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

PURPOSE: To evaluate malignancy risk according to ultrasound (US) features and size change on follow-up US in mixed echoic thyroid nodules and to suggest management guidelines thereof. MATERIALS AND METHODS: Among patients who underwent US-guided fine needle aspiration biopsy, 316 mixed echoic nodules in 303 patients were included after excluding the patients with pure solid or cystic nodules or without further cytopathologic evaluation. We evaluated malignancy risk according to US features and changes in size and shape on follow-up US. RESULTS: The malignancy rate was 31.6% (6 of 19) for nodules with suspicious US features and 2.7% (8 of 297) for nodules without suspicious US features (p<0.001). Among 265 nodules with no suspicious US features and initial benign cytology, 15 nodules with suspicious US change and decreased size, 25 nodules with no suspicious US change and increased size, and 225 nodules with no suspicious US change and no change in size were observed on follow-up USs. The malignancy risk thereof was 0%, 0% and 0.4%, respectively (p=1.000). CONCLUSION: Mixed echoic nodules with no suspicious US features and benign cytology can be followed up using US, as they revealed very low malignancy rates, even if they showed growth on follow-up US.
Adult ; Biopsy, Fine-Needle/methods ; Female ; Humans ; Male ; Middle Aged ; Thyroid Neoplasms/diagnosis/ultrasonography ; Thyroid Nodule/*diagnosis/*ultrasonography

BACKGROUND: This study aims to analyze the effects of insurance types on the medical service uses for heart failure inpatients using propensity score matching (PSM). METHODS: 2014 National inpatient sample based on health insurance claims data was used in the analysis. PSM was applied to control factors influencing the service uses except insurance types. Negative binomial regression was used after PSM to analyze factors that had influences on the service uses among inpatients. Subjects were divided by health insurance type, national health insurance (NHI) and medical aid (MA). Total charges and length of stay were used to represent the medical service uses. Covariance variables in PSM consist of sociodemographic characteristics (gender, age, Elixhauser comorbidity index) and hospital characteristics (hospital types, number of beds, location, number of doctors per 50 beds). These variables were also used as independent variables in negative binomial regression. RESULTS: After the PSM, length of stay showed statistically significant difference on medical uses between insurance types. Negative binomial regression provided that insurance types, Elixhauser comorbidity index, and number of doctors per 50 beds were significant on the length of stay. CONCLUSION: This study provided that the service uses, especially length of stay, were differed by insurance types. Health policy makers will be required to prepare interventions to narrow the gap of the service uses between NHI and MA.
Comorbidity ; Health Policy ; Heart Failure* ; Heart* ; Humans ; Inpatients* ; Insurance* ; Insurance, Health ; Length of Stay ; National Health Programs ; Propensity Score*

In vitro PVR(Proliferative vitreoretinopathy) models allow identification of factor which may inhibit porliferation and contraction. In this study we evaluated the contraction of collagen matrix by choroidal fibroblast and the inhibition of contraction by antipoliferative drug. Each antiproliferative drug showed inhibition of collagen matrix contraction : Colchicine (0.1microgram/ml), Cytochalacin (0.05microgram/ml), Puromycin(10microgram/ml). Transmission electron microgram of collagen matrices containing colchicine, cytochalacin or puromycin showed no collagen fiber surrounding choroid fibroblast and showed cell destruction. Scanning electron microgram of collagen matrices containing colchicine, cytochalacin and puromycin showed that collagen fibers were well preserved without distortion. Colchicine, cytochalacin and puromycin are effective inhibitor of cell mediated contraction in additon to it`s potent antiproliferative effect wherease Interfereon has no anticontractile effect. The current study present a model to investigate the effect of antiproliferative drug on fibroblast mediated collagen matrix contraction.
Choroid ; Colchicine ; Collagen* ; Fibroblasts ; Interferons ; Puromycin ; Vitreoretinopathy, Proliferative

Methotrexate(MTX) is currently one of the most important antineoplastic drugs used in chemotherapy. Intrathecal(IT) MTX is widely used to treat or prevent meningeal leukemia and lymphoma. Aseptic meningitis following IT MTX is not uncommon, but not reported frequently in neurological field. We report a case of aseptic meningitis following IT MTX in acute lymphocytic leukemia.
Antineoplastic Agents ; Drug Therapy ; Leukemia ; Lymphoma ; Meningitis, Aseptic* ; Methotrexate* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

