The purpose of this study was to investigate the performance of elementary school dietitians in terms of nutrition education in the northern portion of Gyeonggi province. Self-administered questionnaires were given to 50 dietitians who have worked in elementary schools with self-operation food service, and 35(70%) dietitians returned the questionnaires. The results are summarized as follows: no students took part in nutrition education as a regular course, but all dietitians performed nutrition education in passive ways, such as 'using home correspondence'(39.0%), 'bulletin board/poster'(22.0%), 'using the internet'(13.4%) and 'indirectly through a classroom teacher'(12.2%). Most respondents performed nutrition education 'one time/month'(66.0%) or 'one time/week'(20.0%). The respondents thought that suitable teaching times for nutrition education were 'during a related subject'(35.5%), 'during lunch time'(22.6%) rather than 'during an independent subject'(16.1%). Most of the dietitians(94.3%) did not perform nutrition counseling because of 'a lack of opportunity'(72.7%) and 'workload'(27.3%). Additionally 88.6% of respondents did not have the time of for nutrition counseling for parents because 'am not a teacher'(56.7%) and 'workload'(30,0%). Information sources for nutrition education were mainly 'internet'(71.4%) and 're-educationa1 materials'(17.1%). They possessed instructional materials in the forms of 'printed materials'(35.1 %), 'exhibition/bulletin board'(31.2%), and 'electrical materials'(33.8%), 'but did not have 'solid materials' such as food models and dolls. Generally they had mostly 'leaflets'(82.9%), 'bulletins'(68.6%), 'internet'(57.1%), and 'CDs'(57.1%). Preferences for instructional materials used were 'printed materials'(46.2%), 'exhibition/bulletin board'(36.5%), and 'electrical materials'(17.3%) 'Leaflets'(80.0%) were mainly used; 'CD'(17.1 %) use was low compared to the proportion possessing CDs. The topics frequently chosen by the subjects for nutrition education were 'table manners'(82.9%), 'basic concepts of food and nutrition'(80.0%), and 'proper food habits'(80.0%), but the topics helpful for practical use, such as 'how much do I eat'(20.0%) and 'nutrition labeling'(37.1%), were not included frequently. The respondents thought that 'eating only what they like'(60.0 %), 'intake of processed foods'(17.8%), and 'obesity'(17.8%) were the most common nutritional problems among elementary school children. They also thought that establishing a regular course for nutrition education was an effective way to cut down on these nutritional problems. In conclusion, nutrition education programs that are combined with effective instructional materials and practical topics should be developed. Additionally, it is recommended that dietitians act as teachers who participate in regular courses as soon as possible.
Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.
Jo, Hyun-Kil;Park, Sung-Min;Kim, Jin-Young;Park, Hye-Mi
Journal of the Korean Institute of Landscape Architecture
/
v.42
no.5
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pp.64-72
/
2014
This study quantified the storage and annual uptake of carbon by apple trees in orchards as a production-type greenspace, and computed the annual carbon emissions from apple cultivation. Tree individuals in the study orchards were sampled to include the range of stem diameter sizes. The study measured biomass for each part including the roots of sample trees through a direct harvesting method to compute total carbon storage per tree. Annual carbon uptake per tree was quantified by analyzing the radial growth rates of stem samples at ground level. Annual carbon emissions from management practices such as pruning, mowing, irrigation, fertilization, and use of pesticides and fungicides were estimated based on maintenance data, interviews with managers, and actual measurements. Regression models were developed using stem diameter at ground level (D) as an independent variable to easily estimate storage and annual uptake of the carbon. Storage and annual uptake of carbon per tree increased as D sizes got larger. Apple trees with D sizes of 10 and 15 cm stored 9.1 and 21.0 kg of carbon and annually sequestered 1.0 and 1.6 kg, respectively. Storage and annual uptake of carbon per unit area in study orchards were 3.81 t/ha and 0.42 t/ha/yr, respectively, and annual carbon emissions were 1.30 t/ha/yr. Thus, the carbon emissions were about 3 times greater than the annual carbon uptake. The study identified management practices to reduce the carbon footprint of production-type greenspace, including efficient uses of water, pesticides, fungicides, and fertilizers. It breaks new ground by including measured biomass of roots and a detailed inventory of carbon emissions.
Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)
This study which applies to the 403 healthy people who don't have particular diseases recently(193 urban aged. 210 rural aged) among male and female aged over 60 years old living in Daegu(city) and Gyungbook(agricultural village) is fulfilled from November 1st to December 31st by interview using the questioned paper which researcher developed, and reached to these tallowing conclusions. 1. Every aged men independent of the place residence answered positively yes but aged women had weak assurance of their health. Especially $38.6\%$ of rural aged women said yes and $51.4\%$ of rural aged women said no. 2. In the sleep and well-regulated life, urban and rural aged generally marked on the sound sleep. Compared with male and female, men answered they had better sleep and regulated life than women. 3. The percentage of the urban and rural aged's judgement on their activity was high and the percentage of the rural aged was lower than the percentage of the urban aged. 4. While $62.6\%$ of urban aged answered they were active. $38.6\%$ of rural female aged answered yes, This shows that the rural female aged regard their health is not good. 5. Compared with same generation. urban aged ranked lower than urban aged in the confidence of physical strength. Especially rural need women answered $42.1\%$ of them were weaker than the same generation. This shows that rural aged women don't have confidence in general physical activities. 6. Taking exercises three times a week which can influence on health cue to sixties and seventies aged ranked $26.1\%$, rarely do is $18.8\%$ and never do is$28.8\%$. Urban and rural aged do not exercise on the purpose of health. 7. The reason of exercise was to advance the physical strength and quality of motion$(34.9\%)$ to get rid of stress$(13.4\%)$ and to prevention of adult illness$(27.8\%)$, prevention of fatness$(15.3\%)$. Aged have a correct understanding that exercise can promote health and protect from the diseases of adult people because the items about the diseases of adult people was marked high. 8. Among the subject of total investigation, 209 persons answered. It showed necessary to recognize that the exercise is still important essential part between adult illness and health care. 9. The $67.7\%$ of urban aged men answered yes in the question of undergoing a physical examination but the rate of not undergoing a physical examination was high in rural aged and urban aged women. According to this, there were the difference of consciousness about health between urban and rural aged. and men and women. 10. Among the people who haying undergone the physical examination, $80.3\%$ of the aged went back to the hospital again because of the result. 11. In the case of stroke, most aged answered the would be placed under medical care. but $53.9\%$ of rural aged women answered they would rely on Chinese medicine. According to this. aged preferred Chinese medicine in some particular diseases. 2. The $58.1\%$ of whole object of this study answered that stroke would be recovered.
Cho, Eun-Young;Park, Young-Shil;Lee, Dae-Hyung;Park, Ji Kyoung;Choi, Sangrhim;Kim, Sun Young;Jang, Pil-Sang;Lee, Dong-Gun;Chung, Nak-Gyun;Kim, Jong-Hyun;Jeong, Dae-Chul;Cho, Bin;Hur, Jae Gyun;Kang, Jin Han;Kim, Hack Ki
Clinical and Experimental Pediatrics
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v.49
no.2
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pp.173-180
/
2006
Purpose : Cytomegalovirus(CMV) infection still remains as a major cause of morbidity and mortality after stem cell transplantation. In this study, we analyzed the results of antigenemia-guided preemptive therapy among children with allogeneic hematopoietic stem cell transplantation to determine the incidence and risk factors associated with CMV antigenemia, and evaluated the efficacy of the CMV antigenemia based preemptive therapy. Methods : We enrolled 213 pediatric patients following allogeneic hematopoietic stem cell transplantation(HSCT), at the Catholic HSCT center between October 1998 and December 2003. Pre-emptive ganciclovir was started when more than 5 CMV Ag-positive cells were detected in matched sibling HSCT, and when any Ag-positive cells were seen in unrelated allogenic HSCT. Results : CMV antigenemia was observed in 88(41.3 percent) of 213 patients on median day 28(day 11-99). In univariated analysis, use of unrelated donors(other than siblings), age of recipient(more than 5 years at transplant) at transplantation, the presence of recipient CMV-IgG before transplantation, TBI-based conditioning regimen and the presence of acute GvHD(grade ${\geq}II$) were the risk factors for positive CMV antigenemia. In multivariate analysis, unrelated bone marrow transplantation, positive recipient CMV serology and acute GvHD(grade ${\geq}II$) were the independent risk factors for positive CMV antigenemia. Conclusion : Risk factors of CMV infection in children were CMV serostatus of the recipient, the source of stem cells, and acute graft-versus-host disease. The pre-emptive therapy based on CMV antigenemia was effective in the prevention of CMV disease.
