• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.112-134
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• 2003

The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.147-154
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• 2001

Background : Bronchoscopy has been widely used for a histologic diagnosis through a transbronchial lung biopsy or for staging of patients with peripheral lung cancer. However a transthoracic needle aspiration (TTNA) has been used more widely for a histologic diagnosis in patient with a small size nodule or a nodule located in the outer portion of the lung because of the low diagnostic yield of bronchoscopy in these cases. The role of bronchoscopy for staging is not well established in patients with peripheral lung cancer diagnosed by a TTNA or patients who are undergoing surgery without a histologic diagnosis. Method: To evaluate the role of bronchoscopy for the staging in patients with peripheral lung cancer, who were diagnosed by TTNA, the medical records of 86 patients with peripheral lung cancer who underwent bronchoscopyat Kyungpook National University Hospital between January 1995 and May 1997 were reviewed. Results : While 53 cases had normal bronchoscopic findings, 33 cases had abnormal bronchoscopic findings comprising 9 cases of tumor, 10 cases of infiltration and 14 cases of compression of which there were 25 cases of T1 and 8 T2 endoscopically. The bronchoscopic staging did not influence the changes of the clinical stage of lung cancer. The frequencies of bronchial involvement tended to increase as the sizes of the nodule increased. Among the 42 patients who underwent surgery, 9 patients staged higher after operation because of lymph node involvement in 8 patients and the involvement of the pulmonary artery in 1 patient. No case staged above after operation due to a bronchial invasion. Conclusion : These findings suggests that bronchoscopy is not useful for staging in patients with peripheral lung cancer diagnosed by a TTNA.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.148-154
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• 2003

Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

• Journal of Mushroom
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• v.13 no.3
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• pp.212-216
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• 2015

A new commercial strain "Mongdol" of oyster mushroom was developed by hyphal anastomosis. It was improved with hybridization between monokaryotic strain derived from Pleurotus ostreatus ASI 0627 and dikaryotic strain derived from P. ostreatus ASI 2929. The optimum temperature of mycelial growth and fruiting body development were $25{\sim}30^{\circ}C$ and $12{\sim}18^{\circ}C$, respectively. When two different media including PDA (potato dextrose agar medium) and MCM (mushroom complete medium) were compared, the mycelial growth of this mushroom was faster in MCM than in PDA. Similar result was observed with the control strain P. ostreatus ASI 2504. Analysis of the genetic characteristics of the new cultivar "Mongdol" showed a different DNA profile as that of the control strain ASI 2504, when RAPD (Random Amplified Polymorphic DNA) primer URP3 and URP6 were used. Fruiting body production per bottle was about 106 g using demonstration farms. The color of pileus was blackish gray and the stipe was long. Therefore, we expect that this new strain "Mongdol" will satisfy the consumer's demand for high quality mushrooms.

• Asian Oncology Nursing
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• v.3 no.2
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• pp.145-154
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• 2003

