The introduction of the strong clover-leafed nail combined with the principle of reaming out the medullary canal and the development of image intensifiers has been extended the indications of the in tramedullary nailing. In this report, an attempt was made to introduce the method and to verify the indications and advantage of retrograde intramedullary nailing of humeral shaft fractures, as compared with the conventionally accepted methods.
Fracture Fixation, Intramedullary ; Humerus ; Methods

This research was performed to evaluate the effects of nutrition education on food waste reduction at school food service. A dietitian conducted nutrition education on environmental protection and proper eating attitude and poor eating habits for 3rd and 5th graders at an elementary school in Seoul. The effectiveness of the education was evaluated by surveying the students before and after the education; 375 responses were analyzed. A questionnaire was designed to compare changes of the students' attitudes and plate waste before and after education. Plate wastes of boiled black rice(p<0.05), potato soup(p<0.05), amaranthus herb salad(p<0.01), and cabbage kimchi(p<0.05) decreased significantly after education. Students' eating attitudes improved significantly(t= -6.22, p<0.01) after nutrition education. Major reasons the students did not eat all foods they were served were large portion sizes (30.59%), low menu preference (29.79%), and tastes (17.82%). The menus with high plate waste rates were cooked vegetable items (35.64%) and soup items (26.6%). After education, students' attitudes on 'food waste pollutes the Earth(p=0.013)', 'food preparation for birthday parties(p<0.01)', and 'restaurant selection for eating out (p<0.01)' changed significantly. After education, plate waste and portion sizes that the students perceived were not negatively correlated. In conclusion, nutrition education on proper eating habits and source reduction is an effective method to reduce food waste generation and to improve students' eating attitudes and awareness on environment.
Amaranthus ; Brassica ; Natural Resources ; Eating ; Education* ; Food Services ; Humans ; Nutritionists ; Portion Size ; Surveys and Questionnaires ; Seoul ; Solanum tuberosum ; Vegetables

OBJECTIVES: Electronic detailing (e-detailing), the use of electronic devices to facilitate sales presentations to physicians, has been adopted and expanded in the pharmaceutical industry. To maximize the potential outcome of e-detailing, it is important to understand medical representatives (MRs)' behavior and attitude to e-detailing. This study investigates how information technology devices such as laptop computers and tablet PCs are utilized in pharmaceutical marketing, and it analyzes the factors influencing MRs' intention to use devices. METHODS: This study has adopted and modified the theory of Roger's diffusion of innovation model and the technology acceptance model. To test the model empirically, a questionnaire survey was conducted with 221 MRs who were working in three multinational or eleven domestic pharmaceutical companies in Korea. RESULTS: Overall, 28% and 35% of MRs experienced using laptop computers and tablet PCs in pharmaceutical marketing, respectively. However, the rates were different across different groups of MRs, categorized by age, education level, position, and career. The results showed that MRs' intention to use information technology devices was significantly influenced by perceived usefulness in general. Perceived ease of use, organizational and individual innovativeness, and several MR characteristics were also found to have significant impacts. CONCLUSIONS: This study provides timely information about e-detailing devices to marketing managers and policy makers in the pharmaceutical industry for successful marketing strategy development by understanding the needs of MRs' intention to use information technology. Further in-depth study should be conducted to understand obstacles and limitations and to improve the strategies for better marketing tools.
Administrative Personnel ; Commerce ; Diffusion of Innovation ; Drug Industry ; Education ; Humans ; Intention* ; Korea ; Marketing*

OBJECTIVE: This study was conducted to identify 3 to 5 years of future management issues in hospital information systems (HIS). METHODS: Two rounds of interview surveys were conducted based on the sample survey of 50 managers from 28 hospital information centers utilizing the Delphi method. RESULTS: From the survey, management issues in HIS were identified in the following order: 'top management support', 'close relationship with users', 'PACS', 'disaster recovery', improving IS strategic planning'. Compared with the 1999 survey, the issues that rank within the top 10 management issues were as follows: 'top management support', 'security and control', 'close relationship with users'. Recently surfaced issues are 'disaster recovery' and 'standardization'. The issues that dropped out of the top 10 ranks were 'network management', 'recruiting and developing IS human resource'which were very fundamental issues in the initial state of the introduction of the hospital information system. CONCLUSION: The two main significance of this study involves predicting future management issues based on the comparison of the current issues with the 1999 issues and recommendingmanagement strategies based on the classification of issues by importance and persistence.
Classification ; Hospital Information Systems* ; Humans ; Information Centers

