• Title/Summary/Keyword: Cut-on condition

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TEMPERATURE CHANGE IN THE PULP ACCORDING TO POLISHING CONDITION OF VARIOUS RESTORATIVE MATERIALS (여러가지 수복물의 polishing조건에 따른 치수 온도변화)

  • Baik, Byeong-Ju;Park, Jong-Ha;Yang, Jeong-Suk;Lee, Seung-Young;Kim, Jae-Gon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.365-376
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    • 1999
  • The importance of finishing and polishing the restoration has been described by several authors. The final step provides for improved metallurgical properties, better marginal adaptation, reduced plaque accumulation. Unfortunately, finishing of the restorations can produce damage from temperature rises at the pulpal wall. The aim of this study was to determine the changes in temperature can be occurred during the use of finishing and polishing instruments under a variety of conditions. ; with or without a water coolant, intermittent or continuous operation, high or low rotation speed, remaining dentin thickness and various restorative materials. Class V preparations were cut on extracted molars and restored with composite resin(Z 100), resin-modified glass ionomer cements(Dyract, Fuji II LC), and amalgam. Finishing was done with aluminum oxide coated disc($Sof-lex^{(R)}$ polishing disc, 3M, USA). The following results were obtained. 1. The rise of temperature during polishing of amalgam restorations was the highest among the all experimental groups except polishing with water coolant(P<0.05). However, there were no statistical differences in temperature rises between Z 100, Dyract and Fuji II LC(P>0.05). 2. The intrapulpal temperature was greatly influenced by the applied time, and intermittent polishing was showed significantly lower temperature rises than continuous polishing(P<0.01). 3. The intrapulpal temperature was increased according to the application of polishing regard less of using water coolant. However, polishing with water coolant showed significantly lower temperature in the pulp than not used water coolant(P<0.01).

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Use of Dried Stoned Olive Pomace in the Feeding of Lactating Buffaloes: Effect on the Quantity and Quality of the Milk Produced

  • Terramoccia, S.;Bartocci, S.;Taticchi, A.;Di Giovanni, S.;Pauselli, M.;Mourvaki, E.;Urbani, S.;Servili, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.7
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    • pp.971-980
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    • 2013
  • Dried stoned olive pomace (DSOP) was administered to dairy water buffaloes, and their productive performance and milk composition were analysed. Sixteen pluriparous lactating buffaloes were divided into two uniform groups (control and experimental), taking into consideration the following parameters: milk production (2,192 and 2,102 kg) and duration of lactation (254 and 252 d) of the previous year, distance from calving (51 and 43 d), milk production (9.71 and 10.18 kg/d), body condition score (BCS) (6.44 and 6.31) and weight (617 and 653 kg) at the beginning of the trial. Both diets had the same formulation: second cut alfalfa hay 20%, corn silage 42%, concentrate 38% but the two concentrates differed in their formulation, the experimental one contained 15.50% of DSOP as fed. The employed DSOP showed high amounts of secoiridoids, such as 3,4-dihydroxyphenylethanol (3,4-DHPEA) (1.2 g/kg DM), 3,4-dihydroxyphenylethanol-elenolic acid di-aldehyde (3,4-DHPEA-EDA) (12.6 g/kg DM), p-hydroxyphenylethanol-elenolic acid di-aldehyde (p-HPEA-EDA) (5.6 g/kg DM) and lignans, which are known to be powerful bioactive compounds. The control diet had an energy-protein content of 0.86 Milk FU/kg DM and 143.3 g/kg DM of crude protein, whereas the experimental diet of 0.87 Milk FU/kg DM and 146.6 g/kg DM of crude protein. Each animal of the two groups received 17 kg DM/d and each buffalo of the experimental group, by way of the concentrate, ingested 1.05 kg DM/d of DSOP. The trial lasted 40 days. No significant difference was found between the BCS (6.41 and 6.53), live weight (625.93 and 662.50 kg) and milk production (9.69 and 10.08 kg/d) of the two groups, as was the case for fat, protein, lactose, pH and coagulating parameters of the two milks. The milk fat of the experimental group had a significantly higher content of total tocopherols (10.45 vs $8.60{\mu}g/g$, p<0.01) and retinol (3.17 vs $2.54{\mu}g/g$, p<0.01). The content of the reactive substances with tiobarbituric acid (TBARs) was significantly lower in the milk fat of the experimental group (12.09 vs $15.05{\mu}g$ MDA/g, p<0.01). The acid content of the milk fat of the experimental group had a significantly higher content (p<0.05) of C18:0 and of $C18:3{\omega}6$. LC-MS/MS analysis showed the presence of 3,4-DHPEA ($36.0{\mu}g/L$) in the milk of the DSOP-fed buffaloes, while other phenols were not found. DSOP, in the quantity utilized, can be used in the feeding of the lactating buffalo; the dietetic-nutritional characteristics of the milk are improved due to a greater contribution of tocopherols, retinol and the presence of hydroxytyrosol.

