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The purpose of this study was to investigate the sanitation management of school foodstuffs and the sanitation knowledge of delivery company workers. A questionnaire that identified employee’s food safety sanitation management, knowledge, and practices was developed based on a review of the literature. The subjects consisted of 201 delivery company workers from 38 delivery companies in the Daegu and Gyeongbuk area. The workers were 30-39 years of age (41.3%) with 1-3 years of working experience (30.8%). Approximately 62% of the respondents were educated and had 1-2 years of food safety experience, 52.7% of the respondents delivered foodstuffs to two schools in the morning. The total score for delivery company worker sanitation knowledge was 3.75/7.00, which was low. The total mean sanitary performance score for factory workers was 4.58/5.00. They indicated that the most difficult part of the operation is delivering on time. Temperature management was another difficulty. In order to secure the best quality of school food to be supplied safely, the thorough sanitation education must be conducted to the school dieticians and delivery company managers. (Korean J Nutr 2011 44(1): 74 ~ 81)

This study assesses the sodium intake of adults by 24-hour urine analysis, dietary records review and a food intake questionnaire. Subjects were 236 adult female in Daegu. The results are summarized as follows: Sodium intake as indicated by the 24-hour urine analysis was 5,805.4 ± 3836.8 mg. This was significantly higher than intake indicated by dietary records (4415.4 ± 1935.1 mg) and the dish frequency questionnaire (DFQ 55)(4293.5 ± 1526.5 mg). The results of the 24-hour urine analysis and DFQ 55 showed that sodium intake was higher for the 65-to-74-year-old age group than for other age groups (p < 0.05, p < 0.05). Review of dietary records to examine typical sodium intake by food groups showed that 53.7% of the sodium consumed by subjects in all age groups came from seasonings and spices (2399.0 ± 1526.5 mg). The analysis of sodium intake by food groups using DFQ 55 showed 34.2% of their sodium came from consumption of kimchi (p < 0.001) and kimch, soup, stew and fish jorim accounted for 57.8% of total sodium intake. The results indicate positive correlation between age and sodium intake, as shown by the 24-hour urine analysis and food intake questionnaire (p < 0.05). Therefore, these results would be valuable as basic data for planning nutrition education for sodium intake reduction. (Korean J Nutr 2010; 43(1): 79 ~ 85)

Guided bone regeneration (GBR) is a technique that a barrier membrane is placed over the bone defect to prevent the cell growth from the connective tissue and epithelium. In this study, in order to determinewhether GBR technique could induce stress in rats, the standardized bone defect in rat calvaria was covered with apatitte membrane. Bone and brain tissues were collected from rats at 3 days, 2, 4, and 16 weeks post-operation, and then alteration of the new bone formation at the defects and stress-related factors were detected with histological examination and Western blot, respectively. From 4 to 16 weeks after the operation, the apatitte membrane was attached to the region of regenerated bone and encapsulated with a thick fibrous layer. Furthermore, the concentration of cortisol, a good indicator of stress, significantly increased 3 days post-operation. However, the increase at 3 days was returned to the basal level in 2 weeks. In Western blot analysis, the highest phosphorylation level of extracellular signalregulated kinase (ERK) was observed 3 day post-operation, while those of the c-jun N-terminal kinase (JNK) and p38 were detected 4 weeks post-operation. Taken together, the results suggest that GBR technique may induce the serious stress on the brain tissue via the induction of ERK phosphorylation during 2 weeks, and that the stress responses restored in 4 week via JNK and p38 signaling pathway.

