The purposes of this study were to evaluate the quality of hospital food services in view of patients in orthopedic wards and accomplish the quality improvement in hospital foodservice operations. Quantitative questionnaires for patients containing foodservice satisfaction and demographic information were developed. A survey of 8 general hospitals was undertaken and detailed information was collected from 290 patients in orthopedic wards. The collected data were processed using the SAS PC 6.12 for descriptive analysis, t-test. In demographic information of patients, 32.6% was over 50 years old and 31% was hospitalized over 30 days. 80% of patients was taking normal diet. 47.7% and 47.9% of patients showed moderate appetite and moderate pain respectively. The overall satisfaction score for patients was 3.24 out of 5, showing slightly higher level than the average score(3.00). According to foodservice involvement scores of patients, they were divided into two groups which were high involved group and low involved group. Two groups showed significant differences in taste of meals, variety of menu, punctuality of meal times, temperature of meals and portion size. The foodservice involvement factor which affected significantly patient foodservice satisfaction was 'kindness of foodservice staff'.
Appetite ; Diet ; Food Service, Hospital ; Hospitals, General ; Humans ; Meals ; Middle Aged ; Orthopedics* ; Portion Size ; Quality Improvement ; Surveys and Questionnaires

The purposes of this study were to evaluate the quality of hospital food services in view of patients in orthopedic wards and accomplish the quality improvement in hospital foodservice operations. Quantitative questionnaires for patients containing foodservice satisfaction and demographic information were developed. A survey of 8 general hospitals was undertaken and detailed information was collected from 290 patients in orthopedic wards. The collected data were processed using the SAS PC 6.12 for descriptive analysis, t-test. In demographic information of patients, 32.6% was over 50 years old and 31% was hospitalized over 30 days. 80% of patients was taking normal diet. 47.7% and 47.9% of patients showed moderate appetite and moderate pain respectively. The overall satisfaction score for patients was 3.24 out of 5, showing slightly higher level than the average score(3.00). According to foodservice involvement scores of patients, they were divided into two groups which were high involved group and low involved group. Two groups showed significant differences in taste of meals, variety of menu, punctuality of meal times, temperature of meals and portion size. The foodservice involvement factor which affected significantly patient foodservice satisfaction was 'kindness of foodservice staff'.
Appetite ; Diet ; Food Service, Hospital ; Hospitals, General ; Humans ; Meals ; Middle Aged ; Orthopedics* ; Portion Size ; Quality Improvement ; Surveys and Questionnaires

Objectives: This study is intended to develop a curriculum for kindergarten food and nutrition education aimed at preschool children, reflecting government policy and meeting the demands of preschool settings. Methods: Existing educational materials were analyzed, and key elements of the 2019 Revised Nuri Curriculum (“Nuri Curriculum”) and Guidelines for Nutrition and Food Education in Kindergartens, Elementary, Middle, and High Schools (“Guidelines”) were examined as foundational information for developing the curriculum for food and nutrition education. Results: Basing ourselves on the five domains of the Nuri Curriculum, “Physical Activity and Health,” “Communication,” “Social Relationships,” “Art Experience,” and “Natural Science Inquiry,” we integrated three areas from the Guidelines, namely “Dietary Habits and Health,” “Dietary Habits and Safety,” and “Dietary Habits and Culture,” to structure the curriculum for kindergarten food and nutrition education. Three specific domains, “Nutrition and Health,” “Food and Culture,” and “Safe Dietary Practices,” were tailored for preschool children, each comprising core concepts, content elements, and educational materials. In the “Nutrition and Health” domain, core concepts such as “nutrition” were addressed through content elements such as “balanced eating” and “vegetables and fruit,” while “health” included elements such as “eating regularly” and “nutrients for disease prevention,” each with two educational content components. The “Food and Culture” domain focused on “food” with content on “local foods (vegetable-garden experience)” and “food culture” with content on “our dining table (rice and side dishes),” “our agricultural products,” “global cuisine (multiculture),” and “considerate dietary practices,” each with four educational content components. The “Safe Dietary Practices” domain included core concepts such as “hygiene” with content on “hand-washing habits” and “food poisoning management,” and “safety” with content on “food labeling.” Conclusions The systematized curriculum for kindergarten food and nutrition education aligns with the Nuri Curriculum and is interconnected with the Guidelines. This curriculum can be used as foundational material for developing educational resources tailored to the characteristics of preschoolers, contributing to effective implementation in early childhood education.

