Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one(26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.
Antineoplastic Combined Chemotherapy Protocols ; Cooking ; Counseling ; Cytarabine ; Diet ; Eating ; Etoposide ; Food Services ; Hospitals, General ; Humans ; Inpatients ; Length of Stay ; Malnutrition ; Meals ; Methotrexate ; Quality Improvement ; Seasons ; Weights and Measures

The management of fractures of os calcis remains highly controversial. The fractures involving subtalar joint may cause serious and persistent disabilities. Recently, the computed tomography (CT) scan has been shown to he superior in evaluating the intraarticular fractures of calcaneus and the most widely used classification is based on the number of fragments especially seen on. Although the classification of calcaneal fractures hy CT, tongue type and joint depression type fractures hy plain radiographic views have been commonly used. Generally, closed reduction and axial fixation with metallic pin for tongue type fractures and open reduction and internal fixation for joint depression type fractures have been performed. The authors did so. The 13 fractures were tongue types and 17 fractures were joint depression types. The intraarticular calcaneal fractures of 30 feet in 26 patients who were treated at Our Lady of Mercy Hospital were analyzed in clinical and radiological aspects from Mar.1991 to Apr.1996. The results were as follows: 1. Of 30 cases, 16 fractures were treated with closed reduction and pinning, and 14 fractures were treated with open reduction and internal fixation. 2. The preoperative, postoperative and the last follow-up average Bohlers angle were 6.0, 21.0 and 20.5 respectively. 3. The preoperative, postoperative and the last follow-up average Gissanes angle was 106, 129 and 126 respectively. 4. Based on assessment of the criteria of Salama et al 19), excellent results were 5, good results were 14, fair results were 6 and poor results were 5. 5. All the five cases of poor results were tongue type fractures and they were treated with closed reduction and axial pinning. 6. Of 7 fractures using autogenous iliac bone graft, 6 fractures were good, I fracture was fair and there was no poor results. Therefore, open reduction and internal fixation for joint depression type calcaneal fractures was thought to be a good method of treatment. But we must consider whether axial fixation with metallic pin for tongue type calcaneal fractures will be a good method of treatment.
Calcaneus ; Classification ; Depression ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tongue ; Transplants

This study was performed to improve the hospital food service in quality and customer satisfaction by using 6-sigma strategy which was processed by DMAIC methods. The research procedure was as follows; analyzing the main causes of customer dissatisfaction of food service by using numerical method, and then finding out the standardized problem solving methods, and finally reforming food service process. The effectiveness of 6-sigma activity was measured by 'food service quality index', 'customer satisfaction index' and 'total food service satisfaction index'. Food service quality index was calculated by adding grade of soup temperature, food service, delivery time, and setting accuracy. Statistical data analyses were completed by using the Minitab Ver. 14. By performing 6 sigma activity, food service quality index was increased from 67 to 79 points (p<0.05) and customer satisfaction index also rise from 73 to 79points (p<0.05). Satisfaction of meals' taste, diverse menu, food setting accuracy, remove of food service, overall food service were significantly improved(p<0.05). The results of capability analysis in food service quality index, customer satisfaction index, and total food service satisfaction index were improved 2.11sigma to 2.49sigma , 1.88sigma to 2.43sigma, and 2.04sigma to 2.47sigma respectively (p<0.05). Therefore this study showed that subjective food service improving process could be measured by objective numerical value which might be used for financial value in hospital management.
Data Interpretation, Statistical ; Food Service, Hospital* ; Food Services ; Problem Solving

Degenerative lumbar spondylolisthesis requires fusion of the involved segments and decompression laminectomy because it is mechanically unstahle and usually associated with stenosis of the spinal canal. Transabdominal retroperitoneal approach through small longitudinal pararectal skin incision provides easy and safe access to L3-4 and L4-5 disc spaces with less bleeding. We thought that anterior interbody fusion enable us to restore the disc space and to reduce partially the listhesis with less hleeding and less harvest of graft hone compared to posterolateral fusion, and also without the risk of neural or dural damage which could he occurred in posterior lumbar interbody fusion 4.15.16.17). Thus, authors performed the same-day anterior and posterior spinal surgery (APSS) in 28 patients (30 disc spaces) from 1992 to 1996 and analyzed the clinical and radiological results. The most common site of involvement was L4-5 level (82.1%). The mean follow-up period was 2 years and 2 months (from l2 months to 4 years). Fusion was ohtained at 29 disc spaces (96.7%) within 24 weeks (average, I 6 weeks). The anterior displacement was corrected up to the average of 65.4% (5.8mm) postoperatively and the average of 60.7% (5.2mm) correction remained at last follow-up. The intervertebral disc space was restored up to the average of 96.9% (7.5mm) postoperatively and the average of 86.0% (6.2mm) restoration remained at last follow-up. Twenty-five out of 28 patients (89.2%) showed excellent or good clinical results hy the criteria of Kim, et al6). In conclusion, the same-day procedure of successive anterior interbody fusion, decompression laminectomy and posterior pedicular instrumentation for the degenerative lumbar spondylolisthesis associated with spinal stenosis was thought to be a good method of treatment.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Hemorrhage ; Humans ; Intervertebral Disc ; Laminectomy ; Skin ; Spinal Canal ; Spinal Stenosis ; Spondylolisthesis* ; Transplants

