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The Clinical Application and Results of Palliative Damus-Kaye-Stansel Procedure (고식적 Damus-Kaye-Stansel 술식의 임상적 적용 및 결과)

  • Lim, Hong-Gook;Kim, Soo-Jin;Kim, Woong-Han;Hwang, Seong-Wook;Lee, Cheul;Shinn, Sung-Ho;Yie, Kil-Soo;Lee, Jae-Woong;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.1-11
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    • 2008
  • Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

Structural Properties of Social Network and Diffusion of Product WOM: A Sociocultural Approach (사회적 네트워크 구조특성과 제품구전의 확산: 사회문화적 접근)

  • Yoon, Sung-Joon;Han, Hee-Eun
    • Journal of Distribution Research
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    • v.16 no.1
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    • pp.141-177
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    • 2011
  • I. Research Objectives: Most of the previous studies on diffusion have concentrated on efficacy of WOM communication with the use of variables at individual level (Iacobucci 1996; Midgley et al. 1992). However, there is a paucity of studies which investigated network's structural properties as antecedents of WOM from the perspective of consumers' sociocultural propensities. Against this research backbone, this study attempted to link the network's structural properties and consumer' WOM behavior on cross-national basis. The major research objective of this study was to examine the relationship between network properties and WOM by comparing Korean and Chinese consumers. Specific objectives of this research are threefold; firstly, it sought to examine whether network properties (i.e., tie strength, centrality, range) affect WOM (WOM intention and quality of WOM). Secondly, it aimed to explore the moderating effects of cutural orientation (uncertainty avoidance and individuality) on the relationship between network properties and WOM. Thirdly, it substantiates the role of innovativeness as antecedents to both network properties and WOM. II. Research Hypotheses: Based on the above research objectives, the study put forth the following research hypotheses to validate. ${\cdot}$ H 1-1 : The Strength of tie between two counterparts within network will positively influence WOM effectivenes ${\cdot}$ H 1-2 : The network centrality will positively influence the WOM effectiveness ${\cdot}$ H 1-3 : The network range will positively influence the WOM effectiveness ${\cdot}$ H 2-1 : The consumer's uncertainty avoidance tendency will moderate the relationship between network properties and WOM effectiveness ${\cdot}$ H 2-2 : The consumer's individualism tendency will moderate the relationship between network properties and WOM effectiveness ${\cdot}$ H 3-1 : The consumer's innovativeness will positively influence the social network properties ${\cdot}$ H 3-2 : The consumer's innovativeness will positively influence WOM effectiveness III. Methodology: Through a pilot study and back-translation, two versions of questionnaire were prepared, one in Korean and the other in Chinese. The chinese data were collected from the chinese students enrolled in language schools in Suwon city in Korea, while Korean data were collected from students taking classes in a major university in Seoul. A total of 277 questionnaire were used for analysis of Korean data and 212 for Chinese data. The reason why Chinese students living in Korea rather than in China were selected was based on two factors: one was to neutralize the differences (ie, retail channel availability) that may arise from living in separate countries and the second was to minimize the difference in communication venues such as internet accessibility and cell phone usability. SPSS 12.0 and AMOS 7.0 were used for analysis. IV. Results: Prior to hypothesis verification, mean differences between the two countries in terms of major constructs were performed with the following result; As for network properties (tie strength, centrality and range), Koreans showed higher scores in all three constructs. For cultural orientation traits, Koreans scored higher only on uncertainty avoidance trait than Chinese. As a result of verifying the first research objective, confirming the relationship between network properties and WOM effectiveness, on Korean side, tie strength(Beta=.116; t=1.785) and centrality (Beta=.499; t=6.776) significantly influenced on WOM intention, and similar finding was obtained for Chinese side, with tie strength (Beta=.246; t=3.544) and centrality (Beta=.247; t=3.538) being significant. However, with regard to WOM argument quality, Korean data yielded only centrality (Beta=.82; t=7.600) having a significant impact on WOM, whereas China showed both tie strength(Beat=.142; t=2.052) and centrality(Beta=.348; t=5.031) being influential. To answer for the second research objective addressing the moderating role of cultural orientation, moderated regression anaylsis was performed and the result showed that uncertainty avoidance moderated between network range and WOM intention for both Korea and China, But for Korea, the uncertainty avoidance moderated between tie strength and WOM quality, while for China it moderated between network range and WOM intention. And innovativeness moderated between tie strength and WOM intention for Korea but it moderated between network range and WOM intention for China. As a result of analysing for third research objective, we found that for Korea, innovativeness positively influenced centrality only (Beta=.546; t=10.808), while for China it influenced both tie strength (Beta=.203; t=2.998) and centrality(Beta=.518; t=8.782). But for both countries alike, the innovativeness influenced positively on WOM (WOM intention and WOM quality). V. Implications: The study yields the two practical implications. Firstly, the result suggests that companies targeting multinational customers need to identify segments which are susceptible to the positive WOM and WOM information based on individual traits such as uncertainty avoidance and individualism and based on that, develop marketing communication strategy. Secondly, the companies need to divide the market on Roger's five innovation stages and based on this information, enforce marketing strategy which utilizes social networking tools such as public media and WOM. For instance, innovator and early adopters, if provided with new product information, will be able to capitalize upon the network advantages and thus add informational value to network operations using SNS or corporate blog.

