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Clinicopathological Analysis of Glomerulonephritis in Children (소아 사구체신염의 임상 및 병리학적 분석)

  • Park Gwang-Yong;Yoon Hye-Kyoung;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.4-12
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    • 1997
  • Purpose: To evaluate the prevalence and clinical manifestations of various glomerulonephritis (GN) in children, a clinicopathological anlysis of 310 biopsied cases were performed. Method: We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 310 cases diagnosed as glomerulonephritis by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital. Results: 1) Male to female ratio was 1.54:1 and the range of age was from 13 months to 15 years 10 months. 2) Among these, 217 (70.0%) patients were belong to primary GN and 93 (30.0%) patients were belong to secondary GN. As a whole, the most common pathologic diagnosis was minimal change lesion (MC, 32.6%), which was followed by IgA nephropathy (IgAN, 15.8%), $Henoch-Sch\"{o}nlein$ purpura nephritis (HSPN, 13.5%), Poststreptococcal glomerulonephritis (PSAGN, 8.1%). 3) Clinical manifestations of patients were asymptomatic urinary abnormality (43.2%), nephrotic syndrome (41.0%), acute glomerulonephritis (14.2%), chronic glomerulonephritis (1.0%), rapidly progressive glomerulonephritis (0.6%). 4) In primary GN, the most common pathologic diagnosis was MC (46.5%), IgAN (22.6%), thin glomerular basement membrane (GBM) disease (7.8%), membranoproliferative glomerulonephritis (MPGN, 5.5%), mesangial proliferative glomerulonephritis (MesPGN,4.6%), focal segmental glomerulosclerosis (FSGS, 4.6%), membranous nephropathy (MN, 0.9%), sclerosing glomerulonephritis (SCGN, 0.9%), crescentic glomerulonephritis (CreGN, 0.5%) and non-specific glomerulonephritis (NonspGN, 6.0%). 5) Major causes of secondary GN were HSPN (45.2%), PSAGN (26.9%), hepatitis B associated glomerulonephritis (HBGN, 17.2%), lupus nephritis (LN, 6.5%), Alport syndrome (2.2%), hemolytic uremic syndrome (1.0%), fibrillary glomerulonephritis (1.0%) in descending order. Conclusions: There are some differences of the results of clinicopathological stuidies of glomerulonephritis in children because of its different indications of renal biopsy, pathologic classification of renal disease and methods of analysis among investigators. In order to establish more reliable data of incidence and classification of childhood glomerulonephritis in Korea, multicenter cooperative study were necessary.

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Effect of Humidified High Flow CO2 Gas Insufflation on the Coronary Endothelium (가습화한 고유량의 이산화탄소가스 통기가 관상동맥 내피세포층에 미치는 영향)

  • 최재성;김준성;서정욱;김기봉
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.131-138
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    • 2004
  • High-flow gas insufflation to get a bloodless field during off-pump coronary artery bypass may have adverse effects on the coronary endothelium. This study was designed (1) to elucidate the effect of carbon dioxide gas insufflations on the coronary endothelium at different flow rates and (2) to assess the protective effect of humidifcation against the coronary endothelial damage. Material and Method: In nine pigs, the left anterior descending coronary artery (LAD) was exposed after a median sternotomy. The LAD was divided into 4 segments and a coronary arteriotomy was made in each LAD segment in the beating heart. The far distal arteriotomy was exposed to room air for 10 minutes and was harvested as a control. Non-humidified carbon dioxide gas at a continuous flow rate of 5 L/min (Group I), humidified carbon dioxide gas at a continuous flow rate of 5 L/min (Group II), and humidified carbon dioxide gas at a continuous flow rate of 10 L/min (Group III) were insufflated for 10 minutes on each coronary arteriotomy site, respectively. After harvesting the coronary segments, hematoxylin-eosin staining, elastic fiber staining, and immunostaining with a CD34 monoclonal antibody were performed to evaluate the depth of endothelial damage and to count the residual endothelial cells, Result: In all three groups (Group I, II, and III), internal elastic laminae were preserved, however, the endothelial layers were significantly damaged by carbon dioxide gas insufflation. The mean percentages of remaining endothelial cells were 20,9$\pm$16.7%, 39.3$\pm$19.6%, and 6.8$\pm$5.3%, in groups I, II, and III, respectively. The percentages of remaining cells were significantly higher in group II than in groups I and III (p=0.008). The percentages of remaining cells were significantly higher in group I than in group III (p=0.008). Conclusions: The harmful effect of carbon dioxide gas insufflation on the coronary endothelium was dependent on the flow rate. The addition of humidification did not protect the coronary endothelium from denudation injury caused by high flow carbon dioxide gas insufflations.

