Hemangioblastomas are low-grade, highly vascular tumors that are usually associated with von Hippel-Lindau syndrome. Hemangioblastomas most commonly occur in the cerebellum, and intradural extramedullary hemangioblastoma of the cauda equina is very rare, especially in patients without von Hippel-Lindau syndrome. Herein, we report a case of intradural extramedullary hemangioblastoma of the cauda equina that was not associated with von HippelLindau syndrome, with a focus on its imaging characteristics and differential diagnoses. We compared the clinical presentation and imaging features of our case with those of previously reported cases in the review of the literature.

Hemangioblastomas are low-grade, highly vascular tumors that are usually associated with von Hippel-Lindau syndrome. Hemangioblastomas most commonly occur in the cerebellum, and intradural extramedullary hemangioblastoma of the cauda equina is very rare, especially in patients without von Hippel-Lindau syndrome. Herein, we report a case of intradural extramedullary hemangioblastoma of the cauda equina that was not associated with von HippelLindau syndrome, with a focus on its imaging characteristics and differential diagnoses. We compared the clinical presentation and imaging features of our case with those of previously reported cases in the review of the literature.

Hibernoma is a rare benign tumor that arises from vestiges of brown fat. Spinal intraosseous hibernoma has only recently been described in the literature, and only 12 cases have been reported to date due to its extreme rarity. Here, we report the case of a patient who was incidentally diagnosed with an intraosseous hibernoma in the thoracic spine, following a diverse imaging work-up and pathologic confirmation. We correlate the clinical presentation and imaging features of our case with those of previously reported cases during our review of the literature.

PURPOSE: The purpose of this study was to explore whether or not there is a relationship between doctor's awareness of clinical nutrition service and needs for a clinical dietitian. METHODS: A cross-sectional survey design was used. The research was carried out by using questionnaires that had been specifically designed for the study. The research was conducted from September to October, 2013 for 311 doctors at 43 hospitals (with over 400 beds). Frequency analysis, factor analysis, reliability analysis, confirmatory factor analysis, and bootstrapping analysis were conducted using SPSS 21.0. RESULTS: ‘Implementation of clinical nutritional service’ (p < 0.001) and ‘usefulness on clinical nutrition service’ (p < 0.001) were found to be correlated with ‘importance of clinical nutrition service’ as an independent variable. The correlation between ‘importance of clinical nutrition service’ as a mediating variable and ‘needs for clinical dietitian’ as a dependent variable was also confirmed (p < 0.001). The results of the bootstrapping test showed that the mediating effect of ‘importance of clinical nutrition service’ was significant. The indirect effect value between ‘implementation of clinical nutrition service’ and ‘needs for clinical dietitian’ was 0.040, indirect effect value between ‘usefulness on clinical nutrition service’ and ‘needs for clinical dietitian’ was 0.095. CONCLUSION: The frequency of providing clinical nutritional services, the quality of clinical nutritional services, and the degree of implementation of clinical nutritional services were found to be important for positive perception of clinical nutrition services by doctors. Therefore, proper provision of clinical nutrition services and effective therapeutic effects will be continuously highlighted, which will increase the awareness of the physician and ultimately increase the demand for clinical nutrition service.
Cross-Sectional Studies ; Negotiating* ; Nutritionists* ; Therapeutic Uses

OBJECTIVES: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. METHODS: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. RESULTS: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). CONCLUSIONS: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.
Delivery of Health Care ; Hospitals ; Humans ; Job Satisfaction ; Korea ; Linear Models ; Long-Term Care* ; Mass Screening ; Nutritionists ; Surveys and Questionnaires

The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.
Ambulatory Care ; Employment ; Fees and Charges ; Food Services ; Gyeonggi-do ; Humans ; Internship and Residency ; Nutritionists* ; Patient Care ; Surveys and Questionnaires ; Seoul ; Social Environment ; Tertiary Care Centers*

