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Hepatotoxicity of Rifampicin and Pyrazinamide Treatment Excluding Isoniazid (Isoniazid를 제외한 Rifampicin과 Pyrazinamide 병합치료의 간독성 빈도)

  • Choi, Ik Su;Park, I-Nae;Hong, Sang-Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.38-43
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    • 2006
  • Background : Even though two-month rifampicin (RMP, R) and pyrazinamide (PZA, P) treatment has some advantages over isoniazid (INH, H) treatment for latent tuberculosis infection (LTBI), it was withdrawn from the list of treatment regimens for LTBI because of reported cases of severe hepatotoxicity. The purpose of this study was to estimate the frequency of hepatotoxicity of RMP and PZA treatment excluding INH in a Korean population. Method : TIn order to recruit patients who were prescribed RMP and PZA excluding INH, 256 INH-resistant tuberculosis patients were investigated through retrospective medical record analysis. A standard four-drug regimen was changed to a RMP/PZA-containing regimen excluding INH in 64 patients (RZ+ group). In the same study period, 146 patients who were prescribed an INH/RMP/PZA-containing standard regimen were randomly selected as a control (HRZ+ group). Clinical characteristics including liver diseases and the frequency of drug-induced hepatitis were compared between the RZ+ and HRZ+ groups. Result : The mean age of patients in the RZ+ group was 50.2 (${\pm}16.2$) and the male-to-female ratio was 36:28. The frequency of underlying liver diseases was 10.9% (7/64), which was not significantly different from that of the HRZ+ group (4.1%, 6/146). Even though the treatment duration of RZ+ ($5.5{\pm}4.8months$) was longer that than that of HRZ+ ($2.7{\pm}2.3months$), the frequency of toxic hepatitis was not significantly different between RZ+ and HRZ+ groups, 3.5% (2/57) and 7.1% (10/140), respectively. Conclusion : Hepatotoxicity was mild and occurred in a minor proportion of patients in a Korean population prescribed an RMP/PZA-containing regimen. A future prospective study including more patients is needed.

Effect of Enzymes Application in Feed with Reduced Concentrations of Energy and Crude Protein in Broiler Chickens (육계에서 에너지 및 조단백질 저감 사료 내 효소제의 적용 효과)

  • Kim, Woong Lae;Kwon, So Hee;Kim, Kwan Eung;Kim, Eun Jib;An, Su Hyun;Kong, Changsu;Kim, Soo Ki;An, Byoung Ki
    • Korean Journal of Poultry Science
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    • v.47 no.3
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    • pp.143-151
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    • 2020
  • This study investigated the effects of the addition of commercial enzyme products to broiler feed with reduced levels of metabolizable energy and crude protein on the growth performance, blood profiles, and cecal microflora. A total of 750 seven-day-old male Ross 308 broiler chicks were randomly allotted to five treatment groups with six replicates (25 birds/replicate) for 28 days. A corn-wheat-soybean meal-based diet was formulated to meet or exceed the nutrient recommendations and used as the control diet. Experimental diets with metabolizable energy reduced by 100 kcal/kg and crude protein by 1% were formulated containing four different commercial enzyme products. Feed intake and weight gain were not affected by the dietary treatments; however, feed conversion ratios were significantly lower (P<0.01) in the control group than in the other treatment groups during the entire experimental period. There were no significant differences in the blood profiles and cecal microflora between the dietary treatments. However, the viscosity of jejunal contents in chicks fed a diet with enzyme B was significantly lower than that in the other groups. The tentative marketing age was unaffected by any of the dietary treatments, and ranged from 26.39 d to 26.84 d. Collectively, the use of commercial enzymes contributed to a similar weight gain as that in chicks fed diets with reduced energy and crude protein levels; however, it failed to maintain the feed conversion ratio.

