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Early and mid-term results of pulmonary valve reconstruction in surgical repair of tetralogy of Fallot; comparison with other techniques of right ventricular outflow reconstruction (활로사징 완전교정술에서 폐동맥 판막 재건술의 조기 및 중기 결과; 우심실 유출로 재건 방법에 따른 비교)

  • Wang, Sheng Wen;Lee, Young Seok;Kim, Si Ho;Kim, Tae Hong;Ban, Ji Eun;Lee, Hyoung Doo;Chang, Yun Hee;Sung, Si Chan
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.635-642
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    • 2006
  • Purpose : The purpose of this study is to determine whether the new pulmonary valve reconstruction technique prevents short-term postoperative pulmonary regurgitation and improves early and mid-term clinical outcome. Methods : We reviewed postoperative echocardiographic variables and chest X-ray films from 31 patients who had undergone valve reconstruction(pulmonary valve reconstruction group : PVR) for the repair of TOF between April 2000 and August 2004. We compared the clinical data of these patients with those from 47 patients who had right ventricular outflow tract reconstruction with a monocusp valve(monocusp ventricular outflow patch group : MVOP) and 22 patients who had a transannular patch repair without a monocusp valve(transannular patch group : TAP). Results : In the PVR group, 25 patients(81 percent) had trivial or mild pulmonary regurgitation in their early post operative echocardiogram. Only 12 patients(26 percent) in the MVOP group had mild pulmonary regurgitation; and no patient in the TAP group had it. Pulmonary valve function was good in 96 percent of the PVR group, 36 percent of the MVOP group, and none in the TAP group in early post-operative echocardiogram. Follow-up echocardiogram(1, 2, 3, 4 years later) of the MVOP and TAP groups showed moderate pulmonary regurgitation and severely decreased valve function in almost all cases. However, in the PVR group 54 percent(16/28), 50 percent(14/28), 37 percent(9/24), and 31 percent(5/16) of the patients had trivial or mild pulmonary regurgitation 1, 2, 3 and 4 years after operation, respectively. The valve function remained good in 80 percent(24/30), 64 percent(18/28), 57 percent(12/21), and 31 percent(5/16) of the patients 1, 2, 3 and 4 years after operation respectively. Conclusion : Pulmonary valve reconstruction is effective in reducing pulmonary regurgitation and right ventricular dilatation in the repair of TOF, even though regurgitation increases with time. Further study is needed to determine long-term results.

Effects of inhaled corticosteroids on bone mineral density and bone metabolism in children with asthma (천식 환아에서 흡입용 스테로이드의 사용이 골밀도와 골대사에 미치는 영향)

  • Choi, Ic Sun;Byeon, Jung Hye;Lee, Seung Min;La, Kyong Suk;Oh, Yeon-Joung;Yoo, Young;Lee, Kee Hyoung;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.811-817
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    • 2009
  • Purpose : Inhaled corticosteroids (ICS) are used as first-line agents for the treatment of persistent asthma; however, their use is accompanied by apprehension of potential systemic adverse effects. This study aimed to assess the effects of ICS on bone mineral density (BMD) and bone metabolism in children with asthma. Methods : From February 2008 to September 2008, 26 asthmatic children treated with ICS (ICS group), 15 asthmatic children treated with leukotriene receptor antagonist (LTRA) (LTRA group), and 30 healthy children (Control group) were selected from the Korea University Anam Hospital. BMD and serum bone-specific alkaline phosphatase (BALP) levels were measured. The asthmatic children underwent spirometry and methacholine bronchial challenge test. Results : There were no significant differences in BMD in the lumbar spine (P=0.254) and proximal femur (P=0.297) among the 3 groups. The serum BALP levels were significantly higher in both the ICS (P=0.017) and LTRA (P=0.025) groups than in the Control group. None of the parameters pertaining to ICS use, such as the mean daily dose during the last 6 months, the total cumulative dose, duration of use, and age of commencement of use, showed significant correlations with BMD (P>0.05 for all parameters). Conclusions : We demonstrated that a low dose of ICS does not exert any significant adverse effect on bone metabolism in asthmatic children. These findings support the current recommendations with regard to the use of ICS for asthmatic children.

