The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, 22.3% of patients were malnourished and 40.7% were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p < 0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p < 0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p < 0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.
Aged ; Cholesterol ; Depression ; Humans ; Ideal Body Weight ; Korea ; Length of Stay ; Malnutrition ; Mass Screening ; Mortality ; Nutrition Assessment* ; Nutritional Status* ; Prevalence ; Seoul

This study was performed to improve the hospital food service in quality and customer satisfaction by using 6-sigma strategy which was processed by DMAIC methods. The research procedure was as follows; analyzing the main causes of customer dissatisfaction of food service by using numerical method, and then finding out the standardized problem solving methods, and finally reforming food service process. The effectiveness of 6-sigma activity was measured by 'food service quality index', 'customer satisfaction index' and 'total food service satisfaction index'. Food service quality index was calculated by adding grade of soup temperature, food service, delivery time, and setting accuracy. Statistical data analyses were completed by using the Minitab Ver. 14. By performing 6 sigma activity, food service quality index was increased from 67 to 79 points (p<0.05) and customer satisfaction index also rise from 73 to 79points (p<0.05). Satisfaction of meals' taste, diverse menu, food setting accuracy, remove of food service, overall food service were significantly improved(p<0.05). The results of capability analysis in food service quality index, customer satisfaction index, and total food service satisfaction index were improved 2.11sigma to 2.49sigma , 1.88sigma to 2.43sigma, and 2.04sigma to 2.47sigma respectively (p<0.05). Therefore this study showed that subjective food service improving process could be measured by objective numerical value which might be used for financial value in hospital management.
Data Interpretation, Statistical ; Food Service, Hospital* ; Food Services ; Problem Solving

PURPOSE: To evaluate the clinicopathological characteristics and prognosis of localized resectable genitourinary sarcomas in adults. MATERIALS AND METHODS: Between September, 1996 and November, 2008, 18 consecutive cases of adults (12 men and 6 women; median age 48.8 years) who were treated for primary genitourinary sarcomas were identified. The following variables were analyzed: patient age, gender, body mass index, American Society of Anesthesiologists (ASA) score, primary organ, tumor histology, size, necrosis, Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade, and surgical margin positivity. Recurrence-free survival and disease-specific survival were the study end-points. RESULTS: The most common presenting symptom was a palpable mass (six cases, 33.3%), the most common site was the kidney (six cases, 33.3%), and the most common histological subtype was leiomyosarcoma (eight patients, 44.4%). Complete resection with negative surgical margins was achieved in 13 patients (72.2%). The median follow-up period was 49.9 months (range 6.4 to 147.6). The recurrence-free survival rates at 1, 3, and 5 years were 81.6%, 66.5%, and 66.5%, respectively. Recurrence-free survival only associated significantly with ASA score (p=0.018). The disease-specific survival rate at 1, 3, and 5 years was 88.9%, 76.2%, and 67.7%, respectively. Disease-specific survival was associated significantly only with FNCLCC grade (p=0.042). CONCLUSION: Although genitourinary sarcomas in adults are a rare group of tumors with a poor prognosis, some patients may have a favorable prognosis. Our findings suggest that FNCLCC grade is the most important prognostic factor for these patients.
Adult ; Aged ; Female ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Prognosis ; Republic of Korea ; Sarcoma/metabolism/pathology/*surgery ; Urogenital Neoplasms/metabolism/pathology/*surgery ; Young Adult

