs in patients with prior history of type II diabetes and without prior diabetic history as well as patients with prior history of type I diabetes.
Acid-Base Equilibrium ; Dehydration ; Diagnosis ; Early Diagnosis ; Female ; Glucose ; Gyeongsangbuk-do ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical Records ; Mortality ; Osmolar Concentration ; Precipitating Factors ; Retrospective Studies

BACKGROUND: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia. METHODS: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer. RESULTS: The cumulative incidence rate increased with age, consuming > or =3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming > or =3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037). CONCLUSIONS: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.
Edible Grain ; Endoscopy ; Follow-Up Studies ; Gastritis, Atrophic ; Humans ; Incidence ; Life Style ; Metaplasia ; Multivariate Analysis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Stomach Neoplasms

Infantile hemangioendothelioma of the liver is a common vascular tumor in infancy. The tumor is usually multinodular or diffuse and classified into two types. We present a case of infantile hemangioendothelioma of the liver, which predominantly consists of type 2. A 4-month-old female was admitted for an evaulation of an abdominal distension. A CT scan of the liver showed a multinodular mass. The right lobectomy was done. Grossly, the mass consisted of round nodules ranging from 2cm to 5cm in diameter. Microscopically, the tumor revealed proliferation of small vascular channels lined by endothelial cells. Bizarre cells and mitotic cells were frequently noted. Vesicular nuclei and multilayering of the endothelial cells were also noted.
Endothelial Cells ; Female ; Hemangioendothelioma* ; Humans ; Infant ; Liver* ; Tomography, X-Ray Computed

Maligant melanomas of the oral or nasal cavity, and the vulvovaginal area are relatively common among the melanomas of non-ocular mucosa. But, primary malignant melanoma arising in the mucosa of the palatine tonsil is rare. We present a case of primary malignant melanoma arising in the mucosa of the palatine tonsil. A 36-year-old male was admitted for evaluation of a recurrent sore throat. Tonsillectomy was performed on the basis of clinical suspicion of chronic tonsillitis. Grossly, the left tonsil was focally dark. Microscopically, the tonsillar mucosa was diffusely infiltrated with tumor cells. Tumor cells revealed numerous melanin pigments. Intraepithelial nests of tumor cells were noted, but pagetoid spread of tumor cells was not found. Tumor cells were positive for S-100 protein and HMB45 stain. There was no evidence of melanoma in the skin or eye.
Male ; Humans

BACKGROUND: The evaluation of obesity in practice has been done indirectly by anthropometric values such as body mass index(BMI), waist and hip circumferences and waisthip ratio(WHR). Somatotype drawing developed by Srensen has been evaluated as a simple instrument of obesity without real somatic measuring in several studies. This study was attempted to evaluate correlation between somatotype drawing and anthropometric values. METHODS: The subjects were measured anthroprmetric values such as height, weight, hip and waist circumferences. After calculating BMI and WHR, we evaluated correlation between these values and somatotype drawing. And we tried to grouping of somatotype drawing with the means of anthropometric values. RESULTS: The data were collected from 224 subjects, whose BMI(kg/m2) and WHR were 22.81+/-2.96 and 0.84+/-0.07(mean+/-SD). Spearmans correlation coefficients(rs) of somatotype drawing were 0.77 with BMI, 0.62 with waist circumference, 0.61 with weight and hip circumference, 0.40 with WHR that remained statistically significant after adjusting age, sex, education level, monthly income and job. And, the grades of somatotype drawing were grouped as 1, 2, 3-4, 5-6, 7 by BMI and hip circumference, 1, 2-4, 5, 6, 7 by waist circumference(ANOVA and Duncans method). CONCLUSIONS: Somatotype drawing has a good correlations with BMI, weight, waist and hip circumference. But it is not applicable to assess WHR because of its relatively lower correlation.
Education ; Hip ; Obesity ; Somatotypes* ; Waist Circumference

Barrett's esophagus is a metaplastic process in which the squamous epithelium of the lowet esophagus is replaced by columnar epithelium. Most cases are believed to be related to prolonged gastroesophageal reflux. Detection of Barretts esophagus is important in that it results in adenocarcinoma in about 10% of patients. We report a case of adenocarcinoma arising from Barrett's esophagus in a 56 year-old man, diagnosed incidentally at a physical check-up. Grossly, the esophagogastric junction was irregular and there were two small ulcers in the lower esophagus. Microscopically, ihe squamous epithelium of the lower hagus was replaced by specialized intesinal mucosa with a small focus of adenocarcinona confined to the submucosa in one area. Many separate dysplastic foci were also present in the nearby esophageal mucosa.
Adenocarcinoma* ; Barrett Esophagus* ; Epithelium ; Esophagogastric Junction ; Esophagus* ; Gastroesophageal Reflux ; Humans ; Intestines* ; Middle Aged ; Mucous Membrane ; Stomach* ; Ulcer

Malignant struma ovarii is a rare tumor of the ovary. This can be diagnosed by histologically when carcinomas of the thyroid gland are excluded. We present a case of malignant struma ovarii arising from cystic teratoma. A 42-year-old female was admitted for evaluation of lower abdominal mass. Hysterectomy and both adnexectomy were performed on the basis of a clinical impression of uterine leiomyoma and an ovarian mass. The uterus revealed intramural leiomyoma, measuring 8 cm in diameter. Ovarian mass was predominantly cystic and partly solid. Microscopically, thyroid tissue with papillary structures were found in the solid area Papillae were complex, branching and randomly oriented. These papillae were infiltrated in the adjacent fibrous capsule, Clinical evidence of a primary thyroid carcinoma was not found.
Female ; Humans

Malignant struma ovarii is a rare tumor of the ovary. This can be diagnosed by histologically when carcinomas of the thyroid gland are excluded. We present a case of malignant struma ovarii arising from cystic teratoma. A 42-year-old female was admitted for evaluation of lower abdominal mass. Hysterectomy and both adnexectomy were performed on the basis of a clinical impression of uterine leiomyoma and an ovarian mass. The uterus revealed intramural leiomyoma, measuring 8 cm in diameter. Ovarian mass was predominantly cystic and partly solid. Microscopically, thyroid tissue with papillary structures were found in the solid area Papillae were complex, branching and randomly oriented. These papillae were infiltrated in the adjacent fibrous capsule, Clinical evidence of a primary thyroid carcinoma was not found.
Female ; Humans

BACKGROUND: To examine whether nonemergency patients can be identified and be safely triaged out of the emergency department. METHODS: Adult patients(16 years or older) who visited to the emergency department were prospectively studied from July 1 to August 31, 1997. Authors developed a new triage composed of vital signs, mental status, chief complaints, etiology, and a mode of transfer. Chi-square test and a discriminant analysis were applied for statistical analysis. RESULTS: In a discriminant analysis, mode of transfer, chief complaint, age, heart rate, mental status, etiology, and body temperature were significant variables in order. In a canonical discriminant value at group mean, a nonemergent value is 0.450 and a emergent value -0.219. CONCLUSIONS: In simply applicable triage method, mode of transfer and chief complaints are more important than vital sign and mental status. This method is useful in disaster situation and non-medical personnel may use this triage method easily. But some patients are not triaged by this triage method, thus more studies and discussions are necessary.
Adult ; Body Temperature ; Disasters ; Emergencies* ; Emergency Service, Hospital* ; Heart Rate ; Humans ; Prospective Studies ; Triage* ; Vital Signs