This study was carried out to provide the improvable way of foodservice management to dietitian in the elementary schools. For this purpose the serving pattern of food, menu planing, nutrition education, leftover management and difficulties in foodservice were investigated. The survey was conducted through questionnaires, which were collected from 249 dietitions randomly selected in Taejon and Chung Nam. Data were analyzed by SAS program. The main results of this study are as follows. The children in Taejon took foods in the class room(65.7%) and those in Chung Nam in the dinning hall(89.9%)(p<0.01). In menu planning the balance of nutrition(42.6%) was mainly considered and then food preference(19.7%), variety of menus(16.1%), food cost(16.1%), composition of food color, taste and texture(3.2%), skills of food making(1.6%) and the number of students(0.8%). They referred cooking magazines(47.7%), the previous menu(42.2%), children's opinion(7.2%) for planing menu. The insufficiency of implements and devices for food(24.1%) and lack of season's food(20.4%) were indicated as difficulties in their job. 34.5% of dietitians used a standard menu, 79.5% investigated food preference of children, 74.3% evaluated taste of foods before serving, and 80.7% regularly checked leftover. The major reason for leftover was careless of the teacher in charge in Taejon and bad taste of foods nutrition in Chung Nam(p<0.001). 98.5% of them answered that they had the responsibility for nutrition education in elementary school. They had a hard time in relationship with the staffs in school(40.6%) and employees for food(39.8%), and lack of market information(38.2%). To efficiency of dietitian's work can be enhanced by reflecting the results of children's food preference and leftover, by using standard cooking method and proper cooking utensil, and by performing nutrition education for children by themselves.
Child ; Cooking ; Cooking and Eating Utensils ; Daejeon* ; Education ; Food Preferences ; Humans ; Menu Planning ; Nutritionists* ; Surveys and Questionnaires

To investigate the children's food habit, one thousand of children from eleven elementary school food service were randomly selected in Taejon. The survey was conducted by questionnaires and data were analyzed by SAS program. The results are summarized as follows. 1. The average height and weight for the 3th grader are 132.0cm and 29.4kg for boys. 131.2cm and 27.9kg for girls. In the case of the 6th grader the average height and weight are 147.1cm, 41.1kg for male, 148.6cm, 41.0kg for female, repectively. Those values are less than national averages. 2. The third grader eats breakfast more regularly than the sixth grader(p<0.001) and 51.5% of the children answer that they take foods for their health. The third grader has better eating habits than the six grader. This survey shows that the sixth grader eat more cereal, milk and vegetable and the third grader has less fruits than the sixth grader. 49.3% of the total children likes eating food at home, 36.6% eating outsid and 14.1% school meal service. 25.8% of the children reply that they do not eat now foods during school meal service. 82.5% of the total children are willing to eat foods served from school meal service if a teacher explains about the information of foods.
Breakfast ; Edible Grain ; Child* ; Daejeon* ; Eating ; Female ; Food Habits* ; Food Services* ; Fruit ; Humans ; Male ; Meals ; Milk ; Surveys and Questionnaires ; Vegetables

This study was done to provide basic information for nutrition education and meal planning by analyzing children's food preference. For this purpose, 938 children from eleven elementary schools under meal service were randomly selected in Taejon. The survey was conducted by questionnaires, and data were analyzed by SAS program. Children prefered ssalbap to japkogbap and liked kimbap the best among one dish foods. But their most favorite foods were chajangmyun in noodles, miyeokkuk in soups, and chamchichigae in pot stew. Sixth graders like kimchichigae more than third graders. In the case of chims, children like duejigalbichim, sogalbichim, and dalgyalchim. In the jorim, they prefered duejigogi jangjorim, mechurial jangjorim to any other jorims. The preference of bockum, namul, jangachi, and jotgal is generally low. Children's preference is high in fruit, drink, fried food, one dish food and is low in jangachi, namul, bockum. These results suggest that the preference of foods should be fully taken into consideration in school meal service so that they can eat foods with pleasure. Foods, which are low in preference due to the cooking method, should be prepared with new cooking methods developed specifically for children. 'Even though the preference of food is low to the children, the nutritious foods should be utilized in the school menu. Then, the imporatance of food intake must be taught to them through nutrition education.
Child* ; Cooking ; Daejeon* ; Eating ; Education ; Food Preferences* ; Fruit ; Humans ; Meals* ; Pleasure ; Surveys and Questionnaires