A Study on the Characteristics of Condensable Fine Particles in Flue Gas (배출가스 중 응축성미세먼지 특성 연구)

  • Gong, Buju;Kim, Jonghyeon;Kim, Hyeri;Lee, Sangbo;Kim, Hyungchun;Jo, Jeonghwa;Kim, Jeonghun;Gang, Daeil;Park, Jeong Min;Hong, Jihyung
    • Journal of Korean Society for Atmospheric Environment
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    • v.32 no.5
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    • pp.501-512
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    • 2016
  • The study evaluated methods to measure condensable fine particles in flue gases and measured particulate matter by fuel and material to get precise concentrations and quantities. As a result of the method evaluation, it is required to improve test methods for measuring Condensable Particulate Matter (CPM) emitted after the conventional Filterable Particulate Matter (FPM) measurement process. Relative Standard Deviation (RSD) based on the evaluated analysis process showed that RSD percentages of FPM and CPM were around 27.0~139.5%. As errors in the process of CPM measurement and analysis can be caused while separating and dehydrating organic and inorganic materials from condensed liquid samples, transporting samples, and titrating ammonium hydroxide in the sample, it is required to comply with the exact test procedures. As for characteristics of FPM and CPM concentrations, CPM had about 1.6~63 times higher concentrations than FPM, and CPM caused huge increase in PM mass concentrations. Also, emission concentrations and quantities varied according to the characteristics of each fuel, the size of emitting facilities, operational conditions of emitters, etc. PM in the flue gases mostly consisted of CPM (61~99%), and the result of organic/inorganic component analysis revealed that organic dusts accounted for 30~88%. High-efficiency prevention facilities also had high concentrations of CPM due to large amounts of $NO_x$, and the more fuels, the more inorganic dusts. As a result of comparison between emission coefficients by fuel and the EPA AP-42, FPM had lower result values compared to that in the US materials, and CPM had higher values than FPM. For the emission coefficients of the total PM (FPM+CPM) by industry, that of thermal power stations (bituminous coal) was 71.64 g/ton, and cement manufacturing facility (blended fuels) 18.90 g/ton. In order to estimate emission quantities and coefficients proper to the circumstances of air pollutant-emitting facilities in Korea, measurement data need to be calculated in stages by facility condition according to the CPM measurement method in the study. About 80% of PM in flue gases are CPM, and a half of which are organic dusts that are mostly unknown yet. For effective management and control of PM in flue gases, it is necessary to identify the current conditions through quantitative and qualitative analysis of harmful organic substances, and have more interest in and conduct studies on unknown materials' measurements and behaviors.

Effects of Iron from an Amino Acid Complex on the Iron Status of Neonatal and Suckling Piglets

  • Wei, K.Q.;Xu, Z.R.;Luo, X.G.;Zeng, L.L.;Chen, W.R.;Timothy, M.F.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.10
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    • pp.1485-1491
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    • 2005
  • This experiment was conducted to investigate the effects of iron from an amino acid complex (Availa-$Fe^{\circledR}$) on the iron status of neonatal and suckling piglets. A total of 24 gestating sows (Landrace${\times}$Large White) were randomly allocated to three dietary treatments. The control diet contained 80 mg $kg^{-1}$ Fe from ferrous sulfate heptahydrate ($FeSO_4$.$7H_2O$), while the two experimental diets were supplemented with an additional 120 mg $kg^{-1}$ Fe from Availa-$Fe^{(R)}$ or $FeSO_4$.$7H_2O$, respectively. The lactating sows remained the same iron treatments as gestating sows, while neonatal piglets of 24 litters born from the above sows were allotted to another three treatments. Piglets from the sows of the control treatment were fed basal diet with no supplemental Fe as control treatment, but were injected with 100 mg Fe as Fe dextran at birth. Piglets from the sows of Availa-$Fe^{(R)}$ or $FeSO_4$.$7H_2O$ treatments were supplemented with 120 mg $kg^{-1}$ iron from Availa-$Fe^{(R)}$ or $FeSO_4$.$7H_2O$, respectively. The total born alive and weaned, and the average piglets weight at birth and at weaning were not significantly affected by the sow' dietary treatments (p>0.05). Iron from Availa-$Fe^{(R)}$ did not demonstrate a statistically significant improvement in hemoglobin concentration, hematocrit and plasma iron of sows on day 90 and 105 of pregnancy and the milk iron of sows during lactation (p>0.05). Neonatal piglets in the Availa-$Fe^{(R)}$ treatment had a significantly higher hemoglobin concentration (p<0.05) and higher hematocrit and plasma iron (p>0.05) than those in the other two treatments, respectively. The hemoglobin of suckling piglets in the Availa-$Fe^{(R)}$ treatment was higher than that of piglets in $FeSO_4$.$7H_2O$ treatment on day 28 (p<0.05). The total iron binding capacity of piglets in Availa-$Fe^{(R)}$ treatment was lower than that of piglets in the control and $FeSO_4$.$7H_2O$ treatment on day 14 (p<0.05), but there was not a statistically significant difference among three treatments on day 28 (p>0.05). However, the hemoglobin and hematocrit of suckling piglets injected with Fe were higher than those of piglets in the other two treatments (p<0.05). This study indicated that the addition of 120 mg $kg^{-1}$ iron from amino acid complex into the diets improved iron status of neonatal and nursing piglets more effectively than the addition of 120 mg $kg^{-1}$ iron from $FeSO_4$.$7H_2O$, however, this improvement of the organic Fe was not sufficient to replace the Fe injection for prevention of iron-deficiency anemia.

