PURPOSE: To describe the appearance and average thickness of the internal anal sphincter with anal endosonography in healthy Korean adults. MATERIAL AND METHODS: 184 subjects(male: 96, female: 88) with no history of anorectal disease or surgery were studied with anal endosonography. The average thickness of internal sphincter was meas ured at the mid-anal canal. For the internal sphincter, which is often asymmetric, the thickness of each 4 part(12, 3, 6 and 9 o'clock direction) were measured in left lateral decubitus position. RESULTS: The anal wall was well visualized in 5 layers(mucosa, submucosa, internal anal sphincter, intersphincteric plane, external anal sphincter) with anal endosonography. The anal endosonogram showed the internal anal sphincter as a homogenous, well-defined, hypoechoic, circular band, and slightly asymmetric. The average thickness of the internal anal sphincter in the area of mid-anal portion was 2.0 0.3 mm(range: 1~3 mm). There was no sexual difference; however, a significant positive correlation with age was found in average thickness of the internal anal sphincter. The correlation with lean body mass was not found. CONCLUSION: The internal anal sphincter is well-visualized, best defined structure by anal endosonography. Average thickeness of the sphincter in Korean appeared to be the same as in the Western.
Adult* ; Anal Canal* ; Endosonography ; Female ; Humans

OBJECTIVES: This study was conducted to identify differences in job stress, satisfaction and commitment of cooking employees working in hotel kitchens with and without HACCP systems. METHODS: Culinary employees of 12 five-star hotels were surveyed and 504 valid data were used for SPSS analysis. Sub factors of working environment factors (job stress, job satisfaction, and job commitment) were examined for analysis. RESULTS: The results showed that hotels that implemented the HACCP system had significantly higher values for the five sub factors of employee job stress (job demand, relationship conflict, organizational system, lack of job autonomy, and job instability; p < 0.001). For the sub factors of job satisfaction (internal and external satisfaction) statistic showed a statistically significant value in hotels that did not implement the HACCP system (p < 0.001). Job attachment and job importance, which are sub factors of job commitment, showed no difference in relation to the implementation of HACCP system, and job responsibility showed a higher p-value in hotels that did not implement HACCP (p < 0.05). CONCLUSIONS: The results of the study indicate that culinary employees working at venues with HACCP systems have more job related stress, lower job satisfaction and partially less job commitment. Based on this outcome, venues that have already implemented or are planning to implement HACCP systems should consider the implications regarding their management of employees. Managerial policies that enhance autonomy, job stability, achievement, self-development, promotion, and compensation should also be implemented. Finally, meticulous attention and high investments into the work environment and human resources are necessary.
Compensation and Redress ; Cooking ; Hazard Analysis and Critical Control Points ; Humans ; Investments ; Job Satisfaction

OBJECTIVES: This study was conducted to identify differences in job stress, satisfaction and commitment of cooking employees working in hotel kitchens with and without HACCP systems. METHODS: Culinary employees of 12 five-star hotels were surveyed and 504 valid data were used for SPSS analysis. Sub factors of working environment factors (job stress, job satisfaction, and job commitment) were examined for analysis. RESULTS: The results showed that hotels that implemented the HACCP system had significantly higher values for the five sub factors of employee job stress (job demand, relationship conflict, organizational system, lack of job autonomy, and job instability; p < 0.001). For the sub factors of job satisfaction (internal and external satisfaction) statistic showed a statistically significant value in hotels that did not implement the HACCP system (p < 0.001). Job attachment and job importance, which are sub factors of job commitment, showed no difference in relation to the implementation of HACCP system, and job responsibility showed a higher p-value in hotels that did not implement HACCP (p < 0.05). CONCLUSIONS: The results of the study indicate that culinary employees working at venues with HACCP systems have more job related stress, lower job satisfaction and partially less job commitment. Based on this outcome, venues that have already implemented or are planning to implement HACCP systems should consider the implications regarding their management of employees. Managerial policies that enhance autonomy, job stability, achievement, self-development, promotion, and compensation should also be implemented. Finally, meticulous attention and high investments into the work environment and human resources are necessary.
Compensation and Redress ; Cooking ; Hazard Analysis and Critical Control Points ; Humans ; Investments ; Job Satisfaction