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Mechanical and Operational Factors Affecting the Efficiency of Rice Polishing Machines (정미기의 능률에 미치는 기계적 요인및 작동조건에 관한 연구)

  • No, Sang-Ha
    • Journal of Biosystems Engineering
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    • v.1 no.1
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    • pp.15-15
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    • 1976
  • In analyzing the operational characteristics of a rice whitening machine, the internal radial pressure of the machine was measured using strain gage equipment. Changes in cylinder and feed screw configurations, screen type, cylinder speed and counter-pressure levels were examined to determine their impact on the quality and quantity of milled rice and the performance of the machine. The results are summarized as follows: 1. The internal radial pressure in the whitening chamber varied with the surface condition of the grain being processed. During the first or second pass through the machine, pressure was relatively low, reached a maximum after two to three passes with combinations I and II, three to six with combination III and then began to fall. 2. The pitch of the feed screw and the size of the feed gate opening which determine the rate of entry of grain into the whitening chamber, appeared to be the most important factor aff-::cting the degree of radial pressure, quality and quantity of milled rice and the efficiency of the machine. Using a feed screw with a wide pitch (4.8cm), radial pressure was relatively high and head rice recovery ratio \vere quite low. In this case capacity and machine effic?iency were much higher than obtained when using a feed screw with a narrow pitch (2.3cm). Very significant responses in radial pressure, head rice recovery rates and machine capacity were observed with changes in cylinder speed and counter-pressure levels when using the wide pitch feed screw. 3. The characteristics of the screen which surrounds the whitening chamber had an important effect on whitening efficiency. The existence of small protuberances on the original screen resulted in significant increases in both machine capacity and efficiency but without a significant decrease in head rice recovery or development of excessive radial pressure. Further work is required to determine the effects of screen surface conditions and the shape of the cylinderical steel roller on the rate of bran removal, machine efficiency and recovery rates. The size of the slotted perforations 0:1 the screen affects total milled rice recovery. The opening size on the original screen was fabricated to accommodate the round shape of Japonica rice varieties but was not suitable for the more slender Indica type. Milling Indica varieties with this screen resulted in a reduction in total milled rice recovery. 4. An increase in cylinder speed from 380 to 820 rpm produced a positive effect on head rice recovery for all machine combinations at every level of counter-pressure used in the tests. Head rice recovery was considerably lower at 380rpm using a wide screw pitch when compared to the results obtained at speeds from 600 to 820 r.p.m. The effects of cylinder speed On radial pressure, capacity and machine efficiency showed contrasting results, depending on the width of the feed screw pitch. With a narrow feed screw pitch (2.3cm), a direct proportional relationship was observed bet?ween cylinder speed and both radial pressure and machine efficiency. In contrast, using a 4.8 centimeter pitch feed roller produced a series of inverse relationships between the above variables. Based on the results of this study it is recommended when milling Indica type long grain rice varieties that the cylinder speed of the original machine be increased from 500-600 rmp up to a minimum of 800 rpm to obtain a greater abrasive effect between the grain and the screen. The pitch of the feed screw should be also reduced to decr?ease the level of internal radial pressure and to obtain higher machine efficiency and increased quality of milled rice with increased cylinder speeds. Further study on the interaction between cylinder speed and feed screw pitch is recommended. 5. An increase in the counter pressure level produced a negative effect On the head rice recovery with an increase in radial pressure, capacity, and machine efficiency over all combinations and at every level of cylinder speed. 6. Head rice recovery rates were conditioned primarily by the pressure inside the whitening chamber. According to the empirical cha racteristics curve developed in this study, the relationships of head rice recovery ($Y_h$) and machine capacity ($Y_c$/TEX>) to internal radial pressure ($X_p$) followed an inverse quadratic function and a linear function respectively: $$Y_h^\Delta=\frac{1}{{1.4383-0.2951X_p^\ast+0.1425X_p^{\ast\ast}}^2} , (R^2=0.98)$$$$Y_c^\Delta=-305.83+374.37X_p^{\ast\ast}, (R^2=0.88)$$The correlation between capacity and power consumption per unit of brown rice expressed in the following exponential function: $$Y_c^\Delta=1.63Y_c^{-0.7786^\{\ast\ast}, (R^2=0.94)$$These relationships indicate that when radial pressure increases above a certain range (1. 6 to 2.0 kg/$cm^2$ based On the results of the experiment) head ricerecovery decrea?ses in a quadratic relation with a inear increase in capacity but without any decrease in power consump tion per unit of brown rice. On the other hand, if radial pressure is below the range shown above, power consumption increases dramatically with a lin?ear decrease in capacity but without significant increases in head rice recovery. During the operation of a given whitening machine, the optimum radial pressure range or the correct capacity range should be selected by controlling the feed rate and/or counter-pressure keeping in mind the condition of the grain, particulary the hardness. It was observed that the total number of passes is related to radial pessure level, feed rate and counter-pressure level. The higher theradial pressure the fewer num?ber of pass required but with decreased head rice recovery. In particular, when using high feed rates, the total number of passes should be increased to more than three by reducing the counter-pressure level to avoid decreaseases in head rice recovery (less than 65 percent head rice recovery on the basis of brown rice) at every cylinder speed. 7. A rapid rise in grain temperature seemed to have a close relationship with the pressure generated inside the whitening chamber and, subsequently with head rice reco?very rates. The higher the rate of increase, the lower were the resulting head rice recoveries.