OBJECTIVE: Decompressive craniectomy (DC) is a useful surgical method to achieve adequate decompression in hypertensive intracranial patients. This study suggested a new skin incision for DC, and analyzed its efficacy and safety. METHODS: In the retrograde reviews, 15 patients underwent a newly suggested surgical approach using n-shape skin incision technique (Group A) and 23 patients were treated with conventional question mark skin incision technique (Group B). Two groups were compared in the terms of the decompressed area of the craniectomy, protruded brain volume out of the skull layer, the operation time from skin incision to bone flap removal, and modified Rankin Scale (mRS) which was evaluated for 3 months after surgery. RESULTS: The decompressed area of craniectomy (389.1 cm² vs. 318.7 cm², p=0.041) and the protruded brain volume (151.8 cm³ vs. 116.2 cm³, p=0.045) were significantly larger in Group A compared to the area and the volume in Group B. The time interval between skin incision and bone flap removal was much shorter in Group A (23.3 minutes vs. 29.5 minutes, p=0.013). But, the clinical results were similar between 2 groups. Group A showed more favorable outcome proportion (mRS 0-3, 6/15 patients vs. 5/23 patients, p=0.225) and lesser mortality cases proportion 1/15 patients vs. 4/23 patients, but these differences were not significantly observed (p=0.225 and 0.339). CONCLUSION: DC using n-shaped skin incision was a feasible and safe surgical technique. It may be an easier and faster method for the purpose of training neurosurgeons.
Brain ; Decompression ; Decompressive Craniectomy* ; Dermatologic Surgical Procedures ; Humans ; Methods ; Mortality ; Neurosurgeons ; Skin* ; Skull ; Surgical Flaps ; Surgical Procedures, Operative

OBJECTIVE: This study was conducted to investigate survival related factors, as well as to evaluate the effects of early decompression on acute subdural hematoma (ASDH). METHODS: We retrospectively reviewed cases of decompressive craniectomy (DC) for decade. In total, 198 cases of DC involved ASDH were available for review, and 65 cases were excluded due to missing data on onset time and a delayed operation after closed observation with medical care. Finally, 133 cases of DC with ASDH were included in this study, and various factors including the time interval between trauma onset and operation were evaluated. RESULTS: In the present study, survival rate after DC in patients with ASDH was shown to be related to patient age (50 years old, p=0.012), brain compression ratio (p=0.042) and brain stem compression (p=0.020). Sex, preoperative mental status, and time interval between trauma onset and operation were not related with survival rate. Among those that survived (n=78), improvements in Glasgow Coma Scale (GCS) score of more than three points, compared to preoperative measurement, were more frequently observed among the early (less than 3 hours between trauma onset and operation) decompressed cases (p=0.013). However, improvements of more than 4 or 5 points on the GCS were not affected by early decompression. CONCLUSION: Early decompression of ASDH was not correlated with survival rate, but was related with neurological improvement (more than three points on the GCS). Accordingly, early decompression in ASDH, if indicated, may be of particular benefit.
Brain ; Brain Stem ; Decompression* ; Decompressive Craniectomy ; Glasgow Coma Scale ; Hematoma, Subdural, Acute* ; Humans ; Retrospective Studies* ; Survival Rate

Neuropilin 1 (NP1) is a part of essential receptor complexes mediating both semaphorin3A (SEMA3A) and vascular endothelial growth factor (VEGF) which is one of important mediators involved in the pathogenesis of asthma. Therefore, it is possible that SEMA3A plays a role in the pathogenesis of asthma through attenuation of VEGF-mediated effects. In the present study, we aimed to evaluate expression levels of SEMA3A and NP1 using induced sputum of asthmatics and a murine model of asthma. Firstly, SEMA3A and NP1 expressions in induced sputum of asthmatics and SEMA3A and NP1 expression on bronchoalveolar lavage (BAL) cells and lung homogenates of asthmatic mice were determined. Then we evaluated the immunolocalization of VEGF receptor 1 (VEGFR1), VEGF receptor 2 (VEGFR2), and NP1 expressions on asthmatic mice lung tissue and their subcellular distributions using fibroblast and BEAS2B cell lines. Sputum SEMA3A and NP1 expressions were significantly higher in asthmatics than controls. Similarly, SEMA3A and NP1 expressions on BAL cells and lung homogenates were significantly elevated in asthmatic mice compared to control mice. Immunohistochemical analysis showed that VEGFR1, VEGFR2, and NP1 expressions were also uniformly increased in asthmatic mice. Our observations suggest that SEMA3A and NP1 may play important roles in the pathogenesis of asthma.
Animals ; Asthma/metabolism/pathology/*physiopathology ; Bronchoalveolar Lavage Fluid/cytology ; Cell Line ; Disease Models, Animal ; Female ; Fibroblasts/metabolism ; *Gene Expression Regulation ; Immunohistochemistry ; Lung/metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Neuropilin-1/*genetics/metabolism ; Semaphorin-3A/*genetics/metabolism ; Sputum/metabolism ; Vascular Endothelial Growth Factor Receptor-1/metabolism ; Vascular Endothelial Growth Factor Receptor-2/metabolism

