• Title/Summary/Keyword: Low Level Control

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Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II

  • Oh, Seil;Kim, June-Soo;Oh, Yong-Seog;Shin, Dong-Gu;Pak, Hui-Nam;Hwang, Gyo-Seung;Choi, Kee-Joon;Kim, Jin-Bae;Lee, Man-Young;Park, Hyung-Wook;Kim, Dae-Kyeong;Jin, Eun-Sun;Park, Jaeseok;Oh, Il-Young;Shin, Dae-Hee;Park, Hyoung-Seob;Kim, Jun Hyung;Kim, Nam-Ho;Ahn, Min-Soo;Seo, Bo-Jeong;Kim, Young-Joo;Kang, Seongsik;Lee, Juneyoung;Kim, Young-Hoon
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.323.1-323.12
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    • 2018
  • Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.

Fertility Status in Northeastern Alpine Soils of South Korea with Cultivation of Vegetable Crops (강원도 고랭지 채소 재배지의 토양 비옥도관리 현황과 전망)

  • Yang, Jae-E.;Cho, Byong-Ok;Shin, Young-Oh;Kim, Jeong-Je
    • Korean Journal of Soil Science and Fertilizer
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    • v.34 no.1
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    • pp.1-7
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    • 2001
  • Total upland area for cultivating the vegetable crops in the Alpine soils of Northeastern South Korea has been extending its limit to meet the increasing demand of vegetable food in recent decades. About 70% of these alpine soils are located in over 7% of the slope and most of vegetable crops have been cultivated intensively without practicing the best management systems. Thus, soil erosion and continuous cropping system have degenerated the soil fertility and shown detrimental effects on water quality. We initiated an intensive and extensive investigation to characterize the fertility problems encountered in these uplands. Objectives of this paper were to characterize the fertility status in the Alpine soils cultivated with vegetable crops for many years and to provide the recommendations for adequate soil management measures including fertilization and erosion control. Soils in general have good drainage with textural classes of loam or sandy loam. Their topographical characteristics tended to lead them to shallow plow layers, and the steepness of the terrain created erosion hazard. Of the soils examined, about 11% of uplands over 30% gradient was found in need of an urgent reforestation. A high content of gravel and firm hardness of soil attributed to inhibit the utilization of farm machinery and plant-root development. The average soil pH 5.6 was slightly low relative to pH 5.70 of the national average. Organic matter content was high compared with 2.0% of national average, but decreased with the prolonged cultivation periods. Available $P_2O_5$ concentration was unusually high due to the consequence of over dose application with chemical and organic fertilizers. Exchangeable cations as Ca, Mg, and K were appeared to be decreased in these regions with prolonging the cultivation periods. There were no significant differences in cation exchange capacity (CEC) and electrical conductivity (EC) among locations. Heavy metal contents were mostly lower than the threshold of danger level designated by Soil Environment Conservation Law of South Korea. Results indicated that a proper countermeasure and the best management practice should be immediately implemented to conserve the top soil and fertility in the Alpine regions.

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Vietnam in 2017: The Situations and Prospects of Economics, Politics, and International Relations (베트남 2017: 경제, 정치, 대외관계의 현황과 전망)

