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

No abstract available.
Estradiol* ; Female ; Humans ; Plasma* ; Progesterone*

This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al. (1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percent-age for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows : In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5 FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a significant difference by job and religion, the degree of hopelessness a significant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.
Anxiety* ; Breast Neoplasms* ; Breast* ; Buddhism ; Daegu ; Diagnosis ; Drug Therapy* ; Humans ; Mastectomy ; Middle Aged ; Nursing ; Surveys and Questionnaires ; Spouses

Fractures of the femoral neck in children are uncommon and usually occur as a result of severe trauma due to their anatomical and physiologic characteristics. There are many difficulties during the treatment period and high incidence of complications such as avascular necrosis, coxa vara and premature epiphyseal closure. Twenty-three cases of fractures of the femoral neck in children which were treated at Kyung-Pook National University Hospital from Aug., 1980 to May, 1989 were analyzed both clinically and radiologically. The results were as follws: l. Among the 23 cases, higher incidence was in girls(13 cases, 56.5%) and the highest incidence was between the age of 11 and 13 years(8 cases, 34.8%). 2. The main cause of fracture was traffic accident(16 cases, 69.6%). 3. The most common type of fracture was the transcervical type(9 cases, 39.1%) and 17 cases (73.9%) were displaced fractures. 4. Associated injuries occurred in 13 cases(56.5%), and the common associated injuries were extremity fractures, head injuries and pelvic bone fractures. 5. Minimally displaced 7 cases(30.4%) were treated by closed reduction & internal fixation, and neglected, irreducible 15 cases(65.2%) by open reduction & internal fixation and undisplaced intertrochanteric fracture(1 case) by closed reduction & hip spica cast. 6. Twenty-three cases were followed from 8 months to 9 years and average period of follow-up studies was 28 months. The results were good in 5 cases(71.4%), fair in 2 cases (28.6%) in closed reduction & internal fixation, and good in 9 cases(60%), fair in 2 case(13.3%), poor in 4 cases(26.7%) in open reduction & internal fixation. 7. Complications were developed in 11 cases(47.8%), and premature epiphyseal closure were in 7 cases(30.4%), and avascular necrosis were in 6 cases(26.1%), and coxa vara were in 3 cases (13%), and delayed union was in 1 case and infection was in 1 case. 8. As a result, we recommend early closed reduction & internal fixation as the favorable method of treatment for the fracture of the femoral neck in children better than open reduction & internal fixation or conservative methods.
Child ; Clinical Study ; Coxa Vara ; Craniocerebral Trauma ; Extremities ; Femur Neck ; Follow-Up Studies ; Hip ; Humans ; Incidence ; Methods ; Necrosis ; Pelvic Bones

PURPOSE: Idiopathic thrombocytopenic purpura (ITP) was the most common disease of thrombocytopenic purpura in children, chronic course was shown in 10%. Splenectomy had been used in chronic thrombocytopenic purpura as classic therapy, and many therapeutic method had been tried. We define response to therapy and long-term outcome of chronic childhood idiopathic thrombocytopenic purpura. METHODS: We retrospectively analyzed 41 patients that treated and diagnosed as chronic thrombocytopenic purpura at the Department of Pediatrics, Severance Hospital between Aug. 1981 and Aug. 1999 and followed for mean 8.2 years. The mean age was 6.2 years (range from 1month to 12.3 years) and sex-ratio of male to female was 1:2. According to therapeutic methods, they were divided into splenectomy group, spleen irradiation group, azathioprine group, interferon group, high-dose oral dexamethasone group, vincristine group, intravenous gammaglobulin group, low-dose prednisone group, and low-dose prednisone with intermittent intravenous gammaglobulin group. The results were classified into complete response (CR: platelets> 100,000/mm3), partial response (PR: platelets> 50,000/mm3), no response (NR: platelets <50,000/mm3). RESULTS: The treatment response and number of patients according to therapeutic methods were as follows; splenectomy group, 12 cases (CR-9 cases, PR-1 case, NR-2 cases), spleen irradiation group, 1 case (CR), azathioprine group, 6 cases (CR-1 case, NR-5 cases), interferon group, 3 cases (CR-1 case, PR-1 case, NR-1 case), high-dose oral dexamethasone group, 4 cases (CR-2 cases, PR-1 case, NR-1 case), vincristine group, 2 cases (NR), intravenous gammaglobulin group, 35 cases (CR-5 cases, PR-5 cases, NR-25 cases), low-dose prednisone group, 5 cases (NR), and low-dose prednisone with intermittent intravenous gammaglobulin group, 30 cases (CR-7 cases, PR-3 cases, NR-20 cases). CONCLUSION: The results of therapeutic method in splenectomy group were the most highest score (12 cases: CR-9 cases, PR-1 case, NR-2 cases), high-dose oral dexamethasone group, interferon group, and low-dose prednisone with intermittent intravenous gammaglobulin group in high incidence order. Spleen irradiation was supposed to trial method of treatment before splenectomy, because the risk was lower than splenectomy, although they had 1 case.
Azathioprine ; Child ; Dexamethasone ; Female ; Humans ; Incidence ; Interferons ; Male ; Pediatrics ; Prednisone ; Purpura, Thrombocytopenic ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies ; Spleen ; Splenectomy ; Vincristine

