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Clarithromycin Therapy for Scrub Typus (쯔쯔가무시(Tsutusgamushi)병에서 Clarithromycin의 치료 효과)

  • Kim, Soon;Jung, Eun Mi;Moon, Kyung Hyun;Yoe, Sung Yeob;Eum, Soo Jung;Lee, Joo Hyung;Jo, Sung Rae;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.175-181
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    • 2002
  • Purpose : Scrub typhus(tsutsugamushi disease) is a febrile disease characterized by fever, rash, eschar, lymphadenopathy. Therapy with tetracycline(doxycycline) or chloramphenicol is currently recommended for the treatment for scrub typhus. But there are limitations in usage a tetracycline(doxycycline) for scrub typhus in the children. Recently, there was a report that azithromycin, a macrolide antibiotic was used for scrub typhus in pregnant woman successfully. So we evaluated the effectiveness of the Clarithromycin, other a macrolide antibiotic, for scrub typhus. Methods : Seven patients with scrub typhus at department of internal medicine and three patients with scrub typhus at department of pediatrics Masan Fatima Hospital were involved for this study. A serologic diagnosis for scrub typhus were performed by use of passive hemagglutination test. Clarithromycin(Abbott Laboratories, North Chicago, IL, USA) was administrated orally in a daily dose of 500 mg for adult patients and 15 mg/kg/bid/day for pediatric patients. Results : There were 7 cases of adult patients, varying from 28 to 76 years of age and 3 cases of pediatirc patients, varying from 4 to 7 years of age with scrub typhus. All of cases had fever, myalgia, headache, rash, eschar. Seven cases had positive passive hemagglutination test and eight cases had abnormal liver function. Mean duration for the removal of fever after medication was 1.3 day(1~2 days) and all cases were recovered without complications. Conclusion : Our results suggest that Clarithromycin therapy may be effective for scrub typhus.

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A Study on Dementia Alzheimer's type published to chinese magazine (중의잡지(中醫雜誌)에 보고(報告)된 Alzheimer형(型) 치매에 대(對)한 고찰(考察))

  • Chae, Jong-gul;Lee, Sang-ryong
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.453-469
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    • 2001
  • This study attempted to analyze the contents of the research papers concerning the diagnosis and treatment of Alzheimer-type dementia presented in the magazine of Chinese Medicine published in China over the period between 1998 and 2000. As a result, the following conclusion was drawn: 1. The Chinese medical category of Alzheimer-type dementia includes amnesia, dementia, stupidity, depression symptom complex, insanity and the like and uses the as the criterion for diagnosis and treatment effect evaluation. 2. The clinical symptoms of Alzheimer-type dementia include lowered intelligence, deterioration of memory, understanding and judgemental power, retardation of the reaction, emotional changes, character changes, behavioral changes and the like and are divided into mild, medium and serious according to the degree of symptom. 3. From the perspective of Bon-Heo-Pyo-Shil(state of deficient vital essence and excessive pestilential vapor), the pattern of Byun-Sung(identification) is divided into deficiency symptom complex, excessive symptom complex and indiscernible fullness and emptiness. The deficiency symptom complex includes deficiency of the liver and kidney, deficiency of essence of the kidney, deficiency of the reservoir of marrow and the like. The excessive symptom complex includes internally blocked stagnant blood, blocking of the passageway due to turbid phlegm, blood stasis due to stagnation of chi, and the like. The indiscernible fullness and emptiness symptom complex includes the deficiency of essence of kidney, blocking of the passageway due to stagnant phlegm, blood stasis due to the deficiency of kidney, blood stasis due to the deficiency of heart and the like. 4. The therapeutics and' prescription of Alzheimer-type dementia include the following: Bo-Shin-Ik-Su-Tang for tonifying the kidney, replenishing the marrow and plugging the essence; Ki-Guk-Ji-Hwang-Hwan-Ga-mi for reinforcing the vital essence of the liver and kidney; Kwi-Bi-Tang-Hap-Yang-Shim-Tang for invigorating the functioning of the spleen and nourishing the heart; Hyel-Bu-Chuk-Eo-Tang-Ga-Mi for activating the blood and resolving the stagnancy of the blood; Bo-Yang-Hwan-Oh-Tang for replenishing chi, activating the blood and resolving the stagnancy of the blood; Beoh-Kwang-Mong-Sung-Tang for invigorating the functioning of the spleen, replenishing the kidney, resolving the phlegm and enlivening the brain; n-Dam-Tang-Ga-Mi for invigorating the functioning of the spleen, replenishing chi, and removing the phlegm and unclogging the passageway); Se-Shim-Tang-Ga-Mi for removing the stagnancy of the liver and resolving the phlegm; and the like. 5. The research papers on, the medication cases of Alzheimer-type dementia understand the pathology of Alzheimer-type dementia from a consistent perspective. They view the pathology of Alzheimer-type dementia as the disease of Bon-Heo-Pyo-Shil(state of deficient vital essence and excessive pestilential vapor) with the combination of the deficiency of essence of the kidney, the deficiency of the brain marrow, blood stasis and blocked phlegm and the like and recommend the prescription of using Bo and Sa simultaneously for treating Alzheimer-type dementia. 6. The research papers on the medication cases of Alzheimer-type dementia reported that the use of creative prescriptions such as Si-Sam-Hang-Ji-Tang, Ji-Yung-Tang, Ka-Mi-Yunh-Ji-Hwan, Ja-Sin-Hwal-Hyel-Tang, Kal-Chang-Ik-Ji-Tang, Ho-Su-Bok-Ji-Tang, Kun-Noe-Ok-Ji-Hap-Je and the like led to the average high efficacy of 85.5%.