The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).
Humans ; Incisor ; Osseointegration ; Survival Rate

OBJECTIVE: To evaluate the types and severity of subcortical aphasia after stroke and to determine the predictors of the degree of aphasic impairment. METHODS: Medical records of 38 patients with post-stroke subcortical aphasia (19 males; mean age, 61.7±13.8 years) were reviewed retrospectively with respect to the following tests: the Korean version of the Western Aphasia Battery (K-WAB), the Korean version of the Modified Barthel Index (K-MBI), and the Fugl-Meyer Index (FMI). The severity of aphasia was evaluated by the aphasia quotient (AQ) and the language quotient (LQ). RESULTS: Anomic aphasia was the most frequent type of aphasia (n=15, 39.5%), and the lesion most frequently observed in subcortical aphasia was located in the basal ganglia (n=19, 50.0%). Patients with lesions in the basal ganglia exhibited the lowest scores on the FMI for the upper extremities (p=0.04). Severity of aphasia was significantly correlated with the K-MBI (Pearson correlation coefficient: γ=0.45, p=0.01 for AQ and γ=0.53, p=0.01 for LQ) and FMI scores for the lower extremities (γ=0.43, p=0.03 for AQ and γ=0.49, p=0.05 for LQ). In a multivariate logistic regression analysis, K-MBI remained the only explanatory variable closely associated with aphasia severity. CONCLUSION: This study showed the general characteristics of post-stroke subcortical aphasia, and it revealed that K-MBI was an associated and explanatory factor for aphasia severity.
Anomia ; Aphasia* ; Basal Ganglia ; Cerebrovascular Disorders ; Humans ; Language Tests ; Logistic Models ; Lower Extremity ; Male ; Medical Records ; Retrospective Studies ; Stroke* ; Upper Extremity

The present study was undertaken to investigate the infection status of Cryptosporidium parvum in the villagers and the reservoir hosts in several rural areas in Korea. A total 5, 262 fecal samples were collected from the inhabitants residing at Gangwon-do, Chungcheongbuk-do, Jeollanam-do, and Gyeongsangnam-do between the dates of September, 2001 to June, 2002. In addition, 1, 453 fecal samples were collected from livestock reared in Gokseong-gun, Jeollanam-do and Chungju-si, Chungcheongbuk-do. All the fecal smears were prepared by formalin-ether sedimentation, and examined by light microscopy after modified acid-fast staining. The overall positive rate of human cryptosporidiosis was 3.3%. Gokseong-gun, Jeollanam-do showed a 8.2% positive rate and appeared as the highest endemic area among the surveyed areas. Haman-gun, Gyeongsangnam-do showed a 0.4% positive rate and was the lowest endemic area. The positive rate of livestock infection in Gokseong-gun, Jeollanam-do was 94%, which was more than ten times higher than that of Chungju-si, Chungcheongbuk-do (9.3%). From these results, it was revealed that cryptosporidiosis was an endemic disease in some rural areas of Korea, and the livestock could be an important source of human infection.
Adolescent ; Adult ; Age Distribution ; Aged ; Animals ; Animals, Domestic/*parasitology ; Cattle ; Cattle Diseases/*epidemiology/parasitology ; Child ; Child, Preschool ; Cryptosporidiosis/*epidemiology/parasitology/veterinary ; Cryptosporidium parvum/*isolation & purification ; Feces/parasitology ; Female ; Human ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Prevalence ; *Rural Population ; Support, Non-U.S. Gov't ; Swine ; Swine Diseases/*epidemiology/parasitology