Purpose: The study was to furnish basic raw materials that evaluate the efficacy of meatal care according to the form and the relative importance of symptom distress which most of cancer sufferers have been experienced. For that, an investigation of five diverse major cancer symptom distress made a comparison between symptom distress and degree of suffering. Method: Study subjects were 138 inpatients with stomach cancer, lung cancer, hepatocellular carcinoma(HCC), large intestine cancer and breast cancer, except those in the terminal-stage, in 'H' university hospital in Seoul and 'K' center in Ilsan gathered from November 20, 2002 to February 20, 2003. To measure the correlation between feeling of discomfort and agony caused by cancer, 5 point scale (from zero to four), stood on the basis of Symptom Distress Scale (SDS, Rodes & Watson, 1987), was used for this study and the Cronbach's coefficient alpha was 0.95. Accumulated data was analyzed with SPSS 10.0 for window, also used by ANOVA and Duncan's Multiple Range Test. Pearson's Correlation Analysis. Results: 1. Symptom distress of cancer patients was noted and defined in their severity-fatigue, anorexia, pain, depression, dyspepsia, changing appearance and nausea. The degree of symptom distress was fatigue, dyspepsia, depression, anorexia, pain, changing appearance and the degree of suffering was nausea, pain, anorexia, dyspepsia, vomiting, breathing difficulty, changing appearance and fatigue. 2. Examining the difference of degree of symptom distress in each cancer cases, it takes the precedence of them. First, in case of stomach cancer, depression, pain, vomiting and nausea were shown in sequence. In case of lung cancer depression, pain, sleeping problem, anxiety, changing appearance, inattentiveness and vomiting were showed in sequence, depression, changing appearance, sleeping problem, pain in case of HCC, depression, pain in case of large intestine cancer and lastly in case of breast cancer changing appearance, depression, pain and anxiety were shown in sequence. The category of the degree of symptom distress that has a signifiant difference was anorexia, activity discomfort, fatigue, constipation or diarrhea, breathing difficulty, dyspepsia, caughing, fever or chillness, scotoma and urinary disorder. Verifying the highest degree of symptom distress in each cancer cases, anorexia was 1.94(F=4.00, p<.01) in stomach cancer, activity discomfort was 0.97(F=3.08, p<.01) in lung cancer and HCC, fatigue was 2.32(F=4.64, p<.01) in HCC, constipation or diarrhea was 1.83(F=22.31, p<.001) in large intestine cancer, breathing difficulty was 1.83(F=4.00, p<.01) in lung cancer, dyspepsia was 2.69(F=9.98, p<.001) in stomach cancer, coughing was 1.53(F=20.49, p<.001) in lung cancer, fever or chillness was 1.23(F=6.88, p<.001) in lung cancer, scotoma was 1.20(F=3.02, p<.05) in lung cancer and urinary disorder was 1.54(F=11.56, p<.001) in HCC. 3. Examining the difference degree of suffering on cancer cases, the result was as follows; depression of lung cancer was 1.17(F=3.76, p<.01), anorexia of stomach cancer was 1.61(F=3.89, p<.01), constipation or diarrhea of large intestine cancer was 1.42(F=10.43, p<.001), changing appearance of breast cancer was 1.65(F=5.43, p<.001), breathing difficulty of lung cancer was 2.27(F=18.57, p<.001), dyspepsia of stomach cancer was 1.97(F=13.56, p<.001), coughing of lung cancer was 1.70(F=22.07, p<.001), fever or chillness of lung cancer was 1.13(F=4.41, p<.01), scotoma of lung cancer was 0.87(F=3.34, p<.05), anxiety of lung cancer was 0.87(F=4.50, p<.001) and urinary disorder of HCC was 1.43(F=16.71, p<.001). 4. In consequence, comparing between symptom distress and degree of suffering on cancer patients undergoing chemotherapy, lung cancer patients showed the highest feeling of discomfort following stomach cancer, HCC, breast cancer and large intestine cancer(F=2.88, p<.05). On those undergoing radiotherapy, lung cancer, HCC, breast cancer, large intestine cancer was in sequence(F=3.78, p<.05) and those resisting radiotherapy, lung cancer, HCC, stomach cancer, large intestine cancer and breast cancer was in sequence(F=2.72, p<.05). 5. Correlation between symptom distress and degree of suffering on cancer patients was generally significant. Conclusion: this study not only defines a significant correlation between symptom distress and degree of suffering but also proffers basic data to evaluate the efficient meatal care depending upon diverse spectrums of symptom distress and degree of suffering.