The Effect of Matrix Metalloproteinase Inhibitor for Left Ventricular Remodeling after Myocardial Infarction in a Rabbit Model (토끼에서 Myocardial Infarction 후 Left Ventricular Remodeling에 대한 Matrix Metalloproteinase의 차단 효과)

  • Kim, Soo-Hyun;Jung, Tae-Eun;Hong, Geu-Ru;Han, Sung-Sae
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.329-340
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    • 2007
  • Background: Matrix Metalloproteinase (MMP) inhibition has emerged as a potential therapeutic strategy for the left ventricular dilatation that occurs after myocardial infarction. This study is designed to evaluate which treatment is better for attenuating the left ventricular remodeling via MMP inhibition 1) during the early, short highly MMP producing period of the initial phase or 2) during most of the period of the initial phase after myocardial infarction. Material and Method: Myocardial infarction was induced by ligation of the left anterior descending coronary artery in rabbits. The experimental group was divided into 3 groups. The myocardial infarction only (MI only) group consisted of 7 cases. The MMP inhibitor administered for 5 days after MI (MMPI 50) group had 6 cases, and these rabbits were given MMP inhibitor for 5 days after myocardial infarction, beginning with the postoperative first day. MMP inhibitor administered for 9 days (MMPI 90) group consisted of 5 cases and these rabbits were given MMPI for 9 days the same manner as above. CG2300 was used as a selective MMPI; this is a potent MMP-2 and -9 inhibitor Two-D echocardiograms were performed on all the groups at the time of preoperative period, the post-operative 1st week, the postoperative 20 week and the postoperative 30 week, and we measured the end-diastolic dimension (EDD), the end-systolic dimension (ESD), and the ejection fraction (EF). Result: The echocardiograms generally showed postoperative left ventricular dilatation in the MI only group. The EDD was increased significantly higher in the postoperative 1 week compared to the preoperative value (p<0.05). The ESD was also increased significantly higher in the postoperative 1st week, the postoperative 20 week and the postoperative 30 week compared to the preoperative value (p<0.05). Left ventricular dilatation was noted to be less In the MMPI 9d group than in the MI only and MMPI 5d groups. In the MMPI 9d group, there was no significant change of EF postoperatively compared to the preoperative period. MMP-2 and MMP-9 were measured from the infarcted myocardial tissue at post-MI 4 weeks by performing western blotting and zymography. The changes the of protein expression and activity of MMP-2 and MMP-9 were not significant in the three MI groups and the normal heart group. Histopathologic examination revealed severe collagen deposition in the MI only group. Collagen accumulation was reduced in both the MMPI groups. The MMPI 9d group revealed an increased number of capillaries. Conclusion: Left ventricular dilatation developed rapidly after, MI from ligation of the coronary artery and MMPI attenuated the ventricular dilatation. The effect of MMPI seemed to have better a result from its usage during most of the period of the initial phase after myocardial infarction. This suggested that increased neovascularization by MMPI may also contribute to attenuation of the left ventricular remodeling.

The Change of Vascular Reactivity in Rat Thoracic Aorta 3 Days after Acute Myocardial Infarction (흰쥐에서 급성심근경색 3일 후 흉부 대동맥 혈관 반응성의 변화)