Studies on production of nuclear transplanted mouse embryos (핵이식 마우스 생산에 관한 연구)

  • Lee, Byeong-chun;Jo, Choong-ho;Hwang, Woo-suk
    • Korean Journal of Veterinary Research
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    • v.33 no.1
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    • pp.151-169
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    • 1993
  • The present study was carried out to investigate the best condition for nuclear-cytoplasm fusion and in vitro culture of nuclear transplanted embryos and to investigate the production of nuclear transplanted offsprings. The nuclei from 2-, 4- and 8-cell mouse embryos were transferred into enucleated 2-cell embryos, and the reconstituted embryos were submitted to direct current(DC) pulses at output voltage of 1.0, 1.5 and 2.0 kV/cm for 100, 150 and $200{\mu}$ sec to induce cell fusion. 1. The culture of intact or zona cut 2-cell embryos in the medium supplemented with cytochalasin B($5{\mu}g/m{\ell}$) and colcemide($0.1{\mu}g/m{\ell}$)for 30 and 60 minutes did not affect the development to later stage. 2. The in vitro developmental rates of group A(a nucleus from one of the blastomeres was removed) and B(electrofusion of group A) were significantly lower than that of control group(p<0.01). 3. When nuclear transplanted embryos were submitted to electrofusion, the significantly higher fusion rates of 2-cell donor nuclei were achieved at the electric field strength of DC 1.5kV/cm for 100 and $150{\mu}$ sec, DC 2.0 kV/cm for $100{\sim}200{\mu}$ sec than DC 1.0 kV/cm for 100 and $150{\mu}$ sec(p<0.01). The significantly higher fusion rates of 4-cell donor nuclei were achieved at DC 2.0 kV/cm for 100 and $150{\mu}$ sec than DC 1.0kV/cm for $100{\sim}200{\mu}$ sec(p<0.01). These fusion rates in 8-cell donor nuclei were 88.7~99.3%. 4. The developmental potency to blastocyst in 2- and 4-cell donor nuclei was significantly higher in DC 1.0 and 2.0 kV/cm for $100{\sim}200{\mu}$ sec treated group and DC 2.0 kV/cm for 150 and $200{\mu}$ sec treated group (p<0.01). The developmental potency to blastocyst in 8-cell donor nuclei was significantly higher in DC 2.0 kV/cm for $100{\mu}$ sec treated group than in DC 1.0 kV/cm for $100{\mu}$ sec treated group and DC 2.0 kV/cm for 150 and $200{\mu}$ sec treated group(p<001). 5. The developmental potency to blastocyst after nuclear transplantation was significantly higher in 2-cell donor nuclei than in 8-cell donor nuclei(p<0.01). 6. The success rate of nuclear injection into enucleated 2-cell embryos was significantly higher in 2-cell donor nuclei than in 4- or 8-cell donor nuclei(p<0.01). 7. The culture time taken for the nuclear transplanted 2-cell embryos to blastocyst stage was significantly longer in 2-cell donor nuclei than in 8-cell donor nuclei(p<0.01). 8. There was no significant difference in the developmental potency of nuclear transplanted embryos within the concentration of EGF at 0 to 15 ng per $m{\ell}$ of BMOC-3 solution. 9. The production rates of offspring after transfer of nuclear transplanted embryos to recipient mouse were significantly higher in 2-cell donor nuclei than in 8-cell donor nuclei(p<0.01).