• Parasites, Hosts and Diseases
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• v.28 no.3
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• pp.143-154
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• 1990

Observations were made on the differences of cell-mediated responses in mice of three infectiorl groups di여erently scheduled in their severity with pathogenic Acanthamoeba culbertseni. Infections were done by dropping $5{\;}{\mu}l$ saline suspension containing $3{\times}10^3,{\;}1{\times}10^4,{\;}or{\;}1{\times}10^5$ trophosoites, respectively. Amoebae were cultured anenically in CGV medium and inoculated into the right nasal cavity of CSH/HeJ mice aging around 6∼8 weeks, under the anesthesia by intraperitoneal injection of secobarbital. Delayed type hypersensitivity (DTH) responses in footpad and blastogenlc responses of mouse spleen cells using ($^3H$)-thymidine and the serum antibody titer were measured up to day 14 after infection, and natural killer cell activities were measured up to day, i after infection. The results obtained in this study were as follows: 1. The mice infected with $3{\times}10^3$ trophosoites showed mortality rate of 17%, and 345 in the mice infected with $1{\times}10^4$ trophozoites and 65% with $1{\times}10^5$ trophozoites. 2. In regard to DTH responses in all experimental groups, the level increased on day 7 and declined on day 14 after infection, but their differences could not be noted between infected and control groups. 3. The blastogenic responses of splenocytes treated with amoeba Iysates and lipopolysaccharides (LPS) showed no difference from the control group. The blastogenic responses of splenocytes treated with concanavalin A were declined significantly in the experimental group as compared with the control group, but the blastogenic responses of splenocytes treated with polyinosinic acid were not different from the control group. There was also no difference among three infected groups. 4. The cytotoxic activity of the natural killer cells was activated on day 1 after infection and declined to the level of control group on day 2 in all experimental groups. On day 5 after infection, the natural killer cell cytotoxicity was significantly suppressed as compared with the control groups. 5. The serum antibody titers of the infected mice increased after day 7, but there was no statistical difference between the three infected groups. In summary of the results, there was no difference in cell-mediated immune responses of three experimental groups scheduled with different infection intensities. But there was a significant difference in cell$.$mediated immune responses between infected and control mice. It is considered that cell-mediated immune responses should be involved in murine model infected with A. culbertsoni.

• Investigative Magnetic Resonance Imaging
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• v.5 no.2
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• pp.149-154
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• 2001

Purpose : Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. Materials and methods ; We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. Results : FLAIR MR image was superior to CT in detecting SAH in the posterior fossa ($1.41{\pm}0.74{\;}vs{\;}0.78{\pm}0.80$; p<0.05) and cortical sulci ($1.11{\pm}0.80{\;}vs{\;}0.70{\pm}0.83$; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. Conclusion : FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.

• Korean Journal of Ecology and Environment
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• v.36 no.3 s.104
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• pp.356-368
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• 2003

Water quality of effluent from wastewater treatment plants (WWTPS) was reviewed to examine the feasibility of agricultural reuse using USEPA and WHO guidelines. It might meet the guidelines for BOD and SS, however, the most critical microbiological concentration was too high and further treatment is required. The pilot study of three treatments were performed to reduce microbiological concentrations. The UV irradiation was proved to be very effective in disinfection of secondary level effluent, and about 30 mW ${\cdot}$ s/$cm^2$ of dose was suggested to meet the even most stringent USEPA guidelines. Slow sand filter demonstrated effective removal of bacteria, and effluent concentration of total coliform (TC), fecal coliform (FC), and E. coli. dropped from about 10,000/100 mL to 300, 200, and 150 MPN/100 mL, respectively, showing over 95% removal. These level of bacterial concentration sufficiently meet the WHO guidelines ($10^3\;{\sim}\;10^5$ FC/100 mL), and could meet the more stringent USEPA guidelines (200 FC/100 mL) if properly applied. Slow sand filter also provided about 50% removal of SS, turbidity, and BOD in addition to bacterial removal. The removal efficiency of pond system was relatively poor, but still showed over 85% removal and effluent concentration of TC, FC, and E. coli was all below 10,000/100 mL. The pond system alone could meet the WHO guidelines, but hardly meet the USEPA guidelines and further treatment might be necessary. Overall, three methods evaluated in the study treat the effluent to meet the WHO microbiological guidelines for agricultural reuse. The UV disinfection and slow sand filter might also could the USEPA guidelines, while the pond system can hardly meet the USEPA guidelines if applied alone. The WHO and USEPA guidelines were made based on data from upland field agricultural system and may not be directly applicable to the paddy field agricultural system. Therefore, national standards for agricultural reuse of reclaimed water should be made considering domestic agricultural systems as well as international guidelines. Also, further investigation is recommended to develop optimum and feasible treatment measures for agricultural reuse of effluent from WWTPs.