A survey on sex life behavior and factors of low back pain (요통환자들의 성생활 행태와 영향 요인 조사)

  • Nam, Chul-Hyun;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.31-49
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    • 2002
  • The purpose of this study was to investigate discomforts and sexual life and to identify the relation between the discomforts and sexual life with low back pain. The data were collected from March 2 through July 31, 2001. Four hundred forty-two questionnaires were returned (response rate=88.0%). Analysis of the data was done with SPSS PC+ and use descriptive statistics, $x^2$-test, t-test, ANOVA. regression. The statistics shows that over than 80% of the adults experienced lumbago at least one time in their life, and Back pain is known as one of the most common complaints made by the patients of all ages in the general hospital or local medical clinics throughout. However, in certain case it leads to a chronic condition which can cause a great deal of problems in management and in financial burden to individuals and society. The result of this study was summarized as follows: 1) It appeared that regarding the distribution of gender, male was the higher(63.6%) then that of female, the portion of forties was 28.5%. Sitting for long time was 23.1% in men and 21.7% in women. Unknown reason including sexual behaviour was 12.9% in men and 15.5% in women. Patients treated medicine and physical therapy were 36.4%. In level of educational background, the rate of high school was 31.0%, technical college was 28.5%. The highest proportion by occupation was 18.3% of office workers, occupation posture was 41.9% of sitting. 2) Men(26.0%) and most of women(34.8%) were not satisfied in the explanation satisfaction rate of sex life concerned disease. 23.8% in men and 23.6% in women considered flexibility of waist good. Man(33.3%) and most of woman(35.0%) considered that Health education is necessary. 32.7% in men and 27.3% in women did't mind educator is whoever. Preventing of lower back pain(LBP) and proper Health education of sex life are demanded in daily life. 3) 58.0% of man and 64.0% of woman mostly had a posture which is man over woman. 28.5% in men and 27.8% in women considered that proper information finding of LBP and sex life was very few and few. 37.7% in men and 42.7% in women have acquired information about sex life flung their friends. 4) The number of sex life was decreased from 2.96 0.98 to 2.61 1.63 and also the time of sex life was decreased from 3.65 1.89 to 226 1.64. The satisfaction rate of sex life changed from 3.60 0.86 to 2.77 1.10. In the number of sex life, The non correct group was 2.62 1.91 and the correct group was higher in 2.68 1.65. In the time of sex life, The non correct group was 2.02 1.47 and the correct group was higher in 229 1.65. The satisfaction rate of sex life was 2.76 0.86 in non correct group and 2.88 1.10 in correct group. So there was a difference. 5) In the satisfaction rate of sex life, Men who have a lower back pain were higher than women and no attack group was higher than attack group. As they had many sex life, the satisfaction rate was higher significantly in statistics. As the time of sex life was short, the satisfaction rate was lower significantly in statistics. As the age was low, the demand rate of Health education was high and as means of patient who had a lower back pain was high, the demand rate of Health education was high. As the patient who had a lower back pain had a long married life, the demand rate of Health education was high and as education level was high, the demand rate of Health education was high. It is necessary to provide patients with conservative treatment, educational teaching, and training to prevent further injuries in the future. In general, it is important to educate the public how to prevent back injuries and how to treat themselves in an onset period to prevent further injuries sliding into a chronic state. Sexuality is an integral part of normal and healthy relationships, but patients are unable to enjoy sex because they are riot able to get into a comfortable position due to back pain. Many conditions of the spine can make certain positions uncomfortable. Health educator should make the education program of the discomforts and the sexual pattern for low back pain in workplace and/or hospital. Further study Is needed on how to integrate the educational program on sexuality into the total rehabilitation program.

