• Title/Summary/Keyword: High Contact

Search Result 4,019, Processing Time 0.046 seconds

An experimental study on the impact of an agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers and enhance their self-confidence and satisfaction in maternal role performance (산욕초기 초산모의 간호목표달성방번 합의가 어머니 역할수행에 대한 자신감 및 만족도에 미치는 영향에 관한 실험적 연구)

  • 이영은
    • Journal of Korean Academy of Nursing
    • /
    • v.22 no.1
    • /
    • pp.81-115
    • /
    • 1992
  • The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t=3.95, p<0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t=1.93, p<0.05), ‘I know that my baby wants most of the times’(t=2.75, p<0.01), ‘When the baby cries, 1 can tell what she/he wants’(t=2.10, p<0.05), ‘I have confidence in my ability to care for the baby’(t=3.72, p<0.01), ‘I trust my own judement in deciding how to care for the baby’(t=1.96, p<0.05), ‘I feel that I know my baby and what to do for him /her’(t=2.44, p<0.01), ‘I am concerned about being able to meet the baby's needs’(t=2.87, p<0.01), ‘I know what my baby likes and dislikes’(t=3.26, p<0.01), ‘I don't know to care for the baby as well as I should’(t=2.07, p<0.05), and ‘I am unsure about whether I give enough attention to the baby’(t=3.04, p<0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=3.95, p<0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t=2.31, p<0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t=2.29, p<0.05), ‘I enjoy taking care of the baby’(t=2.4g, p<0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t=2.87, P<0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t=2.51, p<0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t=2.43, p<0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=2.31, p<0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r=0.57, p<0.01)

  • PDF

Skarn Evolution and Fe-(Cu) Mineralization at the Pocheon Deposit, Korea (한국 포천 광상의 스카른 진화과정 및 철(-동)광화작용)

  • Go, Ji-Su;Choi, Seon-Gyu;Kim, Chang Seong;Kim, Jong Wook;Seo, Jieun
    • Economic and Environmental Geology
    • /
    • v.47 no.4
    • /
    • pp.335-349
    • /
    • 2014
  • The Pocheon skarn deposit, located at the northwestern part of the Precambrian Gyeonggi massif in South Korea, occurs at the contact between the Cretaceous Myeongseongsan granite and the Precambrian carbonate rocks, and is also controlled by N-S-trending shear zone. The skarn distribution and mineralogy reflects both structural and lithological controls. Three types of skarn formations based on mineral assemblages in the Pocheon skarn exist; a sodiccalcic skarn and a magnesian skarn mainly developed in the dolostone, and a calcic skarn developed in the limestone. Iron mineralization occurs in the sodic-calcic and magnesian skarn zone, locally superimposed by copper mineralization during retrograde skarn stage. The sodic-calcic skarn is composed of acmite, diopside, albite, garnet, magnetite, maghemite, anhydrite, apatite, and sphene. Retrograde alteration consists of tremolite, phlogopite, epidote, sericite, gypum, chlorite, quartz, calcite, and sulfides. Magnesian skarn mainly consists of diopside and forsterite. Pyroxene and olivine are mainly altered to tremolite, with minor phlogopite, talc, and serpentine. The calcic skarn during prograde stage mainly consists of garnet, pyroxene and wollastonite. Retrograde alteration consists of epidote, vesuvianite, amphibole, biotite, magnetite, chlorite, quartz, calcite, and sulfides. Microprobe analyses indicate that the majority of the Pocheon skarn minerals are enriched by Na-Mg composition and have high $Fe^{3+}/Fe^{2+}$, $Mg^{2+}/Fe^{2+}$, and $Al^{3+}/Fe^{2+}$ ratios. Clinopyroxene is acmitic and diopsidic composition, whereas garnet is relatively grossular-rich. Amphiboles are largely of tremolite, pargasite, and magnesian hastingsite composition. The prograde anhydrous skarn assemblages formed at about $400^{\circ}{\sim}500^{\circ}C$ in a highly oxidized environment ($fO_2=10^{-23}{\sim}10^{-26}$) under a condition of about 0.5 kbar pressure and $X(CO_2)=0.10$. With increasing fluid/rock interaction during retrograde skarn, epidote, amphibole, sulfides and calcite formed as temperature decreased to approximately $250^{\circ}{\sim}400^{\circ}C$ at $X(CO_2)=0.10$.