Mechanical and Operational Factors Affecting the Efficiency of Rice Polishing Machines (정미기의 능률에 미치는 기계적 요인및 작동조건에 관한 연구)

  • 노상하;최재갑
    • Journal of Biosystems Engineering
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    • v.1 no.1
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    • pp.17-48
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    • 1976
  • In analyzing the operational characteristics of a rice whitening machine, the internal radial pressure of the machine was measured using strain gage equipment. Changes in cylinder and feed screw configurations, screen type, cylinder speed and counter-pressure levels were examined to determine their impact on the quality and quantity of milled rice and the performance of the machine. The results are summarized as follows: 1. The internal radial pressure in the whitening chamber varied with the surface condition of the grain being processed. During the first or second pass through the machine, pressure was relatively low, reached a maximum after two to three passes with combinations I and II, three to six with combination III and then began to fall. 2. The pitch of the feed screw and the size of the feed gate opening which determine the rate of entry of grain into the whitening chamber, appeared to be the most important factor aff-::cting the degree of radial pressure, quality and quantity of milled rice and the efficiency of the machine. Using a feed screw with a wide pitch (4.8cm), radial pressure was relatively high and head rice recovery ratio \vere quite low. In this case capacity and machine effic\ulcorneriency were much higher than obtained when using a feed screw with a narrow pitch (2.3cm). Very significant responses in radial pressure, head rice recovery rates and machine capacity were observed with changes in cylinder speed and counter-pressure levels when using the wide pitch feed screw. 3. The characteristics of the screen which surrounds the whitening chamber had an important effect on whitening efficiency. The existence of small protuberances on the original screen resulted in significant increases in both machine capacity and efficiency but without a significant decrease in head rice recovery or development of excessive radial pressure. Further work is required to determine the effects of screen surface conditions and the shape of the cylinderical steel roller on the rate of bran removal, machine efficiency and recovery rates. The size of the slotted perforations 0:1 the screen affects total milled rice recovery. The opening size on the original screen was fabricated to accommodate the round shape of Japonica rice varieties but was not suitable for the more slender Indica type. Milling Indica varieties with this screen resulted in a reduction in total milled rice recovery. 4. An increase in cylinder speed from 380 to 820 rpm produced a positive effect on head rice recovery for all machine combinations at every level of counter-pressure used in the tests. Head rice recovery was considerably lower at 380rpm using a wide screw pitch when compared to the results obtained at speeds from 600 to 820 r.p.m. The effects of cylinder speed On radial pressure, capacity and machine efficiency showed contrasting results, depending on the width of the feed screw pitch. With a narrow feed screw pitch (2.3cm), a direct proportional relationship was observed bet\ulcornerween cylinder speed and both radial pressure and machine efficiency. In contrast, using a 4.8 centimeter pitch feed roller produced a series of inverse relationships between the above variables. Based on the results of this study it is recommended when milling Indica type long grain rice varieties that the cylinder speed of the original machine be increased from 500-600 rmp up to a minimum of 800 rpm to obtain a greater abrasive effect between the grain and the screen. The pitch of the feed screw should be also reduced to decr\ulcornerease the level of internal radial pressure and to obtain higher machine efficiency and increased quality of milled rice with increased cylinder speeds. Further study on the interaction between cylinder speed and feed screw pitch is recommended. 5. An increase in the counter pressure level produced a negative effect On the head rice recovery with an increase in radial pressure, capacity, and machine efficiency over all combinations and at every level of cylinder speed. 6. Head rice recovery rates were conditioned primarily by the pressure inside the whitening chamber. According to the empirical cha racteristics curve developed in this study, the relationships of head rice recovery ($Y_h$) and machine capacity ($Y_c$/TEX>) to internal radial pressure ($X_p$) followed an inverse quadratic function and a linear function respectively: $$Y_h^\Delta=\frac{1}{{1.4383-0.2951X_p^\ast+0.1425X_p^{\ast\ast}}^2} , (R^2=0.98)$$ $$Y_c^\Delta=-305.83+374.37X_p^{\ast\ast}, (R^2=0.88)$$ The correlation between capacity and power consumption per unit of brown rice expressed in the following exponential function: $$Y_c^\Delta=1.63Y_c^{-0.7786^\{\ast\ast}, (R^2=0.94)$$ These relationships indicate that when radial pressure increases above a certain range (1. 6 to 2.0 kg/$cm^2$ based On the results of the experiment) head ricerecovery decrea\ulcornerses in a quadratic relation with a inear increase in capacity but without any decrease in power consump tion per unit of brown rice. On the other hand, if radial pressure is below the range shown above, power consumption increases dramatically with a lin\ulcornerear decrease in capacity but without significant increases in head rice recovery. During the operation of a given whitening machine, the optimum radial pressure range or the correct capacity range should be selected by controlling the feed rate and/or counter-pressure keeping in mind the condition of the grain, particulary the hardness. It was observed that the total number of passes is related to radial pessure level, feed rate and counter-pressure level. The higher theradial pressure the fewer num\ulcornerber of pass required but with decreased head rice recovery. In particular, when using high feed rates, the total number of passes should be increased to more than three by reducing the counter-pressure level to avoid decreaseases in head rice recovery (less than 65 percent head rice recovery on the basis of brown rice) at every cylinder speed. 7. A rapid rise in grain temperature seemed to have a close relationship with the pressure generated inside the whitening chamber and, subsequently with head rice reco\ulcornervery rates. The higher the rate of increase, the lower were the resulting head rice recoveries.

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The study of bone density assessment on dental implant sites (임플란트 식립 부위의 골밀도 평가에 관한 연구)