This study compared he importance of food service, views to the performance, management objectives, and recognition gap about the contract contents towards the dietetic departments of hospitals that manage the patients' food service and managers of contract managed companies, and dieticians. It conducted questionnaires and survey towards the vice director and dieticians of 17 hospitals, over 500 beds, and the persons responsible for contract managed companies and dietitians who were in charge of food service. The hospitals showed significantly(p<0.05) higher the importance scores in menu planning, the distribution of meal, sanitation management, and leadership than those of the contract managed companies. In the difference of hospitals and contract managed companies about performance, it appeared high in the contract managed companies. In the importance of the foodservice management objective, the hospital had significantly(p<0.05) higher scores in the management of client's satisfaction and quality improvement element through management innovation than those of the contract managed companies. In the importance of contract term, the contract method, expense, and payment condition of commission fee were significantly(p<0.05) high scores in the contract managed companies, compared to the hospital.
Fees and Charges ; Food Services ; Humans ; Leadership ; Meals ; Menu Planning ; Nutritionists* ; Quality Improvement ; Surveys and Questionnaires ; Sanitation

Serological prenatal screening tests are widely used to detect fetal chromosomal abnormalities such as Down and Edward syndromes. Amniocentesis is conducted as a confirmatory test in the screening-positive case. After discovering of presence of fetal cell-free DNA in maternal blood, non-invasive prenatal test (NIPT) coupled with next generation sequencing are performed in abroad. Results of genomics-based NIPT results supplied to Labgenomics laborotory from June, 2013 to August, 2014 were analyzed. Maternal blood samples were collected into specific Cell-Free DNA BCT tube and were transported. The samples were then delivered to Ariosa Diagnostics by FEDEX. Fetal cell-free DNA samples were analyzed using the Harmony test with sequencing of relevant chromosomes and by using the FORTE (fetal-fraction optimized risk of trisomy evaluation) algorism at Ariosa Diagnostics. In all, 149 cases from 28 medical clinics were analyzed. Six subjects were required recollection of samples because of a low fetal DNA fraction in the initially obtained samples. Of these 6 subjects, no sample could be collected from one. Of the remaining 148 cases, 144 had a low risk of trisomy, and 4 had a high risk for Down syndrome, thus providing a positivity percentage of 2.7%. Fetal DNA fraction in the maternal blood samples ranged from 4.2% to 23.7% with a mean value of 12.0%. We have experienced cases with a high risk for Down syndrome with genomics-based NIPT referred to abroad.
Amniocentesis ; Chromosome Aberrations ; DNA ; Down Syndrome ; Prenatal Diagnosis ; Trisomy

This study was carried out to evaluate the relations among workers' general characteristics, work-related behaviors and health related behaviors in a steel industry with 1,134 workers in Pohang. The results were as follows; 1. The mean age of workers was 50 years old and working duration was 15 years and over. Most of them were married(94 5%) and had studied beyond high school (53.0%). They performed three shift work and most of them(63.0%) had experienced industrial accidents. The frequency of noise and dust exposure was defined by a minimum of 6 hours per day, and workers complained about noise exposure(62.9%) and dust(55.6%). There were current smokers(67.7%), current drinkers(74.3%) and current exercising workers(32.3%) in the industry. The number of cigarette consumption in current drinkers was significantly high (13.6 +/- 8.4 pieces/day) and the alcohol consumption in current smokers was significantly high(l04.5 +/- 113.5 g/wk). And the number of cigarette consumption of exercisers was significantly low and the alcohol consumption of exercisers was higher than non-exercisers. 3. The ratio of current smokers on frequent noise in exposed workers versus non-exposed workers was not significantly high but the current drinkers in frequent noise and dust exposed workers was significantly higher than non--exposed. 4. The normal levels of SGOT workers in non-smokers were significantly higher than in current smokers, and the abnormal levels of LFT(SGOT, SGPT, gamma-GTP workers in nondrinkers were significantly high. The normal levels of SBP and DBP workers in current smokers were not significantly high but were significantly high in non-drinkers. 5. The ratio of current smokers in workers unsatisfied with their job and working condition was higher than non-smokers, but the ratio of current drinkers in workers satisfied with their job and working condition were higher. 6. The significant factors for SGOT and gamma-GTP were age, the drinking amount and BMI. But the only significant factor for r-GTP was BMI. The significant factors for DBP were age, the alcohol consumption and BMI And the significant factors for SBP were age, BMI.
Accidents, Occupational ; Alanine Transaminase ; Alcohol Drinking ; Aspartate Aminotransferases ; Drinking ; Dust ; Gyeongsangbuk-do ; Health Behavior* ; Humans ; Male* ; Middle Aged ; Noise ; Smoking ; Steel* ; Tobacco Products