A 63-year-old man complained of intermittent motor weakness of his arm. The magnetic resonance image (MRI) of his brain displayed a high signal lesion in right cingulate gyrus on T2 weighted image. One year later, he showed a stuporous mental status with repeated seizures, and the follow-up brain MRI showed heterogeneously enhanced mass associated with bleeding. He was treated with surgery and radiotherapy for secondary glioblastomas in right cingulate gyrus. One year more later, a mass recurred on the left frontal base, and gliosarcoma was diagnosed. After tumor resection, ventriculoperitoneal shunt, chemotherapy, and re-radiation therapy, all brain lesions were stable. Fourteen months after the diagnosis of gliosarcoma, he complained of dyspnea and back pain. Torso positron emission tomography/computed tomography revealed multiple metastatic lesions in both lungs, pericardium, pleura, liver, lymph nodes, and bones, and metastatic gliosarcoma was diagnosed. One month later, the patient died because of the systemic metastases. We present an unusual case of secondary gliosarcoma with stable brain lesions and extensive systemic metastases.
Arm ; Back Pain ; Brain ; Brain Neoplasms ; Diagnosis ; Drug Therapy ; Dyspnea ; Electrons ; Follow-Up Studies ; Glioblastoma ; Gliosarcoma* ; Gyrus Cinguli ; Hemorrhage ; Humans ; Liver ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Pericardium ; Pleura ; Radiotherapy ; Seizures ; Stupor ; Torso ; Ventriculoperitoneal Shunt

A ICL TM(STAAR Collamer Posterior chamber Implantable Contact Lens) lents ranging from -11D to -21.3D. And then we investigated the visualwas implanted in 12 eyes of 7 patients with preoperative spherical equivalents ranging from -11 D to -21.3 D. And then we investigated the visual acuity, mean endothelial cell loss, change of refractive error and postoperative complications.Average follow-up was 28.1 months. In the immediate postoperative days, all eyes had a significant increase in uncorrected visual acuity and the best corrected visual acuity was improved in 7 eyes(58.3%). Mean percent difference between preoperative and postoperative endothelial cell count was 3.22+/-0.05% . The mean preoperative spherical equivalent refraction was -15.65+/-2.78 D. At a mean follow-up of 1 month, mean spherical equivalent refraction was -1.67+/-0.72D, at a 6months, 12 months, 24 months, mean spherical equivalent refraction was each -1.56+/-0.72D, -1.63+/-0.68D, -1.73+/-0.76D. During follow-up days one eye developed an faint anterior subcapsular cataract but the patient remained symptom free. Other reported complication was transient increased intraocular pressure. Although the follow-up in our study was limited cases(12 eyes), from our experience, the posterior chamber implantable contact lens was efficacious and safe in the correction of high myopic refraction errors.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Refractive Errors ; Refractive Surgical Procedures ; Visual Acuity

PURPOSE: The reasons for breast feeding failure within the first month of birth were related to inappropriate handling of problems in breast feeding. We investigated common reasons for the failure during the neonatal period and assessed medical personnels' attempts to solve them. METHODS: We conducted a survey with a prepared questionnaire on one-hundred-twenty mothers who failed in breast feeding within the first month after delivery. They were selected among those who brought their infants to local private clinics or general hospitals in Taegu from July to August 1999. RESULTS: The breast feeding rate at the starting time of feeding after delivery was significantly higher in the infants who were born at local clinics than general hospitals(52.7% vs 31.8%, P< 0.05), and higher with rooming-in service than routine nursery care(62.1% vs 31.8%, P<0.05). Most with routine nursery care(79.7%) had to feed breast milk at the appointed time. As a consequence, hospital policy was inconvenient for breast feeding. 51.7 per cent of the responders did not even try breast feeding until discharge from hospitals. Information about breast feeding were obtained mainly from their mothers' advice(39.3%). And it was only 7.7 per cent of the responders who obtained information from physicians. The common reasons for breast feeding failure within the first month were insufficient secretion of milk(36.7%), looser stool(16.7%), and inverted nipple(15%), which could have been solved with adequate support and advice from medical personnel. CONCLUSION: To increase the breast feeding rate, medical personnel should actively recommend breast feeding as early as possible after delivery, should educate mothers on the problems that may arise during breast feeding, and should make the hospital environment more convenient for breast feeding.
Breast Feeding* ; Breast* ; Daegu ; Hospitals, General ; Humans ; Infant ; Milk, Human ; Mothers ; Nurseries ; Parturition ; Surveys and Questionnaires

