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Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.300-308
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    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

Efficacy of Long-term Interferon-alpha Therapy in Adult Patients with Recurrent Respiratory Papillomatosis (성인의 재발성 호흡기계 유두종증 환자에서 장기간 인터페론 치료의 유효성)

  • Nam, Hae-Seong;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kwon, O Jung;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.390-395
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    • 2008
  • Background: Since the early 1980s, interferon-alpha ($IFN-{\alpha}$) has been used as adjuvant therapy in pediatric patients with recurrent respiratory papillomatosis (RRP). However, its efficacy in adults needs to be validated. Since 2002, Samsung Medical Center's guidelines have mandated regular injection of $IFN-{\alpha}$ in patients with RRP to prevent recurrence. To evaluate these guidelines, patient data were investigated. Methods: Five patients diagnosed as having RRP by bronchoscopy and histopathology were included. After initial bronchoscopic intervention, including laser cauterization, all patients received subcutaneous injection of 6 million units of $IFN-{\alpha}$ every 2 months. Further bronchoscopic intervention was carried out as needed. Patients were regularly evaluated using bronchoscopy or computed tomography. Results: The median age of the patients was 44 years (range 13~68), and the median duration of papillomatosis was 31 years (range 1~45). Three and two patients had juvenile-onset and adult-onset disease, respectively. Two patients had a history of tracheostomy at the time of diagnosis. The median duration of $IFN-{\alpha}$ therapy was 56 months (range 12~66). Two patients showed complete remission at 12 and 36 months after $IFN-{\alpha}$ injection, respectively. The other three patients showed partial remission, and the number of laser therapy sessions was significantly reduced.Conclusion: Intermittent $IFN-{\alpha}$ injection is effective in patients with long-standing RRP and can reduce the number of laser therapy sessions required in their treatment.

A Critical Liquefaction Resistible Characteristic of Saturated Sands Based on the Cyclic Triaxial Test Under Sinusoidal Loadings (정현하중재하 진동삼축시험에 기초한 포화사질토의 액상화 한계저항특성)

  • 최재순;김수일
    • Journal of the Korean Geotechnical Society
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    • v.20 no.8
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    • pp.147-158
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    • 2004
  • Laboratory dynamic tests are carried out to assess the liquefaction potential of saturated sands in most countries. However, simple results such as the maximum cyclic shear stress and the number of cycles at initial liquefaction are used in the experimental assessment of liquefaction potential, even though various results can be obtained from the dynamic test. In addition, it seemed to be inefficient because more than three dynamic tests with different stress ratio have to be carried out to draw a liquefaction resistance experimental curve. To improve the present assessment method fur liquefaction potential, a new critical resistible characteristic far soil liquefaction is proposed and verified through conventional cyclic triaxial tests with Jumunjin sand. In the proposed method, various experimental data such as effective stress path, stress-strain relationship, and the change of excess pore water pressure can be used in the determination of cumulative plastic shear strains at every 1/4 cycle. Especially, the critical cumulative plastic shear strain to initiate liquefaction can be defined in a specific point called a phase change point in the effective stress path and it can be calculated from a hysteric curve of stress-strain relationship up to this point. Through this research, it is found that the proposed cumulative plastic shear strain can express the dissipated energy to resist dynamic loads and consider the realistic soil dynamic behavior of saturated sands reasonably. It is also found that the critical plastic shear strain can be used as a registible index of soils to represent the critical soil dynamic state, because it seems to include no effect of large deformation.

Effect of Development and Application of Teaching-Learning Materials and Plan using Persimmon juice Dyeing on the Traditional Clothing Life-Culture Education (감즙염색을 이용한 학습자료와 교수-학습과정안 개발 및 적용이 전통 의생활문화 교육에 미치는 효과)