  • Lee, Sub;Roh, Woon-Seok;Jang, Jae-Seok;Bae, Chi-Hoon;Park, Ki-Sung;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.576-587
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    • 2009
  • Background: The up-regulation of the nitric oxide (NO)-cGMP pathway might be involved in the change of vascular reactivity in rats 3 days after they suffer acute myocardial infarction. However, the underlying mechanism for this has not been clarified. Material and Method: Acute myocardial infarction (AMI) was induced by occluding the left anterior descending coronary artery (LAD) for 30 min (Group AMI), whereas the sham-operated control rats were treated similarly without LAD occlusion (Group SHAM), The concentration-response relationships for phenylephrine (PE), KCl, acetylcholine (Ach) and sodium nitroprusside (SNP) were determined in the endothelium intact E(+) and endothelium denuded E(-) thoracic aortic rings from the rats 3 days after AMI or a SHAM operation. The concentration-response relationships of PE in the E(+) rings from the AMI rats were compared with those relationships in the rings pretreated with nitric oxide synthase (NOS) inhibitor $N{\omega}$-nitro-L-arginine methyl ester (L-NAME) or the cyclooxygenase inhibitor indomethacin. The plasma nitrite/nitrate concentrations were checked via a Griess reaction. The cyclic GMP content in the thoracic aortic rings was measured by radioimmunoassay and the endothelial nitric oxide synthase (eNOS) mRNA expression was assessed by real time PCR. Result: The mean infarct size (%) in the rats with AMI was $21.3{\pm}0.62%$. The heart rate and the systolic and diastolic blood pressure were not significantly changed in the AMI rats. The sensitivity of the contractile response to PE and KCl was significantly decreased in both the E(+) and E(-) aortic rings of the AMI group (p<0.05). L-NAME completely reversed these contractile responses whereas indomethacin did not (p<0.05). Moreover, the sensitivity of the relaxation response to Ach was also significantly decreased in the AMI group (p<0.05). The plasma nitrite and nitrate content (p<0.05), the basal cGMP content (p<0.05) and the eNOS mRNA expression (p=0.056) in the AMI rats were increased as compared with the SHAM group. Conclusion: Our findings indicate that the increased eNOS activity and the up-regulation of the NO-cGMP pathway can be attributed to the decreased contractile or relaxation response in the rat thoracic aorta 3 days after AMI.

A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA) (뇌졸중환자의 자가간호 수준과 가족구성원의 간호요구)

  • Cho Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.239-255
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    • 2000
  • The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

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CHEMICAL DEGRADATION OF LIGHT-CURED DENTAL COMPOSITE RESINS (수종 치과용 광중합형 복합레진의 화학적 분해)

  • Yang, Kuy-Ho;Choi, Nam-Ki;Park, Mi-Ran;Park, Eun-Hae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.403-411
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    • 2001
  • The aim of this study was to evaluate the resistance to degradation of four commercial composite resins in an alkaline solution. The brands studied were Unifil(GC, Japan), Palfique(Tokuyama Japan). Definite$Degussa-H\ddot{u}ls$ AG, Germany). Revolution(Kerr, U.S.A.). Preweighed discs of each brand were exposed 0.1N NaOH solution at $60^{\circ}C$. After 14 days they were removed, neutralized with HCl, washed with water and dried. Resistance to degradation was evaluated on the basis of following parameters: (a) mass loss(%) - determined from pre-and post-exposed specimen weights; (b) Si loss(ppm) - obtained from ICP-AE analysis of solution exposed to specimens; and (c) degradation depth$({\mu}m)$ - measured microscopically (SEM) from polished circular sections of exposed specimens. The results were follows: 1. The mass loss of Unifil was 3.21%, it was the highest of materials. But, there was no significant difference among the materials. 2. The degree of degradation layer depth was $107.69\sim47.40{\mu}m$, the sequence of the degree pf degradation layer depth was in descending order by Unifil, Palfique, Revolution, Definite. There was significant difference among the materials except Palfique and Definite. 3. The Si loss of Paltique was 8940.0ppm, it was the highest. There was significant difference among the materials, except Revolution and Definite(p<0.05). 4. The correlation coefficient between mass loss and degradation depth was relatively high(r = 0.06, p<0.05). 5. There was no significant coefficient correlation between Si loss and mass loss, and/or the degree of degradation layer depth and Si loss. 6. When observed with SEM, destruction of bonding is observed between resin matrix and filler. Above results suggested that the hydrolytic degradation is considered as evaluation factor of composite resins.

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Comparison of food and nutrient intake between weekday and weekend for elementary and middle school students by gender in Busan and some parts of Kyungsangnamdo (부산 및 경상남도 일부 지역 초등학생과 중학생의 성별에 따른 주중과 주말의 식품 및 영양소 섭취 실태 비교)