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Effects of conditions for anodization and cyclic precalcification treatments on surface characteristics and bioactivity (양극산화와 석회화 순환처리 조건이 타이타늄 박판의 표면특성 및 생체활성에 미치는 영향)

  • Jang, Yong-Seok;Lee, Kang-Gyu;Jeon, Woo-Yong;Han, A-Lum;Lim, Chung-Ha;Lee, Min-Ho;Bae, Tae-Sung
    • Korean Journal of Dental Materials
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    • v.45 no.4
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    • pp.243-256
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    • 2018
  • The purpose of this study was to investigate the effects of the anodization and cyclic calcification treatment on the surface characteristic and bioactivity of the titanium thin sheet in order to obtain basic data for the production of bioactive titanium membrane. A $30{\times}20{\times}0.08mm$ titanium sheets were prepared, and then they were pickled for 10 seconds in the solution which was mixed with $HNO_3:HF:H_2O$ in a ratio of 12: 7: 81. The $TiO_2$ nanotube layer was formed to increase the specific surface area of the titanium, and then the cyclic calcification treatment was performed to induce precipitation of hydroxiapatite by improvement of the bioactivity. The corrosion resistance test, wettability test and immersion test in simulated body solution were conducted to investigate the effect of these surface treatments. The nanotubes formed by the anodization treatment have a dense structure in which small diameter tubes are formed between relatively large diameter tubes, and their inside was hollow and the outer walls were coupled to each other. The hydroxyapatite precipitates were well combined on the nanotubes by the penetration into the nanotube layer by successive cyclic calcification treatment, and the precipitation of hydroxyapatite tended to increase proportionally after immersion in simulated body solution as the number of cycles increased. In conclusion, it was confirmed that induction of precipitation of hydroxyapatite by cyclic calcification treatment after forming the nanotube $TiO_2$ nanotube layer on the surface of the titanium membrane can contribute to improvement of bioactivity.

Some Instances of Manchurian Naturalization and Settlement in Choson Dynasty (향화인의 조선 정착 사례 연구 - 여진 향화인을 중심으로 -)