BACKGROUND: Succinylcholine is metabolized by plasma cholinesterase (PChE). When it was pretreated by small doses of nondepolarizing muscle relaxants in order to minimize the side effects, there are evidences to be associated with alteration in the duration of action. This study is investigated whether the responses would be related to the enzymatic activities. METHODS: In 21 adult patients, ASA class I or II, PChE levels were measured by the modified Garry method after induction of anesthesia (control value) and at 3, 10, 20 and 30 min following administration of pancuronium 0.1 mg/kg, vecuronium 0.1 mg/kg and atracurium 0.5 mg/kg. Data were expressed as mean (SEM). RESULTS: The levels of PChE were significantly lower (p<0.05) than the control values at 3, 10, 20 and 30 min after given pancuronium as 4764 (270), 4777 (261), 4796 (306) and 4740 (332) IU/L respectively and after given vecuronium as 5004 (341), 5051 (329), 4969 (340) and 4960 (340) IU/L respectively whereas enzyme levels after given atracurium were not significant differences to compare the control values as 5153 (336), 5136 (320) 5124 (312) and 5151 (275) respectively. CONCLUSIONS: The results of present study show that both pancuronium and vecuronium may possibly inhibit PChE activity but this was not affected by atracurium.
Adult ; Anesthesia ; Atracurium* ; Cholinesterases* ; Humans ; Pancuronium* ; Plasma* ; Succinylcholine ; Vecuronium Bromide*

Chronic lymphedema of the penis and scrotum is a rare disease in Korea. Lymphedema can be defined as an accumulation of excessive lymph, proteins, chronic inflammation, edema and fibrosis, secondary to the impairment of the lymph vessels, which can be classified into primary, which is the result of inadequate drainage of lymph caused by agenesis and hypogenesis of lymph vessels, and secondary, which could be due to an obstruction or interruption of the lymphatic system, caused by malignancies, post-operative, post-radiation fibrosis, infection, trauma or excision. The treatment method for a lymphedema of the genitalia is determined by cause, which is crucial to the natural course of the disease. In contrast to a primary lymphedema without soft tissue changes and injury, which could be treated conservatively, surgical excision is the best method to treat a chronic lymphedema with soft tissue changes. In this article, a case of penile and scrotal chronic lymphedema of unknown cause, treated with surgical methods, is reported.
Drainage ; Edema ; Fibrosis ; Genitalia ; Inflammation ; Korea ; Lymphatic System ; Lymphedema* ; Male ; Penis* ; Rare Diseases ; Scrotum* ; Surgical Procedures, Operative

With the rapid aging of the population, Korea introduced public long-term care insurance for older people in 2008. The long-term care insurance was designed as a separate scheme from the national health insurance, with eligibility qualifications and the certification process based on functional disability, benefits and coverage of community-based and institutional care, and a financing structure through multi-party contributions. Delivering appropriate health services to long-term care beneficiaries who manifest a high prevalence of comorbid chronic conditions with rising healthcare costs, however, presents a particular challenge. The lack of coordination between the health and long-term care sectors, limited consideration of physicians' assessments in the certification process, inadequate provision of health services in long-term care facilities, and overlapping and inefficient use of care resources act as barriers to providing comprehensive healthcare for older beneficiaries. Through active participation in the long-term care system, health professionals can help older patients navigate through the complex long-term care terrain to obtain quality healthcare.
Aged ; Aged, 80 and over ; Delivery of Health Care/*economics ; Disability Evaluation ; Humans ; Insurance, Long-Term Care/*economics ; Middle Aged ; National Health Programs/economics

The high prevalence of migraine. Raynaud's phenomenon, visual field defect and Crohn's disease in variant angina raises the possibility that a common underlying defect of mechanism may partially account for all conditions. These are generalized vascular smooth muscle hypercontractility syndromes. Recently high prevalence of esophageal motility disorders has been noted in patients with coronary artery spasm or microvascular angina, leading to the hypothesis of a generalized abnormality in smooth muscle function1,4,5). We expirienced a case of 55-year-old man with angiographically proven variant angina. Who showed reflux esophagitis, classic migraine and Raynaud's disease.
Coronary Vessels ; Crohn Disease ; Esophageal Motility Disorders ; Esophagitis, Peptic* ; Humans ; Microvascular Angina ; Middle Aged ; Migraine Disorders ; Migraine with Aura* ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Prevalence ; Raynaud Disease* ; Spasm ; Visual Fields