  • Kim, Mi Jeong
    • Journal of Nutrition and Health
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    • v.46 no.4
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    • pp.332-345
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    • 2013
  • The aim of this study was to evaluate the nutritional status of elementary and middle school students by gender with an emphasis on comparison of nutritional intake between weekday and weekend. Survey construct included one 24-hour diet recall and two diet records, short food frequency questionnaire, and anthropometry. Eating behaviors and nutritional intake were largely different for four groups divided by age and gender: ME, FE, MM, and FM. Frequency of consumption of healthful foods was significantly higher in the ME and FE groups. The highest and lowest scores for frequency of eating with parents were observed in the FE and FM groups, respectively. The amount of consumption of food groups was lower on weekends than on weekdays and this trend was more prominent in elementary schoolers compared with middle schoolers. In terms of food group consumption as well as energy and nutrient intake, the ME group showed the greatest differences between weekday and weekend, followed by FE, MM, and FM, in descending order. A significantly higher amount of potassium, phosphorus, and calcium was consumed on weekdays than on the weekend in the ME and FE groups. The amount of energy and nutrient intake was smallest in the FM group; however, the difference between weekday and weekend was minimal as well. In comparison of the subjects' energy and nutrient intake with their Korean Dietary Reference Intakes values (%KDRI), the MM group showed the most undesirable results for energy, protein, dietary fiber, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin, vitamin $B_6$, calcium, and zinc. Overall, findings indicated that nutritional intake status may differ between weekday and weekend for elementary and middle schoolers by gender, suggesting that youth may benefit from nutritional education programs that stress the impact of gender and weekend effect on their dietary intake.

User's Impacts on Environmental Deteriorations of Trail in Tôkyusan National Park (덕유산(德裕山) 국립공원(國立公園) 등산로(登山路)의 환경훼손(環境毁損)에 대(對)한 이용영향(利用影響))

  • Seo, Byung Soo;Kim, Sei Cheon;Park, Chong Min;Lee, Chang Heon;Lee, Kyu Wan
    • Journal of Korean Society of Forest Science
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    • v.83 no.3
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    • pp.286-298
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    • 1994
  • The object of this study was to examine the user's impacts on the environmental deteriorations of trail at Ticket Office - Paekryunsa (Temple) Hyangch$\hat{o}$kpong - Dongyupryung - Chilyun Fall area in T$\hat{o}$kyusan National Park. Four trails were sampled in the study area according to the amount of users. Then the user's impacts on trail were measured at each trail. The Ticket Office-Paekryunsa trail was the most used district and followed at Paekryunsa-Hyangch$\hat{o}$kpong trail, Hyangch$\hat{o}$kpong-Dongyupryung trail in descending order. Dongyupryung-Chilyun Fall trail is not used by people because of rest rotation system. The entire width of trail was greater at the more heavily used trail. Maximum depth, cross-sectional area loss, and surface texture and roughness of trail were the highest at Paekryunsa-Hyangch$\hat{o}$kpong trail. Soil hardness, soil acidity, soil moisture content, organic matter content, and exchange canon were influenced by trampling. Soil hardness, soil acidity and exchange canon increased in tramples soil, but content of soil moisture and organic matter decreased therein. Environmental deteriorations of trail were significantly influenced by the amount of users and the slope of trail. Bared lands about $2.000m^2$ were appeared by trampling and camping around Hyangch$\hat{o}$kpong. Effects of carrying of rest rotation system for National Park were partly recognized at Dongyupryung-Chilyun Fall trail.

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Objectives and Contents of Basic Medical Sciences in Nursing Education (간호학 교육에서 기초의과학 교과목별 목표와 내용에 대한 연구)