OBJECTIVES: This study was conducted to investigate the status and need for nutrition and dietary life education among nutrition teachers at schools. These characteristics were analyzed if they were different between elementary schools and middle-high schools. METHODS: Subjects were 151 nutrition teachers from 70 elementary schools, 41 middle schools and 40 high schools in 17 cities nationwide selected by two-stage stratified cluster sampling process. Survey questionnaires included the items on general characteristics, status and need assessment for nutrition and dietary life education. Chi-square test or t-test was used for data analysis by school groups. RESULTS: Nutrition education was implemented at 65.7% of elementary schools and 51.9% of middle-high schools. Nutrition education was mainly performed in 'discretionary activities·extracurricular activities' at elementary school and through 'newsletters, school homepage, foodservice bulletin board' at middle-high school (p<0.001). The most needed topic for nutrition education in nutrition teachers was 'healthy dietary habits and table manners' and this was not significantly different by school groups. Responses on adequate frequency (p<0.01), methods used for nutrition education (p<001), materials for nutrition education (p<0.001), information sources for nutrition education (p<0.001) were significantly different by school groups. Major tasks for activating nutrition education included 'securing the time for implementing nutrition education by reducing work loads' and 'developing standardized nutrition education materials' in schools. CONCLUSIONS: Nutrition education at schools might be activated by improving working conditions of nutrition teachers and developing the practical programs that reflect the needs of nutrition teachers.
Adolescent ; Child ; Education* ; Food Habits ; Humans ; Needs Assessment ; Statistics as Topic

Pseudohypoaldosteronism type 1 (PHA1) is a rare salt-wasting disorder caused byresistance to mineralocorticoid action. PHA1 is of two types with different levelsof disease severity and phenotype as follows: systemic type with an autosomalrecessiveinheritance (caused by mutations of the epithelial sodium channel)and renal type with an autosomal dominant inheritance (caused by mutations inthe mineralocorticoid receptor). The clinical manifestations of PHA1 vary widely;however,PHA1 commonly involves hyponatremia, hyperkalemia, metabolicacidosis and elevated levels of renin and aldosterone. The earliest signs of bothtype of PAH1 also comprise insufficiency weight gain due to chronic dehydrationand failure to thrive during infancy. Here, we report a case of renal PAH1 in a28-day-old male infant harboring a novel heterozygous mutation in NR3C2 gene(c.1341_1345dupAAACC in exon 2), showing only failure to thrive without thecharacteristic of dehydration.

The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: 64.2 +/- 11.5 y, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were 1,648.0 +/- 397.31 kcal/day, 79.2 +/- 27.2 g/day, respectively. The animal protein intake was 42.7 +/- 22.1 g/day, essential amino acids intake was 23.4 +/- 9.92 g/day, and the ratio of essential amino acids to total protein intake was 29.6 +/- 5.42%. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r = 0.435, p < 0.01; r = 0.435, p < 0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN)(r = 0.329, p < 0.05; r = 0.329, p < 0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r = 0.368, p < 0.05; r = 0.405, p < 0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r = 0.032, p < 0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.
Amino Acids, Essential* ; Animals ; Blood Urea Nitrogen ; Creatinine ; Education ; Energy Intake ; Female ; Hematocrit ; Humans ; Ideal Body Weight ; Male ; Malnutrition ; Metabolism ; Mortality ; Nutritional Status* ; Renal Dialysis* ; Risk Factors

Solitary neurofibroma of the glottis is extremely rare and accounts for only 0.1–1.5% of benign laryngeal tumors. Aryepiglottic fold is the most frequent involved site followed by arytenoids and ventricular folds. There have been few reports of neurofibroma of the true vocal cord. We report a case of neurofibroma which was deeply embedded in the vocal cord and misdiagnosed as muscle tension dysphonia with a review of literatures.
Dysphonia ; Glottis ; Larynx ; Muscle Tonus ; Neurofibroma ; Vocal Cords

Parathyroid adenoma can cause extracapsular bleeding. In 1934, Capps first reported a case of massive hemorrhage secondary to rupture of a parathyroid adenoma. Recently, we experienced a 73-year-old female presented with pharyngeal discomfort and extensive ecchymosis over the neck without history of trauma. Endoscopic investigation revealed submucosal hemorrhage in the posterior wall of the hypopharynx. CT scan and ultrasonography demonstrated the presence of a mass below the left thyroid lobe. Serum calcium level was normal and PTH level was elevated. We underwent left thyroidectomy and parathyroidectomy 2 weeks later from first visit. During the operation, hypopharyngeal mucosa was teared and it was treated with pharyngostoma formation and L-tube feeding. We report a rare case of normocalcemic parathyroid adenoma with spontaneous hemorrhage and propose the proper management period with a literature review
Aged ; Calcium ; Ecchymosis ; Female ; Hematoma ; Hemorrhage ; Humans ; Hypopharynx ; Mucous Membrane ; Neck ; Parathyroid Neoplasms ; Parathyroidectomy ; Rupture ; Tears ; Thyroid Gland ; Thyroidectomy ; Tomography, X-Ray Computed ; Ultrasonography