The Analysis and Strengthening Method of Export Competitive Power of Medical Device Industry - With Respect to Medical Device Industry in Gangwon Area (의료기기산업의 수출경쟁력 분석 및 강화방안 -강원지역 의료기기산업을 중심으로-)

  • Lee, Kang-Bin
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.45
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    • pp.191-238
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    • 2010
  • The purpose of this paper is to make research on the trend of the worldwide medical device market, the trend of the medical device market in the major foreign countries, the present status of the medical device industry in Korea and Gangwon area, the present status of export competitive power and the SWOT analysis of competitive power of the medical device industry in Gangwon area, and the strengthening methods of export competitive power of the medical device industry in Gangwon area. As the research method, the questionaire for the strengthening of export competitive power of the medical device industry in Gangwon area was carried out from August 13 to Otober 22, 2009. The worldwide medical device market in 2008 is estimated at USD 210.2 billion, with the United States being the largest market, followed closely by Japan and Western Europe. In 2006, the worldwide export amount of medical devices recorded USD 121.1 billion and the worldwide import amount of medical devices recorded USD 126.3 billion. As of the end of 2008, the number of Korea's medical device manufacturers expanded to 1,726. The production amount of Korea's medical device industry in 2008 recorded 2,525 billion won, and the domestic market volume of medical devices in 2008 recorded 3,618 billion won. Korea's export amount of medical devices in 2008 recorded USD 1,132 million and recorded a 9.67% growth compared to the previous year, and the import amount of medical devices recorded USD 2,123 million and recorded a 1.43% reduction compared to the previous year. As of the end of 2008, the number of Gangwon area's medical device manufacturers expanded to 81. The production amount of Gangwon area's medical industry in 2008 recorded 380 billion won, and Gangwon area's export amount of medical devices recorded USD 269 million and recorded a 0.25% reduction compared to the previous year, and the import amount of medical devices recorded USD 3 million and recorded a 39.63% reduction compared to the previous year. According to the result analysis of the questionaire for the strengthening of export competitive power of medical device industry in Gangwon area(August 13~October 22, 2009), the competing country of the export medical device is the United States being the highest ranking. Comparing to the collective competitive power level 100 of the competing country, the collective competitive level of the export medical device is 60 below and 70-80 below being the highest ranking. Comparing to the quality level 100 of the United States, EU and Japan, the quality level of the export medical device is 80-90 below being the highest ranking. Comparing to the design level 100 of the United States, EU and Japan, the design level of the export medical device is 90-100 below being the highest ranking. Comparing to the technology level 100 of the United States, EU and Japan, the technology level of the export medical device is 80-90 below being the highest ranking. According to the SWOT analysis of competitive power of medical device industry in Gangwon area, the strength is the abundant expert manpower of the medical device in Wonju area. The weakness is the fragility of the brand recognition of the medical device industry. The opportunity is the demand increase of the new medical device owing to the advanced age of population. The threat is the difficulty of entry into overseas market owing to the request of the new specification certification of the medical device. In order to strengthen the export competitive power of the medical device industry in Gangwon area, the following measures should be taken by the government, local self-government body, related organization and medical device industry : the development of new technology and design, the enhancement of brand recognition. the acquisition of the foreign specification certification, the building of overseas distribution channel and after sales service channel, the positive participation in overseas medical device exhibition and opening of medical device exhibition, the training of expert manpower, the strengthening of overseas marketing, and the application of FTA and the establishment of counter measures against FTA. In conclusion, the medical device industry in Gangwon area has the difficulty in the entry into the overseas market owing to the shortage of overseas marketing capability. Therefore, the government and local self-government body should make the intensive and systematical support for overseas marketing of the medical device industry. For the support of overseas marketing, the government and local self-government body should provide positively the support of expenses for the acquisition of foreign specification certification, the support of participation in the overseas medical device exhibition, the despatch of market development mission, the increase of the support amount for R&D investment fund, and the training of expert manpower of medical devices.

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The Variation of Natural Population of Pinus densiflora S. et Z. in Korea (IX) -Needle and Wood Characteristics of Six Populations- (소나무천연집단(天然集團)의 변이(變異)에 관(關)한 연구(硏究)(IX) -광주(廣州), 제천(堤川), 보은(報恩), 무주(茂朱), 구례(求禮), 제주집단(濟州集團)의 침엽(針葉) 및 재질형질(材質形質)-)