  • Park, Soonja;Yoo, Jiyeon
    • Journal of Korean Home Economics Education Association
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    • v.25 no.1
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    • pp.79-94
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    • 2013
  • In this study, the teaching-learning materials and the plan using persimmon juice dyeing, which is one of the traditional natural dyeing methods of Korea, were developed for the purpose of inspiring further awareness of our traditional clothing life-culture. A questionnaire was designed to make a survey on the educational effect, and t-test and Kruscal-Wallis test were conducted to test the significant differences between pre- and post-lessons. A correlation analysis between culture awareness and its education awareness was also done. These prototypes were applied to high school Technology Home Economics classes under the theme, 'Making living goods with persimmon juice dyed fabrics'. Examining the changes in students' awareness of traditional images, and changes in their interest and attitude towards learning in those classes led to the following results. First, as a result of applying LT cooperative learning in order for an understanding of the formation of clothing life-culture and the process of persimmon juice dyeing, many original handicrafts with modern sense were created. Second, a comparative analysis between pre- and post-lessons on the change in students' degree of awareness of traditional clothing life-culture and its education showed that students' awareness had risen after the class; the data was collected from three separate sample groups which had been clustered according to their initial degree of awareness, i.e. high, middle, and low, and the group that scored the lowest before the class showed the greatest improvement. Third, feedback surveys on 'Making living goods with persimmon juice dyed fabrics' classes returned with scores greater than 'moderate', thus revealing that the students' concern and interest towards traditional clothing life-culture hae been enhanced through the class experience. Their attitude had also become more positive. Fourth, since learners with more awareness of the traditional clothing life-culture also showed more awareness of the need for an education designed to promote the culture, a positive correlation between the two had been found. As explained above, the teaching-learning materials and the plan that had been developed for this study has caused a deeper understanding of the value and significance of the traditional natural dyeing and clothing life-culture, and has therefore brought about an educational effect that powers idea creation.

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Mobile Contents Transformation System Research for Personalization Service (개인화 서비스를 위한 모바일 콘텐츠 변환 시스템 연구)

  • Bae, Jong-Hwan;Cho, Young-Hee;Lee, Jung-Jae;Kim, Nam-Jin
    • Journal of Intelligence and Information Systems
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    • v.17 no.2
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    • pp.119-128
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    • 2011
  • The Sensor technology and portable device capability able to collect recent user information and the information about the surrounding environment haven been highly developed. A user can be made use of various contents and the option is also extending with this technology development. In particular, the initial portable device had simply a call function, but now that has evolved into 'the 4th screen' which including movie, television, PC ability. also, in the past, a portable device to provided only the services of a SMS, in recent years, it provided to interactive video service, and it include technology which providing various contents. Also, it is rising as media which leading the consumption of contents, because it can be used anytime, anywhere. However, the contents available for the nature of user's handheld devices are limited. because it is very difficult for making the contents separately according to various device specification. To find a solution to this problem, the study on one contents from several device has been progressing. The contents conversion technology making use of the profile of device out of this study comes to the force and profile study has been progressing for this. Furthermore, Demand for a user is also increased and the study on the technology collecting, analyzing demands has been making active progress. And what is more, Grasping user's demands by making use of this technology and the study on the technology analyzing, providing contents has been making active progress as well. First of all, there is a method making good use of ZigBee, Bluetooth technology about the sensor for gathering user's information. ZigBee uses low-power digital radio for wireless headphone, wireless communication network, and being utilized for smart energy, automatic home system, wireless communication application and wireless sensor application. Bluetooth, as industry standards of PAN(Personal Area Networks), is being made of use of low power wireless device for the technology supporting data transmission such as drawing file, video file among Bluetooth device. With analyzing the collected information making use of this technology, it utilizes personalized service based on network knowledge developed by ETRI to service contents tailor-made for a user. Now that personalized service builds up network knowledge about user's various environments, the technology provides context friendly service constructed dynamically on the basis of this. The contents to service dynamically like this offer the contents that it converses with utilizing device profile to working well. Therefore, this paper suggests the system as follow. It collects the information, for example of user's sensitivity, context and location by using sensor technology, and generates the profile as a means of collected information as sensor. It collects the user's propensity to the information by user's input and event and generates profile in the same way besides the gathered information by sensor. Device transmits a generated profile and the profile about a device specification to proxy server. And proxy server transmits a profile to each profile management server. It analyzes profile in proxy server so that it selects the contents user demand and requests in contents server. Contents server receives a profile of user portable device from device profile server and converses the contents by using this. Original source code of contents convert into XML code using the device profile and XML code convert into source code available in user portable device. Thus, contents conversion process is terminated and user friendly system is completed as the user transmits optimal contents for user portable device.