The purpose of this study was to analyze the performance evaluation index for a salt reduction project. Questionnaires were developed in order to investigate salt reduction programs nationwide. The evaluation index and programs were analyzed through the case study of a salt reduction program in public health centers. The validity of the salt reduction program’s evaluation index was determined based on study of the Delphi survey and on discussion with nutrition and health care professionals. The Delphi survey showed that daily salt intake was the most valid nutritional evaluation index. Stroke mortality and stomach cancer mortality were good health care evaluation indexes. The method for measuring salt intake that had the greatest validity was a 24-hour urine collection. However, 24-hour urine collection had the lowest score for ease of performance. The combined scores of validity and ease of performance showed that the survey method for dietary attitude and dietary behavior, dietary frequency analysis (DFQ 15), and a salty taste assessment, in that order, were proper methods. The high reliability of the salty taste assessment indicated that the percentage of the population that exhibits proper salt intake (2,000 mg sodium or less daily) and the percentage of the population that consumes low-salt diets as nutritional evaluation indexes also will be helpful to evaluate performance of salt reduction programs.

We report a case of a premature newborn baby who presented with hyponatremia, hyperkalemia, and metabolic acidosis accompanied by severe polyhydramnios in utero. The baby was diagnosed with pseudohypoaldosteronism on the basis of normal 17-hydroxyprogesterone levels, elevated aldosterone, and clinical symptoms. His serum electrolyte levels were corrected with sodium chloride supplementation. Sodium supplementation was reduced gradually and discontinued at 5 months of age. At 5 months, the child was able to maintain normal serum electrolyte levels without oral sodium chloride supplementation, and showed normal physical and neurological development. This case illustrates that pseudohypoaldosteronism must be considered if a newborn infant with an antenatal history of severe polyhydramnios shows excessive salt loss with normal levels of 17-hydroxyprogesterone.

The purpose of this paper was to evaluate the effectiveness of a salt reduction education program. Subjects participating in this study were 251 employees (166 in the “educated” group, 85 in the “non-educated” group) at 8 hospital and industry food service operations in Daegu. After the salt reduction education program was carried out, a salty taste assessment of both groups was conducted. The educated group had statistically significant differences and the noneducated group did not have statistically significant differences. In terms of nutrition knowledge, while the nutrition knowledge of the educated group was increased (p < 0.001), that of the non-educated group rose at a rate of 0.92. In terms of dietary attitude, the educated group exhibited increased preference toward less salty foods when compared to the noneducated group (p < 0.001). Regarding dietary behavior, the score of the educated group was improved (p < 0.001), thereby indicating a preference for less salty taste. This means that nutrition education had influence on dietary behavior. However, after education, sodium excretion for the educated group was not significantly decreased, compared to before education. The results show that there was a positive correlation between salty taste assessment and dietary attitude and behavior for a high-salt diet. There was a positive relationship between attitude for a high-salt diet and sodium intake; when people prefere a more salty taste, they eat more sodium. Therefore, in order to change dietary preference away from salty taste and to decrease sodium intake, a nationwide, systematic and continuous salt reduction education program is needed. (Korean J Nutr 2009; 42(4): 350 ~ 357)

Recently, advances in perinatal and neonatal intensive care during the last decades have led to a dramatic increased survival of extremely preterm and extremely low birth weight infants (ELBWI

Purpose : We aimed to examine the effect of rooming-in care on newborn infants emotional stability by comparing them with those cared for in a nursery. Methods : Forty-eight full-term newborn infants born at Cheil General Hospital between July 1 and October 31, 2007, were enrolled. Twenty-four newborn infants were roomed-in in their mothers rooms (rooming-in group), and 24 newborns were cared for in the hospital nursery (the nursery group) for the first 3 days of their lives. Those with perinatal problems that required medical treatment were excluded. By using Brazeltons neonatal behavior assessment scale, we measured irritability and self-quieting as well as the duration of crying after heel-stick puncture for the newborn metabolic screening test. Results : The rooming-in group had a higher irritability score than the nursery group (6.8±1.7 vs. 4.2±2.1, P

Purpose : Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment. Methods : We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007. The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding. Results : Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy. Conclusion : In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.

