BACKGROUND/OBJECTIVES: The purpose of this study was to evaluate the feasibility of application of the draft nutritional standards for school lunches in the Republic of Korea (South Korea) from the supplier perspective. SUBJECTS/METHODS: In November 2018, a pilot operation was conducted at 104 participating schools for 2 weeks each by applying the draft standards A and B. To evaluate the ease and appropriateness of application of the standards, we analyzed the nutritional values and food cost of the school lunches for 2 weeks before and for 4 weeks under the pilot operation. We conducted an online survey of school dietitians or nutrition teachers of the participating schools to evaluate the feasibility of application of the standards in school lunch sites. RESULTS: The proportions of schools of which lunches met the reference values of the school’s own nutritional standards were 19.2% for the standards A and 21.2% for the standards B. The food cost of school lunches applying the standards A (KRW 2,880) was significantly lower than that of school lunches applying the standards B (KRW 3,030) or the existing standards (KRW 2,980). As a result of the survey, the mean score for the ease of application was significantly higher for the standards B (2.75) than for the standards A (2.24). The proportions of school dietitians or nutrition teachers reporting no problem in meeting an existing food cost standard were 72.5% for the standards A and 61.8% for the standards B, respectively. The overall appropriateness of application was higher for the standards B, because almost two-thirds (58.8%) of the respondents answered that the standards B were more appropriate than the standards A. CONCLUSION The standards B were more feasible to apply as nutritional standards for school lunches than the standards A from the supplier perspective.

Purpose: This study examines the attitude of South Korean adults toward food aid to North Korea and factors associated with it. Methods: An online survey involving 1,000 adults aged 19–69 years was conducted between September–October 2019. Throughout South Korea, the subjects were proportionally distributed with respect to gender, age, and region, to represent South Korean adults. Results: A total of 44.6% of the respondents agreed (Agreement group), 36.7% disagreed (Disagreement group), and 18.7% neither agreed nor disagreed to food aid to North Korea. Compared to the Disagreement group, the Agreement group had a higher concern of food aid to North Korea and a more positive perception on the effect of it. The Agreement group selected “direct assistance from the government” whereas the Disagreement group chose “support through international organizations” as the most appropriate channel for food aid to North Korea. Logistic regression analysis revealed that South Korean adults showing a more positive perception on the effect of food aid to North Korea were more likely to agree to the aid (odds ratio [OR], 19.32). Moreover, compared to the conservatives, the progressives were more likely to agree to food aid to North Korea (OR, 5.94). South Korean adults in their 40–50s were more likely to agree to food aid to North Korea than those in their 20–30s (OR, 2.81). South Korean adults with a higher concern of food aid to North Korea (OR, 3.93) and a greater positive perception on Korean unification (OR, 1.88) were more likely to agree to food aid to North Korea. Conclusion The most important factor associated with the attitude of South Korean adults toward food aid to North Korea was their perception on the subsequent effect. As strategies to draw social consensus on food aid to North Korea, we recommend systematizing the monitoring process on the effect of providing food aid to North Korea and informing the public of the outcomes.

Objectives: The purpose of this study was to examine mothers’ knowledge levels on complementary foods and their perception of convenience complementary foods. Methods: An online survey was conducted with mothers aged 20–49 years who had purchased convenience complementary foods and had a preschool child aged 4 months or older. The respondents were categorized into 3 groups based on their knowledge scores:low- (0–50 points), mid- (55–65 points), and high- (70–100 points) knowledge groups. Results The average score of mothers’ knowledge on complementary foods was 58.8 out of 100 points. Working mothers were found to have lower levels of knowledge compared to mothers who were housewives. Only 1/4 of responding mothers had educational experience on complementary foods. Mothers expressed a desire for information on the types of complementary foods (72.2%) and the intake amounts (60.3%) corresponding to each phase of their child’s development. Multivariate analysis of variance revealed significant differences in health (P = 0.002), variety (P = 0.039), and hygiene (P = 0.041) among the factors taken into consideration when purchasing convenience complementary foods according to the mothers’ knowledge levels. Mothers in the high-knowledge group placed a greater importance on ‘balanced nutrition’ (P = 0.022) and ‘hygienic cooking’ (P = 0.010) compared to mothers in the low-knowledge group. The results of the modified importance-performance analysis, which compared the importance and performance of the factors taken into consideration when purchasing convenience complementary foods, highlighted the need for efforts in ‘health,’‘hygiene,’ and ‘price,’ while also indicating an excessive effort in ‘convenience.’ Conclusions: This study suggests expanding relevant education programs to enhance mothers’ knowledge on complementary foods, especially for working mothers. In the industry, marketing strategies for complementary food products could be developed that align with the needs of mothers, focusing on health, hygiene, and price.