Optimization of Mycelial Growth of Entomogenous fungi of the Genus Cordyceps (동충하초속균의 균사생장최적화)

  • Hong, In-Pyo;Nam, Sung-Hee;Jung, I-Yeon;Sung, Gyoo-Byung;Nam, Hack-Woo;Kang, Seok-Woo;Hur, Hyeon;Lee, Min-Woong;Guo, Shun-Xing
    • Journal of Mushroom
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    • v.2 no.3
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    • pp.149-156
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    • 2004
  • This study was carried out to obtain basic data on physiological characteristics for an artificial cultivation of fruiting body of Cordyceps. Specimens such as Cordyceps longissima, C. militaris and C. pruinosa were collected at Mt. Halla of Cheju island in July, 2003. Among four different culture media which have been used for culture of mushrooms, MCM medium was selected for the favorable culture medium of the Cordyceps tested. The initial pH of solid medium for mycelial growth of Cordyceps was good in the range of pH 5.0~7.0 lower than 8.0. The mycelial growth of C. longissima was most favorable on culture media supplemented with glucose, one of monosaccharides. In C. militaris, nine carbon sources were favorable to the mycelial growth as compared with control among 11 carbon sources. Six nitrogen sources were favorable to the mycelial growth of C. longissima as compared with control among 9 carbon sources; namely, the mycelial growth of C. longissima was most favorable on culture media contained potassium nitrate, and followed in order by ammonium citrate and sodium nitrate in 4 weeks incubation.

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Diagnosis and Monitoring of Chronic Myeloid Leukemia: Chiang Mai University Experience

  • Tantiworawit, Adisak;Kongjarern, Supanat;Rattarittamrong, Ekarat;Lekawanvijit, Suree;Bumroongkit, Kanokkan;Boonma, Nonglak;Rattanathammethee, Thanawat;Hantrakool, Sasinee;Chai-Adisaksopha, Chatree;Norasetthada, Lalita
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2159-2164
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    • 2016
  • Background: A diagnosis of chronic myeloid leukemia (CML) is made on discovery of the presence of a Philadelphia (Ph) chromosome. The success of the treatment of this form of leukemia with tyrosine kinase inhibitor (TKI) is monitored by reduction of the Ph chromosome. Objective: To compare the role of conventional cytogenetic (CC) methods with a real time quantitative polymerase chain reaction (RQ-PCR) and fluorescence in situ hybridization (FISH) for diagnosis and treatment monitoring of CML patients. The secondary outcome was to analyze the treatment responses to TKI in CML patients. Materials and Methods: This was a retrospective study of CML patients who attended the Hematology clinic at Chiang Mai University Hospital from 2005-2010. Medical records were reviewed for demographic data, risk score, treatment response and the results of CC methods, FISH and RQ-PCR. Results: One hundred and twenty three cases were included in the study, 57.7% of whom were male with a mean age of 46.9 years. Most of the patients registered as intermediate to high risk on the Sokal score. At diagnosis, 121 patients were tested using the CC method and 118 (95.9%) were identified as positive. Five patients failed to be diagnosed by CC methods but were positive for BCR-ABL1 using the FISH method. Imatinib was the first-line treatment used in 120 patients (97.6%). In most patients (108 out of 122, 88.5%), a complete cytogenetic response (CCyR) was achieved after TKI therapy and in 86 patients (70.5%) CCyR was achieved long term by the CC method. Five out of the 35 analyzed patients in which CCyR was achieved by the CC method had a positive FISH result. Out of the 76 patients in which CCyR was achieved, RQ-PCR classified patients to only CCyR in 17 patients (22.4%) with a deeper major molecular response (MMR) in 4 patients (5.3%) and complete molecular response (CMR) in 55 patients (72.4%). In the case of initial therapy, CCyR was achieved in 95 patients (79.1%) who received imatinib and in both patients who received dasatinib (100%). For the second line treatment, nilotinib were used in 30 patients and in 19 of them (63.3%) CCyR was achieved. In half of the 6 patients (50%) who received dasatinib as second line or third line treatment CCyR was also achieved. Conclusions: CML patients had a good response to TKI treatment. FISH could be useful for diagnosis in cases where CC analysis failed to detect the Ph chromosome. RQ-PCR was helpful in detecting any residual disease and determining the depth of the treatment response at levels greater than the CC methods.