  • Won, Chang-Ae
    • (The)Study of the Eastern Classic
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    • no.37
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    • pp.33-61
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    • 2009
  • In the late Koryo period, until 14th century, there had been at least two groups of Manchurians who were conferred citizenships; one group was living as an original inhabitant in the coastal area of north­eastern part of Korean peninsular, long time ago, and they were over one thousand households. The other was coming down from inland, eastern part of Yoha River, to the area of Tuman River to settle down and they were at least around one hundred and sixty households, including such tribes as Al-tha-ry, Ol-lyang-hap, Ol-jok-hap and others. They were treated courteously, from the early days of Choson dynasty, with governmental policies in an economic, political, and social ways. They were given, for instance, a house, a land, household furniture, and clothes. They were allowed to get marry with a native Korean to settle down. They were educated how to cultivate their lands. It was also possible for them to be given an official position politically or allowed to take a National Civil Official Examination. The fact they could take such an Examination, in particular, means they were treated fairly and equally, because they also had a privilege to improve their social positions through the formal system as much as common people. Two typical families were scrutinized, in this paper, family Chong-hae Lee and family Chon-ju Ju. All of them were successful to settle down with different backgrounds each other. The former were from a headman, Lee Jee-ran, who controlled his tribe, over five hundred households. He was given three titles of a meritorious retainer at the founding of Chosun dynasty, at the retrieval of armies, and an enshrined retainer. His son, Lee Wha-yong, was also given a vassal of merit who kept a close tie successfully with the king's family through a marriage. Upon the foundation of their ancestors, their grandsons, family Lee Hyo-yang and family Lee Hyo-gang, each, had taken solid root as an aristocratic Yang-ban class. The former became a high officer family, generation by generation, while the latter changed into a civil official family through Civil Official Examinations. They lived mainly around Seoul, Kyong-gi Province and some lived in their original places, Ham-kyong Province. Chu-man, the first ancestor, was given a meritorious retainer at the founding of the dynasty and Chu-in was also given a high officer position from the government. They kept living at the original place, Ham-heung, Ham-kyong Province, and then became an outstanding local family there. They began to pass the Civil Official Examinations. After 17th century on the passers were 17 in Civil Official Examinations and 40 were passed in lower civil examinations. The positions in government they attained usually were remonstrance which position was prohibited particularly to North­Western people at that time. The Chosun dynasty was open to Machurians widely through the system of envoy, convoy, and naturalization. It was intended to build up an enclosure policy through a friendly diplomatic relation with them against any possible invasion from outside. This is one reason why they were supported fully that much in a various way.

Study of BiJeung by 18 doctors - Study of II - (18인(人)의 비증(痺證) 논술(論述)에 대(對)한 연구(硏究) - 《비증전집(痺證專輯)》 에 대(對)한 연구(硏究) II -)