  • CHAE, Su Hong;LEE, Han Woo
    • The Southeast Asian review
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    • v.28 no.1
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    • pp.21-51
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    • 2018
  • This article takes several approaches in explaining recent developments in Vietnam. First, it draws upon an array of sources that idealize Vietnam's embrace of capitalism and integration into the global market in order to sketch out its economy's progress in 2017. Second, it observes, evaluates, and diagnoses recent changes in the Vietnamese economy in the medium to long term by incorporating conflicting perspectives on Vietnam's performance as a capitalist country. Third, this article traces the power shifts that have risen from internal struggles in the Communist Party over political and social issues. Fourth, it elaborates on the aforementioned impact that foreign relations have had on socio-political developments in Vietnam, as well as the government's response. In so doing, it also attempts to evaluate, however briefly, the significance of the 25th anniversary of South Korea-Vietnam relations. Finally, it examines the public's reaction to the post-reform transitions in light of recent sociocultural changes. 2017 was a memorable year for Vietnam: a continuous march toward capitalism; the resulting expansion of the Vietnamese people's demands; political controversies and government control; the looming instability of United States-China relations and various attempts to address the situation. These events will inevitably replicate themselves in the future as the ostensibly socialist Vietnam adopts a capitalist model. The problem is that it is unclear whether these experiences will continue with the consent of the people of socialist Vietnam or engender resistance. It is difficult to achieve meaningful consent in the status quo of worsening inequalities, widespread corruption, monopoly on power, and sustained use of unskilled low-wage workers. In other words, when concerns such as welfare, public health, and the environment are set aside in favor of economic development and commercialization as they have been, discontent, rather than consent, will prevail. It is thus important to keep a watchful eye on the viability of the nominal economic growth, surface-level political stability, and strategic responses to foreign relations that took place in 2017.

Comparison of Carbon Storage Based on Alternative Action by Land Use Planning (토지이용에 따른 대안별 탄소 저장량 비교)

  • Seulki Koo;Youngsoo Lee;Sangdon Lee
    • Journal of Environmental Impact Assessment
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    • v.32 no.6
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    • pp.377-388
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    • 2023
  • Carbon management is emerging as an important factor for global warming control, and land use change is considered one of the causes. To quantify the changes in carbon stocks due to development, this study attempted to calculate carbon storage by borrowing the formula of the InVEST Carbon Storage and Sequestration Model (InVEST Model). Before analyzing carbon stocks, a carbon pool was compiled based on previous studies in Korea. Then, we estimated the change in carbon stocks according to the development of Osong National Industrial Park (ONIP) and the application of alternatives. The analysis shows that 16,789.5 MgC will be emitted under Alternative 1 and 16,305.3 MgC under Alternative 2. These emissions account for 44.4% and 43.1% of the pre-project carbon stock, respectively, and shows that choosing Alternative 2 is advantageous for reducing carbon emissions. The difference is likely due to the difference in grassland area between Alternatives 1 and 2. Even if Alternative 2 is selected, efforts are needed to increase the carbon storage effect by managing the appropriate level of green cover in the grassland, creating multi-layered vegetation, and installing low-energy facilities. In addition, it is suggested to conserve wetlands that can be lost during the stream improvement process or to create artificial wetlands to increase carbon storage. The assessment of carbon storage using carbon pools by land cover can improve the objectivity of comparison and evaluation analysis results for land use plans in Environmental Impact Assessment and Strategic Environmental Impact Assessment. In addition, the carbon pool generated in this study is expected to be used as a basis for improving the accuracy of such analyses.

Evaluation of the Fruit Quality Indices during Maturation and Ripening and the Influence of Short-term Temperature Management on Shelf-life during Simulated Exportation in 'Changjo' Pears (Pyrus pyrifolia Nakai) (배 신품종 '창조'의 성숙 중 품질 요인 변화 및 수송온도 환경에 따른 반응성)