Occurrence and Geochemical Characteristics of the Haenam Pb-Zn Skarn Deposit (해남 연-아연 스카른광상의 산상과 지화학적 특성)

  • Im, Heonkyung;Shin, Dongbok;Heo, Seonhee
    • Economic and Environmental Geology
    • /
    • v.47 no.4
    • /
    • pp.363-379
    • /
    • 2014
  • The Haenam Pb-Zn skarn deposit is located at the Hwawon peninsula in the southwestern part of the Ogcheon Metamorphic Belt. The deposit is developed along the contact between limestone of the Ogcheon group and Cretaceous quartz porphyry. Petrography of ore samples, chemical composition of skarn and ore minerals, and geochemistry of the related igneous rocks were investigated to understand the characteristics of the skarn mineralization. Skarn zonation consists of garnet${\pm}$pyroxene${\pm}$calcite${\pm}$quartz zone, pyroxene+garnet+quartz${\pm}$calcite zone, calcite+pyroxene${\pm}$garnet zone, quartz+calcite${\pm}$pyroxene zone, and calcite${\pm}$chlorite zone in succession toward carbonate rock. Garnet commonly shows zonal texture comprised of andradite and grossular. Pyroxene varies from Mn-hedenbergite to diopside as away from the intrusive rock. Chalcopyrite occurs as major ore mineral near the intrusive rock, and sphalerite and galena tend to increase as going away. Electron probe microanalyses revealed that FeS contents of sphalerite become decreased from 5.17 mole % for garnet${\pm}$pyroxene${\pm}$calcite${\pm}$quartz zone to 2.93 mole %, and to 0.40 mole % for calcite+pyroxene${\pm}$garnet zone, gradually. Ag and Bi contents also decreased from 0.72 wt.% and 1.62 wt.% to <0.01 wt.% and 0.11 wt.%, respectively. Thus, the Haenam deposit shows systematic variation of species and chemical compositions of ore minerals with skarn zoned texture. The related intrusive rock, quartz porphyry, expresses more differentiated characteristics than Zn-skarn deposit of Meinert(1995), and has relatively high$SiO_2$ concentration of 72.76~75.38 wt.% and shows geochemical features classified as calc-alkaline, peraluminous igneous rock and volcanic arc tectonic setting.

The Deposition of Tear Protein according to Soft Lens Materials and The Cleaning Efficacy of Multi-purpose Solution according to the Surfactant Types (소프트렌즈 재질 별 누액단백질 침착 및 계면활성제 종류에 따른 다목적용액의 세척효율)

  • Park, Mijung;Kwon, Young Dae;Lee, Wang Jae;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
    • /
    • v.19 no.2
    • /
    • pp.179-188
    • /
    • 2014
  • Purpose: The present study was aimed to investigate the cleaning efficacy of multi-purpose solutions containing different types and content of surfactants and their effect on the visible light transmittance of soft lens. Methods: Soft lenses made of different materials (etafilcon A and hilafilcon B) were deposited tear proteins by using the artificial tear and then compared the resulting cleaning efficacy and visible light transmittance after cleaning the lens with 6 types of multi-purpose solutions containing different content of surfactants. Results: The cleaning efficacy of multi-purpose solutions was variously shown as approximately 23~43% according to the active concentration of surfactants and surface tension in multi-purpose solution when etafilcon A lens cleaned with rubbing. The highest cleaning efficacy was detected when cleaned with the multi-purpose solution containing hydrogen peroxide besides surfactant however, the amount of remaining protein was still high on the lens. After washed with multi-purpose solution, the visible light transmittance of lens was in 89.8 to 90.8%. The amount of protein deposited on hilafilcon B lens was very small compared with it on etafilcon A lens even though it was incubated in artificial tears for 7 days, which showed 5~10% of protein amount in etafilcon A lens and the decrease of visible light transmittance was also not significant. In case of rubbing with multi-purpose solution, the cleaning efficacy on hilafilcon B lens was in 45.4 to 67.4% however, the order of cleaning efficacy of multi-purpose solution was different from it on etafilcon A lens. The visible light transmittance of hilafilcon B lens has been restored to the level of new lens. Conclusions: From the result, it is concluded that the appropriate multi-purpose solution should be selected according to the lens material and the amount of protein deposit on the basis of understanding surfactants and active principle for proper care of protein deposit on soft lens and the cleaning with rubbing is more efficient for lens care regardless of manufacturer's guideline.