  • Park, Su-Won;Jang, Soo-Mi;Choi, Byoung-Hwan;Son, Han-Na;Park, Bong-Chan;Kim, Chang-Hwan;Son, Jang-Ho;Sung, Iel-Yong;Lee, Ji-Ho; Cho, Yeong-Cheol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.5
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    • pp.417-422
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    • 2010
  • Introduction: Bone density is one of the important factors for the long term success of endosseous implants. The bone density varies from site to site and from patient to patient. A preoperative evaluation of the bone density is quite useful to oral surgeons for planning dental implantation. More accurate information on the bone density will help surgeons identify suitable implant sites, thereby increase the success rate of dental implantation. This study examined the correlation between the bone density measured preoperatively by computed tomography (CT) and the implant primary stability measured by resonance frequency analysis. Furthermore, the effects of the implant sites, gender, age and generalized systemic disorder patients on the bone density and primary implant stability were examined. Materials and Methods: One hundred and fourteen patients were selected. None of the patients had undergone a tooth extraction or bone graft history in the previous year. Preoperatively, the patients underwent CT scanning to evaluate the Hounsfield unit (HU), and resonance frequency analysis (RFA) was used to evaluate the implant primary stability at the time of implant installation. All implants were 4.0 mm diameter and 11.5 mm length US II. All patients were recorded and the HU and implant stability quotient (ISQ) value were evaluated according to the sites, gender and age. Results: The highest HU values were found in the mandibular anterior site ($827.6{\pm}151.4$), followed by the mandibular molar site ($797{\pm}135.1$), mandibular premolar site ($753.8{\pm}171.2$), maxillary anterior site ($726.3{\pm}154.4$), maxillary premolar site ($656.7{\pm}173.8$) and maxillary molar site ($621.5{\pm}164.9$). The ISQ value was the highest in the mandibular premolar site ($81.5{\pm}2.4$) followed by the mandibular molar site ($80.0{\pm}5.7$), maxillary anterior site ($77.4{\pm}4.1$), mandibular anterior site ($76.4{\pm}11.9$), maxillary premolar site ($74.2{\pm}14.3$) and maxillary molar site ($73.7{\pm}7.4$). The mean HU and ISQ value were similar in females and males. (HU: P=0.331, ISQ: P=0.595) No significant difference was also found in the age group respectively. However, the correlation coefficients between the variables showed a closed correlation between the HU and ISQ value. Conclusion: These results showed close correlation between the bone density (HU) and primary stability value (ISQ) at the time of implant installation (Correlation coefficients=0.497, P<0.01). These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis.

A Clinicopathological Study of Rapidly Progressive Glomerulonephritis in Children (소아 급속 진행성 사구체 신염의 임상-병리학적 고찰)

  • Cho Hee-Yeon;Chung Dae-Lim;Kang Ju-Hyung;Ha Il-Soo;Choi Yong;Cheong Hae-Il
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.176-185
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    • 2004
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

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A study on the adjustment problems of the aged (노후적응에 관한 연구 - 생활만족도 및 가족의 교류도를 중심으로-)

  • 서병숙
    • Journal of the Korean Home Economics Association
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    • v.27 no.2
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    • pp.133-148
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    • 1989
  • This study attempts of analyze empirically the living status of the elderly in Korea by finding out the problems of it in the family and by clarifying the influences of the family environmental variables and the values on the adjustment of the aged. To carryout the aim of this study, the causes and the patterns of the problems for the aged had been found out through the review of literature. Based on them the questionnaire was prepared including the questions of the values, family environmental vriables as well as the degree of satisfaction of thier liver and the extent of life interchange. The former variables were taken as independent and the latter were taken