The purpose of this study is to examine how nutritionists, principals and parents evaluated the importance and priorities of different selection factors for food materials suppliers in an attempt to suggest how to ensure the best supplier choice, since the selection of the best supplier was mandatory for the successful TQM of school food services. This study especially aims to develop priority alternatives based on relative rather than absolute assignments on selection of suppliers for school food service materials. To apply AHP, the selection factors of a food materials suppliers were grouped into five categories, which included quality, service, reliability, hygiene and price. And the five categories involved 28 elements. As the result, quality was considered most crucial on the whole, followed by service, reliability, hygiene and price; and food labeling in the category of quality evaluated as that of first priority in the totality evaluation elements.
Dietary Sucrose ; Food Labeling ; Food Services ; Humans ; Hydroxyproline ; Hygiene ; Parents

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

Systemic air embolism occurs when air enters the pulmonary venous system as a result of a positive gradient caused by low pulmonary venous pressure or increased airway pressure, or both. Systemic air embolism has been frequently reported after penetrating thoracic trauma and can induce life-threatening complications. In blunt thoracic trauma, systemic air embolism has been rarely diagnosed. Because air embolism associated with blunt trauma is more insidious, diagnosis is usually not appreciated unless special circumstances allow discovery of air in major vessels or coronary arteries, such as during emergency resuscitative thoracotomy. We report a case of systemic air embolism in an 18-month-old girl after accidental thoracic blunt trauma and review related literature.
Child* ; Coronary Vessels ; Diagnosis ; Embolism, Air* ; Emergencies ; Female ; Humans ; Infant ; Thoracotomy ; Venous Pressure

To understand the clinical results of aortic root replacement with either inclusion or open technique, we analysed 53 patients who underwent replacement of the aortic root with composite graft between October,1980, and May, 1995. Annuloaortic ectasia was the most common indication for operation(29 patients), follwed by aortic dissection(22 patients). Among 53 patients, 19(35%) had Marfan syndrome. Three patients died during hospitalization (Mortality: 5.5%). The follow up was possible in 48 patients(Follow-up rate; 94%,mean duration;37 months). The actuarial survival rate at 24 months was 95% in open technique group, and 87% in inclusion technique group. Late complications developed in 10 patients. Dissecting aneurysm in the remaining aorta was noted in 3 patients with inclusion technique, and a pseudoaneurysm from coronary artery anastomosis site developed in a patient with inclusion technique. In conclusion, there was no statistical differences in survival for 24 months between inclusion technique and open technique group. But late problems in the remaining aorta or death from unknown cause occurred with moderate frequency ; careful follow-up after aortic root replacement thought to be important for long term survival.
Aneurysm, Dissecting ; Aneurysm, False ; Aorta ; Coronary Vessels ; Dilatation, Pathologic ; Follow-Up Studies ; Hospitalization ; Humans ; Marfan Syndrome ; Survival Rate ; Transplants

Specific or non-specific cytolytic processes of free-living amoebae causing meningoencephalitis have been emphasized and the cytolytic ability related to hydrolases in Entamoeba sp. and Naegleria sp. has also been reported since the latter half of 1970's. However, no information on hydrolase activities in Acanthamoeba sp. is available. Hydrolases in Acanthamoeba culbertsoni, a pathogenic species of free-living amoebae, were assayed and compared with those in a non-pathogenic species, A. royreba. Pathogenicity of these two species was confirmed through experimental infection to BALB/c mice. Hydrolase activities and cytotoxic effects between pathogenic and non-pathogenic species were compared in the trophozoites cultured in CGV media and in CHO cell line, respectively. The results are summarized as follows: The mice infected with A. culbertsoni were all dead 15 days after nasal inoculation, and the mean survival time was 8.5 days. Also the mice infected with this pathogenic species mani fested typical meningoencephalitis, whereas the mice infected with A. royreba did not. Hydrolases detected both in the cell extracts and culture media were acid phosphatase, beta- N-acetyl galactosaminidase, beta-N-acetyl glucosaminidase, alpha-mannosidase, neutral proteinase and acid proteinase, all of which were detected with remarkably higher rate in A.culbertsoni than in A. royreba. A. culbertsoni revealed strong cytotoxicity for the target CHO cells, whereas A. royreba did not show any specific cytotoxicity. About 80 % of the target cells mixed with A. culbertsoni were dead 48 hours after cultivation, and more than 95% of the target cells were dead 72 hours after cultivation. Hydrolase activities in A. culbertsoni cultured with the target cell line were assayed according to the culture time. The activities of acid phosphatase, beta-N-acetyl glucosaminidase, beta-N-acetyl glucosaminidase, alpha-mannosidase and acid proteinase in this pathogenic amoeba were detected higher in amoeba extracts than in culture media up to 120 hours after cultivation, but after 120 hours of cultivation those activities were detected higher in culture media than in the amoeba lysates. Neutral proteinase activity in A. culbertsoni increased more in EBSS medium than in the lysate specimens although the activity in the extracts was generally steady according to the cultivation time. Summarizing the above results, it is concluded that there were differences in hydrolase activities between pathogenic A. culbertsoni and non-pathogenic A. royreba, and that some hydrolase activities were detected remarkably higher in A. culbertsoni which revealed strong cytotoxicity to the target CHO cell line.
parasitology-protozoa ; Acanthamoeba culbertsoni ; Acanthamoeba royreba ; biochemistry ; hydrolase ; acid phosphatase ; beta-N-acetyl galactosaminidase ; beta-N-acetyl glucosaminidase ; alpha-mannosidase ; neutral proteinase ; acid proteinase ; mouse ; hydrolase ; acid phosphatase ; beta-N-acetyl galactosaminidase ; beta-N-acetyl glucosaminidase ; alpha-mannosidase ; neutral proteinase ; acid proteinase