  • Yim, Kyong Bin;Lee, Kyong Jae
    • Journal of Korean Society of Forest Science
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    • v.44 no.1
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    • pp.1-25
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    • 1979
  • Six natural populations of Pinus densiflora S. et Z. as shown in the location map (Flg 1) were studied during 1978. The numerial pouplation codes, 13 to 18. The results of populations 1 to 12 were reported in previous papers. Following the study methods described before, 20 trees were sampled from each population and morpological characteristics such as stem forms, branching habit needle and wood properties investigated. The results are summerized as follows; 1. The mean stand ages were ranged from 36 to 97 of years. The growth performances of trees of population 14. 15 and 18 was similar, but 13, 16, and 17 seemed to be inferior more or less. 2. The ratios of clear bole length were 0.70 in population 18 as the highest but 0.28 for population 16 as the lowest. 3. The population 17 was considered to be a stand of the coarser branching habit having the crown index (The maximum crown diameter/the crown height) 158 though the branching angles were almost horizontal. 4. The differences were observed in the clear bole length ratios and crown-indices between population as shown In Fig. 3 and 4. 5. As to the serration density, number of stomata row and resin duct; the significant differences exist between individual trees within population and also between populations. 6. Population 18 shown resin duct index 0.119 as the maximum. 7. The patterns of diameter growth, based on the width of 10-year-ring segment unit(for example, the 1st segment denotes the with between pith center and 10th year ring and the 2nd one is from 11th to 20th ring and so on.), were alike among populations as shown in Fig 9. 8. Significant differences between population in mean summer wood percentage as well as in wood specific gravity was observed. The values of wood specific gravity were increased with the increase of ages in population 14, 18 however vice versa in population 13, 15, and 17. 9. The fiber length was mereased with the increased of age but no differences between populations as shown in Fig. 12.

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A DOUBLE BLIND CROSS-OVER COMPARISON OF ANTIDEPRESSANT AND ANTIANXIETY EFFECTS OF PAROXETINE AND PLACEBO IN CHILD-ADOLESCENT AND ADULT DEPRESSIVE NEUROSIS (소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에 대한 Paroxetine의 항우울 및 항불안 효과 검증 : 위약과의 이중맹 교차 비교실험)

  • Kim, S. Peter;Hong, Kyung-Sue
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.83-92
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    • 1994
  • Paroxetine is a potent and selective serotoin re-uptake inhibitor. It is well known as an effective and safe antidepressant and increasingly used for neurotic or non-psychotic depression with anxiety symptoms. The present study assessed antidepressant and antianxiety efficacy and tolerability of paroxetine against placebo in child-adolescent and adult depressive neurosis patients. 232 subjects aged 8-55 years and meeting DSM-III-R criteria for depressive neurosis or dysthymia were divided into 8 subgroups according to their sex and age(8-11 yeard old, 12-17 years old, 18-35 years old and 36-55 years old subgroup in each male and female group). In each subgroup, the randomly assigned half of the patients were treated with paroxetine(10-30mg/day) and the others with placebo for the first 2 weeks in double blind fashion. After 1 week of drug-washout period, paroxetine and placebo groups were crossed over. The depression and anxiety symptoms were assessed with Hamilton Depression Scale(HDS) and Hamilton Anxiety Scale(HAS) at baseline and every 1 week during the trial periods. The levels of reduction in HDS and HAS scores from baseline after 2-week trial were compared between paroxetine- and placebo- treated periods by paired t-test. In all the 8 subgroups, statistically significant differences between paroxetine and placebo were found on the antidepressant efficacy after 2-week treatment. The antidepressant efficacy of paroxetine compared to placebo was most prominent in child and adolescent female groups. On anxiety symptoms, paroxetine was also significantly more effective than placebo. The antianxiety efficacy of paroxetine compared to placebo was most prominent in male and female child groups and young adult female group aged 18-35 years. As for the adverse effects of paroxetine, 3 out of 232 subjects reported mild indigestion and abdominal pain. however, in all the 3 cases, the symptoms improved without reduction of dosage or discontinuation of the drug. In conclusion, paroxetine showed significantly higher antidepressant and antianxiety efficacy compared to placebo in child-adolescent and adult depressive neurosis patients after 2-week treatment. Further trials of paroxetine in depressive neurosis are warranted to elucidate the long-term antidepressant and antianxiety efficacy of paroxetine.