  • Lee, Ug-Yong;Choi, Jin-Ho;Ahn, Young-Jik;Chun, Jong-Pil
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.378-385
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    • 2017
  • In this study, we evaluated the changes of fruit quality indices during fruit development and ripening in Korean new pear cultivar 'Changjo', developed from a cross between 'Tama' and '81-1-27' ('Danbae' ${\times}$ 'Okusankichi') in 1995 and named in 2009, to determine appropriate harvest time and to enhance the market quality and broaden the cultivation area. The fruits of 'Changjo' pears harvested from 132 days after full bloom (DAFB) to 160 DAFB. Fruit growth and quality indices were monitored at 1 week interval by measuring fruit weight, length, diameter, firmness, and taste related quality indices. The calculated fruit fresh weight increased continuously with fruit development and reached to an average of 594g on Sep. 20 (160 DAFB). The ratio of length to diameter declines as fruit maturation progress, resulting in 0.898 for ripe fruit stage as a round oblate shape. Flesh firmness of 'Changjo' pears showed over 30N until 153 DAFB and then decreased abruptly with fruit ripening, reaching a final level of about 26.44N on 160 DAFB. Starch content of fruit sap was also decreased abruptly after 146 DAFB which decreased almost half of the fruits harvested at 139 DAFB. In parallel with the decrease of flesh firmness, ethanol insoluble solids (EIS) content decreased sharply with fruit ripens, only 50% of EIS was detected on the fruits harvested on 160 DAFB when compared to that of the fruits harvested on 139 DAFB (Aug. 30). The maximum value of soluble solids contents was observed in the fruits harvested on 153 DAFB, resulting in $14.2^{\circ}Brix$. The changes of skin color difference $a^*$ which means loss of green color occurred only after 139 DAFB, coincide with the decrease of SPAD value of the fruit skin. The sugars of the 80% ethanol soluble fraction consisted mainly of fructose, sorbitol, glucose and sucrose, also increased during maturation and ripening. Fructose and sucrose contents were larger than those of glucose and sorbitol in flesh tissues. These results were explained that stored starch is converted to soluble sugars during fruit maturation, mainly in fructose and sucrose increasing the sweetness of this cultivar. Total polyphenols were increased up to middle of fruit maturation (146 DAFB) and then decreased continuously until the end of fruit maturation. Consequently, our results suggested that the commercial harvest time of 'Changjo' pears should not be passed 153 DAFB and late harvest of this cultivar would not good for quality maintenance during shelf-life. As a result of the post-harvest low-temperature acclimation experiment during the short-term transportation period, fruits harvested at 146 DAFB tended to maintain higher firmness after 14 days of simulated marketing at $25^{\circ}C$ compared to fruits harvested at 153 DAFB regardless of temperature set. And, the slower the rate of decrease to the final transport temperature of $5^{\circ}C$, the higher the incidence of internal browning and ethylene production. Therefore, in order to suppress the physiological disorder and to maintain the fruit quality when exporting to Southeast Asia in the 'Chanjo' pears, it is desirable to lower the temperature of the fruits within a short time after harvest and to set the harvest time before 146 days after full bloom.

The Ability of Anti-tumor Necrosis Factor Alpha(TNF-${\alpha}$) Antibodies Produced in Sheep Colostrums

  • Yun, Sung-Seob
    • 한국유가공학회:학술대회논문집
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    • 2007.09a
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    • pp.49-58
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    • 2007
  • Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

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Processing of Water Activity Controlled Fish Meat Paste by Dielectric Heating 1. Formulation and Processing Conditions (내부가열을 이용한 보장성어육(고등어) 연제품의 가공 및 제품개발에 관한 연구 1. 원료${\cdot}$첨가물의 배합 및 가공조건)

