The purpose of this study was the improvement and modification of the HACCP verification checklist in school foodservices. For this, the HACCP verification checklist was modified on the basis of an existing school foodservice format. The modified checklist was composed of 28 items, including CCPs (critical control points), microbial test, and other components of the HACCP system than CCPs. To confirm the suitability of the modified checklist, comparisons were made based on the microbiological quality of cooked foods, utensils, and number of aerial microbes in the working area. In this study, the applicability of the modified checklist was determined by focusing on cooked squid with seasoned fresh vegetables (Ojingeochaesomoochim). The following results were obtained from 14 schools in Changwon. The checklist scores for maintaining hot foods over 60degrees C or serving within 2 hours, microbial tests of drinking water, food contact surfaces and cooking utensils, monitoring tools, and usage of suitable sanitizers were 2 points each (The possible highest score is 2 points). On the contrary, the checklist score for microbial test of cooked foods was the lowest of all the items. The correlation coefficient (r) between the improved checklist and microbiological quality of cooked foods was 0.699 (P<0.01), whereas that between the improved checklist and microbiological quality of cooking utensils was 0.612 (P<0.05). The correlation coefficient between the improved checklist and aerial plate count in the working area was -0.556 (P<0.05). Our results indicate the potential possibility of using the HACCP verification checklist in school foodservices.
Checklist ; Cooking and Eating Utensils ; Decapodiformes ; Drinking Water ; Humans ; Seasons ; Vegetables

PURPOSE: This study was carried out to obtain basic data for developing effective pain management by identifying the positive and negative determinants for pain management in both cancer patients and their nurses. METHOD: The participants were 85 cancer patients and 78 nurses at C university hospital in Seoul. Data were collected from December 2004 to March 2005 using structured questionnaires. RESULTS: The level of pain peaked at 5.02 when going into the hospital, and was then lowered to 2.08. The waiting time for analgesics was less than 30 minutes in 81.1% of the patients and for 68.2% answered that they reported their pain when the pain was no more endurable. Just over eighty percent (80.6%) of the patients were satisfied with the pain management. Only 10.3% of the nurses used a standardized tool for assessing patients, pain and 64.1% gave analgesics whenever patients complained of pain, while 19.2% did not when patients complained too frequently. Nurses who were unsatisfied with pain management accounted for 85.4% of the participants. Patients showed higher levels of barriers to pain management than nurses. CONCLUSION: There is a need to give cancer patients and nurses appropriate information on effective cancer pain management.
Analgesics ; Humans ; Pain Management* ; Surveys and Questionnaires ; Seoul

PURPOSE: This study was conducted to investigate the effects of foot reflexzone massage on state - anxiety and discomfort of ovarian cancer patients receiving chemotherapy. METHOD: A quasi experimental design with a non equivalent control group and non synchronized design was used. The experiment was conducted from October 1, 2003 to September 30, 2004. The subjects consisted of 40 patients admitted to C University Hospital. Twenty subjects were assigned to the experimental group and received foot reflexzone massage everyday for 3 days. The other 20 subjects were in the control group and received routine care. Foot reflexzone massage was done on both feet of the subjects for 30 minutes for 3 days using standard protocol. The 'State-Anxiety Inventory' developed by Spielberger was used to measure the degree of state-anxiety. Discomfort was assessed using the 'Symptom Distress Scale' of McCorkle and Young. Data was analyzed by a SAS program using t-test, Wilcoxon signed rank sum test and Wilcoxon rank sum test. RESULTS: State-anxiety and discomfort of subjects receiving foot reflexzone massage were significantly lower than those of the control group. CONCLUSION: These findings indicate that foot reflexzone massage could be an effective nursing intervention for relieving state-anxiety and discomfort in ovarian cancer patients.
Anxiety ; Drug Therapy* ; Foot* ; Humans ; Massage* ; Nursing ; Ovarian Neoplasms* ; Research Design

The variations of the occipital sinus were studied in 50 Korean adult cadavers. The morphology of the sinus was classified into 5 types accordingo to its number and the connection with the marginal sinus. These results were compared with the data of the occipital sinus of bones (Sir and Chung, 1907). And the opening of the occipital sinus in the confluens sinuum was observed. 1. A single small occipital sinus was found in 40%. Single occiital sinus with two large marginal sinuses was observed in 8%. The single sinus with a left marginal sinus (6%) and with a right marginal sinus(4%) were present. Double occipital sinuses were observed in 10% of the cadavers. No occipital sinus was discernible in 32%. 2. There were 39 openings of the occipital sinus including the double sinuses. The occipital sinuses communicated with the confluence sinuum in 35 cases (89.7%), with the straight sinus in 5.1% and with the right or left transverse sinus in 1 case, respectively. The openings in the confluens sinuum were found on the left side(51.3%), on the right side (10.3%) and in the center(28.2%). 3. The diameters of the occipital sinus were variable according to the connection with the sigmoid sinus. 4. The difference was found between the data of the morphological types of the occipital sinus that were studied in cadavers and in dry bones.
Adult* ; Cadaver ; Colon, Sigmoid ; Humans