BACKGROUND: Kawasaki disease (KD) is an acute inflammation of middle-sized arteries such as the coronary artery. KD is an important disease due to its high mortality rate, which approaches 1-2% without appropriate treatment. Since the various mucocutaneous lesions of KD are related to the dermatologic field, dermatologists should take an interest in this disorder and understand the lesions. OBJECTIVE: To evaluate the characteristics of cutaneous lesions in Korean patients with KD. METHODS: A total of 919 patients with KD were assessed at the department of pediatric cardiology and dermatology, Myongji hospital between January 2006 and December 2010. RESULTS: Of the 919 patients, 566 (61.6%) were diagnosed with typical KD and 353 (38.4%) with atypical KD. KD was most frequent in the 4 year-old group (22.7%), and the ratio of male to female was 1.5:1. Among the mucocutaneous manifestations, erythema of the oropharyngeal mucosa (75.7%) occurred most frequently, followed by polymorphous trunk rash (41.7%), and changes of palms and soles (25.6%). A total of 606 patients (65.9%) with KD had associated diseases as follows: pneumonia (211 patients; 34.8%), pharyngotonsilitis (168 patients; 27.7%), gastroenteritis (132 patients; 21.8%), asthma (15 patients, 2.5%), atopic dermatitis (11 patients, 1.8%). CONCLUSION: Our study shows that change in the lips or oral cavity is the most common mucocutaneous manifestation in both classic and atypical KD. Also, morbiliform rash is the most common pattern of polymorphous rashes. Interestingly, erythema multiforme-like lesions occupied accounted for a considerable portion of KD cases compared to previous studies.
Arteries ; Asthma ; Cardiology ; Coronary Vessels ; Dermatitis, Atopic ; Dermatology ; Erythema ; Exanthema ; Female ; Gastroenteritis ; Humans ; Inflammation ; Lip ; Male ; Mouth ; Mucocutaneous Lymph Node Syndrome ; Mucous Membrane ; Pneumonia

The incidence of drug-resistant tuberculosis (DR-TB) in pediatric populations is a critical indicator of national TB management and treatment strategies. Limited data exist regarding the rate of pediatric DR-TB. In this study, we aimed to analyze the status of DR-TB in Korean children from 2007 to 2013. We analyzed specimens submitted to the Korean Institute of Tuberculosis using Mycobacterium tuberculosis culture and drug susceptibility tests (DSTs) from January 2007 through December 2013. Specimens from patients ≤ 19 years of age were included. Among the 2,690 cases, 297 cases were excluded because of insufficient data, leaving 2,393 cases for the final analysis. In total, resistance to one or more TB drugs was 13.5%. The resistance rates of each of the drugs were as follows: isoniazid (INH) 10.2%, rifampin (RFP) 5.1%, ethambutol (EMB) 3.7%, and pyrazinamide (PZA) 3.1%. The resistance rate of multidrug-resistant TB (MDR-TB) was 4.2%, and that of extensively drug-resistant TB (XDR-TB) was 0.8%. The overall drug resistance rate demonstrated significant increase throughout the study period (P < 0.001) but showed no significant difference compared to previous study from 1999 to 2007. The drug resistance rate of PZA in ≤ 15 years of age group was significantly greater than that of > 15 years (P < 0.001). The drug resistance rate has increased throughout the study period.
Adolescent* ; Child* ; Drug Resistance ; Ethambutol ; Humans ; Incidence ; Isoniazid ; Mycobacterium tuberculosis ; Pyrazinamide ; Rifampin ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