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The Changes of Types of Nutritional Risk and Nutritional Intake according to Depression and Self-esteem among the Elderly in Chunnam Province (전남지역 노인에서 우울 및 자아존중감의 인식정도에 따른 영양위험도 및 영양소 섭취량의 변화 양상)

  • Kim, Bok-Hee;Jung, Eun
    • Journal of the Korean Home Economics Association
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    • v.46 no.8
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    • pp.97-107
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    • 2008
  • This study was conducted in order to identify the relationship between psychological factors, such as depression and self-esteem, and nutritional status, such as nutritional risk index and nutrient intake, among the elderly in Chunnam Province. The participants were 119 elderly individuals over the age of 65 years who visited the Senior Welfare Center in Chunnam province between January 29 and February 2, 2007. This study was conducted using a structured questionnaire that included, the Center for Epidemiologic Studies Depression Scale (CES-D), General Self Efficacy Scale (GSES), Nutritional Screening Initiative Checklist (NSI checklist), questions pertaining to the general characteristics of the participants and an estimation of nutrient intake using the 24-hour recall method. Data were analyzed by the SPSS program. Analysis of the participant's CES-D scores revealed that 43.7% of the subjects were normal and 56.3% had more than mild depression. The mean GSES score was 45.9 for the entire group of subjects (51.9 for men, 43.6 for women). The mean nutritional risk index value was 4.30 (5.03 for men, 4.01 for women). Analysis of the participant's scores on the NSI checklist revealed that 69.7% of the subjects were normal and 30.3% exhibited a moderate nutritional risk. The CES-D was positively correlated with the NSI checklist (p < 0.05) but negatively correlated with nutrient intake. However, the GSES was negatively correlated with the NSI checklist (p < 0.05), but positively correlated with nutrient intake (P < 0.01 for protein, calcium, phosphorus, zinc etc.). The results of this study indicate that it is necessary to manage psychological factors, including depression and self-esteem, in the elderly in order to decrease their nutritional risk and increase their nutrient intake.

Effect of Major Depressive Disorder and Insomnia on Somatization (주요 우울증과 불면증이 신체화 증상에 미치는 영향)

  • Jun, Jin Yong;Kim, Seog Ju;Lee, Yu-Jin;Cho, Seong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.19 no.2
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    • pp.84-88
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    • 2012
  • Introduction: The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively. Methods: A total of 181 participants (73 males and 108 females ; mean age $41.59{\pm}8.92$) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R). Results: There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08). Conclusion: In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.

The Comparison of Work of Breathing Between Before Extubation and After Extubation of Endotracheal Tube (기계 호흡 치료후 기관내관 제거 전후 호흡 일(Work of Breathing)의 비교)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Choe, Kang-Hyeon;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.329-337
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    • 1997
  • Background : Since endotracheal tube is the most important factor involved in the imposed work of breathing during mechanical ventilation, extubation of endotracheal tube is supposed to reduce respiratory work of patient. However, some patients show labored breathing after extubation despite acceptable blood gases. We investigated the changes of work of breathing before and after extubation and the factors involved in the change of WOB after extubation. Methods : The subjects were 34 patients(M : F = 20 : 14, mean age = $61{\pm}17yre$) who recovered from respiratory failure after ventilatory support and were considered to be ready for extubation. The patients with clinical or radiologic evidences of upper airway obstruction before endotracheal intubation for mechanical ventilation were excluded. Vital sign, physical examination, chest X-ray, work of breathing and other respiratory mechanic indices were measured prior to, immediately, 6, 24 and 48 hours after extubation serially. Definition of weaning failure after extubation was resumption of ventilatory support or reintubation of endotracheal tube within 48 hour after extubation because of respiratory failure. The patients were classified into group 1(decreased work of breathing), group 2(unchanged work of breathing) and group 3(increased work of breathing) depending on the statistical difference in the change of work of breathing before and after extubation. Results : Work of breathing decreased in 33%(11/34, group 1), unchanged in 41%(14/34, group 2) and increased in 26%(9/34, group 3) of patients after extubation compared with before extubation. Weaning failure occurred 9%(1/11) of group, 1, 28.6%(4/14) of group 2 and 44%(4/9) of group 3 after extubation(p = 0.07). The change of work of breathing after extubation was positively correlated with change of mean airway resistance(mRaw). (r = 0.794, p > 0.01). In three cases of group 3 whose respiratory indices could be measured until 48 hr after extubation, the change in work of breathing paralleled with the sequential change of mRaw. The work of breathing was peaked at 6 hr after extubation, which showed a tendency to decrease thereafter. Conclusions : Reversible increase of work of breathing after extubation may occur in the patients who underwent extubation, and the increase in mRaw could be responsible for the increase in work of breathing. In addition, the risk of weaning failure after extubation may increase in the patients who have increased WOB immediately after extubation.

