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

PURPOSE: After the administration of Organ Transplantation Law in Feb. 9. 2000, the number of brain death donation has decreased due to the strictness of donation process, the lack of publicity activities, so the activation of brain death donation issue has arose. Intensive Care Unit (ICU) nurse is the first person that contacts with the brain death donor, the provider of donor care and also the maker of rapport with patient family, accordingly they are considered to be one of the important human resource. The purpose of this study is to analyse the attitude of the brain death donation and the relative factors. METHODS: The subjects were 184 ICU nurses in hospitals, who work in the Neurosurgery and Neurology ICU. RESULTS: (1) The rate of positive attitude about organ donation for the nurses who have the knowledge of enforcement of 'Organ Transplantion Law', the knowledge of first connect point is KONOS (Korean Network for Organ Sharing) and the knowledge of brain death organ donation nursing care, was higher than the others with p=0.050, p=0.029 and p=0.048, respectively. (2) The rate of positive attitude about organ donation for the nurses who experienced the complete process of organ donation, received education on organ donation and transplant, was higher than the others with p=0.007, p=0.043, respectively. The nurses who did not experience brain death organ donation nursing care had higher rate of negative attitude than the others with p=0.022, and for those who have experienced the complete process of organ donation nursing care had a higher negative attitude than others with p=0.006. (3) The positive attitude items were divided 3 groups - the respondants' recognition and will, the benefits of organ donation, the role of organ donation process. The negative attitude items were divided 3 groups - the difficulty of organ donation, the respondants' opposition, the uncoorperation of gaurdians and medical staffs. CONCLUSION: The results of this study is believed to be a useful tool in facilitating organ donation as a groundwork for publicity, education and policy.
Brain Death* ; Brain* ; Critical Care* ; Education ; Humans ; Intensive Care Units* ; Jurisprudence ; Medical Staff ; Neurology ; Neurosurgery ; Nursing Care ; Organ Transplantation ; Tissue and Organ Procurement* ; Tissue Donors ; Transplants

The blood-retinal barrier, that outward movement from the eye into the blood appears to predominate and the penetration into the eye of only a few important metabolic products is allowed, is particularly tight non-leaky junction on blood ocular barrier. In order to investigate the extent of destruction in blood retinal barrier after injection of silicone oil in the vitreous of the rabbit, author serially studied the change of fluorescein concentration in vitreous using the HPLC, ERG changes, and histopathologic changes of the retina. The results were belows, 1. The changes of fluorescein concentration in the vitreous showed increasing tendency, with time. The concentration of fluorescein were 0.008 micro/ml in 1st week, 0.069 micro/ml in 2nd week, 0.058 micro/ml in 3rd week, 0.325 micro/ml in 4th week, respectively. 2. The amplitude of photopic b wave in normal rabbit was lower than that of scotopic b wave, but there wasn't significant difference in latency between photopic and scotopic b wave. The amplitudes of b wave in silicone oil injected eyes showed lower voltage than that of normal eyes. 3. The amplitudes of b wave in silicone oil injected eyes were 210 micro V at 1st week, 150 micro V at 2nd week, 72 micro V at 3rd week, 63 micro V at 4th week in average. They showed prominent decrease in voltage from 1st week to 3rd week, but decreased slightly from 3rd week to 4th week. 4. Histopathologically, the retinal changes of the silicone oil injected eyes in 3rd week showed increased cellularity in ganglion cell layer and presented many vacuoles. In 4th week, ganglion cells were decreased but vacuoles were more increased in number.
Blood-Retinal Barrier* ; Chromatography, High Pressure Liquid ; Fluorescein ; Ganglion Cysts ; Rabbits* ; Retina ; Retinaldehyde ; Silicone Oils* ; Vacuoles

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

The purpose of this study was comparing the serial change of serum creatinine and Resistive Index (RI) after renal transplantation. From Jul. 1995 to Feb. 1997, we examined Doppler sonography for 32 out of 99 patients, who were undertaken renal transplantation, whose resistive index were taken at POD #1 and POD #5 and named initial resistive index. The late resistive index were examined when they discharged or when the acute rejection was suspicious. The RI rejection group, which was consist of 22 out of 32 patients, were selected whose late resistive index were increased more 0.05 than inital resistive index. The RI control group, which was consist of 10 out of 32 patients, was selected whose late resistive index were not more 0.05 than initial resistive index. The group which was consist of 21 patient, had over 1.8 mg/dL of serum creatinine. The rest, 11 patients, had not more than 1.8 mg/dL of serum creatinine. The Student's T-test was used for the statistical analysis. In the RI rejection group, late RI value (0.77+/-0.04) was significantly higher than initial RI (p<0.05) and the increase of RI in the acute rejection group were significantly greater than that in the control group (p<0.05). With the serial changes of late RI more 0.05 than initial RI, we obtained 85.0% of sensitivity and 58.3% of specificity for the prediction of the acute rejection. In the patients with the serum creatinine over 1.8 mg/dL, the sensitivity was 85.0% and the specificity was 66.7%. In the patients with the serum creatinine over 1.8 mg/dL and increased RI over 0.05, the sensitivity was 94.1% and specificity was 66.7%. The result shows that serial changes of duplex Doppler scan and the level of serum creatinine after renal transplantation were not enough to predict acute rejection. But the correlation of the result show more higher sensitivity. We suggest to be able to use the Doppler sonography and serial changes of serum creatinine level with the other clinical findings to predict the acute rejection after renal transplantation.
Creatinine* ; Humans ; Kidney Transplantation* ; Sensitivity and Specificity

No abstract available.
Humans ; Referral and Consultation*

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction

Congenital hypertrophy of the retinal pigment epithelium (CHRPE) has been described in association with systemic disorders such as Gardner's syndrome (intestinal polyposis, osteomas, and benign soft-tissue tumors), Turgot's syndrome (glioma-polyposis syndrome) and familial adenomatous polyposis (FAP) of the colon. FamiIial adenomatous polyposis is an autosomal dominant disorder characterized by hundreds of polyps throughout the entire colon, and in all patients carcinoma of the color, develops at the age of 40 to 50 years. We describe a family with familial adenomatous polylpcsis coli and congenital hypertrophy of the retinal pigment epithelium. All of them except mother showed flat, weII-demarcated, round to oval pigmented patches of CHRPE. We emphasize the importance of CHRPE as a clinical marker in identifying patients With FAP since they are at risk for cancer.
Adenomatous Polyposis Coli* ; Biomarkers ; Colon ; Gardner Syndrome ; Humans ; Hypertrophy ; Mothers ; Osteoma ; Polyps ; Retinal Pigment Epithelium* ; Retinaldehyde*