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Examination of Urban Gardening as an Everydayness in Urban Residential Area, Haebangchon (도심주거지에 나타나는 일상문화로서의 도시정원가꾸기에 대한 고찰 - 용산구 용산동2가 해방촌을 중심으로 -)

  • Sim, Joo-Young;Zoh, Kyung-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.2
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    • pp.1-12
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    • 2015
  • This study explores urban gardening and garden culture in residential area as an everydayness that has been overlooked during the modern period urbanization and investigates the meaning and value of urban gardening from the perspective of urban formations and growth in spontaneous urban residential area, Haebangchon. The result identified that urban gardening as a meaning of contemporary culture is a new clue to improving the urban physical environment and changing the lives and community network of residents. Haebangchon is one of the few remaining spontaneous habitations in Seoul, and was created as a temporary unlicensed shantytown in 1940s. It became the representative habitation for common people in downtown Seoul through the revitalization of the 60s and the local reform through self-sustaining redevelopment projects during the 70s through the 90s. This area still contains the image of times during the 50s to the 60s, the 70s to the 80s and present, with the percentage of long-term stay residents high. Within this context, the site is divided into third quarters, and the research undertaken by observation and investigation to determine characteristics of urban gardening as an everydayness. It can be said that urban gardening and garden culture in Haebangchon is a unique location culture that has accumulated in the crevices of the physical condition and culture of life. These places are an expression of resident's desires that seeking out nature and gardening as revealed in densely-populated areas and the grounds of practical acting and participating in care and cultivation. It forms a unique, indigenous local landscape as an accumulation of everyday life of residents. Urban gardens in detached home has retained the original function of the dwelling and the garden, or 'madang', and takes on the characteristic of public space through the sharing of a public nature as well as semi-private spatial characteristic. Also, urban gardens including small kitchen garden and flowerpots that appear in the narrow streets provide pleasure as a part of nature that blossoms in narrow alley and functions as a public garden for exchanging with neighbors by sharing produce. This paper provides the concept of redefining the relationship between the private-public area that occurs between outside spaces that are cut off in a modern city.

Analysis of the Reduction Effect of Combined Treatment with UV-C and Organic Acid to Reduce Aspergillus ochraceus and Rhodotorula mucilaginosa Contamination (Aspergillus ochraceus와 Rhodotorula mucilaginosa 저감을 위한 자외선과 유기산 복합처리 효과 분석)

  • Eun-Seon Lee;Jong-Hui Kim;Bu-Min Kim;Mi-Hwa Oh
    • Journal of Food Hygiene and Safety
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    • v.39 no.1
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    • pp.54-60
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    • 2024
  • This study investigated the effectiveness of using pathogens and aqueous acids to reduce the Aspergillus ochraceus and Rhodotorula mucilaginosa contamination in livestock production environments. For this study, 1 mL of each bacterial suspension (107-108 spores/mL) was inoculated on a knife surface, dried at 37℃, and used under each treatment condition. First, to investigate the effect of organic acids, acetic, lactic, and citric acids were used. Subsequently, to select the appropriate concentration, they were prepared at concentrations of 0.5, 1, 2, 3, 4, and 5%, respectively. Accordingly, to further maximize the effect of organic acid treatment, we combined the treatment with ultraviolet light. The two strains showed a significant difference (P<0.05) compared to the initial strain, with a greater than 90% decrease in the concentrations of all organic acids. Consequently, acetic and lactic acids decreased by approximately 5 and 2 log colony forming unit (CFU)/cm2, respectively, when treated with ultraviolet light (360 mJ/cm2); however, citric acid decreased by less than 1 log CFU/cm2. However, when manufactured with 4% acetic acid, a severe malodor was emitted, making it difficult for workers to use it in a production environment. Accordingly, the optimal treatment conditions for organic acid and ultraviolet light for application were selected as follows: immersion in a 4% lactic acid solution for 1 minute and then, sterilization with ultraviolet light at 360 mJ/cm2. Finally, when a pork meat sample was cut with a knife that was finally washed with lactic acid and treated with ultraviolet light, the low level of inoculum transferred from the cleaned knife to the surface of the sample was not detected. In conclusion, using this established method can prevent cross-contamination of the surface of the meat during processing.