The purpose of this study is to evaulate the relationship between end-tidal PCO2(PetCO2) and arterial PCO2(PaCO2) by placing patients from the supine to the lateraI decubitus position and by the changes from two lung ventilation(TLV) to one lung ventilation(OLV) during noncardiac thoracic surgery in 20 patients. All patients had been intubated with double-lumen endobronchial tubes and respirations were controlled with a rate of 14- l7 breaths per minute and tidal volume of 8 ml/kg by an anesthetic ventilator. End tidal PCO2 and arterial PCO2 were measured at three different measurement points(supine plus TLV, lateral decubitus plus TLV, and lateral decubitus plus OLV). End tidal PCO was obtained by mainstream infrared analysis, and arterial blood samples for arterial PCO2 were taken from the radial artery simultaneously. The results were as follows: l) The mean difference between arterial and end tidal carbon dioxide tension(Pa-etCO2) was 7.5+/-2.9mmHg at the supine position, TLV(r=0.76, P<0.01). 2) The mean Pa-etCO2 was 6.2+/-3.1 mmHg at the lateral decubitus position, TLV(r =0.68, P < O.ol ). 3) The mean Pa-etCO2 was 7.1+/-2.5 mmHg at the lateral decubitus position, OLV(r=0.85, P< 0.01). 4) The changes in Pa-etCO2 were very slight during thoracotomy and endobronchial anesthesia, these were of negligible clinical importance. We conclude that measurement of PetCO2 is reliable as a guideline of ventilation during endobronchial anesthesia.
Anesthesia* ; Carbon Dioxide* ; Carbon* ; Humans ; Lung ; Radial Artery ; Supine Position ; Thoracic Surgery ; Thoracotomy ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases

Malignant gastric lymphoma is an uncommon but important lesion with a more favorable prognosis than that ofgastric carcinoma. A total of 16 cases of gastric malignant lymphoma examined during a period from Jan. 1980 toSept. 1983 at Seoul National University Hospital were subjected to the radiological and pathologic correlations.In all cases, the diagnosis was established by histopathology of the resected specimens (9 cases) or endoscopicbiopsy specimesn ( 7 cases). Based on the comparative study of upper G-I series and macroscopic findings of thesurgically resected specimen, the authors investigated the reliable radiographic findings which can be valuable indifferentiation of gastric lymphoma from other gastric lesions, especailly carcinoma, and suggested the followingdiagnostic criteria for the malignant lymphoma of the stomach. 1. Discrete multiple polypoid lesions with orwithout central umbilication. 2. Geographic ulcer, deviated from center of the mass. 3. Irregular thickness ofelevated rim of the mass. 4. Diffuse giant gastric rugae. 5. Giant gastric rugae, mixed with other lesion.
Diagnosis ; Lymphoma ; Prognosis ; Seoul ; Stomach ; Ulcer

This study aimed to compare the effects of activity-based personalized nutrition education (APNE) with a general instruction for diabetes (control, CTRL) in middle-aged and older Korean outpatients with type 2 diabetes. After an initial screening, 70 subjects were randomly assigned to APNE (n = 37) or CTRL (n = 33) group. APNE considered each patient’s anthropometry, blood chemistry data, and dietary habits in addition to planning meal choices with the aid of registered dietitians. After 3 months, dietary behavior, food intake, and anthropometric and blood measurement results were evaluated. Fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels decreased in the APNE group (n = 33) but not in the CTRL group (n = 23). In the APNE group, the meal intervals and number of days of consuming high-fat food were decreased, while the number of days following a meal plan and balanced diet that entailed consuming fruits, vegetables, and healthy food was increased. A lower consumption of carbohydrates, saccharides, grains, and tuber crops and a higher protein, pulses, and fat-derived calorie intake compared with the initial values were observed in the APNE group. In contrast, only the number of days following the meal plan and balanced diet was increased in the CRTL group, without significantly changing the individual macronutrient-derived calorie intake. The APNE approach appeared to effectively educate outpatients with type 2 diabetes about changing their dietary behavior and food intake and improving the clinical parameters related to diabetic conditions.
Anthropometry ; Blood Glucose ; Carbohydrates ; Chemistry ; Diet ; Eating ; Education* ; Fasting ; Food Habits ; Fruit ; Hemoglobin A, Glycosylated ; Humans ; Mass Screening ; Meals ; Nutritionists ; Outpatients* ; Vegetables

The effects of oral premedication with diazepam and atropine were evaluated. We made three kinds of syrup which were composed of diazepam 0.3mg/0.5cc, diazepam 0.3 mg mixed with atropine 0.001 mg in 0.5cc and diazepam 0.3mg mixed with atropine 0.03mg in 0.5cc, respectively. The 1st was administered to Group l (n=21), the second to group ll (n=21) and the last to group lll (n= 24) one and half to two hours before induction of anesthesia. Each child received 0.5 cc/kg. On arrival at pediatric operating room, anxiety levels, vital signs, antisalivatory effect and side effects were checked. The attitude of children was evaluated just before induction of anesthesia. In group land lll, slight elevation of diastolic blood pressure was noticed. The satisfaotory levels, checked by anxiety level O, were 86% in group l, 90% in group ll and 79% in group lll. The altitudes in the operating rooms just before induction of anesthesia were satisfactory and cooperative in 77 %, 81%, and 87% of patients in group l, ll and lll, respectively. Antisalivatory effect was not good in group l, but satisfactory in 82% and 75% of cases in group ll and lll. But side effect was present in 25% of cases in group ll and lll, in spite of 10% in group l. So we can conclude that preoperative oral diazepam in a dose of 0.3mg/0.5cc/kg is very good for the reduction of anxiety and the additiopn of atropine may increase the incidence of side effects. Threefore we recommend parentreral belladonna alkaloids just before induction instead of preoperative oral medication.
Altitude ; Anesthesia ; Anxiety ; Atropine ; Belladonna Alkaloids ; Blood Pressure ; Child* ; Diazepam ; Humans ; Incidence ; Operating Rooms ; Premedication* ; Vital Signs