An Evaluation on the Operating of Fisheries Extension Services (어촌지도사업의 평가)

  • 최정윤
    • The Journal of Fisheries Business Administration
    • /
    • v.17 no.2
    • /
    • pp.65-106
    • /
    • 1986
  • 1, The Purpose of Study This is a study on the Evaluation of the operating of Fisheries Extension Services of Korea, for performing the activities such as guiding fisheries technique as well as offering industrial information to the fishermen in fishing village. By doing so, the Fisheries Extension Sevices(FES) can materialize the continued growth of fisheries, the social and economic development of fishing village, and the increase in income by enhancing the knowledge level of Fishermen, etc. In performing fisheries policy, this activity plays a great role on the research and development activity, and it has become practical since 1976 in Korea. In order to meet immediately with the problem of fisheries technical innovation and rapid environmental changes surrounding the fisheries, the fishermen should not only enhance their scientific and comprehensive capacity in fisheries technique but abtain various effective information. Generally, as most of all the fishemen are poor in the managerial structure and scattered in fishing villages, they have little opportunity in the contact of information. As a result, it is nessessary for the FES to perform the fishing business by the extension service officials who has received special training and acquired fisheries know-how in these fields. And yet, FES is under the unfullfilled circumstance in such factors as manpower, technical know-how, equipment, and the service system etc., which is required in promoting the social, economic development of fishing village and in resolving the high technique demand of fisherman. This study on the fisheries extension services have been studied from those backgrounds. 2. Research Method The data of collecting methods which were necessary in carrying out this study was adopted by the questionaire research on the present extension service activity, through the subject of the extension services (driving agency of the work and the officials), the object(fishemen) and the 3rd observers to the extension services (the authorities concerned). The research sample was taken by the sampling extraction of total 1, 774 men from the above 3 groups. And the research was carried out from August, 1986 to October, 1986, supported from the Fisheries Extension Office (FEO) located in field during the research process. In this study, the levels of the extension operating were determined and estimated in accordance with the extension service method, morale of extension service officials and the extension service system, etc. through the collected data of the research questionaire paper. And based on this result, the essential conditions of the extension services were grasped, and also we tried to present the various activity plan necessary to promote the operating of the extension services. The questionaire research data was calculated by the computer center of National Fisheries University of Pusan, and the total result was again tried on the one demension analysis along with two dimension analysis to search out the relativity between the questionaire, and the statistical test was done $\chi$$^2$test in significance level of l~5%. 3. Contents of Study This study consists of 7 chapters and the contents are as follows : Chapter I : The object and method of the study Chapter II : The assessment and analysis of the extension services Chapter III : The contents and method of the extension services Chapter IV : Analysis of the essential conditions for the extension services Chapter V : The evaluation of activities of extension services Chapter Ⅵ : Conclusion.4. Results and RecommendationTherefore, the results of this study estimated by logical process and analysis are as follows : 1) Most of Korean fishing villages and coastal fishermen have shown much concerns about fisheries technique and social changes, thus many of them were confronted with new problems on how to adapt and to meet changes. 2) Majority of fishermen estimated FEO as an organization of specific technologies with all the thing concerning the fisheries technique in general. Therefore the fishermen wanted to utilize the FEO as an adaptable method for the modern fisheries techniques as well as the environmental changes. 3) In contrast with the fast changes of the fisheries technique, the complexity and variety of technical system and the broadness of fishing village and fishermen, it was revealed that the necessary factors such as the facilities, manpower, budget, and the level of applying techniques of the FEO located in field were highly insufficient. Accordingly, the guiding efficiency was low and the extension services did not provide full solution to the various request from fishermen. 4) It is possible to classify the activation factor for the extension service into two large dimension ; personal dimension relevant to guidance officials and work dimension relevant to the organization. And it was found that the activation level of the work dimension was far lower than the personal dimension between them. So, the activation should be done first in the dimesion to promote the activation of the extension services. 5) The extension services officials are now demoralized in general, thus it is necessary to take reality into consideration : the expense of activity, the adequate endowment of activity scope and the reasonable operation of the position class, etc to enhance its morale. However, in order to do the FES activation, first of all, the systems should be established which is lain unsettled stage until now. And there must be change in the understanding of government i.e. the fisheries extension services are the essential policy subject to build up the base of fisheries growth and modernize the fisheries management. And it should be driven positively with the recognition of the "lasting project".g project".uot;.