  • LEE Kang-Ho;LEE Byeong-Ho;You Byeong-Jin;SUH Jae-Soo;JO Jin-Ho;JEONG In-Hak;JEA Yoi-Guan
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.17 no.5
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    • pp.353-360
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    • 1984
  • As an effort to expand the utilization of mackerel which has been thought disadvantageous to processors due to the defects in bloody dark color of meat, high content of lipid, and low stability of protein, and to develope a new type of product, so called, preservative fish meat paste, the processing method was studied in which dielectric heating was applied by means of cooking, pasteurization, dehydration, and control of water activity. The principle of this method is based on that dielectric heating can initiate a rapid dispersion or displacement of moisture in the meat tissue so that the level of water acivity can be controlled by dehydration with hot air meanwhile the product is cooked, pasteurized, and texturized. And the product is finally heated with electric heaters and vacuum sealed to stabilize water activity and storage stability. In present paper, a formula for preparing the fish meat-stach paste, the conditions of dielectric heating and dehydration, shape and size of the product, and other parameters were tested to optimize the process operation. A formula of the fish meat-starch paste to provide proper textural properties and water activity was $10\%$ starch, $1.5\%$ salt, $3\%$ soybean, $0.6\%$ MSG, $2\%$ sucrose, and $3\%$ sorbitol against the weight of fish meat. A proper shape and size of the product to avoid foaming and case hardening during heating was sliced disc of 8 cm $diameter{\times}0.8$ cm thickness or $10{\times}10$ cm square plate with 1.0 cm thickness. The disc shape was recommended because it resulted more uniform heating, minimum foaming and case hardening. And it was also advantageous that disc was simply provided when the fish meat disc was stuffed in the same, solidified in boiling water for 2 to 3 minutes, and sliced. Condition of dielectric heating was critical to decide the levels of sterility, water activity, and textural property of the product. The temperature at the center of the meat disc slices was raised up to $95^{\circ}C$ in 1.5 minutes so that continuous exposure to microwave caused expanded tissue and hardening ending up with a higher water content. Heating for 5 to 6 minutes was adequate to yield the final water activity of 0.86 to 0.83(35 to $40\%$ moisture). It is important, however, that heating had to be done periodically, for instance, in the manner of 2.0, 1.5, 1.5, and 1.0 minute to give enough time to displace or evaporate moisture from the meat tissue. The product was dehydrated for 2 to 3 minutes by hot air of $60^{\circ}C$, 3 to 5m/sec and finally exposed to electric heaters for 5 to 6 minutes until the surface was roasted deep brown. These conditions of heating and dehydration resulted in a complete reduction of total plate count from an initial count of $5.3{\times}10^6/g$ to less than $3{\times}10^2/g$. General composition of the product was $40.1\%$ moisture, $20.8\%$ protein, $17.4\%$ lipid, $16.2\%$ carbohydrate, and $5.5\%$ ash. Textural properties revealed folding test AA, hardness 42, cohesiveness 0.53, toughness 4.6, and elasticity 0.8.