• Journal of Yeungnam Medical Science
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• v.17 no.2
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• pp.146-154
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• 2000

Background and Purpose: Radioopaque lesions are commonly seen in patients who received thoracic radiotherapy for various kinds of thoracic neoplasm, But therir exact diagnos are sometimes uncertain. Patients and Methods: We examined simple chest radiograph and computed tomogram(CT) of 69 patients who received thoracic radiotherapy for lung cancer and were follow up at least 6 months in Yeungnam University Medical Center. Results: Of the 69 patients. thirty-eight patients showed radioopaque lesions in their chest radiographs except radiation fibrosis; radiation pneumonitis was witnessed in 24 patients. infectious pneumonia in 8 patients, and recurrence in 6 patients. In radiation pneumonitis patients, the pneumonitis occurred usually between 50 to 130 days after receiving radiation therapy, and interval between pneumonitis and fibrosis is 21 to 104 days. Simple chest radiographs of radiation pneumonitis(24 patients) represented ground glass opacities or consolidation in 4 cases(type I, 17%), reticular of reticulonodular opacities in 10 cases(type II, 42%), irregular patchy consolidations in 2 cases( type III, 8%), and consolidation with fibrosis in 8 cases(type IV, 33%), CT represent ground glass opacities or consolidation in 5 cases(type I, 29%), irregular nodular opacities in 3 cases(type II, 19%), irregular opacity beyond radiation fields in 3 cases(type III, 18%), and consolidation with fibrosis in 6 cased(type IV, 35%). The CT of four patients who represented type II on simple chest radiographs reveal type I and III, and CT of two patients with clinical symptoms who had no abnormal finding on simple radiograph revealed type I. Conclusions: In conclusion, computed tomogram is superior to the simple radiograph when trying to understand the pathologic process of radiation pneumonitis and provide confidence in the diagnosis of radiation induced lung disease.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.275-292
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• 2000

The purpose of this study was to analyze the relationship between knowledge, self-efficacy and quality of life of patients suffering from rheumatic arthritis. The data were collected from 100 rheumatic arthritis patients 1 university hospital, K rheumatic clinic in kwang-ju city for 20 days from March 2 to March 22, 1999, by means of questionnaires. The instruments used in this study were the knowledge scale developed by Kim, the self-efficacy scale developed by Long et al and the quality of life scale developed by Rho. The data were analyzed by t-test, ANOVA, Pearson's Correlation Coefficient, and Stepwise Multiple Regression by using the SAS program. The results of this study were summarized as follows : 1. The total mean score of knowledge was 15.01(SD${\pm}$3.08), In self-efficacy, the total mean score was 1030.40(SD${\pm}$233.42), In quality of life, the total mean score was 135.19(SD${\pm}$11.07). 2. The relationship between general characteristics and knowledge were significant difference in sex(t=19.03, p=.00), occupation(F=2.34, p=.03), types of exercise (F=2.95, p=.0.3), and time of exercise(F=3.20, p.=02). 3. The relationship between general characteristics and self-efficacy were significant difference in religion(F=2.75, p=.04), in monthly salary(F=3.64, p=.01), in occupation(F=2.30, p=.03), in period of rheumatic arthritis(F=2.70, F=.03), in time of exercise(F=3.77, P=.01), and in effectiveness of exercise (F=4.56, p= .02). 4. The relationship between general characteristics and quality of life were significant difference in age(F=3.36, p=.01), monthly income(F=3.11, p=.02), types of housing(t=4.93, p=.02), arid time of exercise(F=3.03, p=.03). 5. There was not significant correlation between the subjects knowledge and quality of life. 6. There was significant correlation between the self-efficacy and quality of life(r=462, p<.011). 7. The main factor influencing on quality of life was self-efficacy(21.4%).