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

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

OBJECTIVES: Genomic function of vitamin D receptor (VDR) indicates spermatogenesis that is important for in male reproductive organ authors evaluated the VDR expression in seminal vesicles with high cholesterol (HC) formula diet rat, because there is no report about relationship or difference in VDR in seminal vesicles between HC and control. METHODS: Male C57BL/6 mice aged 5 weeks were raised for 13 weeks. After one week of adaptation-period, they were fed different diet on normal AIN-93G diet, or HC diet containing 2% cholesterol for 12 weeks. The antibodies used were rabbit anti-VDR primary polyclonal. RESULTS: There was no significant difference in VDR reactivity in seminal vesicles, body weight of rat and weight of seminal vesicles between HC group and normal control group. CONCLUSION: Our data give the no difference in expression of VDR of seminal vesicles rat between HC formula diet and normal AIN-93G diet. But we confirmed the VDR expression in seminal vesicles.
Animals ; Antibodies ; Body Weight ; Cholesterol* ; Diet ; Humans ; Male ; Mice* ; Rats ; Receptors, Calcitriol* ; Seminal Vesicles* ; Spermatogenesis ; Vitamin D* ; Vitamins*

Revascularization of immature necrotic teeth is a reliable treatment alternative to conventional apexogenesis or apexification. In case 1, a 12-year-old boy had his necrotic, immature mandibular left second premolar treated with a revascularization technique. At a24-month follow-up, periapical radiolucency had disappeared and thickening of the root wall was observed. In cases 2 and 3, a10-year-old boy had his necrotic, immature, bilateral mandibular second premolars treated with the same modality. At 48-month(in case 2) and 42-month (in case 3) follow-ups, loss of periapical radiolucencies and increases in the root wall thickness were also observed.
Apexification ; Bicuspid ; blood supply ; diagnostic imaging ; pathology ; surgery ; Child ; Dental Papilla ; blood supply ; drug effects ; pathology ; Dental Pulp ; blood supply ; drug effects ; pathology ; Dental Pulp Necrosis ; pathology ; therapy ; Follow-Up Studies ; Humans ; Male ; Mandible ; Neovascularization, Physiologic ; Radiography ; Regeneration ; Root Canal Irrigants ; therapeutic use ; Root Canal Therapy ; methods ; Tooth Apex ; blood supply ; diagnostic imaging ; Tooth, Deciduous ; blood supply ; pathology ; Treatment Outcome

Revascularization of immature necrotic teeth is a reliable treatment alternative to conventional apexogenesis or apexification. In case 1, a 12-year-old boy had his necrotic, immature mandibular left second premolar treated with a revascularization technique. At a 24-month follow-up, periapical radiolucency had disappeared and thickening of the root wall was observed. In cases 2 and 3, a 10-year-old boy had his necrotic, immature, bilateral mandibular second premolars treated with the same modality. At 48-month (in case 2) and 42-month (in case 3) follow-ups, loss of periapical radiolucencies and increases in the root wall thickness were also observed.

BACKGROUND: The purpose of this study is to know the healthcare-associated infection (HAI)s in small and medium sized hospitals, less than 400 beds. METHODS: We had web based surveillance for HAIs in 27 hospitals from August to October 2010. The surveillance performed in 1-2 ICUs and 1 general ward in each hospitals by CDC definition. And for the multi-drug resistant organisms (MDROs), we reviewed all of blood culture results. RESULTS: We identified 319 HAIs among 269,436 patients days. The HAIs rate was 1.18 (CI 1.05-1.32)/1,000 patient-days. Urinary tract infection was the most common HAI (52.4%) in this study followed by pneumonia (18.9%), blood-stream infections (14.2%), surgical site infection (7.9%), and others (6.6%). There were 76.5% of device associated infections in UTI, 46.7% in BSI, and 18.3% in pneumonia. The rate of HAIs in ICU was higher than that of in general ward (4.6 vs 0.9/1,000 patient-days). However, the indwelling catheter associated urinary tract infection rate was lower in ICU (2.6 vs 4.4/1,000 device days). There were no significant differences in central line-associated blood stream infection rate (1.5 vs 1.8) and ventilator-associated pneumonia rate (3.0 vs 0.0). The common microorganisms found in HAIs were Escherichia coli (19.8%), Staphylococcus aureus (13.1%), and Pseudomonas aeruginosa (12.7%). Moreover, 90.9% of S. aureus were resistant to methicillin, and 38.2% of P. aeruginosa and 44.4% of Acinetobacter baumannii were resistant to imipenem. Total of 66 MDROs were isolated from blood culture and the result shows that the MRSA was 84.6% (56 case), carbapenmen-resistant Acinetobacter spp. was 10.6% (7 case), and vancomycin-resistant enterococci was 4.6% (3 case). CONCLUSION: The characteristics of HAIs in small and medium sized hospitals will be contributed to the decision making of governance policy for infection control and to provide comparable data for these hospitals.
Acinetobacter ; Acinetobacter baumannii ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Decision Making ; Escherichia coli ; Humans ; Imipenem ; Infection Control ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Patients' Rooms ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas aeruginosa ; Rivers ; Staphylococcus aureus ; Urinary Tract Infections