PURPOSE: Acute diarrhea in young children is a major problem in pediatric hospitals worldwide. We evaluated the clinical efficacy of orally administered Lactobacillus acidophilus in the treatment of acute diarrhea in children. METHODS: From September 2002 to July 2003 at National Police Hospital 41 children aged 3 months to 5 years with acute diarrhea were enrolled in this study. The patients were randomized to one of two groups to receive either 0.5 x 10(8) colony forming unit (CFU) of L. acidophilus or matching placebo on admission and every 8 hours during hospitalization. RESULTS: The mean duration of diarrhea in all 41 children was decreased (p=0.001) in the L. acidophilus (40.5 hours) group compared to the placebo (56.6 hours) group. Stool frequency was also reduced (p=0.01) on the 3rd day in the L. acidophilus group. Rotavirus was identified in 58% of the patients. The decrease of duration of diarrhea was more significant in rotavirus-negative patients (p=0.002) compared to the rotavirus-positive patients (p=0.027). CONCLUSION: L. acidophilus shows to be an effective therapeutic agent in acute diarrhea in children. Further studies are needed to confirm the present findings.
Child* ; Diarrhea* ; Hospitalization ; Hospitals, Pediatric ; Humans ; Lactobacillus acidophilus* ; Lactobacillus* ; Police ; Probiotics ; Rotavirus ; Stem Cells

The incidence of endobronchial tumor in the pediatric period is very rare and the symptoms are very close to those of respiratory tract infection. Diagnosis can be delayed because of low clinical suspicion and the many ways in which these tumors can present. We report the first case, in Korea, of a pulmonary carcinoid tumor that presented with recurrent pneumonia at the same location in adolescence. Treatment is surgical and geared towards complete resection while sparing healthy lung parenchyma. Long-term and careful follow up is recommended to detect local and distant metastasis.
Adolescent* ; Carcinoid Tumor* ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lung ; Neoplasm Metastasis ; Pneumonia* ; Respiratory Tract Infections

OBJECTIVE: This study was conducted in order to investigate predictors of smoking cessation in outpatients. METHOD: Subjects were 401 adult smoking patients who saw their doctors in the outpatient setting at a university hospital, regardless of their willingness of otherwise in smoking cessation. Physicians delivered a brief, stop smoking prompt to all patients who smoked one or more cigarettes a day. Then they referred to on-site counselors who provided a brief, nurse assisted intervention with a survey to a randomly assigned intervention group (200 smoking patients), whom the counselors telephoned later to prevent relapse or promote the motivation to quit, or gave only a survey to a control group (201 smoking patients). After at least 5 months, self-reported current smoking cessation was confirmed later using cut-off values of 7 ppm or less in expired alveolar air after breath holding portable CO analyzer. RESULTS: After 5 months, subjects in the intervention group were 1.56 times (95% C.I. 0.89-2.73) more likely to quit smoking than those in the non-intervention group (14.0% vs. 9.0%). Willingness to quit smoking in a month, scheduled admission in a month, self efficacy score and FTND (Fagerstrom Test for Nicotine Dependence) score were all significantly related with smoking cessation. In stepwise multiple logistic regression, previous attempts to quit smoking were significant instead of self efficacy score. In the intervention group who had willingness to quit smoking in a month (132 smoking patients), FTND score, whether quit date was today, and whether quit promise paper was submitting were all significantly related with smoking cessation. In stepwise multiple logistic regression, scheduled admission in a month and whether quit date was today were significant predictor variables. Smoking cessation treatment should be tailored to individual smoking patients considering these predictors.
Adult ; Breath Holding ; Counseling ; Humans ; Logistic Models ; Methods ; Motivation ; Nicotine ; Outpatients* ; Recurrence ; Self Efficacy ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Products