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EFFECTS OF SUSPENDED SILT AND CLAY ON THE MORTALITY OF SOME SPECIES OF BIVALVES (이매패류의 폐사에 미치는 현탁부이의 영향)

  • CHANG Sun-duck;CHIN Pyung
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.11 no.4
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    • pp.227-231
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    • 1978
  • Effects of suspended silt and clay on the survival of the rearing bivalves, Meretrix lusoria, Cyclina sinensis and Mactra veneriformis were studied. During sixty-five days of experimental cultures in different concentrations of suspended silt and clay and in different time of immersions, mortalities of the bivalves were checked every day, and the rates of shell movement and oxygen consumption were measured. In general, the higher the concentration of silt and clay and the longer the immersion time, the earlier the occurence, and the higher the rate of the mortalities of the experimental bivalves. M. veneriformis was subjected to earlier mortality than the others, and the period of $50\%$ mortality was the shortest of the three species (37 days in 1,000 ppm), and longer was that of C. sinensis(42 days). Mortality of M. lusoria occured latest and $50\%$ mortality was seen at the immersion time of 50-51 days. Particularly, M. lusoria showed no mortality in the sea water with 100 ppm of suspended silt and clay, and even in the concentrations of 500 or 1,000 ppm they were able to survive without mortality only if the immersion time was short (12-18 hours per day). M. veneriformis and C. sinensis were also able to survive without mortality when the immersion time was short (12 hours per day) in low concentration (100 ppm). Shell movements of experimental bivalves varied depending upon species. In the case of M. veneriformis the shell was opened continuously and C. sinensis opened their shells frequently, while M. lusoria maintained their shells closed in any experimental concentrations of sea water with suspended silt and clay. Total metabolic activity of M. veneriformis was found to be highest while that of M. lusoria showed the lowest. Little difference of oxygen consumption in excised gill tissue was shown between the control group and the experimental groups. Consequently, it may be stated that the mortality results from a immersion in sea water with high concentration of suspended silt and clay for long-time although the survival rates of the experimental bivalves depend also upon the species, physiological conditions, concentration of suspended silt and clay and immersion time. The survival percentage of bivalve y in relation to the time (day) of immersion X in sea water of suspended silt and clay was found to be: $$M.\;lusoria\;(1,000\;ppm):\;y=7.7\times10^9\;\chi^{-4.77}\;(500\;ppm):\;y=259\chi^{-0.26}$$ $$C.\;sinensis\;(1,000\;ppm):\;y=-21\chi+936\;(\chi<44),\;y=-0.65\;\chi+35\;(\chi>44)$$ $$(500\;ppm):\;y=4.4\times10^5\;\chi^{-2.27}$$ $$M.\;veneriformis\;(1,000\;ppm):\;y=-18\chi+716\;(\chi<39),\;y=-0.89\chi+39\;(\chi>39)$$

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A Study on the Necessary Number of Bolus Treatments in Radiotherapy after Modified Radical Mastectomy (변형 근치적 유방절제술 후 방사선치료에서 볼루스 적용횟수에 대한 고찰)