GROWTH OF SOUTH AND WEST COAST PACIFIC OYSTER SPATS(CRASSOSTREA GIGAS) AFTER CROSS-TRANSPLANTATION (남해산 및 서해산 참굴(Crassostrea gigas)종패의 상호 이식 후의 성장)

  • CHUNG Jong Rak;KWAK Hi-Sang
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.3 no.2
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    • pp.129-136
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    • 1970
  • As an attempt to determine if the morphological differences between the southern and western oysters are due simply to the local ecological factors or are based on their fundamental genetic nature, oyster seeds produced in 1968 at Tong-Young, Ye-Chun, and Ko-Hung on the south coast and at Kan-Wol-Do on the west coast were cross-transplanted during May of 1969 to compare their growth. The spats were placed in plastic baskets which permitted free water flow through and the baskets hung from a wooden rack located at a tidal zone of less than I hour exposure at a depth chosen to keep the baskets submerged in water at all times. Twice a month the growth of the spats were measured along with the air and water temperature and salinity. The early summer spats, which were $17-240\%$ larger, in size, than the late summer spats at the time of cross-transplantation, grew more slowly than the late summer spats when exposed to identical environmental conditions, shortening the initial gap to a $5-20\%$ level as the first year of the growth phase came to an end in December. The growth of the Kan-Wol-Do spats lagged considerably behind the southern spats at all localities tested, whereas there were no significant differences among the latter groups. This suggests that the morphological differences between southern and western Pacific oysters in Korea are a manifestation of genetic variety and that Pacific oysters cultured along the south coast are of an identical variety as they are commonly believed to be. The seasonal changes in temperature and salinity even during rainy season in both the southern and western coastal areas are well within the range suitable for successful spawning, and spat fall. However, since the results were based on twice-a-month measurements with no data covering the critical period before and after spawning, they can only serve to indicate at best the general pattern of changes in the environmental conditions of each growing area.

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THE TASTE COMPOUNDS FERMENTED ACETES CHINENSIS (새우젓의 정미성분에 관한 연구)