  • Sohn, Dong Woo;Oh, Min Suk
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.595-646
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    • 2000
  • I. Introduction Bi(痺) means blocking. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. says that Bi is combination of PungHanSeup. And many doctors said that BiJeung is caused by food, fatigue, sex, stress and change of weather. Therefore we must treat BiJeung by character of patients and characteristic of the disease. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. So I studied ${\ll}Bijeungjujip{\gg}$. II. Final Decision 1. JoGeumTak(趙金鐸) devided BiJeung into Pung, Han, Seup and EumHeo, HeulHeo, YangHeo, GanSinHeo by charcter or reaction of pain. And he use DaeJinGyoTang, GyegiGakYakJiMoTang, SamyoSan, etc. 2. JangPaeGyeu(張沛圭) focused on division of HanYeol(寒熱; coldness and heat) in spite of complexity of BiJeung. He also used insects for treatment. They are very useful for treatment of BiJeung because they can remove EoHyeol(瘀血). 3. SeolMaeng(薛盟) said that the actual cause of BiJeung is Seup. So he thought that BiJeung can be divided into PungSeup, SeupYeol, HanSeup. And he established 6 rules to treat BiJeung and he studied herbs. 4. JangGi(張琪) introduced 10 prescriptions and 10 rules to cure BiJeung. The 1st prescription is for OyeSa, 2nd for internal Yeol, 3rd for old BiJeung, 4th for Soothing muscles, 5th for HanSeup, 6th for regular BiJeung, 7th for functional disorder, 8th for YeolBi, 9th for joint pain and 10th for pain of lower limb. 5. GangSeYoung(江世英) used PungYeongTang(風靈湯) for the treatment of PungBi, OGyeHeukHoTang(烏桂黑虎湯) for HanBi, BangGiMokGwaTang(防己木瓜湯) for SeupBi, YeolBiTang(熱痺湯) for YeolBi, WoDaeRyeokTang(牛大力湯) for GiHei, HyeolPungGeunTang(血楓根湯) for HyeolHeo, ToJiRyongTang(土地龍湯) for the acute stage of SeupBi, OJoRyongTang(五爪龍湯) for the chronic stage of SeupBi, and so on. 6. ShiGeumMook(施今墨) devided BiJeung into four types. They are PungSeupYeol, PungHanSeup, GiHyeolSil(氣血實) and GiHyeolHeo(氣血虛). And he introduced the eight rules of the treatment(SanPun(散風), ChukHan(逐寒), GeoSeuP(, CheongYeol(淸熱), TongRak(通絡), HwalHyeol(活血), HaengGi(行氣), BoHeo(補虛)). 7. WangYiYou(王李儒) explained the acute athritis and said that it can be applicable to HaneBi(行痺). And he used GyeJiJakYakJiMoTang(桂枝芍蘂知母湯) for HanBi and YeolBiJinTongTang(熱痺鎭痛湯) for YeolBi. 8. JangJinYeo(章眞如) said that YeolBi is more common than HanBi. The sympthoms of YeolBi are severe pain, fever, dried tongue, insomnia, etc. And he devided YeolBi into SilYeol and HeoYeol. In case of SilYeol, he used GyeoJiTangHapBaekHoTang(桂枝湯合白虎湯) and in case of HeoYeol he used JaEumYangAekTang(滋陰養液湯). 9. SaHaeJu(謝海洲) introduced three important rules of treatment and four appropriate rules of treatment of BiJeung. 10. YouDoJu(劉渡舟) said that YeolBi is more common than HanBi. He used GaGamMokBanGiTang(加減木防已湯) for YeolBi, GyeJiJakYakJiMoTang or GyeJiBuJaTang(桂枝附子湯) for HanBi and WooHwangHwan(牛黃丸) for the joint pain. 11. GangYiSon(江爾遜) focused on the internal cause. The most important internal cause is JeongGiHeo(正氣虛). So he tried to treat BiJeung by means of balance of Gi and Hyeol. So he ususlly used ODuTang(烏頭湯) and SamHwangTang(三黃湯) for YeolBi, OJeokSan(五積散) for HanBi, SamBiTang(三痺湯) for the chronic BiJeung. 12. HoGeonHwa(胡建華) said that to distinguish YeolBi from Hanbi is very difficult. So he used GyeJiJakYakJiMoTang in case of mixture of HanBi and YeoBi. 13. PiBokGo(畢福高) said that the most common BiJeung is HanBi. He usually used acupuncture with medicine. He followed the theory of EumYongHwa(嚴用和)-he focused on SeonBoHuSa(先補後瀉). 14. ChoiMunBin(崔文彬) used GeoPungHwalHyeolTang(祛風活血湯) for HanBi, SanHanTongRakTang(散寒通絡湯) for TongBi(痛痺), LiSeupHwaRakTang(利濕和絡湯) for ChakBi(着痺), CheongYeolTongGyeolChukBiTang(淸熱通經逐痺湯) for YeolBi(熱痺) and GeoPungHwalHyeolTang(祛風活血湯) for PiBi(皮痺). 15. YouleokSeon(劉赤選) introduced the common principle for the treatment of BiJeung. He used HaePuneDeungTang(海風藤湯) for HaengBi(行痺), SinChakTang(腎着湯), DokHwalGiSaengTang(獨活寄生湯) for TongBi(痛痺), TongPungBang(痛風方) for ChakBi(着痺) and SangGiYiMiTangGaYeongYangGakTang(桑枝苡米湯加羚羊角骨) for YeolBi(熱痺). 16. LimHakHwa(林鶴和) said about TanTan(movement disorders or numbness) and devided TanTan into the acute stage and the chronic stage. He used acupuncture at the meridian spot like YeolGyeol(列缺), HapGok(合谷), etc. And he also used MaHwangBuJaSeSinTang(麻黃附子細辛湯) in case of the acute stage. In the chronic stage he used BangPungTang(防風湯). 17. JinBaekGeun(陳伯勤) liked to use three rules(HwaHyeol(活血), ChiDam(治痰), BoSin(補腎)) to treat BiJeung. He used JinTongSan(鎭痛散) for the purpose of HwalHyeol(活血), SoHwalRakDan(小活絡丹) for ChiDam(治痰) and DokHwalGiSaengTang(獨活寄生湯) for BoSin(補腎). 18. YimGyeHak(任繼學) focused on YangHyeolJoGi(養血調氣) if the stage of BiJeung is chronic. And in the chronic stage he insisted on not using GalHwal(羌活), DokHwal(獨活) and BangPung(防風).