Purpose : It has been described that the incidence of breastfeeding jaundice is 13% and that of breast milk jaundice is 2%. The incidence in Korea was believed to be higher, but there were no studies to prove this assumption. The purpose of this study was to investigate the incidence of jaundice of healthy breastfed full-term infants in Korea. Methods : 839 infants were enrolled who were admitted to the Postpartum Care Center of the Cheil General Hospital between January 1 and December 31, 2005, and were followed up for more than 7 days. Those infants were divided into 3 groups; Exclusive breastfeeding group; Partial breastfeeding group; Formula feeding group. If they became icteric, transcutaneous bilirubin (TcB) was measured by research nurses with JM-103 Jaundice meter (Konica Minolta sensing, Inc., Osaka, Japan). Using this method we investigated the incidence of breast milk jaundice of healthy breastfed full-term infants. Results : There were no significant differences in sex, birth weight, Apgar score, or obstetric risk factors among 3 groups but there were higher rates of vaginal delivery in the exclusive breastfeeding group. The incidence of breast milk jaundice was 10.8% in the exclusive breastfeeding group and 4.4% in the partial breastfeeding group. The incidence of breast milk jaundice in the breastfed infants was 6.3%. The incidence was significantly higher in the exclusive breastfeeding group than in the partial breastfeeding group. Conclusion : The incidence of breast milk jaundice of healthy breastfed full-term infants was 6.3%. It was found that the incidence of breast milk jaundice was higher in this study than in other countries. But it was not a population-based study, so further study with the large sample sizes is needed.

Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.

Purpose:We studied the usefulness of transcutaneous bilirubinometers in follow-up of bilirubin levels during phototherapy in neonatal jaundice patients. Methods:Transcutaneous bilirubin (TcB) was measured twice per day on 90 neonatal jaundice patients without risk factors of jaundice by transcutaneous bilirubinometer JM-103(Minolta/Hill-Rom Air-shields, Japan). TcB was measured simultaneously on the patched-forehead (TcB-PF), patched- chest(TcB-PC), unpatched-forehead (TcB-UF) and unpatched-chest (TcB-UC) of infants with neonatal jaundice. Plasma bilirubin (PB) was measured by American Optical bilirubinometer (American Optical Co, Buffalo, USA) within 30 minutes after transcutaneous bilirubinometer measurement. Each TcB was compared with PB. Results:In the study group, the mean gestational age was 38.6±1.3 wk, the mean birthweight was 3,207.0±472.1 g, the mean age at start of phototherapy was 4.9±0.9 days and the mean duration of phototherapy was 1.3±0.6 days. The correlation between TcB and PB level was observed. The correlation between TcB of the patched part (TcB-PF, TcB-PC) and PB was more significant than that of the unpatched part (TcB-UF, TcB-UC) and PB. The most significant correlation was between PB and TcB-PC. Conclusion:TcB was useful in the follow-up of jaundice during phototherapy as well the screening of jaundice in neonatal jaundice patients. TcB of patched-chest area was the most reliable site in transcutaneous bilirubinometer examination in neonatal jaundice patients

Purpose:The aim of this study was to analyze the results and contributing factors of catch-up growth in very low birth weight infants(VLBWI) at the corrected age of 2 years. In addition, we looked for a relationship between the catch-up growth and the development by the bayley scales of infant development II(BSID II). Methods:A retrospective analysis by evaluating medical records was done for the 76 VLBWI whose follow-up was possible up to a corrected age of 2 years, out of the 114 who had been treated in the neonatal intensive care unit during the January of 2000 to December of 2001 at Samsung Cheil Hospital. Based on the Standard Korean Infant's Growth Curve, the catch-up growth group was defined over the 10th percentile of weight at 2 years as the corrected age and the failed catch-up growth group was defined under the 10th percentile. We investigated the clinical factors and courses of each group and compared the scores of the BSID II. Results:The catch-up growth group of the VLBWI was 51 infants and the failed catch-up growth group was 25 infants. In comparison with maternal clinical factors, use of antenatal steroids was significantly higher in the catch-up growth group. In comparisn with clinical factors and courses of VLBWI, two clinical factors were significantly different between the two groups : birth weight and intrauterine growth retardation(IUGR). Numbers of delayed development were increased in the failed catch-up growth group but statistically significant differences could not be observed. Conclusion:The catch-up growth of the VLBWI was affected by the use of antenatal steroids, birth weight and IUGR. No significant differences regarding neurodevelopmental outcome were observed between the catch-up and failed catch-up growth groups.