This study is the conditions of location according to formed the times in the clan village. The results of this study are as follows ; 1. in the 15th century, the characterestics of the village established residencial place where mountain stream flowed surrounded by the mountain and deep in the mountains with superior quality land. That's because Sa-dae-bu put equal importance on beautiful scenery and practical benefit for living. Stream House provided economical foundation for Sa-dae-bu to be able to keep confucial manners by putting limit their economic status to small medium sized land owner. Topographical condition such as valley or hollow separated from the exterior maintained unification of consanguineous village in self sufficient farming society and held on to independent territory against external to be able to stay away from turbulent days so that they formed residential area of Sa-dae-bu clan. And the valley where flowed clean water was considered as the connection of continuous place where distinctiveness of form in each curve and and factor of calm and dynamic scenery of the clean stream. Scholars in the middle of Chosun Dynasty located in the utopia as place for confucious retirement to study, a place for refinement by combination with the nature or as a way of spacial practice based on Confucious view of nature. 2. in the 16th-l7th century, Most of existing consanguineous villages adopt deep in the mountains for refuge. at that place, upward rank was established by settlement of the ancestor who entered in the village first, the principal was placed in the center of the village and since descendants became numerous, it was serialized as the space of descendants. So, it was arranged in the order of social rank. Most of the villages showed development step by step started from precaution by apperance of the mountain to the lower part. It's because the topography of valley around the village worked as the natural hedge against external force and genealogy of the clan, regularity of social status, order of entrance into the village were reflected into residencial destribution. Also, order of the rank coincided with the one of aspects on geomancy. Genealogical rank within the village represented spacial rank. Houses of descendants and branch families were placed lower than the principal which showed worship to the principal. 3. In 18th century after, as the village was settled nearby cultivated land considering economical loss caused by long distance between residencial area and cultivated land, direction of sect followed by development of village expanded from the front part of the village to the rear part. The principal that was poped out to the front presented frontage over exterior. Therefore, residencial area of branch families expanded to the rear starting from the principal. This represented a slice of social structure at that time. after 18th century, spirit was percieved superior over material, After then, development of cultivation and expantion of land created difference of economic strength within one village. In order to maintain and show off the status of Yang-ban, economic power of indigenous land owner became fundamental, so, sense to worship and to keep the principal became weak eventually. Taking advantage of that situation, residencial area of branch family expanded to the rear part of the principal which showed dual disposition conflicted with each other. However, these clan rules were destroyed and new rules were created after 18th century because of the situation and consciousness at that time.
Cystic fibrosis transmembrane conductance regulator (CFTR) gene and sodium-independent $Cl^-/HCO_3^-$ anion exchanger (AE) genes are expressed in a wide variety of mammalian tissues including cholangiocytes. They play an important role in the regulation of intracellular pH (pHi) as well as in transepithelial acid/base transport necessary for biliary bicarbonate secretion. The aim of this study was to examine the expression level of CFTR gene and AE genes (AE1, AE2 and AE3) in the cholangiocytes and the hepatocytes, and also measure AE2 gene expression level after bile duct ligation (BDL). As we previously described, isolated hepatocytes and cholangiocytes from the liver of normal and BDL rats were prepared and gene expression levels were measured by using RT-PCR. We found that AE1, AE2, and AE3 genes were expressed in both hepatocytes and cholangiocytes, but CFTR was only in cholangiocytes. AE2 gene expression level was higher in the BDL hepatocytes than normal hepatocytes, which was significantly different between two groups. AE2 gene expression level was lower in the BDL cholangiocytes than normal cholangiocytes. However, AE2 gene expression level in both hepatocytes and cholangiocytes were not changed with a longer duration of BDL. These results suggest that CFTR and AE2 may play an important role in the pathogenetic mechanism of biliary cholestatic liver disease.
Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.
Purpose: Peritoneal lavage cytology is regarded as a useful diagnostic test for detecting intraperitoneal micrometastsis. However, there are currently no reports about cytological examination with $ThinPrep^{(R)}$ (CY), a newly introduced fluid-based diagnostic system, in patients with advanced gastric cancer (AGC). This study was performed to analyze the clinical significance of intraoperative peritoneal lavage for CY in AGC patients. Materials and Methods: 424 AGC patients were suspected to have serosal exposure macroscopically during surgery and they underwent intraoperative peritoneal lavage for CY between 2001 and 2006 at Korea Cancer Center Hospital. The clinical data, pathological data and CY results were collected and analyzed retrospectively. Results: The percentage of cytology positive results was 31.1%, and this was well correlated with the T-stage, N-stage and P-stage. The 3-year survival rates of CY0 and CY1 were 68.1% and 25.9%, respectively. According to the P-stage and CY, the 3-year survival rates were 71.1% in P0CY0, 38.9% in P0CY1, 38.5% in P1/2/3CY0 and 11.0% in P1/2/3CY1. Interestingly, both the P0CY1 and P1/2/3CY0 survival curves were similar figures, but they were significantly different from those of the other groups. Multivariate analysis indicated that CY was an independent, strong prognostic factor for survival, as well as sex, the T-stage, N-stage, P-stage, other metastasis and the serum CEA. CY1 was revealed as a risk factor for peritoneal recurrence in the curative resection group. Conclusion: The results certify indirectly that cytological examination using $ThinPrep^{(R)}$ is a very reliable diagnostic method for detecting intraperitoneal micrometastasis from the fact that it is not only a strong prognostic factor, but it is also a risk factor for peritoneal recurrence in AGC patients. Therefore intraoperative peritoneal lavage should be included in the routine intraoperative staging workup for AGC, and its result will provide a good target for the treatment of peritoneal micrometastasis.
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