PURPOSE: This study was performed to assess the clinical and epidemiological changes after the introduction of the rotavirus vaccine in Korea, as well as to determine the efficacy of the rotavirus vaccine among hospitalized rotaviral gastroenteritis patients over the past two years. METHODS: We analyzed yearly and seasonal patterns of 1,165 inpatients who were hospitalized for rotaviral gastroenteritis under the age of 5 years between 2006 and 2013. We also conducted a survey among 460 gastroenteritis patients who were hospitalized between 2012 and 2013 regarding the rotavirus vaccination and the symptoms of gastroenteritis. Among those individuals surveyed, clinical indices were analyzed for 124 patients who were tested positive for the rotavirus antigen. RESULTS: The incidence of Rotaviral gastroenteritis have decreased significantly by year 2010. After the introduction and widespread dissemination of the rotavirus vaccine, the onset of the disease and the seasonal peak have been delayed. Overall, the vaccinated group showed a lower rate of positivity than the unvaccinated group. Among the hospitalized rotaviral gastroenteritis patients, the vaccinated group had a shorter hospitalization period, less severe clinical symptoms of gastroenteritis, and better laboratory test results. CONCLUSIONS: After introduction of the rotavirus vaccine in Korea, there were two main trends observed: 1) the overall level of disease incidence was reduced; 2) the severity of rotaviral gastroenteritis cases also decreased. Based on this data, more children should receive vaccination in order to prevent the rotavirus infection and decrease the severity of rotaviral gastroenteritis.
Child ; Epidemiologic Studies* ; Epidemiology ; Gastroenteritis* ; Hospitalization ; Humans ; Incidence ; Inpatients ; Korea ; Rotavirus Infections ; Rotavirus* ; Seasons ; Vaccination

PURPOSE: Tumor necrosis factor (TNF)-alpha is thought to contribute to pulmonary hypertension. We aimed to investigate the effect of infliximab (TNF-alpha antagonist) treatment on pathologic findings and gene expression in a monocrotaline-induced pulmonary hypertension rat model. METHODS: Six-week-old male Sprague-Dawley rats were allocated to 3 groups: control (C), single subcutaneous injection of normal saline (0.1 mL/kg); monocrotaline (M), single subcutaneous injection of monocrotaline (60 mg/kg); and monocrotaline + infliximab (M+I), single subcutaneous injection of monocrotaline plus single subcutaneous injection of infliximab (5 mg/kg). The rats were sacrificed after 1, 5, 7, 14, or 28 days. We examined changes in pathology and gene expression levels of TNF-alpha, endothelin-1 (ET-1), endothelin receptor A (ERA), endothelial nitric oxide synthase (eNOS), matrix metalloproteinase (MMP)2, and tissue inhibitor of matrix metalloproteinase (TIMP). RESULTS: The increase in medial wall thickness of the pulmonary arteriole in the M+I group was significantly lower than that in the M group on day 7 after infliximab treatment (P<0.05). The number of intra-acinar muscular arteries in the M+I group was lower than that in the M group on days 14 and 28 (P<0.05). Expression levels of TNF-alpha, ET-1, ERA, and MMP2 were significantly lower in the M+I group than in the M group on day 5, whereas eNOS and TIMP expressions were late in the M group (day 28). CONCLUSION: Infliximab administration induced early changes in pathological findings and expression levels of TNF-alpha, and MMP2 in a monocrotaline-induced pulmonary hypertension rat model.
Animals ; Antibodies, Monoclonal ; Arteries ; Arterioles ; Endothelin-1 ; Gene Expression ; Humans ; Hypertension, Pulmonary ; Injections, Subcutaneous ; Male ; Monocrotaline ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; Receptors, Endothelin ; Tumor Necrosis Factor-alpha ; Infliximab

OBJECTIVES: This study was conducted to investigate the status and need for nutrition and dietary life education among nutrition teachers at schools. These characteristics were analyzed if they were different between elementary schools and middle-high schools. METHODS: Subjects were 151 nutrition teachers from 70 elementary schools, 41 middle schools and 40 high schools in 17 cities nationwide selected by two-stage stratified cluster sampling process. Survey questionnaires included the items on general characteristics, status and need assessment for nutrition and dietary life education. Chi-square test or t-test was used for data analysis by school groups. RESULTS: Nutrition education was implemented at 65.7% of elementary schools and 51.9% of middle-high schools. Nutrition education was mainly performed in 'discretionary activities·extracurricular activities' at elementary school and through 'newsletters, school homepage, foodservice bulletin board' at middle-high school (p<0.001). The most needed topic for nutrition education in nutrition teachers was 'healthy dietary habits and table manners' and this was not significantly different by school groups. Responses on adequate frequency (p<0.01), methods used for nutrition education (p<001), materials for nutrition education (p<0.001), information sources for nutrition education (p<0.001) were significantly different by school groups. Major tasks for activating nutrition education included 'securing the time for implementing nutrition education by reducing work loads' and 'developing standardized nutrition education materials' in schools. CONCLUSIONS: Nutrition education at schools might be activated by improving working conditions of nutrition teachers and developing the practical programs that reflect the needs of nutrition teachers.
Adolescent ; Child ; Education* ; Food Habits ; Humans ; Needs Assessment ; Statistics as Topic