• Journal of Microbiology and Biotechnology
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• v.25 no.4
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• pp.526-536
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• 2015

Leptospirosis is a worldwide zoonotic disease caused by pathogenic Leptospira, a genus of which more than 250 serovars have been identified. Commercial bacterin vaccines are limited in that they lack both cross-protection against heterologous serovars and long-term protection. This study investigated in mice the immunogenicity of an anti-leptospirosis vaccine, using the outer membrane proteins LipL32 and Loa22 as antigens. The immunogenicity of this vaccine formulation was compared with those induced by vaccines based on LipL32 or Loa22 alone. A DNA-encapsulated chitosan nanoparticle was used for in vivo DNA delivery. Using a unique DNA plasmid expressing both lipL32 and loa22 for vaccination, higher antibody responses were induced than when combining plasmids harboring each gene separately. Therefore, this formulation was used to test the immunogenicity when administered by a heterologous prime (DNA)-boost (protein) immunization regimen. The specific antibody responses against LipL32 (total IgG and IgG1) and Loa22 (IgG1) were higher in mice receiving two antigens in combination than in those vaccinated with a single antigen alone. Although no significant difference in splenic CD4⁺ T cell proliferation was observed among all groups of vaccinated mice, splenocytes from mice vaccinated with two antigens exhibited higher interferon-γ and IL-2 production than when using single antigens alone upon in vitro restimulation. Taken together, the immunogenicity induced by LipL32 and Loa22 antigens in a heterologous primeboost immunization regimen using chitosan as a DNA delivery system induces higher immune response, and may be useful for developing a better vaccine for leptospirosis.

• Korea Journal of Hospital Management
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• v.14 no.2
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• pp.60-74
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• 2009

This study purports to verify managerial effectiveness of the integrated delivery system(IDS) of Japanese health care institutions through comparing the managerial performance between hospital groups providing with both acute and nursing care and those with acute care only. Data on the managerial performance of 697 hospitals providing with nursing care together and 819 hospitals providing with acute care only were collected from Japanese Central Social Insurance Medical Councils 2001, 2003, 2005, and were analyzed using mean comparison test(t-test) between the two groups. The results revealed that there were significant differences between the two groups in such indicators as ratio of material cost, labor cost, depreciation rate, total margin, operating margin, average number of outpatient per day, average revenue of an inpatient per day, total amount of labor cost, gross revenue per employee, and labor productivity. However, we could not find out any consistent evidence which support the effect of integrated delivery system on the hospital managerial performance. Further discussion was made on the limitation of the study and future research agenda relevant to the topic.

• 대한예방의학회:학술대회논문집
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• 2000.10a
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• pp.213-214
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• 2000

• Korea Journal of Hospital Management
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• v.9 no.1
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• pp.1-21
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• 2004

The United States has a unique health care system, which is unlikely any other health care systems in the world. The major part of basic functional components of the system -financing, insurance, delivery, and payment- is in private hands. A market-oriented economy invites the participation of numerous private entities that are interested in carrying out the key functions of health systems. Due to this central feature, U.S.health care is not delivered through a network of interrelated components designed to work together coherently. For lack of standardization, the various components of the system fit together only loosely. The involvement of numerous players in the key functions leads to duplication, overlap, inadequacy, inconsistency, and waste, which add to the complexity and also make the system inefficient. Hence, cost containment remains an elusive goals. Moreover, the system falls short of delivering equitable services to all americans, though consumption of health care services is the largest in the world. On the other hand, United States leads the world in the latest and the best in medical technology, medical training, and research. It offers some of the most sophisticated institutions, products, and processes of health care delivery. This article discuss the characteristic features of the U.S. health care system. and its performance, trying to seek its implication on Korean health care system.

