Purpose: The 2020 Dietary Reference Intakes for Koreans (KDRIs) serves as a foundation for daily nutrient and energy recommendations aiming to enhance public health and prevent chronic diseases. They act as guidelines for maintaining proper nutrition and overall health.Using KDRIs is crucial for promoting healthier lifestyles and making informed dietary choices. Thus, this study explores the influence of a nutrition education program, based on the 2020 KDRIs, on the nutrition knowledge and dietary habits of undergraduates in Gyeongsangnam-do and Gyeonggi-do. Methods: The nutrition education program, designed with diverse instructional materials, was executed across a wide range of universities. The education group (n = 75) engaged in the program for a 6-week instructional period, while the control group (n = 53) underwent the survey without participating in the education program. Nutrition Quotient (NQ) and knowledge assessments were administered to both groups immediately before and after the instructional period. Results: Within the education group, the nutrition education program positively impacted responses to NQ practice items, including knowledge of nutrition, daily intake, and portion sizes (p < 0.05). In contrast, there were no significant differences between the before and after responses of the control group for most survey items. Post-program evaluations showed significantly higher self-assessment scores and increased satisfaction levels (p < 0.05), with the satisfaction rate for the education program using the 2020 KDRIs reaching 99.2%. Conclusion This study has demonstrated the positive impact of an effective nutrition education program. However, there is a need for the continuous development and implementation of nutrition education programs to sustain these outcomes and further enhance the nutritional education experience.

The recommended meal composition allows the general people to organize meals using the number of intakes of foods from each of six food groups (grains, meat·fish·eggs·beans, vegetables, fruits, milk·dairy products and oils·sugars) to meet Dietary Reference Intakes for Koreans (KDRIs) without calculating complex nutritional values. Through an integrated analysis of data from the 6th to 7th Korean National Health and Nutrition Examination Surveys (2013–2018), representative foods for each food group were selected, and the amounts of representative foods per person were derived based on energy. Based on the EER by age and gender from the KDRIs, a total of 12 kinds of diets were suggested by differentiating meal compositions by age (aged 1–2, 3–5, 6–11, 12–18, 19–64, 65–74 and ≥ 75 years) and gender.The 2020 Food Balance Wheel included the 6th food group of oils and sugars to raise public awareness and avoid confusion in the practical utilization of the model by industries or individuals in reducing the consistent increasing intakes of oils and sugars. To promote the everyday use of the Food Balance Wheel and recommended meal compositions among the general public, the poster of the Food Balance Wheel was created in five languages (Korean, English, Japanese, Vietnamese and Chinese) along with card news. A survey was conducted to provide a basis for categorizing nutritional problems by life cycles and developing customized web-based messages to the public. Based on survey results two types of card news were produced for the general public and youth. Additionally, the educational program was developed through a series of processes, such as prioritization of educational topics, setting educational goals for each stage, creation of a detailed educational system chart and teachinglearning plans for the development of educational materials and media.

Background and Objectives: Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure. However, in pediatric and congenital heart disease (CHD) patients, current adult indications cannot be directly applied because of heterogeneity in anatomy and diagnosis. Therefore, CRT responses and clinical outcomes in these patients were investigated to derive possible candidates for CRT. Methods: This study retrospectively analyzed 16 pediatric and CHD patients who underwent CRT implantation at a single center in early (0.7±0.2 year) and late (4.7±0.3 years) follow-up period after CRT. Results: The median age at CRT implantation was 2.5 (0.3–37.2) years, and median follow-up duration was 6.3 (0.1–13.6) years. Thirteen had non-transvenous CRT. Two had congenital complete atrioventricular (AV) block with previous right ventricular pacing, 5 had dilated cardiomyopathy (DCM) with left bundle branch block, and 9 had CHD. The mean ejection fraction of the systemic ventricle increased from 28.1±10.0% to 44.3±21.0% (p=0.003) in early and 51.8±16.3% (p=0.012) in late outcome. The mean functional class improved from 3.1±0.9 to 1.8±1.1 after CRT (p=0.003). Twelve patients (75%) showed improvement in ventricular function or functional class after CRT. Proportion of responders differed between patients without CHD (2/2 patients with complete AV block and 5/5 with DCM, 100%) and those with CHD (5/9, 56%), although statistical significance was not reached (p=0.088). Conclusions CRT improved ventricular function and functional status according to the underlying condition in pediatric and CHD patients. However, further large and longer-term studies are needed to establish the guideline for the patient selection of CRT in these patients.