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Effects of HapKok (LI-4) , SamUmGyo (SP-6) Acupuncture on Uterine Motility and Cyclooxygenase-2 Manifestation in Rats (합곡(合谷), 삼음교(三陰交) 자침(刺鍼)이 백서(白鼠) 자궁(子宮) 운동(運動) 및 Cyclooxygenase-2 발현(發現)에 미치는 영향(影響))

  • Lee, Byung-Chul;Lee, Ho-Sub;Kim, Kyung-Sik;Lee, Geon-Mok;Na, Chang-Soo;Kim, Jung-Sang;Hwang, Woo-Jun
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.187-208
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    • 2000
  • By the activation of ovary hormone, many morphological changes occur in the epithelial cell lines and muscle cells in rat uterus. These two cells in uterus are important to the implantation of embryo, maintaining pregnancy and starting parturition. One important change associated with the morphological change of these two cells in uterus is the change on prostaglandin(PG) metabolism. Its presence and synthesis in endometriurn and myometrium in uterus affects estrous cycle and the start of embryo implantation in uterus. It also performs as an important modulator in parturition. So the abnormally weak expression of PG causes difficulty during labor and over-expression causes pre-term labor. PG biosynthesis starts from either free or liberated arachidonic acids from membrane phospholipid by phospholipase. Such arachidonic acids are converted into PG catalyzed by Cyclooxygenase. Under normal physiological condition, Cyclooxygenase-1(COX-1) having 602 units of amino acids controls the synthesis of PG. It acts as a local hormone regulating vasomodulation of blood flow, flexible muscle movement, increasing the blood permeability and contributing the protective role in preserving integrity of the stomach lining and Cyclooxygenase-2 (COX-2) is induced by the inflammation, pregnancy and increased its expression until parturition. Lipid metabolite like PG is located in uterine and expression of COX-2 increased with pregnancy. Increased expression of COX proteins in epithelial cells and myometrial cells are told to increase the muscle contractility in uterus but decreased right after the labor in rat. It is a good sign indicating that COX proteins are deeply related to the start of labor. Currently, Several studies report the use of PG and COX-2 inhibitor as medication for controlled abortion or to prevent pre-term labor but they entail various side-effects. Our study proposed to suggest use of acupuncture as an another mediator to control abortion or pre-term labor without causing unnecessary side-effects by those medicines. Two acupuncture sites, LI-4 & SP-6 were selected due to their known efficacy. From the immunohistochemical staining of COX-2, normal expression of COX-2 protein in nonpregnant SD rat's uterus revealed that COX-2 protein was primarily detected in the lumina epithelial lining and in the epithelial cell lining contacting the stromal cells. High resolution optical microscopic scanning revealed distinguishable staining in the myometrial mucosa. LI-4 acupuncture administered nonpregnant rat's uterus showed strong expression for COX-2 in endometrium contacted with lumina epithelial lining of rat uterus and in myometrial mucosa. Stromal cells showed more staining than untreated nonpregnant rat's uterus and stronger staining in stromal cells contacting myometrial layer compared to untreated nonpregnant rat's uterus. SP-6 acupuncture administered nonpregnant rat's uterus showed weak expression for COX-2 in myometrial layers and stromal cells but no staining was visible in lumina epitheliai and glandular epithelial cells. Few stromal cells and myometrial mucosa were positively stained for COX-2. Pregnant SD rat's uterus was also immunostained for COX-2 expression after 18 days of pregnancy. Unlike to untreated nonpregnant rat's uterus, luminal epithelial cells were not positively stained for COX-2 but stronger staining for COX-2 was revealed in stromal cells. LI-4 acupunctured SD rat's uterus had very strong expression of COX-2 in luminal epithelial lining. Few stromal cells showed stronger positive COX-2 staining and myometrial layers also showed more expression than untreated pregnant rat. SP-6 acupuncture administered pregnant SD rat's uterus showed positive expression of COX-2 in epithelial cells of luminal mucosa layer but weaker than that of LI-4 acupuncture treatment's case. However, strong positive staining was revealed in stromal mucosa and myometrial layers. Virgin SD rat's uterus motility index during LI-4 acupuncture was 66.52 % (Prob〉T = 0.0197) compared to its motility before the acupuncture treatment but the motility index was slighdy elevated up to 79.58 % (Prob〉T = 0.1175) after the acupuncture. During the SP-6 acupuncture treatment for 30 minutes, uterus motility index was 90.52 % (Prob〉T = 0.1832) showing lesser decrement but consequently reached similar motility index decreasal to 79.95 % (Prob〉T = 0.0215) after the acupuncture treatment as LI-4 showed. LI-4 acupuncture tend to be a quick treatment to reducing the uterus motility in a virgin rat but eventually both two acupuncture administration created very similar reduction of uterus motility seeing the index after the both acupunctures. The uterus movement monitored during the LI-4 acupuncture administered for 30 minutes, Pregnant SD rat showed decreased motility down to 77.90 % (Prob〉 T = 0.0076) compared to uterus motility before the acupuncture and it continuously decreased down to 71.81 %(Prob〉T = 0.0214) after the removal of needle. The statistical analysis using paired t-test showed significance difference for both two motility indexs at =0.05. SP-6 acupuncture administered to pregnant SD rat also had similar pattern of decreasing uterus motility index down to 74.70 % (Prob〉T = 0.1730) during the initial 30 minutes acupuncture administration and it was continuously lowered to 71.52 % (Prob〉T = 0.0155) after the acupuncture. The paired t-test resuit for SP-6 suggest prompt response of uterus motility index to the SP-6 acupuncture treatment but consequently reached same level of inducing the motility reduction as LI-4 at =0.05 level.