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Clinical Application of Serum CEA, SCC, Cyfra21-1, and TPA in Lung Cancer (폐암환자에서 혈청 CEA, SCC, Cyfra21-1, TPA-M 측정의 의의)

  • Lee, Jun-Ho;Kim, Kyung-Chan;Lee, Sang-Jun;Lee, Jong-Kook;Jo, Sung-Jae;Kwon, Kun-Young;Han, Sung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.785-795
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    • 1997
  • Background : Tumor markers have been used in diagnosis, predicting the extent of disease, monitoring recurrence after therapy and prediction of prognosis. But the utility of markers in lung cancer has been limited by low sensitivity and specificity. TPA-M is recently developed marker using combined monoclonal antibody of Cytokeratin 8, 18, and 19. This study was conducted to evaluate the efficacy of new tumor marker, TPA-M by comparing the estabilished markers SCC, CEA, Cyfra21-1 in lung cancer. Method : An immunoradiometric assay of serum CEA, sec, Cyfra21-1, and TPA-M was performed in 49 pathologically confirmed lung cancer patients who visited Keimyung University Hospital from April 1996 to August 1996, and 29 benign lung diseases. Commercially available kits, Ab bead CEA (Eiken) to CEA, SCC RIA BEAD (DAINABOT) to SCC, CA2H (TFB) to Cyfra2H. and TPA-M (DAIICHI) to TPA-M were used for this study. Results : The mean serum values of lung cancer group and control group were $10.05{\pm}38.39{\mu}/L$, $1.59{\pm}0.94{\mu}/L$ in CEA, $3.04{\pm}5.79{\mu}/L$, $1.58{\pm}2.85{\mu}/L$ in SCC, $8.27{\pm}11.96{\mu}/L$, $1.77{\pm}2.72{\mu}/L$ in Cyfra21-1, and $132.02{\pm}209.35\;U/L$, $45.86{\pm}75.86\;U/L$ in TPA-M respectively. Serum values of Cyfra21-1 and TPA-M in lung cancer group were higher than control group (p<0.05). Using cutoff value recommended by the manufactures, that is $2.5{\mu}/L$ in CEA, $3.0{\mu}/L$ in Cyfra21-1, 70.0 U/L in TPA-M, and $2.0{\mu}/L$ in SCC, sensitivity and specificity of lung cancer were 33.3%, 78.6% in CEA, 50.0%, 89.7% in Cyfra21-1, 52.3%, 89.7% in TPA-M, 23.8%, 89.3% in SCC. Sensitivity and specificity of nonsmall cell lung cancer were 36.1%, 78.1% in CEA, 50.1%, 89.7% in Cyfra21-1, 53.1%, 89.7% in TPA-M, 33.8%, 89.3% in SCC. Sensitivity and specificity of small cell lung cancer were 25.0%, 78.5% in CEA, 50.0%, 89.6% in Cyfra21-1, 50.0%, 89.6% in TPA-M, 0%, 89.2% in SCC. Cutoff value according to ROC(Receiver operating characteristics) curve was $1.25{\mu}/L$ in CEA, $1.5{\mu}/L$ in Cyfra2-1, 35 U/L in TPA-M, $0.6{\mu}/L$ in SCC. With this cutoff value, sensitivity, specificity, accuracy and kappa index of Cyfra21-1 and TPA-M were better than CEA and SCC. SCC only was related with statistic significance to TNM stages, dividing to operable stages(TNM stage I to IIIA) and inoperable stages (IIIB and IV) (p<0.05). But no tumor markers showed any correlation with significance with tumor size(p>0.05). Conclusion : Serum TPA-M and Cyfra21-1 shows higher sensitivity and specificity than CEA and SCC in overall lung cancer and nonsmall cell lung cancer those were confirmed pathologically. SCC has higher specificity in nonsmall cell lung cancer. And the level of serum sec are signiticantly related with TNM staging.