Infantile cortical hyperostosis, or Caffey's disease, usually presents with typical radiological features of soft tissue swelling and cortical thickening of the underlying bone. The disease can be fatal when it presents antenatally, especially before a gestational age of 35 weeks. This fatal, premature form of the disease is known to occur in various ethnic groups around the globe, and approximately 30 cases have been reported in English literature. This paper is unique in that it is the first paper to report a lethal form of prenatal-type infantile cortical hyperostosis diagnosed in South Korea. Born at gestational age of 27 weeks and 4 days, the patient had typical features of polyhydramnios, anasarca, hyperostosis of multiple bones, micrognathia, pulmonary hypoplasia, and hepatomegaly. The patient was hypotonic, and due to pulmonary hypoplasia and persistent pulmonary hypertension, had to be supported with high frequency ventilation throughout the entire hospital course. Due to the disease entity itself, as well as prolonged parenteral nutrition, liver failure progressed, and the patient expired on day 38 when uncontrolled septic shock was superimposed. The chromosome karyotype of the patient was normal, 46, XX, and COL1A1 gene mutation was not detected.
Edema ; Ethnic Groups ; Gestational Age ; Hepatomegaly ; High-Frequency Ventilation ; Humans ; Hyperostosis ; Hyperostosis, Cortical, Congenital ; Hypertension, Pulmonary ; Infant, Newborn ; Infant, Premature ; Karyotype ; Korea ; Liver Failure ; Micrognathism ; Parenteral Nutrition ; Polyhydramnios ; Shock, Septic

BACKGROUND: This study aimed to determine the effect of a multidisciplinary approach on the birth rate of fetuses with prenatally diagnosed congenital heart diseases (CHDs). METHODS: Among the fetuses of 724 gravidas who underwent fetal echocardiography in Samsung Medical Center from January 2013 to June 2017, 463 fetuses with normal cardiac structure, arrhythmia or simple left-to-right shunt were excluded, and the remaining 261 were included in the study. The subjects were subdivided into groups based on whether they were consulted multidisciplinarily, that is, consulted simultaneously by pediatric cardiologists, obstetricians and pediatric cardiac surgeons or not. They were also categorized based on the initial fetal echocardiogram results. RESULTS: Among the fetuses in the multidisciplinary group, 64.5% of the fetuses were given birth to, and the proportion was not different from that in the non-multidisciplinary group (68.6%, P = 0.48). The delivery rate in the multidisciplinary consultation group were 69.2% in the transposition of the great arteries group, 63.6% in the tetralogy of Fallot group, 68.8% in the pulmonary atresia or interrupted aortic arch group, 62.5% in the coarctation of aorta group, 60.0% in the atrioventricular septal defect group, 70.0% in the functional single ventricle group, and 55.6% in the hypoplastic left heart syndrome group; there were no significant differences between the 10 echocardiogram groups. However, when the subjects were categorized into Fontan repair group and biventricular repair group, the Fontan repair group showed a significant increase in the likelihood of delivery when a multidisciplinary approach was taken (P = 0.035). CONCLUSION: When a fetus was diagnosed with a CHD where Fontan repair should be considered, a multidisciplinary approach resulted in increased possibility of delivery.
Aorta, Thoracic ; Aortic Coarctation ; Arrhythmias, Cardiac ; Arteries ; Birth Rate ; Echocardiography ; Fetus ; Heart Defects, Congenital ; Heart Diseases ; Hypoplastic Left Heart Syndrome ; Parturition ; Prenatal Diagnosis ; Pulmonary Atresia ; Surgeons ; Tetralogy of Fallot

PURPOSE: Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data. MATERIALS AND METHODS: A total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage. RESULTS: The median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn’t receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132). CONCLUSION: Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.
Adenocarcinoma ; Chemotherapy, Adjuvant* ; Colon* ; Colonic Neoplasms* ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Risk Factors ; Treatment Outcome