A Study on the Tree Surgery Problem and Protection Measures in Monumental Old Trees (천연기념물 노거수 외과수술 문제점 및 보존 관리방안에 관한 연구)

  • Jung, Jong Soo
    • Korean Journal of Heritage: History & Science
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    • v.42 no.1
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    • pp.122-142
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    • 2009
  • This study explored all domestic and international theories for maintenance and health enhancement of an old and big tree, and carried out the anatomical survey of the operation part of the tree toward he current status of domestic surgery and the perception survey of an expert group, and drew out following conclusion through the process of suggesting its reform plan. First, as a result of analyzing the correlation of the 67 subject trees with their ages, growth status. surroundings, it revealed that they were closely related to positional characteristic, damage size, whereas were little related to materials by fillers. Second, the size of the affected part was the most frequent at the bough sheared part under $0.09m^2$, and the hollow size by position(part) was the biggest at 'root + stem' starting from the behind of the main root and stem As a result of analyzing the correlation, the same result was elicited at the group with low correlation. Third, the problem was serious in charging the fillers (especially urethane) in the big hollow or exposed root produced at the behind of the root and stem part, or surface-processing it. The benefit by charging the hollow part was analyzed as not so much. Fourth, the surface-processing of fillers currently used (artificial bark) is mainly 'epoxy+woven fabric+cork', but it is not flexible, so it has brought forth problems of frequent cracks and cracked surface at the joint part with the treetextured part. Fifth, the correlation with the external status of the operated part was very high with the closeness, surface condition, formation of adhesive tissue and internal survey result. Sixth, the most influential thing on flushing by the wrong management of an old and big tree was banking, and a wrong pruning was the source of the ground part damage. In pruning a small bough can easily recover itself from its damage as its formation of adhesive tissue when it is cut by a standard method. Seventh, the parameters affecting the times of related business handling of an old and big tree are 'the need of the conscious reform of the manager and related business'. Eighth, a reform plan in an institutional aspect can include the arrangement of the law and organization of the old and big tree management and preservation at an institutional aspect. This study for preparing a reform plan through the status survey of the designated old and big tree, has a limit inducing a reform plan based on the status survey through individual research, and a weak point suggesting grounds by any statistical data. This can be complemented by subsequent studies.

A Study on the Useful Trend of Plants Related to Landscape and How to Plant and Cultivate Through 'ImwonGyeongjaeji(林園經濟志)' ('임원경제지'를 통해 본 식물의 이용경향과 종예법(種藝法))