PURPOSE: To evaluate incidentally observed thickened mucosa of paranasal sinuses on brain MRI of patients without evidence of sinusitis. MATERIALS AND METHODS: We reviewed brain MRI of 82 adults aged over 20 ; 45 were males and 37 were females. Brain axial MRI was obtained from the hard palate with 8mm thickness and 2mm gap. The mucosal thickness of incidentally observed paranasal sinuses seen on brain MRI was measured at the mostly thickened portion by T2- and T1-weighted images. RESULTS: The mean mucosal thickness at the most thickened portion of paranasal sinuses, regardless of their location was 3.5mm with S.D. of 1.5mm. The mucosal thickening was observed more commonly in maxillary (79 patients, mean 3.0mm, S.D. 1.4mm) and ethmoid sinuses (80 patients,mean 2.7mm, S.D. 1.1mm) than in sphenoid (39 patients, mean 1.6mm, S.D. 1.4mm) or frontal sinuses (38 patients, mean 1.9mm, S.D. 1.4mm). CONCLUSION: Mucosal thickening of up to 6.5mm was a common finding on brain MRI of patients without evidence of sinusitis ; accuracy was 95%.
Adult ; Brain* ; Ethmoid Sinus ; Female ; Frontal Sinus ; Humans ; Magnetic Resonance Imaging ; Male ; Mucous Membrane ; Palate, Hard ; Paranasal Sinuses* ; Reference Values* ; Sinusitis

PURPOSE: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. MATERIALS AND METHODS: Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3+/-24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. RESULTS: Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9+/-12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. CONCLUSION:: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.
Acetazolamide ; Adolescent ; Basal Ganglia ; Brain* ; Cerebellum ; Child ; Female ; Frontal Lobe ; Healthy Volunteers ; Humans ; Male ; Occipital Lobe ; Parietal Lobe ; Perfusion ; Rabeprazole ; Reference Values ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon* ; Volunteers

It is very difficult to differentiate radiation myelopathy from metastatic intramedullary spinal cord tumor. We described a case of chronic progressive radiation myelopathy, in which serial magnetic resonance imaging was of great value for the differential diagnosis.
Diagnosis, Differential ; Magnetic Resonance Imaging* ; Radiation Injuries ; Spinal Cord Diseases* ; Spinal Cord Neoplasms

BACKGROUND: FSH is a heterodimeric glycoprotein and is composed of alpha and beta subunits. alpha subunit is common to FSH and LH, while an unique beta subunit determines the biological specificity of each hormone. The synthesis of beta subunit is the primary rate-limiting step in the synthesis of each hormone. Although FSH plays a pivotal role in folliculogenesis and ovulation, very little studies have been performed on the regulation of FSH beta gene expression. Therefore, the present study attempted to examine the effect of GnRH or activin on the expression of FSH beta mRNA as well as FSH release and signaling pathway involved in their actions. METHODS: The primary cultures of rat anterior pituitary were used for this study. To determine FSH beta mRNA levels, northern blotting method was used. The concentration of FSH in the culture medium was evaluated by using a specific radioimmunoassay for rat FSH. RESULTS: PMA, an activator of PKC, increased FSH beta mRNA levels and FSH release, whereas forskolin, an activator of adenylate cyclase, showed no effect. The application of GnRH augmented FSH release, but not FSH beta mRNA levels. However, the administration of activin increased FSH beta mRNA levels as well as FSH release. Staurosporine, an inhibitor of PKC, suppressed activin-induced increment of FSH beta mRNA levels and FSH release. CONCLUSION: The present study demonstrated that activin rather than GnRH is a major regulator for FSH beta mRNA expression, and suggest that PKC-dependent pathway is also involved in the action of activin on the expression of FSH beta mRNA and FSH release.
Activins ; Adenylyl Cyclases ; Animals ; Blotting, Northern ; Colforsin ; Female ; Follicle Stimulating Hormone ; Follicle Stimulating Hormone, beta Subunit ; Gene Expression* ; Glycoproteins ; Gonadotropin-Releasing Hormone ; Ovulation ; Radioimmunoassay ; Rats* ; RNA, Messenger ; Sensitivity and Specificity ; Staurosporine