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Relation Among Parameters Determining the Severity of Bronchial Asthma (기관지천식 환자의 증상의 중증도를 나타내는 지표들간의 연관성)

  • Lee, Sook-Young;Kim, Seung-June;Kim, Seuk-Chan;Kwon, Soon-Suk;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.585-593
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    • 2000
  • Background : International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendation of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. Methods : This study examined the relationship between the symptom score and measurements of $FEV_1$ and PEF when expressed as a percentage of predicted values in asthmatics (n=107). Results : The correlation of $FEV_1$ % with PEFR% was highly significant (r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of $FEV_1$ % and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of $FEV_1$ % and symptom score. 39% of the patients classified as having moderate asthma on the basis of $FEV_1$ % recording would be considered to have severe asthma if symptom score alone were used. Low baseline $FEV_1$ and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. Conclusion : The relationships between the symptom score, PEFR and $FEV_1$ were generally poor. When assessing asthma severity, age, duration, $PC_{20}$, and baseline $FEV_1$ should be considered.

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Management and Supporting System on the Occupational Health Nursing Services Provided in Group Occupational Health Agencies of Korea (소규모 사업장 보건관리대행기관의 간호업무 운영관리 지원체계)

  • Yoo, Kyung-Hae
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.2
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    • pp.193-211
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    • 1999
  • This study was carried out to investigate the management and support system affecting to the occupational health nursing services(OHNS) provided in group occupational health agencies(GOHA). Questionnaire was developed and distributed to 82 nurses who were working in GOHA and who agreed to participate in the survey. The results were as follow: 1. OH nurses responded were mostly in the age of twenty to thirties(89%), married(73.7%), technical college graduates(88.9%), worked in hospital(85.4%) and participated more than 1 year in group occupational health services (96.3%). 2. Fifty eight point four percent of the OH nurses worked in number of workplace more than 30 to less than 60 in the OHNS form. The figure of workplaces undertaken by nurses was ranged greatly from 9 to more than 100. Number of employees who cared by nurses were mostly under 5,000 peoples in 93.3%. The types of industry was mostly manufacturing and located in the order of factory complex area, suburban, urban and others. 3. Most OH nurses(87.8%) were fully involved in the OHNS for the SSE. Their working days to visit SSE was 5 days per week(77.8%) and one day in the GOHA at 41.3%. 4. The OH documents using by nurses were found in more than 23 different types. However, they were largely summarized in the types of 'Workplace Health Management Card', 'Personal Health Counselling Card', 'Daily Health Management Report', 'Visiting List of Workplace' and 'Sick Employee List'. 5. The items of laboratory test provided by GOHA were mostly achieved in the purpose of basic health examination. They were used to be the blood pressure check(98.8%), blood sugar test (98.8%), urine sugar and protein(91.4%), SGOT and SGPT(85.3% each), cholesterol (82.9%), hepa vaccine immunization(82.9%), r-GPT(81.7%), hemoglobin(79.3%) and triglyceride(75.5%). 6. The OH nurses(92.7%) followed the work pattern to visit the GOHA before and after small-scale enterprises(SSE) visit by car driven by nurses in 74.3%. They were payed by GOHA for transportation fees in certain amounts. However, nurse is the main person(75.0%) who covers up in case of traffic accident. If the GOHA has no transportation regulation for the formal workplace visit, data showed that nurses had been responsible to take charge(31.7%). 7. The personnel manager who takes in charge for nursing services was 'nurse' in 61.7% and 41.2% worked as the final decision maker related to nursing work. The OH nurses' opinions about factors affecting to the management were classified in the four areas such as 'Nature(Quality) of health professional'. 'Content of OHNS', 'Delivery system of the GOHS', and 'Others'. The factors were indicated highly in 'Authority as health professional', 'Level of perception of director on the OH' and 'Physical work condition for OHNS'. The things that this study suggests in the recommendation would be summarized in such as the management and supporting system working for SSE in the OHNS is necessary to reform thoroughly. The reconsidered aspects might be in the matters of number of workplaces undertaken by nurses, development of effectively practical health documents, preparation for guideline of the laboratory test in the workpleces, establishment of convenient and encouraging support system and cooperation between other health professionals with respect and skill.

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