  • Shin, Sang-Sup
    • Korean Journal of Heritage: History & Science
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    • v.45 no.4
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    • pp.140-157
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    • 2012
  • The result of a study on the useful trend of plants related to landscape and how to plant and cultivate through 'ImwonGyeongjaeji Manhakji'of Seoyugu is as follows: First, 'ImwonGyeongjaiji Manhakji', composed of total 5 volumes (General, Fruit trees, vegetables and creeper, plants, others) is a representative literature related to landscape which described the names of plants and varieties, soil condition, how to plant and cultivate, graft, how to prevent the insect attack etc systematically. Second, he recorded the tree planting as Jongjae(種栽) or Jaesik(栽植), and the period to plant the trees as Jaesusihoo(栽樹時候), transplanting as Yijae(移栽), making the fence as Jakwonri(作園籬), the names of varietieis as Myeongpoom(名品), the suitable soil as Toeui(土宜), planting and cultivation as Jongye(種藝), treatment as Euichi(醫治), protection and breeding as Hoyang(護養), garden as Jeongwon(庭園) or Wonpo(園圃), garden manager as Poja(圃者) or Wonjeong(園丁). Third, the appearance frequency of plants was analyzed in the order of flowers, fruits, trees, and creepers and it showed that the gravity of deciduous trees was 3.7 times higher than that of evergreen trees. The preference of flower and trees, fruit trees and deciduous trees and broad-leaved trees includes (1) application of the species of naturally growing trees which are harmonized with the natural environment (2) Aesthetic value which enables to enjoy the beauty of season, (3) the trend of public welfare to take the flowers and fruits, (4) the use of symbolic elements based on the value reference of Neo-Confucianism etc. Fourth, he suggested the optimal planting period as January(上時) and emphasized to transplant by adding lots of fertile soil and cover up the seeds with soil as high as they are buried in accordance with the growing direction and protect them with a support. That is, considering the fact that he described the optimal planting period as January by lunar calendar, this suggests the hints in judging the planting period today. For planting the seeds, he recommended the depth with 1 chi(寸 : approx. 3.3cm), and for planting a cutting, he recommended to plant the finger-thick branch with depth 5 chi(approx. 16.5cm) between January and February. In case of graft of fruit trees, he described that if used the branch stretched to the south, you would get a lot of fruit and if cut the branches in January, the fruits would be appetizing and bigger. Fifth, the hedge(fence tree) is made by seeding the Jujube tree(Zizyphus jujuba var. inermis) in autumn densely and transplanting the jujube tree with 1 ja(尺 : approx. 30cm) interval in a row in next autumn and then binding them with the height of 7 ja(approx. 210cm) in the spring of next year. If planted by mixing a Elm tree(Ulmus davidiana var. japonica) and a Willow(Salix koreensis), the hedge whose branch and leaves are unique and beautiful like a grating can be made. For the hedge(fence tree), he recommended Trifoliolate orange(Poncitus trifoliata), Rose of sharon(Hibiscus syriacus), Willow(Salix koreensis), Spindle tree(Euonymus japonica), Cherry tree(Prunus tomentosa), Acanthopanax tree(Acanthopanax sessiliflorus), Japanese apricot tree(Prunus mume), Chinese wolf berry(Lycium chinense), Cornelian tree(Cornus officinalis), Gardenia(Gardenia jasminoides for. Grandiflora), Mulberry(Morus alba), Wild rosebush(Rosa multiflora) etc.

The Effect of Price Discount Rate According to Brand Loyalty on Consumer's Acquisition Value and Transaction Value (브랜드애호도에 따른 가격할인율의 차이가 소비자의 획득가치와 거래가치에 미치는 영향)