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Measurement of Nursing Service Quality using SERVQUAL Model (SERVQUAL 모델을 이용한 간호 서비스 질 측정)

  • Lim, Ji-Young;Kim, So-In
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.2
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    • pp.259-279
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    • 2000
  • This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

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Novel Nucleotide Variations, Haplotypes Structure and Associations with Growth Related Traits of Goat AT Motif-Binding Factor (ATBF1) Gene

  • Zhang, Xiaoyan;Wu, Xianfeng;Jia, Wenchao;Pan, Chuanying;Li, Xiangcheng;Lei, Chuzhao;Chen, Hong;Lan, Xianyong
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.10
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    • pp.1394-1406
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    • 2015
  • The AT motif-binding factor (ATBF1) not only interacts with protein inhibitor of activated signal transducer and activator of transcription 3 (STAT3) (PIAS3) to suppress STAT3 signaling regulating embryo early development and cell differentiation, but is required for early activation of the pituitary specific transcription factor 1 (Pit1) gene (also known as POU1F1) critically affecting mammalian growth and development. The goal of this study was to detect novel nucleotide variations and haplotypes structure of the ATBF1 gene, as well as to test their associations with growth-related traits in goats. Herein, a total of seven novel single nucleotide polymorphisms (SNPs) (SNP 1-7) within this gene were found in two well-known Chinese native goat breeds. Haplotypes structure analysis demonstrated that there were four haplotypes in Hainan black goat while seventeen haplotypes in Xinong Saanen dairy goat, and both breeds only shared one haplotype (hap1). Association testing revealed that the SNP2, SNP5, SNP6, and SNP7 loci were also found to significantly associate with growth-related traits in goats, respectively. Moreover, one diplotype in Xinong Saanen dairy goats significantly linked to growth related traits. These preliminary findings not only would extend the spectrum of genetic variations of the goat ATBF1 gene, but also would contribute to implementing marker-assisted selection in genetics and breeding in goats.