  • PDF

Effects of Horseshoe Expander (Horseshoe Expander의 확장 효과에 관한 연구)

  • Chung, Kyu-Rhim;Park, Young-Guk;Lee, Young-Jun;Kim, Hong-Suk
    • The korean journal of orthodontics
    • /
    • v.30 no.5 s.82
    • /
    • pp.553-563
    • /
    • 2000
  • Horseshoe Expander is one of Slow Maxillary Expansion(SME) which aims to accommodate the contra- lateral expansion and midpalatal suture expansion or the palate. The appliance consists of skeleton type strew embedded in split Horseshoe appliance. It is the objectives of the presentation to manifest the changes in dental & craniofacial components subsequent to the application of Horseshoe Expander. The subjects for this study consisted of 32 patients (mean age : 12.7). frontal, lateral cephalometric headfilm were taken and study casts were fabricated before and after expansion. 24 items were measured, compared preexpansion with postexpansion. Especially, palatal volume was measured by means of 'Hydro-measurement method'. Tooth axis measurement on the dental casts were made with Universal bevel protractor, and Horseshoe Expander group were compared with RME group. This study of changes to maxillary expansion with Horseshoe Expander revealed the following significant results. 1. Triangular-shaped expansion pattern appeared in frontal cephalometric headfilm. 2. Palatal plane, occlusal plane, mandibular plane and upper incisor to FH increased in lateral cephalometrir headfilm. 3. Palatal volume increased significantly. A slight bite opening, reduction of occlusal contact points showed in dental casts. 4. A 2.2:1 ratio of the amount of intermolar width in maxilla(orthodontic movement) to maxillary width (orthopedic movement) was determined. 5. Horseshoe Expander group has less buccal tipping tendency than RME group, by taking high correlation coefficients in the upper second premolar and first molar. It was suggested that Horseshoe Expander showed less orthodontic changes, less buccal tipping tendency. In addition, it was effective in maxillary expansion.

  • PDF

Awareness of Major Zoonoses among Dairy Farmers in Gyeonggi Province (경기도 낙농업자의 주요 인수공통감염증 인지도)

  • Choi, Kum-Bal;Lim, Hyun-Sul;Lee, Kwan;Min, Young-Sun
    • Journal of agricultural medicine and community health
    • /
    • v.35 no.4
    • /
    • pp.339-349
    • /
    • 2010
  • Objective: We surveyed awareness levels of brucellosis, Q fever and enterohemorrhagic Escherichia coli (EHEC) among dairy farmers in Gyeonggi Province to suggest directions for public education and public relations. Methods: We designed questionnaires to evaluate awareness of 3 major zooneses. We conducted a questionnaire survey to assess knowledge of the general characteristics of them, information sources for the awareness of zooneses, and the mode of transmission. Subjects were 716 workers from 482 dairy farms in Gyeonggi province. Results: The awareness levels for brucellosis, Q fever, and EHEC were 90.2%, 2.5% and 56.6%, respectively. Awareness of brucellosis and EHEC were tended to increase with higher number of school years. Television was the most common route of information for these zoonoses. Most common responses for questions concerning the method of transmission for each zoonoses, 'Contact with parturient fluid or placenta of animal' was 63.2% for brucellosis, 'Ingestion of raw meat or residual product' was 66.7% and 64.2% for Q fever and EHEC, respectively. The most common reason why dairy farmers think that it is difficult to prevent zoonoses was the inconvenience of wearing protection. Conclusions: Education programs for zoonoses, especially Q fever, are needed for dairy farmers. In addition, publicity information activities about prevention of zoonoses are needed for high risk groups, such as the dairy farmers surveyed.