as dependent variables, so that the relationship between the two variables could be exemplified. The 400 aged over 60 living in Seoul and the other cities were selected through the purposive sampling and interviewed. The answers of the 376 respondents, 94% of the sample, were analyzed for this study. The following results have been found out through the various statistical analysis such as frequency distribution, chi-square test, pearson's correlation, analysis of variance and cluster analysis. At first, the results from the examination of the frequency distribution regarding the living status of the aged are; I) sixteen percent of the respondents living with their married offspring were receiving economical support, though they pointed out the problems of the extended family are the inconveniences with their children (60%) and simpleness (20%) of their livers. It seems that the aged in Korea are poor and have negative opinion on the relationship with their offspring even if they live in the same house. Secondly, it has been found out that the family environmental variables, especially such as sex, occupation, residence, education, level, living ability and the family type, play and important role not only on the degree of satisfaction of their liver but also on the extent of interchange of their lives. However, the variables such as religion and whether the spouse is alive or not do not play and important role. Thirdly, the reported main reasons of their delightness were healthy life (1.87%), the well-being of their offspring (2.08%), the spouse's long life (3.38%), religious activity (5.05%), the hobby activity (4.31%) and the participation in the social activity (5.05%). While, they mainly concern about the illness (1.98%), offspring (2.00%), econmic difficulties (3.39%), inharmonious home (3.81%) and the despicable treatment (3.81%). The respondents wer classified into two groups, they are dependent and independent, using cluster analysis. Health, social activity, offspiring, religion, couple's long life among the factors which lead them to be delighted were turned out to be statistically signhificant at 0.01 significance level between the two groups. As far as their worrisome matters are concerned, health and economic difficulties were significantly different between the two groups. Fourthly, regarding the life interchange, it has been proved that there is a statistically significant differences betwwen the two groups in the economic and the emotional satisfaction, help for ordinary life, status in the family, subjective and objective relationship with offspring, but not in economic dependency and the activity status. Fifthly, it has been noted that there is a high correlation between the degree of life's satisfaction and the extent of life interchange. On the basis of the results mentioned above, it could be concluded taht; i) The majority of the aged in Korea are not economically active, and thus they live with their married offspring even of they have a negative opinion on the subjective relationship with them. This can be pointed out as the main problem of the aged and thus it needs to be studied further. ii) the environmental variables such as age, sex education level, family type and occuption (which can not be changed by their effrot) turned out to give an important effect on the extent of the life interchange among the aged. iii) The respondents who are identified as independent group have a higher degree of life satisfaction and family status than the group identified as defendent. Thus, it can be inferred that it is possible for them to adjust their life by making an effort to modify themselves. iv) The high correlation between the extent of life interchange and the degree of life satisfaction indicates that the elderly themselves can adjust in order to obtain the higher degree of life satisfaction. Therefore, the following suggestions are derived from this study. First of all, the aged should try to be psychologically independent. Second, they need to control themselves in order to achieve self-assurance. Third, the community have to prepare a program of self-development for the aged. Fourth, the social welfare policy that can solve the problem of illness and poverty of the elderly should be introduced, so that their minimum requirements can be satisfied.