The Literatural Study on Prescription about Low Back Pain (요통 치방에 대한 문헌적 고찰)

  • Lee, Sung-Hwan;Kim, Young-Il;Yang, Gi-Young;Kim, Jeong-Ho;Heo, Yoon-Kyoung;Lee, Hyun
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.41-59
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    • 2007
  • From the study of prescription on low back pain, the following conclusions are obtained. 1. Among classified cause of low back pain, ShinHur(腎虛) lowback pain and its prescription was most mentioned. 2. Prescriptions such as ChungAWhan(靑娥丸), KookBangAnShinWhan(局方安腎丸) BoSooDan(補髓丹) BaekBaeWhan(百倍丸) DooChungWhan(杜沖丸) JangBonDan(壯本丹) NokKakWhan(鹿角丸) were used in ShinHur(腎虛) type low back pain. 3. Prescription such as TaekRanTang(澤蘭湯) JiRyongSan(地龍散) YoeShinSan(如神散) ShinKookJoo(神麴酒) SoeGuenSan(舒筋散) were used in JwaSumJilBak(閃挫跌撲) type low back pain. 4. Prescription such as ChangChulTang(蒼朮湯) JumTongTang(拈痛湯) ChulBuTang(朮附湯) YiChoChangBaekSan(二炒蒼栢散) were used in SeupYoel(濕熱) type low back pain. 5. Prescription such as ChunGoongYookGaeTang(川芎肉桂湯) GaMiSaMulTang(加味四物湯) PaHoelSanDongTang(破血散疼湯) JiRyongSan(地龍散) were used in UhHoel(瘀血) type low back pain. 6. Prescription such as (蒼術復煎散) (五積散) (摩腰丹) (滲濕湯) were used in HanSeup(寒濕) type low back pain. 7. Prescription such as GaMiYiJinTang(加味二陳湯) GongYeonDan(控涎丹) SaMoolTangHapYiJinTangGaMi(四物湯合二陳湯加味) were used in DamUem(痰飮) type low back pain. 8. Prescription such as OhJukSanGaMi(五積散加味) OhYakSoonGiSanGaMi(烏藥順氣散加味) GaMiYongHoSan(加味龍虎散) SoSokMyoungTang(小續命湯) were used in Poong(風) type low back pain. 9. Prescription such as (四物湯合二陳湯) (仰腰湯) were used in SikJuk(食積) type low back pain and (五積散) (煨腎散) (三花神祐丸) in Seup(濕) type low back pain. 10. Prescription such as ChilKiTang(七氣湯) ChimHyangGangKiTang(沈香降氣湯) ChoKiSan(調氣散) InSamSoonKiSan(人參順氣散) were used in Ki(氣) type low back pain.

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Enhancement of Performance of Shell and Tube Heat Exchanger Using Pertinent Leakage Flow Between Baffle and Tube Bundles (배플과 관군간의 적정 누설유동을 이용한 쉘-관 열교환기의 성능향상)

  • Nguyen, Van Hap;Lee, Geun Sik
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.39 no.3
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    • pp.223-229
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    • 2015
  • In this study, the effects of the leakage flow between the baffle and tube bundles on the performance of a shell and tube heat exchanger (STHE) were examined using the commercial software ANSYS FLUENT v.14. A computational fluid dynamics model was developed for a small STHE with five different cases for the ratio of the leakage cross-sectional area to the baffle cross-sectional area, ranging from 0 to 40%, in order to determine the optimum leakage flow corresponding to the maximum outlet temperature. Using fixed tube wall and inlet temperatures for the shell side of the STHE, the flow and temperature fields were calculated by increasing the Reynolds number from 4952 to 14858. The present results showed that the outlet temperature, pressure drop, and heat transfer coefficient were strongly affected by the leakage flow, as well as the Reynolds number. In contrast with a previous researcher's finding that the leakage flow led to simultaneous decreases in the pressure drop and heat transfer rate, the present study found that the pertinent leakage flow provided momentum in the recirculation zone near the baffle plate and thus led to the maximum outlet temperature, a small pressure drop, and the highest heat transfer rate. The optimum leakage flow was shown in the case with a ratio of 20% among the five different cases.