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: We evaluated the clinical characteristics of respiratory viruses that were frequently found in children during spring/summer, namely, human bocavirus (hBoV), human metapneumovirus (hMPV), parainfluenza virus (PIV), and human rhinovirus (hRV). METHODS: This study enrolled patients with acute lower respiratory infection in whom respiratory virus reverse transcriptase polymerase chain reaction was performed between March 2013 and August of 2013. We retrospectively reviewed the medical records to collect the patients' data. RESULTS: A total of 96 patients were enrolled and divided into 5 categories: hBoV in 19 patients (19.8%), hMPV in 18 patients (18.8%), PIV in 16 patients (16.7%), hRV in 20 patients (20.8%), and negative result in 23 patients (24.0%). The mean age of the patients was 8.2+/-5.9 months (median, 7.5 months; range, 1-24 months), and the male-to-female ratio was 1.1:1. The most common diagnoses were acute bronchiolitis (62.5%) and pneumonia (30.2%). Compared to other patients, those with hBoV were older (12.3+/-4.9 months, P=0.001) and more frequently diagnosed with acute bronchiolitis (P=0.005). In addition, they showed higher incidences of tachypnea and rales (P=0.039 and P=0.035, respectively), and were more frequently treated with oxygen and systemic steroids (P=0.044 and P=0.001, respectively) than the other patients. CONCLUSION: We compared respiratory viruses in children during spring/summer and found that hBoV may have more severe clinical manifestations than other viruses.
Bronchiolitis ; Child* ; Diagnosis ; Human bocavirus* ; Humans ; Humans* ; Incidence ; Medical Records ; Metapneumovirus ; Oxygen ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Steroids ; Tachypnea

Various ophthalmic complications can occur after intranasal sinus surgery due to the closed anatomic relationship between orbit and paranasal sinuses. The authors experienced a patient who had complained of sudden proptosis and loss of vision in his right eye 2 days after Caldwell-Luc operation from the otolaryngologic clinic. Fundoscopic finding showed cherry-red spot, scattered retinal hemorrhage, retinal edema, arteriovenous obstruction sign. Emergent decompression surgery was done, under the impression of retinal vessel obstruction caused by orbital compression, and his visual acuity improved moderately after this procedure.
Decompression ; Exophthalmos ; Humans ; Orbit* ; Papilledema ; Paranasal Sinuses ; Retinal Hemorrhage ; Retinal Vessels* ; Retinaldehyde* ; Visual Acuity

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

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

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

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