Reliability of Muscle Evaluation with a Tactile Sensor System (촉각센서를 이용한 근육평가의 신뢰도 조사)

  • Oh, Young-Rak;Lee, Dong-Ju;Kim, Sung-Hwan;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
    • /
    • v.30 no.3
    • /
    • pp.337-344
    • /
    • 2005
  • A tactile sensor employs a piezoelectric element to detect contact frequency shifts and thereby measure the stiffness or softness of material such as tissue, which allows the sensor to be used in many fields of research for urology, cardiology, gynecology, sports medicine and caner detection and especially for cosmetics and skin care. In this study, reliability of the tactile sensor system was investigated with its manual application to the muscles susceptible to temporomandibular disorders. Stiffness and elasticity of anterior temporalis, masseter and trapezius muscles were calibrated bilaterally from 5 healthy men with an average of 24.5$\pm$0.94 years. The tactile sensor used in this study had a computer-controlled and motor-driven sensor unit which automatically pressed down on the skin surface over the muscles being measured and retracted, thereby providing the hysteresis curve. The slope of the tangent of the hysteresis curve (${\Delta}f/{\Delta}x$) is defined as stiffness of the muscle being measured and the distance between the two parts of the curve as its elasticity. To determine inter-examiner reliability, all the measurements were performed by the two examiners A and B, respectively and the same examination were repeated with an interval of 2 days for intra-examiner reliability. The results from this study demonstrated high reliability in measuring stiffness and elasticity of anterior temporalis, masseter and upper trapezius muscles using a tactile sensor system. It is suggested that the tactile sensor system can be a highly reproducible and effective instrument for quantitative evaluation of the muscle in head and neck region.

Drug Resistance Patterns of the Bacterial Strains Isolated from Rural Areas and an Urban General Hospital (무의촌균주(無醫村菌株) 및 병원균주(病院菌株)의 항균제(抗菌劑) 내성(耐性) 양상(樣相)에 관(關)한 연구(硏究))

  • Rhee, Kwang-Ho;Kim, Ik-Sang;Shin, Hee-Sup;Cha, Chang-Yong;Lee, Seung-Hoon;Chang, Woo-Hyun;Lim, Jung-Kyoo
    • The Journal of the Korean Society for Microbiology
    • /
    • v.15 no.1
    • /
    • pp.19-32
    • /
    • 1980
  • Besides the benefits of antimicrobial agents in the control of various infectious diseases, widespread and prolonged use of particular antimicrobial agents has brought about the increase of drug-resistant strains in a community and the profound changes in the pattern of infectious diseases. In Korea, there are some remote villages where no clinics and drug stores are available and the residents in those areas are assumed to have fewer chances to contact with antimicrobial agents. In the present study, the differences in susceptibilities to 14 antimicrobial agents between the isolates from rural areas(R) and Seoul National University Hospital(SNUH, H) were studied. The isolates and their numbers were Staphylococcus aureus, R;55, H;68), Enterococci(R;28, H;30), Escherichia coli(R;40, H;40), Enterobacter aerogenes(R;25, H;21) and Klebsiella pneunoniae(R;58, H;67). Minimal inhibitory concentrations(MIC's) of penicillin, ampicillin, carbenicillin, cephalexin, tetracycline, oxytetracyline, doxycycline, minocycline, gentamicin, kanamycin, streptomycin, erythromycin, troleandomycin and co-trimoxazole were determined by agar dilution method. I. Comparison of MIC's and resistant strain proportions between isolates from SNUH and rural areas. MIC's and/or resistant strain proportions of the isolates from SNUH were significantly higher than those of the isolates from rural areas in the cases of 1. S. aureus to doxycycline, streptomycin and kanamycin. 2. E. coli to penicillin, ampicillin, carbenicillin, tetracycline, oxytetracycline, doxycycline, minocycline, streptomycin, kanamycin, erythromycin and co-trimoxazole. 3. E. aerogences to carbenicillin, tetracycline, oxytetracycline, doxycycline, minocycline, streptomycin, kanamycin, genaamicin and co-trimoxazole. 4. K pneunoniae to penicillin, ampicillin, tetracycline, oxytetracycline, doxycycline, monocycline, streptomycin, kanamycine, gentamicin and co-trimoxazole. However, the mean MIC and resistant strain proportion of S. aureus to tetracycline were higher in isolates from rural areas than in those from SNUH and Enterococci showed no differences in susceptibilities to the antimicrobial agents between isolates from rural areas and from SNUH. Therefore, in general, differenes in susceptibility to these antimicrobial agents between the isolates from rural areas and SNUH were remarkably greater and broader in gram negative enteric bacteria. II. Multiple drug resistance pattern. Patterns and incidences of multiple drug resistance were studied with penicillin, ampicillin, tetracycline, cephalexin, gentamicin, streptomcin, kanamycin and co-trimoxazole in Enterococci, E. coli, E. aeroges and K. pneumoniae. There appeared significant differences in the incidence of multiply drug-resistant strains and multiple drug resistance patterns between the isolates from SNUH and rural areas in Enterococci, E. coli, E. aerogenes and K. pneumoniae. However, there was no difference in the incidence of multiply drug-resistant strains between isolates of S. aureus from SNUH and rural areas but the pattern of multiple resistance of the SNUH strains of S. aureus was diverse, while that of the rural strains was predominantly confined to penicillin-tetracycline combination. The incidence of multigly drug-resistant strains and diversity of their patterns were the highest in E. coli strains isolated from SNUH and there were no multiply drug resistant strrains in Enterococci and K. pneumoniae strains isolated from rural areas. The number of drug-resistance determinants was also different between the isolates from rural areas and SNUH. Most of the multiply drug-resistant strains of E. coli, E. aerogenes and K. pneumoniae isolated from SNUH were resistant to more than 3 kinds of antimicrobial agents, most frequently to ampicillin, tetracycline and streptomycin, while multiply drug-resistant strains from rural areas were resistant to 2 kinds of antimicrobial agents among ampicillin, tetracycline and streptomycin. With drug-resistant E. coli strains, resistance to tetracycline which was used most widely since 1951 was most frequently involved as a part of mutliple drug-resistance, followed by resistance to ampicillin and streptomycin. This strongly suggests that emergence of drug-restant strains in a community is directly dependent on the selective pressure exerted by the antimicrobial agent used. III. Cross resistance. Cross resistance of bacteria was studied among tetracycline penicillin, aminoglycoside and macrolide derivatives by analyzing correlation coefficients of sucseptibilities using the least square method. In this study, there were high correlations among the susceptibilities to related derivatives. It appears that the relatively low correlations in susceptibilities present in some cases are due to intrinsic resistance of E. aerogenes to penicillin, Enterococci to aminoglycoside and E. coli E. aerogenes and K. pneumoniae to macrolide derivatives.