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An Analysis of Teachers' Level of Usage and Concern Over the 7th Science Curriculum (제7차 과학 교육과정에 대한 지구과학 교사들의 관심도와 활용도 분석)

  • Lee, Yong-Seob;An, Hyun-Hee;Kim, Sang-Dal;Kim, Jong-Hee
    • Journal of the Korean earth science society
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    • v.24 no.5
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    • pp.378-392
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    • 2003
  • The purpose of this study is to investigate the depth of earth science teachers' concern over the 7th Science Curriculum and levels of their use of it in reality, using the tools "Concern" and "Levels of use" which are two important tools use in CBAM. The results of the study are as follows. How much concern do the earth science teachers have over the 7th Science Curriculum? There are seven stages (from 0 stage to 6 stage) of teachers' concern over the curriculum. o stage represents teachers' indifference to the curriculum and 98% teachers are placed in this stage. According to the study on teachers' teaching experience, teachers having from 10 to 14 years of teaching experience are the most indifferent to the 7th Science Curriculum, compared to other teachers. Which levels of use of the 7th science curriculum do earth science teachers choose in reality? There are five levels of use (from 1 to 5) of the 7th curriculum. 43.97% of teachers are placed in the 3rd level called "Mechanical level", which represents a teacher-concerned learning method with consideration of learners' response. According to the study on teachers' frequency of level of use in the fields of "Instruction objects, Instruction contents, Instruction methods, Instruction materials and Evaluation.", teachers chose high levels of use in the fields of "Instruction objects and Instruction contents" and low levels of use in the other three fields. What factors are barriers for earth science teachers to perform the 7th Science Curriculum in reality? 80.9% of teachers have trouble performing the 7th Science Curriculum in reality because of too much routine work, official papers, and lack of instructional materials, laboratories, training systems and workshops. The two biggest barriers among the above are routine work and of official papers. According to the study on teachers' teaching experience, teachers having from 0 to years of teaching experience have the most trouble in performing the curriculum in reality, compared to other teachers.

A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance - (병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 -)

  • Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.7 no.1
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II

  • Oh, Seil;Kim, June-Soo;Oh, Yong-Seog;Shin, Dong-Gu;Pak, Hui-Nam;Hwang, Gyo-Seung;Choi, Kee-Joon;Kim, Jin-Bae;Lee, Man-Young;Park, Hyung-Wook;Kim, Dae-Kyeong;Jin, Eun-Sun;Park, Jaeseok;Oh, Il-Young;Shin, Dae-Hee;Park, Hyoung-Seob;Kim, Jun Hyung;Kim, Nam-Ho;Ahn, Min-Soo;Seo, Bo-Jeong;Kim, Young-Joo;Kang, Seongsik;Lee, Juneyoung;Kim, Young-Hoon
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.323.1-323.12
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    • 2018
  • Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.