  • CHUNG Seung-Yong;LEE Eung-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.9 no.2
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    • pp.79-110
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    • 1976
  • In Korea fermented fish and shellfish have traditionally been favored and consumed as seasonings or further processed for fish sauce. Three major items in production quantity among more than thirty kinds which are presently available in the market are fermented anchovy, oyster and small shrimp. They are usually used as a seasoning mixture of Kimchi in order to provide a distinctive flavor. Fermented small shrimp, Acetes chinensis is most widely and largely used ana occupies an important position in food industry of this country. But no study on its taste compounds has been reported. This study was attempted to establish the basic data for evaluating taste compounds of fermented small shrimp. The changes of such compounds during fermentation as free amino acids, nucleotides and their related compounds, TMAO, TMA, and betaine were analysed. In addition, change in microflora during the fermentation under the halophilic circumstance was also investigated. The samples were prepared with three different salt contents of 20, 30 and $40\%$ to obtain the proper degree of fermentation at a controlled tempeature of $20{\pm}2^{\circ}C$. The results are summarized as follows: Volatile basic nitrogen increased rapidly until 108 days of fermentation and afterwards it tended to increase slowly. Amino nitrogen also increased rapidly until 43 days of fermentation and then increased slowly. Extract nitrogen increased and marked the maximum value at 72 day fermentation and then decreased slowly. ADP, AMP and IMP tended to degrade rapidly while hypoxanthine increased remarkably at 27 day fermentation but slightly decreased at 72 day fermentation. It is presumed that the characteristic flavor of fermented small shrimp might be attributed to the relatively higher content of hypoxanthine. In the free amino acid composition of fresh small shrimp abundant amino acids were proline, arginine, alanine, glycine, lysine, glutamic acid, leucine, valine and threonine in order. Such amino acids like serine, methionine, isoleucine, phenylalanine, aspartic acid, tyrosine and histidine were poor. In small shrimp extract, proline, arginine, alanine, glycine, lysine and glutamic acid were dominant holding $18.5\%,\;14.6\%,\;10.8\%,\;8.7\%,\;8.1\%\;and\;7.7\%$ of total free amino acids respectively. The total free amino acid nitrogen in fresh small shrimp was $63.9\%$ of its extract nitrogen. The change of free amino acid composition in the extract of small shrimp during fermentation was not observed. Lysine, alanine glutamic acid, proline, glycine and leucine were abundant in both fresh sample and fermented products. The increase of total free amino acids during 72 day fermentation reached approximately more than 2 times as compared with that of fresh sample and then decreased slowly. Fermented small shrimp with $40\%$ of salt was too salty to be commercial quality as the results of organoleptic test showed. It is found that 72 day fermentation with $20\%\;and\;30\%$ of salt gave the most favorable flavor. It is convinced that the characteristic flavor of fermented small shrimp was also attributed to such amino acids as lysine, proline, alanine, glycine and serine known as sweet compounds, as glutamic acid with meaty taste, and as leucine known as bitter taste. The amount of betaine increased during fermentation and reached the maximum at 72 day fermentation and then decreased slowly TMA increased while TMAO decreased during fermentation. The amount of TMAO nitrogen in fermented small shrimp was $200mg\%$ on moisture and salt free base. Betaine and TMAO known as sweet compounds were abundant in fermented small shrimp. It is supposed that these compounds could also play a role as important taste compounds of fermented small shrimp. At the initial stage of fermentation, Achromobacter, Pseudomonas, Micrococcus denitrificans which belong to marine bacteria were isolated. After 40 day fermentation, they disappeared rapidly while Halabacterium, Pediococcus, Sarcian, Micrococcus morrhuae and the yeasts such as Saccharomyces sp. and Torulopsis sp. dominated. It is concluded that the most important taste compounds of fermented small shrimp were amino acids such as lysine, proline, alanine, glycine, serine, glutamic acid, and leucine, betaine, TMAO and hypoxanthine.

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The Stakeholder's Response and Future of Mountain Community Development Program in Rep. of Korea (한국 산촌개발사업에 대한 이해관계자의 의식과 향후 발전방안)

  • Yoo, Byoung Il;Kim, So Heui;Seo, Jeong-Weon
    • Journal of Korean Society of Forest Science
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    • v.94 no.4 s.161
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    • pp.214-225
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    • 2005
  • The mountain village development program in Korea started in the mountain villages, the 45.9% of total land and one of the typical marginal region, from 1995 to achieve the equilibrium development of national land and the sustainable mountain development in Chapter 13 in Agenda 21, and it has been accelerated to increase the happiness and the quality of life of mountain community residents through the expansion by province and the improvement of related laws and regulations. This study has been aimed to analyze the response of main stakeholder's -mountain village residents and local government officials - on mountain villages development, and to provide the future plan as community development. The survey and interview data were collected from the mountain villages which already developed 59 villages and developing 15 villages in 2003. The mountain village development program has achieved the positive aspects as community development plan in the several fields, - the voluntary participation of residents, the establishment of self-support spirit as the democratic civilians, the development of base of income increasement, the creation of comfortable living environment, the equilibrium development with the other regions. Especially the mountain residents and local government officials both highly satisfy with the development of base of income increasement and the creation of comfortable living environment which are the main concerns to both stakeholder. However through the mountain development program, it is not satisfied to increase the maintenance of local community and the strengthening of traditional value of mountain villages. Also to improve the sustainable income improvement effects, it is necessary to develop the income items and technical extension which good for the each region. In the decentralization era, it is necessary for local government should have the more active and multilateral activities for these. With this, the introduction of methods which the mountain community people and the local government officials could co-participate in the mountain villages' development from the initial stages and the renovation of related local government organizations and the cooperatives will be much helpful to the substantiality of mountain development program. Also it is essential for the assistance of central government to establish the complex plan and the mountain villages network for all mountain area and the exchange of information, the education and training of mountain villages leader who are the core factor for the developed mountain villages maintenance, the composition of national mountain villages representatives. In case the development proposals which based on the interests of the main stakeholder's on mountain community could be positively accepted, then the possibility of the mountain village development as one of community development will be successfully improved in future.