  • PDF

Application of the QUAL2E Model and Risk Assessment for Water Quality Management in Namyang Stream in Hwaong Polder (화옹유역 남양천의 수질관리를 위한 QUAL2E적용과 위해성 평가)

  • Jang, Jae-Ho;Jung, Kwang-Wook;Kim, Hyung-Chul;Yoon, Chun-Gyeong
    • Korean Journal of Ecology and Environment
    • /
    • v.39 no.1 s.115
    • /
    • pp.110-118
    • /
    • 2006
  • The Namyang Stream in Hwaong polder was planned for several water uses including recreation, where people can contact the water and consume some amount during the recreational activity. A human health risk was assessed from exposure to E. coli in the Namyang Stream, which receives partially treated wastewater from watershed. The QUAL2E model was applied to simulate stream water quality, and this model was calibrated and verified with field monitoring data. The calibration result showed a high correlation coefficient of greater than 0.9. The mean concentration of E. coli in the Namyang Stream from the QUAL2E output was in the range of 5,000 ${\sim}$ 8,000 MPN 100 mL^{-1}$, which exceeded national and international guidelines. The Beta-Poisson was used to estimate the microbial risk of pathogens ingestion and the Monte-Carlo analysis (10,000 trials) was used to estimate the risk characterization of uncertainty. The Microbial risk assessment showed that the risk ranged from 7.9 ${\times}\;10^{-6}\;to\;9.4\;{\times}10^{-6}$. Based on USEPA guidelines, the range of $10^{-6}\;to\;10^{-8}$ was considered reasonable levels of risk for communicable disease transmission from environmental exposure, and the risk above $10^{-4}$ was considered to be in the danger of infection. Therefore, water quality of the Namyang Stream might not be in the danger of infection although it exceeded national and international guidelines. However, it was in the range of communicable disease transmission, and thorough wastewater collection and treatment at the source is recommended to secure safe recreation water quality.