An epiglottic cyst is a common form of laryngeal cysts which are rare causes of upper airway obstruction. A congenital laryngeal cyst always causes neonatal respiratory distress, but an acquired cyst shows very wide spectrum of symptoms such as no specific complaints, dysphagia, respiratory difficulty, or even death according to its size, location, or age. From anesthesiologists' point of view, an asymptomatic undiagnosed laryngeal cyst is a major concern. Unexpectedly, it can cause difficult airway such as 'cannnot intubate' or 'cannot intubate and cannot ventilate' situation during anesthesia. Recently we discovered an undiagnosed epiglottic cyst obscuring laryngeal inlet, leading to difficult intubation during general anesthesia for decompression and fusion of lumbar vertebrae. Fortunately, mask ventilation was possible, and after failed attempts of direct laryngoscopy, we could perform oral fiberoptic bronchoscope-aided intubation. He was discharged 10 days later with no harmful events.
Airway Obstruction ; Anesthesia ; Anesthesia, General ; Bays ; Bronchoscopes ; Decompression ; Deglutition Disorders ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lumbar Vertebrae ; Masks ; Ventilation

BACKGROUND AND OBJECTIVES: Endoscopic repair of cerebrospinal fluid (CSF) leak can avoid morbidity of open approaches and has shown a favorable success rate. Free mucosal graft is a good method, and multi-layered repair is more favorable. The inferior turbinate has been commonly utilized for the free mucosal graft, but we newly designed it as a bone-periosteal-mucosal composite graft for multilayered reconstruction. SUBJECTS AND METHOD: Four subjects with a skull base defect were treated with this method. The inferior turbinate was partially resected including the conchal bone and was trimmed according to defect size. Both bony parts and periosteum were preserved on the basolateral side of the mucosa as a composite graft. The graft was applied to the defect site using an overlay technique. RESULTS: All cases were successfully repaired without any complications. Three of them had a defect size greater than 10–12 mm, and the graft stably repaired the CSF leakage. CONCLUSIONS: Endoscopic repair of CSF leakage using inferior turbinate composite graft is a simple and easy method and would be favorable for defect sizes greater than 10 mm.
Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid* ; Methods ; Mucous Membrane ; Periosteum ; Skull Base ; Transplants* ; Turbinates*

This study was carried out to derive and evaluate reference computed tomography (CT)-based indices for normal canine spine. CT and magnetic resonance images were acquired from 12 clinically normal Beagle dogs (normal group) and 50 dogs with 56 spinal disorders (patient group). Image acquisition regions were cervical spine (C2–T1), thoracic spine (T1–T13), and lumbar spine (L1–L7). Measured indices were: the ratios of width to height of the spinal cord including the dura matter (CR) and of the vertebral foramen (FR), and the ratio of the cross-sectional area of the spinal cord to that of the vertebral foramen (CFAR). Reliability analysis was performed to evaluate intermodality agreement. Student's t-tests and receiver operating characteristic curves were used to discriminate the normal and patient groups on CT. Intermodality agreements of the normal and patient groups were acceptable to excellent. The highest discriminating levels of CR at the vertebral body level and the intervertebral disc space level were 1.25 or more and 1.44 or more, respectively. FR and CFAR had the highest discriminating level at the cervical region. This report presents quantitative information on canine spinal morphometry; the obtained indices may be helpful for CT screening of dogs with spinal disorders.
Animals ; Dogs ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Mass Screening ; ROC Curve ; Spinal Cord ; Spine

This study evaluated the feasibility of using texture analysis and machine learning to distinguish radiographic lung patterns. A total of 1200 regions of interest (ROIs) including four specific lung patterns (normal, alveolar, bronchial, and unstructured interstitial) were obtained from 512 thoracic radiographs of 252 dogs and 65 cats. Forty-four texture parameters based on eight methods of texture analysis (first-order statistics, spatial gray-level-dependence matrices, gray-level-difference statistics, gray-level run length image statistics, neighborhood gray-tone difference matrices, fractal dimension texture analysis, Fourier power spectrum, and Law's texture energy measures) were used to extract textural features from the ROIs. The texture parameters of each lung pattern were compared and used for training and testing of artificial neural networks. Classification performance was evaluated by calculating accuracy and the area under the receiver operating characteristic curve (AUC). Forty texture parameters showed significant differences between the lung patterns. The accuracy of lung pattern classification was 99.1% in the training dataset and 91.9% in the testing dataset. The AUCs were above 0.98 in the training set and above 0.92 in the testing dataset. Texture analysis and machine learning algorithms may potentially facilitate the evaluation of medical images.
Animals ; Area Under Curve ; Cats ; Classification ; Dataset ; Dogs ; Fourier Analysis ; Fractals ; Lung ; Machine Learning ; Neural Networks (Computer) ; Pattern Recognition, Visual ; Radiography, Thoracic ; Residence Characteristics ; ROC Curve