  • Kim, Young-Ei;Kim, Jae-Yeong;Shin, Chang-Nag
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.247-269
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    • 2007
  • In recent years, one of the major reasons for the fierce competition amongst firms is that they strive to increase their own market shares and customer acquisition rate in the same market with similar and apparently undifferentiated products in terms of quality and perceived benefit. Because of this change in recent marketing environment, the differentiated after-sales service and diversified promotion strategies have become more important to gain competitive advantage. Price promotion is the favorite strategy that most retailers use to achieve short-term sales increase, induce consumer's brand switch, in troduce new product into market, and so forth. However, if marketers apply or copy an identical price promotion strategy without considering the characteristic differences in product and consumer preference, it will cause serious problems because discounted price itself could make people skeptical about product quality, and the changes of perceived value might appear differently depending on other factors such as consumer involvement or brand attitude. Previous studies showed that price promotion would certainly increase sales, and the discounted price compared to regular price would enhance the consumer's perceived values. On the other hand, discounted price itself could make people depreciate or skeptical about product quality, and reduce the consumers' positivity bias because consumers might be unsure whether the current price promotion is the retailer's best price offer. Moreover, we cannot say that discounted price absolutely enhances the consumer's perceived values regardless of product category and purchase situations. That is, the factors that affect consumers' value perceptions and buying behavior are so diverse in reality that the results of studies on the same dependent variable come out differently depending on what variable was used or how experiment conditions were designed. Majority of previous researches on the effect of price-comparison advertising have used consumers' buying behavior as dependent variable. In order to figure out consumers' buying behavior theoretically, analysis of value perceptions which influence buying intentions is needed. In addition, they did not combined the independent variables such as brand loyalty and price discount rate together. For this reason, this paper tried to examine the moderating effect of brand loyalty on relationship between the different levels of discounting rate and buyers' value perception. And we provided with theoretical and managerial implications that marketers need to consider such variables as product attributes, brand loyalty, and consumer involvement at the same time, and then establish a differentiated pricing strategy case by case in order to enhance consumer's perceived values properl. Three research concepts were used in our study and each concept based on past researches was defined. The perceived acquisition value in this study was defined as the perceived net gains associated with the products or services acquired. That is, the perceived acquisition value of the product will be positively influenced by the benefits buyers believe they are getting by acquiring and using the product, and negatively influenced by the money given up to acquire the product. And the perceived transaction value was defined as the perception of psychological satisfaction or pleasure obtained from taking advantage of the financial terms of the price deal. Lastly, the brand loyalty was defined as favorable attitude towards a purchased product. Thus, a consumer loyal to a brand has an emotional attachment to the brand or firm. Repeat purchasers continue to buy the same brand even though they do not have an emotional attachment to it. We assumed that if the degree of brand loyalty is high, the perceived acquisition value and the perceived transaction value will increase when higher discount rate is provided. But we found that there are no significant differences in values between two different discount rates as a result of empirical analysis. It means that price reduction did not affect consumer's brand choice significantly because the perceived sacrifice decreased only a little, and customers are satisfied with product's benefits when brand loyalty is high. From the result, we confirmed that consumers with high degree of brand loyalty to a specific product are less sensitive to price change. Thus, using price promotion strategy to merely expect sale increase is not recommendable. Instead of discounting price, marketers need to strengthen consumers' brand loyalty and maintain the skimming strategy. On the contrary, when the degree of brand loyalty is low, the perceived acquisition value and the perceived transaction value decreased significantly when higher discount rate is provided. Generally brands that are considered inferior might be able to draw attention away from the quality of the product by making consumers focus more on the sacrifice component of price. But considering the fact that consumers with low degree of brand loyalty are known to be unsatisfied with product's benefits and have relatively negative brand attitude, bigger price reduction offered in experiment condition of this paper made consumers depreciate product's quality and benefit more and more, and consumer's psychological perceived sacrifice increased while perceived values decreased accordingly. We infer that, in the case of inferior brand, a drastic price-cut or frequent price promotion may increase consumers' uncertainty about overall components of product. Therefore, it appears that reinforcing the augmented product such as after-sale service, delivery and giving credit which is one of the levels consisting of product would be more effective in reality. This will be better rather than competing with product that holds high brand loyalty by reducing sale price. Although this study tried to examine the moderating effect of brand loyalty on relationship between the different levels of discounting rate and buyers' value perception, there are several limitations. This study was conducted in controlled conditions where the high involvement product and two different levels of discount rate were applied. Given the presence of low involvement product, when both pieces of information are available, it is likely that the results we have reported here may have been different. Thus, this research results explain only the specific situation. Second, the sample selected in this study was university students in their twenties, so we cannot say that the results are firmly effective to all generations. Future research that manipulates the level of discount along with the consumer involvement might lead to a more robust understanding of the effects various discount rate. And, we used a cellular phone as a product stimulus, so it would be very interesting to analyze the result when the product stimulus is an intangible product such as service. It could be also valuable to analyze whether the change of perceived value affects consumers' final buying behavior positively or negatively.

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Study for Diagnostic Efficacy of Minibronchoalveolar Lavage in the Detection of Etiologic Agents of Ventilator-associated Pneumonia in Patients Receiving Antibiotics (항생제를 사용하고 있었던 인공호흡기 연관 폐렴환자에서의 원인균 발견을 위한 소량 기관지폐포세척술의 진단적 효용성에 관한 연구)

  • Moon, Doo-Seop;Lim, Chae-Man;Pai, Chik-Hyun;Kim, Mi-Na;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.321-330
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    • 1999
  • Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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