OBJECTIVES: The purpose of this study was to evaluate the effect of nutrition education using materials based on social cognitive theory. Education topics focused on improving health-related and dietary self-awareness and behavior capability in adolescents. METHODS: Participants were recruited from a middle school for girls; 67 students (educated group, n=34 and control group, n=33) participated. The education group received 12 lessons in club activity class. Self-administered surveys were conducted for each group before and after the nutrition education program. The questionnaires consisted of variables such as self-efficacy, outcome expectation, outcome expectancy, knowledge, and dietary practices based on the social cognitive theory. Education satisfaction was evaluated using a five-point Likert scale for two sections: a) teaching and learning and b) education results. The data were analyzed using a t-test and Chi Square-test (significance level: p < 0.05). RESULTS: In the education group, post-education, there were significant differences in self-efficacy (p < 0.05), knowledge (p < 0.01), and dietary practices (p < 0.05), whereas outcome expectation and expectancy did not show any significant differences. None of the variables showed any significant differences in the control group. Educational satisfaction scores were 4.38 ± 0.12 (teaching and learning) and 4.14 ± 0.15 (education results). CONCLUSIONS: This study showed that improving adolescent's awareness and behavior capability has a positive effect on their dietary practices. Moreover, this study suggested that a theory-based determinant should be considered to improve dietary behavior among adolescents.
Adolescent ; Education* ; Female* ; Humans ; Learning

BACKGROUND AND OBJECTIVES: It takes considerable time and effort to make decisions about management and follow up for the thyroid cancer. Also there are risks of incorrectness or confusion on the part of thyroid specialists. We developed a thyroid cancer calculator that does automatic thyroid cancer staging, prognosis predicting and suggesting follow-up strategies in order to reduce the burden of thyroid specialists who have to memorize a lot of guidelines and statistics, and to give consistency to the treatment plan. MATERIALS AND METHOD: An automatic thyroid cancer calculator was developed by using a computer program called 'Qt 5.2 version', based on patient demographics, diagnosis, treatment, and follow-up status. This partly cited the history of prior thyroid cancer or other cancer registration, and focused on the specification of differentiated thyroid cancer. RESULTS: The program consisted of survival, recurrence and, dynamic re-stratification with follow-up. The patient registration form consisted of identification number, name and operation date, and patients needed to enter their thyroid cancer status, including clinical and pathologic information after registration. The entered information could be easily accessed in a few seconds. The program helped to update patient's current status, promptly collect data for clinical studies of thyroid cancers and provide better patient care. This program was simple, convenient and time-saving for users as it specifically contained important thyroid cancer items. CONCLUSION: Although this program is still in its primitive stage, the Kosin thyroid calculator reduces the workload of thyroid specialists and prevents the loss of clinical data. Furthermore, it could be a useful tool for the management and research of thyroid cancer.
Demography ; Diagnosis ; Follow-Up Studies* ; Humans ; Neoplasm Staging ; Patient Care ; Prognosis* ; Recurrence ; Specialization ; Thyroid Gland ; Thyroid Neoplasms*

Many surgical methods for the reconstruction of orbital floor fractures have been reported, and theseinclude transorbital, transantral and transnasal endoscopic approaches, among others. The choice of surgical approach and materials for the reduction of orbital blowout fractures depends on the surgeon's experience and preference. For the cases of large orbital floor fractures, reduction has beenperformed most frequently through the transantral approach, and the herniated orbital tissue generally has been supported by asilastic block, silastic tube or urethral balloon catheter. However, the transantral approach has significant drawbacks that includethe requirement of removal surgery, displacement of materials, and inflammation of the maxillary sinus. To overcome these negative effects, the authors used fibrin glue tosecure the reduction through the transantral approach in two cases of patients with orbital floor fractures.
Catheters ; Fibrin Tissue Adhesive* ; Humans ; Inflammation ; Maxillary Sinus ; Orbit* ; Orbital Fractures

Papillon-Lefevre syndrome (PLS) is an extremely rare autosomal recessive disorder characterized by palmoplantar keratoderma and periodontitis and occuring with an estimated incidence of 1-4 cases per million. Patients with PLS are highly susceptible to infection. The etiology of an infective susceptibility is unknown; however, an association with defects in neurophil dysfunction, insufficient lymphocyte response to pathogens, defects in monocyte functions and impairment of NK cell cytotoxic function has been suggested. To our knowledge, this is the first case report of atypical maxillary sinusitis accompanied by PLS, and we represent the case with a review of the related literatures.
Humans ; Incidence ; Keratoderma, Palmoplantar ; Killer Cells, Natural ; Lymphocytes ; Maxillary Sinus ; Maxillary Sinusitis ; Monocytes ; Papillon-Lefevre Disease ; Periodontitis