The purpose of this research was to understand how individuals reflect on the frequency and quantity of foods that they consume. Participants selected 5 males and 15 females aged 30 years or older were first interviewed on the frequency of their food consumption. Then based on this data, they were given a cognitive interview using the method of verbal proving. The individual cognitive interviews were recorded with consent while being conducted after complete approval by the Seoul National University Institution Review Board. The recorded material was evaluated using a thematic analysis after transcribing them into text. By analyzing stages of reflection, the major barriers to make the device difficult are revealed: 1) More difficulty in remembering events over the course of a full year due to diversification in the types of food that people consume 2) difficulty calculating the average for seasonal foods 3) difficulty estimating the amount of consumption from the photos presented 4) difficulty estimating amount of consumption from the quantity presented 5) difficulty processing foods that people think are healthy and foods are unhealthy simultaneously 6) difficulty having to consider foods where target food goes in as an ingredient; 7) difficulties arising from having to increase frequency when the amount consumed is higher than the quantity that is presented 8) difficulty having to combine the frequency and quantity of each food item when numerous foods are clustered into one category. These findings show that the less participants were involved in cooking, the more diverse their eating habits were, and the more they tried to adhere to rules of filling out the questionnaire, the more it was difficult for them to come up with an answer to the question being asked. It therefore seems necessary to construct a Food Frequency questionnaire that is attentive to these problems that arise from the recall stages.
Cooking ; Eating ; Female ; Humans ; Male ; Surveys and Questionnaires* ; Seasons ; Seoul

PURPOSE: The outcomes of a surgical approach for patients with an esophageal carcinoma remain unsatisfactory despite its high complication rates. We conducted a phase II trial, using combined FP (5-fluorouracil and cisplatin) chemotherapy and concurrent radiotherapy, as a definitive therapy for patients with esophageal cancer. MATERIALS AND METHODS: Patients with histologically proven esophageal cancer were enrolled onto this study. The treatment consisted of four courses of chemotherapy and six and a half weeks of radiotherapy. The patients received chemotherapy in weeks 1, 5, 12 and 16 (5-fluorouracil 1, 000 mg/m2 on days 1 to 4 and cisplatin 75 mg/m2 on day 1). Radiotherapy was administered at a dose of 59.4 Gy, in five 1.8 Gy fractions a week. RESULTS: A total of 22 eligible patients entered the study. Of the 19 evaluable patients, a complete response occurred in 7 (37%), and a partial response in 8 (42%). After a median follow-up of 35 months, the overall survival rate was 32% at three years and the median survival was 11 months. Fourteen (64%) received planned dose of radio-therapy and 13 (59%) received more than three courses of chemotherapy. However, there was no difference in three-year survival rates between the patients that received less than three courses of chemotherapy and those that received three or more courses (31% vs. 32%). The major treatment related toxicity was mucositis, which developed in every patient, with grades III or IV in thirteen (59%) patients. During the treatment, the patients lost, on average, 3.8% of their body weight. The mean hospital stay was 23 days, with a total duration of treatment of 74 days. CONCLUSIONS: Concurrent FP chemoradiotherapy was effective as a definitive therapy for patients with esophageal cancer. The major toxicity was mucositis. Although the treatment was relatively feasible, a randomized trial of reduced courses of chemotherapy is warranted.
Body Weight ; Chemoradiotherapy* ; Cisplatin ; Drug Therapy ; Esophageal Neoplasms* ; Follow-Up Studies ; Humans ; Length of Stay ; Mucositis ; Radiotherapy ; Survival Rate