• Journal of Digital Convergence
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• v.10 no.6
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• pp.303-310
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• 2012

In order to analyze factors that support effective health care delivery system, this study aimed to research general public's perception on the functions of medical institutions(based on the levels of treatment: primary care, secondary care, and tertiary care), choices of medical institution when contracted with an unfamiliar disease, and recognition of diseases based on their severities. We collected data using self-administered survey from 400 general public living in Seoul, S. Korea from April 25 to May 18, 2011. The analysis was conducted using frequency analysis, chi-square test, and t-test; we analyzed the data to see if there are differences based on gender, age, and level of education. The result of both recognition of functional differences of medical institutions and selection of medical institutions when contracted with unfamiliar diseases showed that there were no significant differences based on the gender; however there were significant differences when considering the age and education. Looking at the result of the knowledge of the disease classification based on its severity, there were significant differences in age, gender, and education. In order to provide sustainable and effective health care delivery system, utilization of primary care as well as education and promotion regarding the functional differences of medical institutions and classification of disease based on its severity need to be encouraged.

• Journal of Korean Clinical Nursing Research
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• v.16 no.1
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• pp.167-175
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• 2010

Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.

• Journal of Preventive Medicine and Public Health
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• v.4 no.1
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• pp.89-94
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• 1971

• International Journal of Stem Cells
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• v.16 no.1
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• pp.36-43
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• 2023

Background and Objectives: Lymphoblastoid cell lines (LCLs) deposited from disease-affected individuals could be a valuable donor cell source for generating disease-specific induced pluripotent stem cells (iPSCs). However, generation of iPSCs from the LCLs is still challenging, as yet no effective gene delivery strategy has been developed. Methods and Results: Here, we reveal an effective gene delivery method specifically for LCLs. We found that LCLs appear to be refractory toward retroviral and lentiviral transduction. Consequently, lentiviral and retroviral transduction of OCT4, SOX2, KFL4 and c-MYC into LCLs does not elicit iPSC colony formation. Interestingly, however we found that transfection of oriP/EBNA-1-based episomal vectors by electroporation is an efficient gene delivery system into LCLs, enabling iPSC generation from LCLs. These iPSCs expressed pluripotency makers (OCT4, NANOG, SSEA4, SALL4) and could form embryoid bodies. Conclusions: Our data show that electroporation is an effective gene delivery method with which LCLs can be efficiently reprogrammed into iPSCs.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.44 no.3
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• pp.106-116
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• 2021

This paper considers a joint problem for blood inventory planning at hospitals and blood delivery planning from blood centers to hospitals, in order to alleviate the blood service imbalance between big and small hospitals being occurred in practice. The joint problem is to determine delivery timing, delivery quantity, delivery means such as medical drones and legacy blood vehicles, and inventory level to minimize inventory and delivery costs while satisfying hospitals' blood demand over a planning horizon. This problem is formulated as a mixed integer programming model by considering practical constraints such as blood lifespan and drone specification. To solve the problem, this paper employs a Lagrangian relaxation technique and suggests a time efficient Lagrangian heuristic algorithm. The performance of the suggested heuristic is evaluated by conducting computational experiments on randomly-generated problem instances, which are generated by mimicking the real data of Korean Red Cross in Seoul and other reliable sources. The results of computational experiments show that the suggested heuristic obtains near-optimal solutions in a shorter amount of time. In addition, we discuss the effect of changes in the length of blood lifespan, the number of planning periods, the number of hospitals, and drone specifications on the performance of the suggested Lagrangian heuristic.

• Clinical and Experimental Vaccine Research
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• v.11 no.3
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• pp.235-248
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• 2022

Currently, mucosal infectious diseases are still a very high global health burden, but there are few effective vaccines to prevent mucosal-borne diseases. The development of mucosal vaccines requires the selection of appropriate antigens, delivery system strategies, and adjuvants to increase vaccine efficacy but limited studies have been conducted. The aim of this review is to describe the mucosal immune system, as well as the potential for the development of vaccines and mucosal adjuvants, and their challenges. The study was conducted by applying inclusion criteria for the articles, and a review was conducted by two readers with the agreement. It was known that mucosal vaccination is a potential route to be applied in future preventive efforts through vaccination. However, limited studies have been conducted so far and limited mucosal vaccination has been approved. New technological approaches such as material development involving nano- and micro-patterning are important to intensively open and investigate the potential area of development to provide better vaccination methods.