We report here the results of surveys on external quality assessment (EQA) of blood bank tests in Korea carried out in 2014. The proficiency testing specimens were prepared at Ajou University Hospital and the response rates for the 1st and 2nd trials were 94.3% (537/549) and 96.0% (545/554), respectively. No answers were considered incorrect, and the average accuracy rates of six different test items on the regular survey were as follows: ABO grouping, 98.5% to 100.0%; RhD typing, 98.1% to 99.4%; crossmatching, 91.2% to 99.6%; direct antiglobulin test (DAT) using a polyspecific reagent, 96.7% to 98.4%; DAT using an immunoglobulin-G monospecific reagent, 93.8% to 98.7%; DAT using a C3d monospecific reagent, 89.5% to 98.7%; unexpected antibody screening test, 96.2% to 100.0%; and antibody identification test, 69.8% to 100.0%. Test items for the pilot survey were reactivities to anti-A1 and anti-H, Rh subgrouping, and ABO antibody titration. Except for the result of the antibody identification test for specimens with multiple antibodies, we obtained excellent survey results for the EQA of blood bank tests carried out in 2014. In addition, the number of participating institutes was higher in 2014 than in 2013. The EQA of blood bank tests in 2014 should be helpful for improving the quality of the participating laboratories.
Academies and Institutes ; Antibodies ; Blood Banks ; Coombs Test ; Korea ; Laboratory Proficiency Testing ; Mass Screening

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.
Cross-Sectional Studies* ; Delivery of Health Care ; Hand ; Hospitals, General* ; Korea ; Length of Stay ; Mass Screening ; Nutritionists ; Surveys and Questionnaires ; Tertiary Care Centers*

The aim of the present study was to examine the causal-effect of baseline (year 2004) serum gamma-glutamyl transpeptidase (GGT) level with the prevalence of metabolic syndrome (MS) in year 2008. The study was comprised of male workers who underwent a regular health check-up in 2004 and 2008. MS was diagnosed according to the American Association of Clinical Endocrinologists (AACE) criteria. In the subgroup analysis according to serum GGT level, triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) showed a significant increasing tendency (p < 0.001). In addition, unexpectedly results were consistent in non-drinkers (p < 0.001). GGT level was significantly associated with risk factors of MS (waist circumference [WC]: r = 0.18, p < 0.001; fasting blood glucose [FBG]: r = 0.16, p < 0.001; TG: r = 0.29, p < 0.001). As the secondary biomarker, homeostasis model assessment of insulin sensitivity (HOMA-S) and TC had significant correlations with GGT level (HOMA-S: r = -0.14, p < 0.001; TC: r = 0.21, p < 0.001). In the 4-year prospective analysis, the predictive effect of baseline GGT concentrations on change in MS status was evaluated using Cox proportional model. Elevated GGT concentrations measured in 2004 were associated with the risk of MS incidence after 4 years (GGT: HR 1.7 [95% CI: 1.2-2.3]) (p < 0.01). This observation indicates that an elevated GGT level could be suggested as a subsidiary marker for MS and partially reflects dyslipidemia as a component of MS.
Blood Glucose ; Cholesterol ; Cholesterol, LDL ; Cohort Studies* ; Dyslipidemias ; Fasting ; gamma-Glutamyltransferase* ; Homeostasis ; Humans ; Incidence ; Insulin Resistance ; Male* ; Prevalence ; Prospective Studies ; Risk Factors ; Triglycerides

BACKGROUND: It is well-known that cell-free nucleic acids rise in patients with many types of malignancies. Several recent experimental studies using cancer cell lines have shown that changes in cell-free RNA are predictive of the response to chemotherapy. The objective of this study was to determine whether quantification of free RNA can be used as a biomarker for clinical responses to chemotherapy in patients with lung cancer. METHODS: Thirty-two patients with lung cancer (non-small cell lung cancer, n=24; small cell lung cancer, n=8) were divided into 2 groups according to their responses to chemotherapy (response group, n=19; non-response group, n=13). Blood samples were collected before and after two cycles of chemotherapy. Real-time quantitative RT-PCR was used for transcript quantification of the glyceraldehyde-3-phosphate dehydrogenase gene. RESULTS: The pre chemotherapy values (Response group 41.36+/-1.72 vs. Non-response group 41.33+/-1.54, p=0.78) and post chemotherapy values (Response group 39.92+/-1.81 vs. Non-response group 40.41+/-1.47, p=0.40) for cell free RNA concentrations, expressed as Ct GAPDH (threshold cycle glyceraldehyde-3-phosphate dehydrogenase gene) levels, was not different between the two groups. There was no significant relationship between changes in the cell free RNA level clinical responses after chemotherapy (p=0.43). CONCLUSION: We did not find a correlation between quantification of serum cell free RNA levels and clinical responses to chemotherapy in patients with lung cancer. Further investigations are needed to determine whether the cell free RNA level is a useful predictor of responses to chemotherapy in patients with lung cancer.
Biomarkers ; Cell Line ; Humans ; Lung ; Lung Neoplasms ; Nucleic Acids ; Oxidoreductases ; Pilot Projects ; RNA ; Small Cell Lung Carcinoma