  • 최명애;신기수
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1455-1468
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    • 1999
  • The purpose of this study was to investigate the objectives and contents of basic medical sciences at department of nursing in college of nursing, and junior college of nursing, thus ultimately providing the basic data to standardize the curriculum of the basic medical sciences in nursing education. Seventy eight professors who were in charge of teaching basic medical sciences to at 22 colleges of nursing/ department of nursing, and 20 junior colleges of nursing responded to the questionnaires that consisted of the questions regarding objectives and contents, of basic medical sciences. Based on the description of objectives, the description related to nursing, nurse, nursing science was cathegorized as on objective applicable to nursing science, the description related to medicine or clinical medicine as medical model, the description without description related to medicine was cathegorized as knowledge acquisition. The number of schools corresponding to each category were summerized in descending order. The objectives of basic medical sciences were categorized by concepts and number of schools corresponding to the categorized concept. The findings of the study are as follows ; 1. The subjects of basic medical science identified were physiology, anatomy, biochemistry, pathology, microbiology, and pharmacology in most colleges of nursing and junior colleges. Two colleges of nursing/department of nursing (9.1%) and 19 junior colleges of nursing(95%) did not offer biochemistry, 1 college of nursing /department of nursing(5%) did not offer pathology & pharmacology. 2 junior colleges of nursing (10%) did not offer pharmacology, 1 junior college of nursing(5%) did not offer pathology. The other 1 junior college of nursing did not offer microbiology. 2. Objectives of physiology were to acquire knowledge and understanding on human function in both 6 (50%) colleges and 5 junior colleges. Objectives of anatomy were to acquire knowledge on human structure in both 4 (57%) colleges and 2 (50%) junior colleges; knowledge applicable to nursing sciences in both 3 (42.8%) colleges and 2 (50%) junior colleges. Objectives of biochemistry was to obtain knowledge and understanding on biochemistry, and understanding of basic concepts about biochemistry. Objectives of pathology were to obtain knowledge and understanding on pathology in both 4 (57.1%) colleges and 5(62.5%) junior colleges. Objectives of microbiology were to acquire knowledge and understanding on microbiology in both 5(83.8%) colleges and 6(85.7%) junior colleges. Objectives of pharmacology were to acquire knowledge on pharmacology in both 7(100%) colleges and 8(100%) junior colleges. 3. Contents of physiology in 19 (100%) schools were membrane transport, digestion, circulation, nervous system and respiration. In 16(84.2%) were kidney and muscle, that in 13(68.4%) were endocrine physiology. In 11(57.9%) were introduction and that in 9(47.4%) were structure and function of cells. Contents of anatomy in 11(100%) schools were skeletal system, muscle system, digestive system, circulatory system, concepts regarding human structure. In 10(90.9%) schools were endocrine system and nervous system, and in 5(45.5%) schools were blood, urinary system and cell. Contents of biochemistry in 6(100%) schools were history of biochemistry, body regulating factor, bioenergy, health and nutrition, nutrition of cell, energy production system. In 5(83.3%) schools were metabolism of protein and carbohydrate and enzyme, and in 3(50%) schools were metabolism of energy and fat. Contents of microbiology in 13(100%) schools were environment and influenc of bacteria, virus, G(-) rods, purulent cocci, G(+) rods. In 10 (76.9%) were immunity, diphtheria, enterobacteria, and in 9(69.2%) were spirochete, rickettsia and clamydia, and that in 6(46.2%) were sterilization and disinfection. Contents of pathology in 14(100%) schools were cell injury and adaptation, inflammation, respiratory diseases, circulatory diseases. In 10(71.4%) were neurological disorders, in 8(57.1%) were immunity and disease, and in 7 (50%) were tumor and progressive changes. Contents of pharmacology in 15(100%) were cardivascular drugs, introduction to pharmacology, hypnotics, analgesics, local anesthetics, an ticonvulsants. In 12(80%) were drugs activity on sympathetic and parasympathetic nervous system, and in 11(73%) were sulfa drugs, antibiotics, drug abuse and addiction.

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Perception and Utilization of Food Labeling System of Middle School Students in Gwangju (광주지역 중학생의 식품표시에 대한 인식 및 이용실태)

  • Kim, Yun-Ji;Jeon, Eun-Raye;Yoo, Maeng-Ja;Jung, Lan-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.6
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    • pp.796-806
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    • 2012
  • This study was conducted to investigate dietary attitude, and nutritional knowledge of middle school students in Gwangju and examine their perception and utilization of food labeling systems. The total and mean dietary attitude scores were 75 and 49.47, respectively. The total and mean nutrition knowledge scores were 15 and 10.88, respectively. Girls showed significantly higher nutrition knowledge than boys (p<0.01). Overall, 62.9% of respondents checked food labeling, and there were significant differences in dietary attitudes among groups that did and did not checking labeling (p<0.001), with higher dietary attitude being associated with checking the label. Moreover, higher nutritional knowledge was associated with checking the food label. Individuals who checked the food label considered the expiration date (54.9%), product name (14.4%) and price (10.2%). The main reasons for checking food labeling were (in descending order) to confirm the expiration date (61.6%), determine the ingredients and nutritional information, learn how to store the product, and compare the price and weight with other products. The overall satisfaction with the food labeling system was 16.20 out of 30, and significant differences (p<0.001) were observed among individuals with high, moderate and low dietary attitudes, as indicated by satisfaction scores of 17.54, 16.32 and 14.86, respectively. Individuals with high, moderate and low dietary attitudes had nutritional knowledge scores of 15.79, 16.08, and 17.08 respectively. The overall score for understanding nutrition labeling was 4.71 out of 7, and the understanding differed significantly among groups (p<0.01), with those with moderate food attitudes having the highest score.