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Effects of the Development of Cracks into Deeper Zone on Productivity and Dryness of the Clayey Paddy Field (점토질 논 토양의 심층화가 토지생산성 및 유면건조에 미치는 영향)

  • 김철기
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.15 no.3
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    • pp.3059-3088
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    • 1973
  • The Object of research was laid on the dry paddy field which had a low level of underground water, rather than on a paddy field with a high level of underground water. In the treatment of the clay paddy field before transplanting we employed 3 kinds of methods; deep plowing, development of cracks by drying the surface of the field under which pipe drain was built. This study was to find which one, among these three methods, is the most effective to let roots extend to deep zone and increase the yield of rice and at the same time, for trafficability of large scale machinery which will be introduced to the harvest, in the light of the earth bearing capacity in relation with underground drainage. In the treatments of plots, 1) the kyong plot was plowed 39 days before transplanting and dried, 2) the kyun plot was plowed again 2days before transplanting after plowing 39 days before transplanting, leveling field surface in the saturation with water and developing the cracks by drying, 3) the kyunam plot was plowed again 2 days before transplanting after setting the drainage pipe and at the same time plowing 39 days before transplanting, leveling field surface in the saturation with water and developing the cracks by drying. Also each plot above had three different levels of soil depth, respectively; that is 15cm, 25cm, 35cm. The kyong plot with 15cm-depth was he control. The results obtained were as follows; 1. The kyunam plot showed a remarkably lager amount of water consumption by better underground drainage than the kyong and the kyun plot, and the kyong plot indicated a greater amount of water consumption than the kyun plot. Therefore the amount of available rainfall was decreased in the order of kyunam>kyong>kyun. The net duty of water decreased in the order of kyunam>kyong>kyun and its showed about 105cm in depth at the kyunam plot, about 70cm in depth at the kyong plot and about 45cm in depth at kyun plot, regardless of soil depth. 2. According to the tendency that the weight of the total root was effected by the maximum depth of the crack, it seemed that the root development was more affected by the depth of the crack than by only the crack itself. The weight of the total roots tended to increase as the depth of the crack got deeper and deeper, and the weight of the total roots was increased in the order of kyun<kyunam<kyong. 3. In the growing of the plant height, the difference did not appear at the beginning of growing(peak period of tillering) of any plot, But for the mid period of growing(ending period of tillering) to the period of young panicle formation, the deeper the depth of plot is, the more the growing goes down. On the contrary at the late period of growing, growth was more vigorous in the plot with deep depth than in the plot with shallow depth. Since the midperiod of growing, in the light of experimental treatment, the kyun plot was not better in growing than the other two plots and no remarkable defference was shown between the kyunam and the kyong plot, but the kyunam plot had the tendency of superiority in growing plant height. 4. As the depth of plot went deeper, the decreasing tendency was shown in the number of tillers through a whole period of growingi. When the above results were observed concering each plot of experimental treatment, the kyun plot was always smaller in the number of tiilers than the kyunam and the kvong plot, and the kyong plot was slightly larger than the kyunam plot in the number of tillers. 5. When each plot of the different experimental treatments was compared with the control plot(15-kyong), yield(weight of grains) was increased by 17% for the 35-kyong plot, by 10% for the 35-kyunam and yields for the other plots were less or nomore than the control plot. On the whole, as the depth of plot went deeper, yields for plots was increased in the order of kyong>kyunam>kyun. 1% of significance between the levels of depths and 5% of significance between the treatments were shown. 6. The depth of consumptive water which was more effective on the weight of grains is that of the last half period. When the depth of consumptive water was increased at the range of less than 2.7cm/day in the 15cm plot, 3.0cm/day in the 25cm plot and 3.3cm/day in the 35cm plot, the weight of grains was increased, and at the same time the weight of grains was increased as the depth of plot went deeper. The deeper plots was of advantage to the productivity at the same depth of consumptive water. 7. The increase in the weight of grains in propertion to the weighte of root showed a tendency to increase depending on the depth of plot at each plot of the same weight of roots. The weight of roots and grains together increasezd in the order of kyun>kyunam>kyong, considering each treatment of experimental plot. The weight of grains was in relation to the minimum water content ratio during the midperiod of surface drainage and the average earth temperature was mainly affected by the minimum water content ratio because it was relatively increased in proportion to the water content ratio(at less than 40%) 8. The weight ratio of straw to grain showed an increasing tendency at the plot of shallow depth and had a relation of an inversely exponental function to the weight of roots. At the same depth of plot except the 15cm plot, the weight ratio of straw to grain was increased in proportion to the depth of consumptive water. The weight of grains was increased as the depth of consumptive water was increased to some extent, but at the same time the weight of ratio of straw to grain was increased. 9. At a certain texture of soils the increase in the amount of the cracks depends on meteorological conditions, especially increase in amounts of pan evaporation. So if it rains during the progressing of field drying the cracks largely decrease. The amount of cracks of clay soil had relation of inversely exponental function to the water content ratio(at more than 25%). The maximum depth of crack kept generally a constant value at less than 30% of water content ratio. 10. The cone index showed the tendency that it was propertional to the amount of cracks within a certain limit but more or less inversely proportional over a certain limit. The water content ratio at the limit may be about 25%. 11. The increase in the cone index with the progressing of time after final surface drainage showed the tendency that it was proportional to the depth of consumptive water at the last half of growing period. Based on the same depth of if the cone index in the kyunam plot was much larger than in the other two plots and that in the kyong plot was much smaller than in the kyun plott, as long as the depth of plot was deeper, especially in the 35-kyong plot. 12. In the light of a situation where water content ratio of soil decreased and the cone index increased after final surface drainage the porogress of the field dryness was much more rapid in the kyunam plot than in the kyong plot and the kyun plot, especially slowest in the kyong plot. In the plot with deeper zone the progress was much slower. The progress requiring the value of the cone index, $2.5kg/cm^2$, that working machinary can move easily on the field changed with the time of final surface drainage and the amount of rainfall, but without nay rain it required, in the kyunam plot, about 44mm in total amount of pan evaporation and more than 50mm in the other two plots. Therefore the drying in the kyunam plot was generally more rapid in the kyunam plot was generally more rapid over 2days than in the kyun plot, and especially may be more rapid over 5days than in the 35-kyong plot.

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