Langerhans cell histiocytosis (LCH) is characterized by clonal proliferation and accumulation of abnormal dendritic (Langerhans) cells in various organs. Pulmonary involvement, although rare in children, has been reported in 20%–50% of childhood cases of multisystem LCH. Isolated pulmonary LCH in children, especially in infants, is still rarer, but should be suspected in those with cystic lung disease. We report a case of a 10-month-old boy who presented with chronic dyspnea and whose chest computed tomography (CT) scan demonstrated cystic lesions. Lung biopsy established the diagnosis of LCH; microscopy revealed a background of lymphocytes and eosinophils with kidney-shaped abnormal cells. These abnormal cells were positive for S-100, CD207 (Langerin), and CD1a on immunohistochemical staining. Chemotherapy was administered using a cytotoxic agent (vinblastine) and a steroid. After 12 weeks of induction chemotherapy, although no significant change in cyst size was noted on chest CT, clinical symptoms improved. Consolidation chemotherapy was then administered for 1 year. Thereafter, chest CT findings demonstrated a significant decrease in cyst size and a significant increase in the volume of normal lung parenchyma. Therefore, aggressive treatment of isolated pulmonary LCH in infants with severe tissue destruction and symptoms seems warranted.
Biopsy ; Child ; Consolidation Chemotherapy ; Diagnosis ; Drug Therapy ; Dyspnea ; Eosinophils ; Histiocytosis, Langerhans-Cell* ; Humans ; Induction Chemotherapy ; Infant* ; Lung ; Lung Diseases ; Lymphocytes ; Male ; Microscopy ; Thorax ; Tomography, X-Ray Computed

The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.
Ambulatory Care ; Employment ; Fees and Charges ; Food Services ; Gyeonggi-do ; Humans ; Internship and Residency ; Nutritionists* ; Patient Care ; Surveys and Questionnaires ; Seoul ; Social Environment ; Tertiary Care Centers*

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability.vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.
Hospitals, Convalescent ; Hospitals, General ; Job Satisfaction* ; Korea ; Nutritionists* ; Surveys and Questionnaires ; Tertiary Care Centers

Initially described in young Japanese women, Kikuchi's disease predominantly produces histiocytic necrotizing lymphadenitis of the cervical lymph nodes along with fever; it always follows a benign course with excellent outcomes. Kikuchi's disease is rarely associated with systemic lupus erythematosus (SLE). However, the microscopic features of Kikuchi's disease can be similar to lupus lymphadenitis. Patients with Kikuchi's disease should be assessed for SLE and have long-term follow-up evaluations for the development of SLE. We present a 21-year-old woman with tender multiple cervical lymphadenopathy and the clinical manifestations of SLE.
Asian Continental Ancestry Group ; Female ; Fever ; Follow-Up Studies ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lupus Erythematosus, Systemic* ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases ; Young Adult

PURPOSE: The purpose of this study was to explore whether or not there is a relationship between doctor's awareness of clinical nutrition service and needs for a clinical dietitian. METHODS: A cross-sectional survey design was used. The research was carried out by using questionnaires that had been specifically designed for the study. The research was conducted from September to October, 2013 for 311 doctors at 43 hospitals (with over 400 beds). Frequency analysis, factor analysis, reliability analysis, confirmatory factor analysis, and bootstrapping analysis were conducted using SPSS 21.0. RESULTS: ‘Implementation of clinical nutritional service’ (p < 0.001) and ‘usefulness on clinical nutrition service’ (p < 0.001) were found to be correlated with ‘importance of clinical nutrition service’ as an independent variable. The correlation between ‘importance of clinical nutrition service’ as a mediating variable and ‘needs for clinical dietitian’ as a dependent variable was also confirmed (p < 0.001). The results of the bootstrapping test showed that the mediating effect of ‘importance of clinical nutrition service’ was significant. The indirect effect value between ‘implementation of clinical nutrition service’ and ‘needs for clinical dietitian’ was 0.040, indirect effect value between ‘usefulness on clinical nutrition service’ and ‘needs for clinical dietitian’ was 0.095. CONCLUSION: The frequency of providing clinical nutritional services, the quality of clinical nutritional services, and the degree of implementation of clinical nutritional services were found to be important for positive perception of clinical nutrition services by doctors. Therefore, proper provision of clinical nutrition services and effective therapeutic effects will be continuously highlighted, which will increase the awareness of the physician and ultimately increase the demand for clinical nutrition service.
Cross-Sectional Studies ; Negotiating* ; Nutritionists* ; Therapeutic Uses