The study was designed to investigate food waste management practices and to identify factors affecting food waste generation at school food services. A total of 202 dietitians employed at elementary schools participated in the survey. The mean food waste weight per school was 77.54 kg, forty percent of the schools generated food waste of 50~100 kg every day and 53% generated plate waste less than 50 kg. Three quarters of the dietitians perceived plate waste as a major component of the food waste and vegetable dishes were a major source of the plate waste. Half of the dietitians used a food waste pick-up service for waste disposal, which was the most preferred waste disposal method. Approximately 90% of the dietitians conducted education on plate waste reduction for students but their perceptions on the effectiveness of the education was inconsistent. The contents were environmental issues (70.3%) and unbalanced food choice (56.7%). According to factor analysis based on performance score, solid waste management practices were grouped into 'information collecting and education', 'supervision of production process', 'cooperation with related groups', and 'control over production planning'. Practices appertaining to 'cooperation with related groups', 'information collecting and education' factor need to be improved. Dietitians should pay attention to 'recycle and reuse of left over' practice. Waste generation differed significantly by dietitians' ages and working experience. In order to reduce plate waste, more effective education materials and methods need to be developed and support from principals, teachers, and parents is necessary.
Education ; Food Services* ; Humans ; Nutritionists ; Parents ; Solid Waste ; Vegetables ; Waste Management*

OBJECTIVES: This study was performed to investigate the incidence and the clinical significance of inlet patch of heterotopic gastric mucosa in Koreans. This lesion can be found by close observation around the upper esophageal sphincter during upper gastrointestinal endoscopy. METHODS: From March 1, 1996 to July 8, 1996, at Kwak's hospital, randomly selected 271 patients undergoing routine diagnostic upper gastrointestinal endoscopy were included in this study. Patients with the inlet patch were confirmed by histology. Clinical symptoms observed through medical history were recorded. RESULTS: Twenty-six cases(9.6%) of the 271 patients studied had heterotopic gastric mucosa which was found at or just below the upper esophageal sphincter, varing from 3 to 30mm in diameter. It was velvety red in color and distinct from the surrounding normal squamous esophageal mucosa, resembling the Z-line at the esophagogastric junction. Parietal cells were identified in all 18 cases in which biopsy specimen contained deep glands, and chief cells were found in 14 cases. Histologically, fundic gland type was most frequent. The symptoms were relatively mild, 5 out of 6 patients who complained of throat discomfort were relieved by H2 antagonists. CONCLUSION: In Koreans the incidence of heterotopic gastric mucosa in the upper esophagus was similar to the reports from western countries unlike Barrett's esophagus. The etiology of these patches appeared to be congenital rather than acquired from reflux of gastric acid. This was supported by its location in the proximal esophagus and lack of correlation with reflux esophagitis. It must be considered as one of the differential diagnosis of a patient who complains of throat discomfort during diagnostic upper gastrointestinal endoscopy. Attention needs to be paid to find possible development of complications such as stricture and adenocarcinoma in patients with the inlet patch of heterotopic gastric mucosa.
Adenocarcinoma ; Barrett Esophagus ; Bays* ; Biopsy ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Esophageal Sphincter, Upper ; Esophagitis, Peptic ; Esophagogastric Junction ; Esophagus ; Gastric Acid ; Gastric Mucosa* ; Humans ; Incidence* ; Mucous Membrane ; Pharynx ; Rabeprazole

The aim of this study is to appraise the efficacy of both recent therapeutic modalities and the prognosis after the biliary drainage procedure of various biliary diseases. A retrospective review of biliary drainage procedures for biliary disease was done from January 1986 to June 1996. We have experienced 252 cases at Pusan National University Hospital. The results were obtained as follows: 1) The most common age group was the 6th decade, and the ratio of male to female was 1:1.3. 2) Operative procedures consisted of sphincteroplasty in 62 cases(24.6%), choledochoduodenostomy in 63 cases(25%), choledochojejunostomy in 72 cases(28.6%), and choledochojejunostomy with defunctionalized jejunal limb in 55 cases(21.7%). 3) The indications for operative procedures of biliary drainage were as follows: intrahepatic stone in 67 cases(26.6%), dilated CBD with muddy stones in 57 cases(22.6%), CBD stone with stenosis of sphincter in 15 cases(5.9%), recurrent or residual stones in 89 cases(35.3%), and malignant disease in 24 cases(9.6%). 4) The preoperative diagnostic procedures were operative cholangiography, T-tube cholangiogram, ultrasound, ERCP, PTC, and abdominal CT. 5) The postoperative procedures for remaining stones after operation were choledochoscopic extraction, saline irrigation and reoperation. 6) The postoperative complications included wound infection (18 cases, 7.1%), respiratory infection (4 cases, 1.6%), GI trouble (19 cases, 7.5%), cholangitis ( 2 cases, 0.8%), residual stone (25 cases, 11%), pancreatitis ( 1 case, 0.4%), and biliary fistula (5 cases, 1.9%). Recently many therapeutic techniques have contributed to improving biliary drainage. We suggest that an apprapriate operation be selected according to the situation when performing biliary drainage for biliary diseases.
Biliary Fistula ; Busan ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledochostomy ; Constriction, Pathologic ; Drainage* ; Extremities ; Female ; Humans ; Male ; Pancreatitis ; Postoperative Care ; Postoperative Complications ; Prognosis ; Reoperation ; Retrospective Studies ; Surgical Procedures, Operative ; Tomography, X-Ray Computed ; Ultrasonography ; Wound Infection