The use of antibiotics, including therapeutically in human and veterinary medicine, or as prophylaxis of growth promotion in animal husbandry, ultimately exerts selective pressure favorable for the propagation of antibiotic resistant bacteria. In this study we have determined the resistance for antibiotics of E. coli from pig farm environment, and investigate genetic relatedness by random amplification of polymorphic DNA (RAPD). Six farms were randomly selected in Gyeongsanman-do and Busan provinces for collecting samples from feces, manure and underground water. A total of 88 isolates from feces, 74 isolates from manure and 1 isolate from underground water were analyzed by antibiotic resistance and RAPD. Antibiotic resistance testing was performed by disk diffusion method using 16 antibiotics. The highest percentage of antibiotic resistance of isolates from feces and manure was found to the following antibiotics; tetracycline (100% and 100%), sulfamethoxazole/trimethoprim (60.2% and 62.2%), streptomycin (50.0% and 68.9%), chloramphenicol (56.8% and 56.8%), ampicillin (50.0% and 81.1%) and cephalothin (50.0% and 51.4%). Of isolates from feces and manure, 22.7% and 20.3% showed multiple resistance to 4 and 5 antibiotics, respectively. The isolates from GE pig farm showed six RAPD patterns. A single pattern, RAPD-C, was predominat in feces isolates (50.0%) and manual isolates (46.7%), and the rest of feces isolates showed RADP-A, B and E pattern and manure isolates showed D and E pattern. One isolate from underground water showed F pattern. The appearance of multiresistant in E. coli isolates from pig farms environment is a problem of major concern of public health and RAPD may offer an useful tool of discrimination for the epidemiological investigation.
Ampicillin ; Animal Husbandry ; Anti-Bacterial Agents ; Bacteria ; Busan ; Cephalothin ; Chloramphenicol ; Diffusion ; Discrimination (Psychology) ; DNA ; Drug Resistance, Microbial* ; Escherichia coli* ; Escherichia* ; Feces ; Groundwater ; Humans ; Manure ; Public Health ; Streptomycin ; Tetracycline ; Veterinary Medicine

BACKGROUND: The prevalence of childhood obesity in South Korea has increased owing to economic improvement and the prevailing Westernized dietary pattern. As the incidence of chronic diseases caused by obesity is also expected to increase, effective interventions to prevent childhood obesity are needed. Therefore, we conducted a Delphi study to determine the priorities of a potential intervention research on childhood obesity prevention and its adequacy and feasibility. METHODS: The two-round Delphi technique was used with a panel of 10 childhood obesity experts. The panelists were asked to rate “priority populations,”“methods of intervention,”“measurement of outcomes,”“future intervention settings,” and “duration of intervention” by using a structured questionnaire. Finally, a portfolio analysis was performed with the adequacy and feasibility indexes as the two axes. RESULTS: For priority populations, the panel favored “elementary,”“preschool,” and “middle and high school” students in this order. Regarding intervention settings, the panelists assigned high adequacy and feasibility to “childcare centers” and “home” for preschool children, “school” and “home” for elementary school children, and “school” for adolescents in middle and high school. As the age of the target population increased, the panelists scored increasing numbers of anthropometric, clinical, and intermediate outcomes as highly adequate and feasible for assessing the effectiveness of the intervention. CONCLUSION: According to the results of the Delphi survey, the highest-priority population for the research on childhood obesity prevention was that of elementary school students. Various settings, methods, outcome measures, and durations for the different age groups were also suggested.
Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Delphi Technique ; Health Services Needs and Demand ; Humans ; Incidence ; Korea ; Obesity ; Outcome Assessment (Health Care) ; Pediatric Obesity* ; Prevalence