Colonic diverticulosis is small outpouching from the lumen of the colon, and this caused by mucosal herniation. Most patients are asymptomatic, but 5~15% of those affected manifest diverticular bleeding. Because most of them stop bleeding spontaneously, the source of the bleeding can not be found by colonoscopy in 15% of these cases. We report here on a case of sigmoid diverticular bleeding that detected by capsule endoscopy in a 68-year old woman who presented with acute obscure gastrointestinal bleeding.
Aged ; Capsule Endoscopy* ; Colon ; Colon, Sigmoid* ; Colonoscopy ; Diverticulosis, Colonic ; Female ; Hemorrhage* ; Humans

BACKGROUND: Staphylococcus aureus is a major bacteremia-causing pathogen in hemodialysis patients, frequently colonizing patient skin and mucosa. Active infection control is necessary to prevent methicillin-resistant S. aureus (MRSA) infection in hospitals; however, the spread of community-associated MRSA has recently become a concern for MRSA infection control. We evaluated the nasal colonization of MRSA among hemodialysis patients and the molecular characterization of the MRSA isolates. METHODS: Nasal swabs were obtained from 482 hemodialysis patients in 7 nationwide hospitals in November 2009, and cultured for MRSA colonization. Swabs were inoculated and cultured in 6.5% NaCl tryptic soy broth, then subcultured on MRSASelect medium (Bio-Rad, Hercules, CA) for 20-24 h. Multiplex PCR was performed to analyze staphylococcal cassette chromosome mec (SCCmec) types of MRSA isolates. RESULTS: Of 482 hemodialysis patients, 57 (11.8%) carried MRSA, ranging from 6.7% to 19.0%. Among the 57 MRSA isolates, we identified 3 (5.3%) SCCmec II, 1 (1.8%) SCCmec IIA, 30 (52.6%) SCCmec IIB, 1 (1.8%) SCCmec III, 6 (10.5%) SCCmec IV, and 16 (28.1%) SCCmec IVA subtypes. CONCLUSION: The MRSA carriage rate (11.8%) of hemodialysis patients in this study was high. The SCCmec IIB subtype, a healthcare-associated strain, was the predominant strain, although SCCmec IV isolates, typically found in community-associated MRSA infections, were also frequently observed. To prevent healthcare-associated MRSA infections in hemodialysis patients, standardized infection control measures should be performed, and efforts to reduce MRSA carriage rates should be considered.
Colon* ; Humans ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mucous Membrane ; Multiplex Polymerase Chain Reaction ; Renal Dialysis* ; Skin ; Staphylococcus aureus

A hemodialysis room is the healthcare facility utmost demanding an infection control because dialysis patients have chronic serious underlying conditions and high risks of bloodborne infection due to a indwelling intravascular catheter, a frequent exposure to bloods or body fluids, and a blood transfusion as well as a hemodialysis room can be a mixing vessel to encounter both hospital-acquired pathogens and community-acquird pathogens. Therefore the Korean Society for Nosocomial Infection Control (KOSNIC) purposed to develop a guideline for the infection control in a hemodialysis room with support of Korean Center for Disease Control (KCDC). This guideline was composed of 11 chapters including vascular access control, dialysis water, microbiological and chemical monitoring of dialysis water and dialysates, components and passage of dialysates, maintenance of dialysis machines, disinfection, waste management, infection surveillance, aseptic techniques and standard precaution, environmental control, prevention of bloodborne infections and 5 appendices composing basic infection control techniques. This is the first official guideline approved by KOSNIC and KCDC of the infection control in a hemodialysis room in Korea. Here the guideline was published except appendices and entire guideline including those can be downloaded on hompages of KOSNIC (http://www.kosnic.org/) and KCDC (http//www.cdc.go.kr/).
Blood Transfusion ; Body Fluids ; Catheters ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Delivery of Health Care ; Dialysis ; Dialysis Solutions ; Disinfection ; Glycosaminoglycans ; Humans ; Infection Control ; Korea ; Renal Dialysis ; Waste Management ; Water