The role of alveolar macrophages (AMs) in the pathogenesis of asthma is still unknown. The aim of the present study was to investigate the effects of AM in the murine model of asthma. AMs were selectively depleted by liposomes containing clodronate just before allergen challenges, and changes in inflammatory cells and cytokine concentrations in bronchoalveolar lavage (BAL) fluid were measured. AMs were then adoptively transferred to AM-depleted sensitized mice and changes were measured. Phenotypic changes in AMs were evaluated after in vitro allergen stimulation. AM-depletion after sensitization significantly increased the number of eosinophils and lymphocytes and the concentrations of IL-4, IL-5 and GM-CSF in BAL fluid. These changes were significantly ameliorated only by adoptive transfer of unsensitized AMs, not by sensitized AMs. In addition, in vitro allergen stimulation of AMs resulted in their gaining the ability to produce inflammatory cytokines, such as IL-1beta, IL-6 and TNF-alpha, and losing the ability to suppress GM-CSF concentrations in BAL fluid. These findings suggested that AMs worked probably through GM-CSF-dependent mechanisms, although further confirmatory experiments are needed. Our results indicate that the role of AMs in the context of airway inflammation should be re-examined.
Animals ; Asthma/*immunology ; Bronchoalveolar Lavage Fluid/chemistry/cytology/immunology ; Cytokines/biosynthesis/immunology ; Disease Models, Animal ; Female ; Immunization ; Immunomodulation/*immunology ; Inflammation/*immunology ; Leukocytes/immunology ; Macrophages, Alveolar/*immunology ; Mice ; Mice, Inbred C57BL ; Ovalbumin/immunology

Eosinophils have been reported to modulate T cell responses. Previously, we reported that high-mobility group box 1 protein (HMGB1) played a key role in the pathogenesis of asthma. This study was conducted to test our hypothesis that eosinophils could modulate T cell responses via HMGB1 in the pathogenesis of asthma characterized by eosinophilic airway inflammation. We performed in vitro experiments using eosinophils, dendritic cells (DCs), and CD4+ T cells obtained from a murine model of asthma. The supernatant of the eosinophil culture was found to significantly increase the levels of interleukin (IL)-4 and IL-5 in the supernatant of CD4+ T cells co-cultured with DCs. HMGB1 levels increased in the supernatant of the eosinophil culture stimulated with IL-5. Anti-HMGB1 antibodies significantly attenuated increases of IL-4 and IL-5 levels in the supernatant of CD4+ T cells co-cultured with DCs that were induced by the supernatant of the eosinophil culture. In addition, anti-HMGB1 antibodies significantly attenuated the expressions of activation markers (CD44 and CD69) on CD4+ T cells. Our data suggest that eosinophils modulate CD4+ T cell responses via HMGB1 in the pathogenesis of asthma.
Antibodies ; Asthma* ; Dendritic Cells ; Eosinophils* ; HMGB1 Protein ; Inflammation ; Interleukin-4 ; Interleukin-5 ; Interleukins ; T-Lymphocytes

Objectives: This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness. Methods: An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 transmission and to evaluate vaccine effectiveness. Results: The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facility (<500 m), and the unvaccinated. Age, the distance between religious facility and residences, and the absence of vaccination were identified as risk factors for infection. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%). Conclusion This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.

BACKGROUND/AIMS: Because there is a lack of effective biomarkers, we aimed to discover proteomic candidate markers for hepatocellular carcinoma (HCC) in cirrhotic patients at the highest-risk of HCC, and to validate the markers. METHODS: We collected tumor tissue from 5 cirrhotics with HCC, and from 5 cirrhotics without HCC, who underwent liver resection or transplantation. These tissue samples were analyzed by 2-dimensional difference gel electrophoresis coupled with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and potential markers were validated at the transcriptional and translational levels. We also performed western blot assays using other blood samples from 10 cirrhotics with HCC and 10 without HCC. RESULTS: Among the 66 distinguishable spots on 2-D gel images, we identified 15 proteins overexpressed more than 1.5 fold in terms of volume ratio in the tumors. Ten of the over-expressed proteins were identified by MALDI-TOF MS; of those, only methionine adenosyltransferase 1 (MAT1), a protein specific for liver, and acyl-CoA dehydrogenase were significantly up-regulated in tumors in further immunoblotting analyses (Ps<0.05). There was no between-pair difference in MAT1 mRNA measured by real-time polymerase chain reaction (P=0.96). However, in western blots of serum samples, distinct MAT1 bands were observed in all 10 HCC patients, but in only 2 of the non-HCC patients. CONCLUSIONS: MAT1 is a potential marker for surveillance in cirrhotic patients with and without prior HCC.
Acyl-CoA Dehydrogenase ; Biomarkers ; Blotting, Western ; Carcinoma, Hepatocellular ; Humans ; Immunoblotting ; Liver ; Liver Cirrhosis ; Mass Spectrometry ; Methionine Adenosyltransferase ; Methionine ; Proteomics ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Two-Dimensional Difference Gel Electrophoresis