  • Hong, Chae-Seon;Kim, Jong-Sik;Kim, Young-Kon;Park, Young-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.2
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    • pp.113-117
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    • 2006
  • Purpose: Post-mastectomy radiotherapy (PMR) is known to decrease loco-regional recurrence. Adequate skin and dermal dose are achieved by adding bolus. The more difficult clinical issue is determining the necessary number of bolus treatment, given the limits of normal skin tolerance. The aim of this study is to evaluate the necessary number of bolus treatment after PMR in patients with breast cancer. Materials and Methods: Four female breast cancer patients were included in the study. The median age was 53 years(range, $38{\sim}74$), tumor were left sided in 2 patients and right sided in 2patients. All patients were treated with postoperative radiotherapy after MRM. Radiotherapy was delivered to the chest wall (C.W) and supraclavicular lymph nodes (SCL) using 4 MV X-ray. The total dose was 50 Gy, in 2 Gy fractions (with 5 times a week). CT was peformed for treatment planning, treatment planning was peformed using $ADAC-Pinnacles^3$ (Phillips, USA) for all patients without and with bolus. Bolus treatment plans were generated using image tool (0.5 cm of thickness and 6 cm of width). Dose distribution was analyzed and the increased skin dose rate in the build-up region was computed and the skin dose using TLD-100 chips (Harshaw, USA) was measured. Results: No significant difference was found in dose distribution without and with bolus; C.W coverage was $95{\sim}100%$ of the prescribed dose in both. But, there was remarkable difference in the skin dose to the scar. The skin dose to the scar without and with bolus were $100{\sim}105%\;and\;50{\sim}75%$. The increased skin dose rates in the build-up region for Pt. 1, Pt. 2. Pt. 3 and Pt. 4 were 23.3%, 35.6%, 34.9%, and 41.7%. The results of measured skin dose using TLD-100 chips in the cases without and with bolus were 209.3 cGy and 161.1 cGy, 200 cGy and 150.2 cGy, 211.4 cGy and 160.5 cGy, 198.6 cGy and 155.5 cGy for Pt. 1, Pt. 2, Pt. 3, and Pt. 4. Conclusion: It was concludes through this analysis that the adequate number of bolus treatments is 50-60% of the treatment program. Further, clinical trial is needed to evaluate the benefit and toxicity associated with the use of bolus in PMR.

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Effect Assessment of Safety Education in Laboratories of Department of Dental Technology Applied of Theory of Planned Behavior (TPB) (TPB 이론을 적용한 치기공학 전공 대학생들의 실습실 안전교육 효과 평가)

  • Park, Jong-Hee;Lee, Myung-Sun
    • The Journal of Korean Society for School & Community Health Education
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    • v.9 no.2
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    • pp.15-31
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    • 2008
  • Objective: This study is a quasi-experimental study by nonequivalent control group pretest-posttest design, performed in order to identify whether the program developed on the basis of Ajzen(1988, 1991)'s theory of planned behavior (TPB) for predicting the safety behavior of students of department of dental technology affects intention toward safety behavior and general behavior. Therefore, the purpose of this study is to identify whether the safety education in laboratories in which knowledge is reinforced on the basis of the TPB theory affects safety behavior. Methodology: The theoretical framework of this study was established on the basis of the TPB by Ajzen(1988, 1991). This study was performed between May 20 and December 5, 2006, and the subjects included 101 in the experimental group and 98 in the control group, a total of 199. The experimental group was educated through six 50-minute sessions (twice a week) for three weeks. The experimental group was pretested, educated, and then asked to answer the pro-questionnaire after finishing the sixth session, but the control group was free from intervention. The research tool in this study was developed by the authors with reference to the process of tool development used in Schifter and Ajzen (1985) based on Ajzen and Fishbein(1980)'s tool development guide. Results: The data were analyzed through SPSS 14.0 version. The reliability test of attitude, subjective norm, perceived norm, intention, and behavior toward safety behavior as TPB variables was calculated of Cronbach's alpha coefficient, and general characteristics and the homogeneity test of the experimental and the control groups were analyzed through t test and $X^2$ test. According to the results of the analysis, the experiment group may be higher than the control group after the safety education in the scores of attitude, the subjective norm, the perceived norm, and the intention toward safety behavior as TPB independent variables showed no significant difference, but there was significant difference in the behavior and the knowledge. Meanwhile, according to the results of the pretest and posttest, eleven items in the experimental group and two items in the control group showed significant difference in the behaviors, and twelve in the former and four in the latter were significantly different in the knowledge. Conclusion: The safety education program developed on the basis of TPB was identified to enhance safety behavior and knowledge. Therefore, the safety education program used in this study for students of department of dental technology may be utilized as database for safety education in the department of dental technology.

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Analysis of Set-up Errors during CT-scan, Simulation, and Treatment Process in Breast Cancer Patients (유방암 환자의 모의치료, CT 스캔 및 치료 과정에서 발생되는 준비 오차 분석)

  • Lee, Re-Na
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.169-175
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    • 2005
  • Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.

Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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