Purpose:As hearing ability affects language and cognitive development, early detection and intervention of congenital hearing defects is very important. We analyzed the result of newborn hearing screening using automated auditory brainstem response and estimated the incidence of congenital hearing defects in newborn infants in Korea. Methods:Hearing screening tests were done on 7,218 newborn infants who were delivered at Cheil General Hospital from July 1, 2004 to June 30, 2005. The first screening test was done on the second day of life with automated auditory brainstem response(AABR) using ALGO○③ Newborn hearing screener(NatusⓇ Medical Incorporated, San Carlos, USA) with 35 dB sound level. The newborn infants who did not pass the initial screening test took the second screening AABR test before discharge from the nursery. Infants who did not pass these screenings at the nursery were followed up at the Department of Otorhinolaryngology, Samsung Seoul Hospital. Results:Total 7,218 infants(83.3 percent of total 8,664 live births of the Cheil General Hospital) were screened in the nursery, and 55 of them failed to pass the newborn screening. Among 55 infants who were referred, six were lost during follow-up, and 14 were confirmed as hearing impaired. Six of them(42.8 percent) do not have any risk factors for hearing impairment. We can estimate that the incidence of hearing defects is about 1.9-2.8 per 1,000 live births. Conclusion:Automated auditory brainstem response is an effective tool to screen the hearing of newborn infants. Congenital hearing loss is more frequent than metabolic diseases on which screening tests are available in the newborn period. About 40 percent of infants who have hearing defects do not have any risk factors for hearing impairment. Therefore, universal newborn hearing screening must be recommended to all neonates

In schizophrenia, when treatment using antipsychotics fails, lithium, which is known as an antimanic drug, can also be administered. It is reported that 12~20% of patients taking lithium develop nephrogenic diabetes lactotrophs. Hyperprolactinemia is induced by typical antipsychotics, as they block the dopamine-2 receptors of latotrophs in the pituitary gland. Therefore, atypical antipsychotics for decreasing the side effect, such as hyperprolactinemia, can be used. However, hyperprolactinemia can be induced by risperidone, one of the atypical antipsychotics. Here, a case of drug induced nephrogenic diabetes insipidus and simultaneous hyperprolactinemia, which occurred in a patient with schizophrenia, is reported (J Kor Soc Endocrinol 20:407～412, 2005). ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Background:Hyperlipidemia has been known as an independent risk factor in the development of coronary artery disease. This study was carried out to compare nutrient intakes, smoking status, antioxidant vitamins, and plasma lipids in patients with coronary heart disease(CHD and in normal healthy subjects among Korean population in Taegu. Possible causes of this disease in patients are discussed. Methods:Anthropometric assessments included mean intakes of nutrients, and the levels of plasma lipids(apolipoprotein (Apo) A-Ⅰ, Lipoprotein (Lp) (a), and antioxidant vitamins(such as vitamins A and E were measured in female and male subjects with CHD against healthy controls. Results:Dietary cholesterol and fat intakes were significantly higher in CHD groups in men and women. Total plasma cholesterol, LDL-C, triglyceride, thiobarbituric acid reactive substance (TB- ARS, atherogenic index and Lp(a levels were significantly higher in CHD patients than in the normal group in both men and women. Apo A-I, HDL-C and vitamin E levels were lower in CHD patients than in the normal group. The number of smokers was higher in CHD patients than in the normal group in both sexes of subjects. Conclusion:High fat and high cholesterol intakes seemed to be a major factor for the hyper- lipidemia in the CHD patients. Their abnormal lipoprotein profile, which appeared in patient plasma, corresponded well to dietary intake patterns. However, long term studies are needed to investigate * 본 논문은 1995년 한국인삼연초연구원 흡연위생과제 연구비 지원으로 이루어졌음. 교신저자:최명숙 702-701 대구광역시 북구 산격동 1370 전화 (053 950-6232 전송 (053 950-6229