VEP(Visual Evoked Potential) is being widely used as a diagnostic method in amblyopia. In order to assess the visual improvement during occlusion therapy and VEP change between pre and post-occlusion therapy in amblyopia, 32 amblyopic chi1dren ranging from 3 to 13 years old were investigated. The results were as follows: 1. Among 21 cases of visual improvement above 2 lines with Han's visual acuity chart, occlusion therapy was effective in 73.7% of strabismic amblyopia, and 87.5% of anisometropic amblyopia. The mean period of visual improvement above 2 lines was 2.2 months. 2. As compared to non-amblyopic eye, VEP amplitude of amblyopic eye was significantly reduced. 3. There was no statistic significance of P3 latency between amblyopic and non-amblyopic eyes. 4. As compared to control group, the side difference of amblyopic group was significantly increased. 5. With visual improvement above 2 lines, increase of amplitude was revealed 87.5% and decrease of side difference was revealed 87.5% in 10 cases of investigating VEP change. 6. In 7 eyes of visual improvement above 2 lines, change of P2 latency between pre-occlusion and post-occlusion therapy revealed no significance statistically.
Adolescent ; Amblyopia* ; Humans ; Visual Acuity

The purpose of this study was to assess the energy value of breakfast and its relation to total daily nutrient intake and serum lipid. Dietary intakes were evaluated through the 3-day dietary recalls(interview for 1day and self-report for 2 days) from 333 Korean urban adults aged 20-49 year. Serum lipids in fasting blood samples were measured form 98 of those 333 adults. Low energy breakfast(<15% of daily energy intake) was consumed by 22.6% of males and 18.5% of females. 59.4 of males and 43.3% of females consumed a breakfast of average energy intake(15-25% daily energy intake) ; and 18.1 of males and 38.2% of females consumed a significant contribution to a total daily nutrient intake. The daily nutrient intake except crude fiber and vitamin A, B, B, and C in males and except vitamin C in females significantly increased as the energy value of breakfast increased. The differences in energy and nutrient intakes at breakfast were not made up for by other meals. To make matters worse, the satisfactory-energy breakfast group took more energy at dinner compared with the low-energy and average-energy breakfast group took more energy at dinner compared with the low-energy and average-energy breakfast groups in females. Among serum lipid parameters, TG was negatively correlated with energy provided at breakfast, and total cholesterol and LDL-cholesterol had a negative correlation with energy and carbohydrates provided at breakfast in males. For females TG was positively correlated with the ratio of carbohydrates to energy at breakfast but negatively correlated with the ratio of fat to energy at breakfast. These results suggest that satisfactory energy intakes at breakfast have positive effects on the adequacy of daily nutrient intake and may positively affect the serum lipid status.
Adult* ; Ascorbic Acid ; Breakfast* ; Carbohydrates ; Cholesterol ; Fasting ; Female ; Humans ; Male ; Meals ; Vitamin A

Herpes zoster is a viral disease that produces inflammatory lesions in the posterior root ganglia and is characterized clinically by pain and a skin eruption in the distribution of the affected ganglia. Involvement of motor roots or the CNS occurs in a small percentage of the patients. There are few reports about multiple cranial and upper cervical nerve involvement. We report a herpes zoster with multiple cranial(VI, VII, VIII, XII) and upper cervical(C2,3) nerves involvement. The patient was a 79-year-old woman who presented with painful vesicular eruption on left side of face and neck. She complained of decreased hearing and hyperacusis of left ear. Neurologic examination showed decreased taste sensation of left anterior tongue, left facial palsy, and tongue deviation to the left side.
Aged ; Ear ; Facial Paralysis ; Female ; Ganglia ; Hearing ; Herpes Zoster* ; Humans ; Hyperacusis ; Neck ; Neurologic Examination ; Sensation ; Skin ; Tongue ; Virus Diseases

Torsion dystonia (TD) is a clinical syndrome characterized by prolonged spasms of muscle contraction, which distort the body into typical dystonic posture. The pathological or biochemical basis of either the familial types or of most sporadic forms of idiopathic or primary TD is unknown. We present a 40-year old man who showed a kinesigenic axial dystonia with ipsilateral upper extremity atrophy for 14 years. The symptoms and signs were spontaneous onset, nonprogrwsive course, and induced by voluntary activity but relieved by rest and sleep and responded to trihexyphenidyl medication.
Adult ; Atrophy* ; Dystonia Musculorum Deformans ; Dystonia* ; Humans ; Muscle Contraction ; Posture ; Spasm ; Trihexyphenidyl ; Upper Extremity*

Arterial dissection begins with spontaneous or traumatic rent of intima, which sometimes allows blood to penetrate the layers of the arterial wall. Dissections of the craniocervical arteries are separated according to whether they are extracranial or intracranial, spontaneous or traumatic. Dissection of intracranial portions of the carotid system is rare, but it may be one of the important causes of ischemic stroke in the young adults. Cerebral angiography, MRI, and Doppler sonography are important diagnostic methods in this case. Initial treatment with anticoagulants or antiplatelet agents are effective in many cases, but sometimes surgical method is recommended. We presented ischemic infarctions in young men secondary to traumatic and spontaneous intracranial arteries dissection
Anticoagulants ; Arteries* ; Cerebral Angiography ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Male ; Platelet Aggregation Inhibitors ; Stroke ; Young Adult