BACKGROUND: Segmental thoracic epidural anesthesia (sTEA) is commonly used for postoperative pain control in chest or upper abdominal surgery. But it is not commonly used for the purpose of pure regional anesthesia. Therefore we investigated the usefulness of sTEA for mastectomy and evaluated the effects of sTEA on respiration and hemodynamics. METHODS: Twenty patients scheduled for mastectomy were randomly assigned. Under sitting position, epidural catheter was inserted at T3-4 or T4-5. 20 ml of 0.375% ropivacaine with fentanyl 50 microg was injected to maintain anesthesia. The targeted sensory anesthetic dermatomal levels were determined by pinprick and measured at 5 min intervals for the first 15 min after injection of the drugs. If sensory block was not adequate, subsequent 5 ml doses of ropivacaine was injected. Supplemental oxygen (3-6 L/min) was administered through a face mask. After dermatomal level was checked, propofol infusion for sedation was started. Arterial blood sampling was taken for ABGA. RESULTS: Average sensory anesthetic dermatomal levels is C5.5 +/- 1.9 - T8.9 +/- 2.7. During surgery, hypotension was noted in 25% of patients. It was treated with ephedrine 6 mg i.v. Average PaCO2 is 47.9 +/- 7.7 mmHg. CONCLUSIONS: Above results suggest that sTEA is suitable for mastectomy as a method of regional anesthesia.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, Epidural* ; Catheters ; Ephedrine ; Fentanyl ; Hemodynamics ; Humans ; Hypotension ; Masks ; Mastectomy* ; Oxygen ; Pain, Postoperative ; Propofol ; Respiration ; Thorax

There is an evidence that onset time and potency of the non-depolarizing neuromuscular blocking agents are related. However the relationship between onset time and the recovery has not been investigated yet. In this experiment, the onset times of six neuromuscular blocking agents have been compared with their recovery times. The neuromuscular transmission of mivacurium 0.15 mg/kg, atracurium 0.4 mg/kg, vecuronium 0.08 mg/kg, pipecuronium 0.08 mg/kg, pancuronium 0.1 mg/kg and succinylcholine 1 mg/kg were studied in 58 adult healthy patient (ASA I and II) during O2-N2O-isoflurane anesthesia using train-of-four stimulation with Relaxograph. It has been demonstrated that there is a close relationship between onset time and recovery in depolarizing neuromuscular blocking agent but not in non-depolarizing agents. Consequently, it is proposed that the relationships between the onset time and the recovery may hardly expected in clinical practice following systemic administration of non-depolarizing neuromuscular blocking agents.
Adult ; Anesthesia ; Atracurium ; Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Pancuronium ; Pipecuronium ; Succinylcholine ; Vecuronium Bromide

BACKGOUND: The measurement of cardiac output (CO) is an important part of anesthetic practice in patients undergoing major surgery. The thermodilution method (TDM), using a pulmonary artery catheter, is still accepted as the standard procedure. However, the use of the method is associated with several limitations and severe complications. The use of a transesophageal Doppler ultrasound monitor (EDUM; Hemosonic 100(TM)) is less invasive and calculates CO from a simultaneous measurement of blood flow velocity and diameter of the descending aorta. The aim of this study was to compare the cardiac output measured by the use of the TDM and an EDUM. Methods:In 20 patients undergoing major abdominal surgery, CO and other hemodynamic profiles were measured simultaneously by the use of the TDM and an EDUM. RESULTS: The cardiac output, cardiac index, and the systemic vascular resistance monitored by both devices were highly correlated (correlation coefficients range from 0.63 to 0.88). Bland and Altman analysis showed a consistently negative mean bias for an EDUM and the TDM. This finding indicates an overestimation of the hemodynamic profile by the use of an EDUM. CONCLUSIONS: Although Bland and Altman analysis showed a significant bias, the use of an EDUM results in cardiac output, cardiac index, and total systemic vascular resistance measurements that are considerably similar to those obtained using the TDM, and a strong correlation exists for the use of the two methods.
Aorta, Thoracic ; Bias (Epidemiology) ; Blood Flow Velocity ; Cardiac Output* ; Catheters ; Hemodynamics ; Humans ; Pulmonary Artery ; Thermodilution* ; Ultrasonography* ; Vascular Resistance