• Development and Reproduction
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• v.10 no.1
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• pp.19-32
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• 2006

Genomic DNA isolated from two species of Korean freshwater crab(Eriocheir sinensis) and swimming crab(Portunus trituberculatus) was amplified several times by PCR reactions. The seven arbitrarily selected primers OPA-05, OPA-13, OPA-16, OPB-06, OPB-15, OPB-17 and OPD-10 were used to generate the identical, polymorphic, and specific fragments. 505 fragments were identified in the freshwater crab species, and 513 in the swimming crab from Buan: 81 specific fragments(16.0%) in the freshwater crab species and 100(19.5%) in the swimming crab. 165 identical fragments, with an average of 23.6 per primer, were observed in the freshwater crab species. 66 fragments, with an average of 9.4 per primer, were identified in the swimming crab species. The numbers of polymorphic fragments in the freshwater crab and swimming crab were 50 and 14, respectively. The oligonucleotides decamer primer OPB-17 generated identical DNA fragments, approximately 300 bp, in both the freshwater crab and swimming crab species. Compared separately, the average genetic difference was higher in the swimming crab than in the freshwater crab species. The average genetic difference was $0.726{\pm}0.004$ between the freshwater crab and swimming crab species. The dendrogram obtained by the seven primers indicates four genetic clusters: cluster 1(FRESHWATER 01), cluster 2(FRESHWATER 02, 03, 04, 05 and 06), cluster 3(FRESHWATER 07, 08, 09, 10 and 11), and cluster 4(SWIMMING 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 and 22). The shortest genetic distance displaying significant molecular difference was between individuals SWIMMING no. 18 and SWIMMING no. 17 from swimming crab(0.096). Ultimately, individual no. 02 of the freshwater crab was most distantly related to freshwater crab no. 03(genetic distance = 0.770). As stated above, the potential of RAPD-PCR to identify diagnostic markers for the identification of two crab species has been demonstrated.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.768-773
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• 2004

Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to february 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 45 male, and 11 female patients, and their mean age was 51.2$\pm$43.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6$\pm$1.6. Annuloplasty was per-formed in all cases. The CPB time was 182,1$\pm$63.7 minutes and the ACC time was 133.1$\pm$45.6 minutes. Aver-age follow up period was 49.2$\pm$7.1 months. Result: There was no early death. Early reoperation was performed in bud patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and ano-ther received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2$\pm$7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), 1 in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2$\pm$0.35 $\textrm{cm}^2$ Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.

• The Korean Journal of Mycology
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• v.25 no.1 s.80
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• pp.35-45
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• 1997

The yellow fungal isolates inhabiting at the cereals (Hwang-Kuk, HK-fungi) were widely collected from the mejus and nuluks in Korea; the meju is a raw material for Korean traditional foods for soysauce and soypaste, and the nuluk is a raw material for Korean traditional rice wine. These isolates, well known as an Aspergillus oryzae producing amylase for Korean rice wine or producing protease for soybeans, were compared with Aspergillus species known. All isolates were microscopically observed to be a species of A. oryzae or its related, but to be difficult to be identified. Thus, RAPD-DNA techniques were applied for these isolates and analyzed with nummerical values using NT-system, or Ecological programs or Factorial analyses. Several common bands of RAPD-DNA in the 28 isolates were synthesized with the different OPD primers and speculated to be used for identification of HK fungi. The HK-fungi isolated were revealed to belong to the group of A. flavus previously defined. Particularly, the isolates collected from mejus were analyzed to be more closed to A. flavus, The species of A. flavus, A. oryzae and A. sojae were grouped at the values lower than those indicating the diversity of species. In other words, these three fungal species were not distinguishable and all isolates known as a HK-fungus were very closed to A. flavus, All isolates were not diversified at groupings of RAPD-DNA, and considered to be not the natural flora at the mejus or nuluks. The meju or nuluk having the above fungi as the fungal flora were speculated to be not termed "Korean traditional foodstuffs".The yellow fungal isolates inhabiting at the cereals (Hwang-Kuk, HK-fungi) were widely collected from the mejus and nuluks in Korea; the meju is a raw material for Korean traditional foods for soysauce and soypaste, and the nuluk is a raw material for Korean traditional rice wine. These isolates, well known as an Aspergillus oryzae producing amylase for Korean rice wine or producing protease for soybeans, were compared with Aspergillus species known. All isolates were microscopically observed to be a species of A. oryzae or its related, but to be difficult to be identified. Thus, RAPD-DNA techniques were applied for these isolates and analyzed with nummerical values using NT-system, or Ecological programs or Factorial analyses. Several common bands of RAPD-DNA in the 28 isolates were synthesized with the different OPD primers and speculated to be used for identification of HK fungi. The HK-fungi isolated were revealed to belong to the group of A. flavus previously defined. Particularly, the isolates collected from mejus were analyzed to be more closed to A. flavus, The species of A. flavus, A. oryzae and A. sojae were grouped at the values lower than those indicating the diversity of species. In other words, these three fungal species were not distinguishable and all isolates known as a HK-fungus were very closed to A. flavus. All isolates were not diversified at groupings of RAPD-DNA, and considered to be not the natural flora at the mejus or nuluks. The meju or nuluk having the above fungi as the fungal flora were speculated to be not termed 'Korean traditional foodstuffs'.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Journal of Preventive Medicine and Public Health
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• v.18 no.1
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• pp.25-39
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• 1985

This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.232-242
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• 2010

Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.37-45
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• 1984

This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.290-297
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• 1997

Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.21 no.3
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• pp.140-149
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• 2008

Objective : This study was performed to find out the difference of symptoms between rhinitis and sinusitis in young patients who were diagnosed by PNS plain radiograph( PNS series), Methods: We did statistical analysis about 147 new outpatients under 12 year-old who had visited the department of ophthalmology, otolaryngology, dermatology in Kyung Hee Oriental Medicine Center from March 2, 2006 to February 29, 2008. All of the patients were diagnosed by PNS series and we divided the patients with two groups; rhinitis group and sinusitis group. We checked the OPD records and explore the distribution on sex, experience of past western therapy, age and duration. Then we divided symptoms into nine; 'nasal obstruction', 'purulent rhinorrhea', 'cough & sneezing', 'watery rhinorrhea', postnasal drip', 'sputum', 'head problem', 'snoring & throat discomfort' and 'epistaxis'. We also divided age into 2 groups: $0\sim7$ years old and $8{\sim}12$ years old. We carried out chi-square test as a statistical method. Results : The results were as follows. 1. Sinusitis group were 102(69.5%); 62 have only sinusitis. 40 have both sinusitis and adenoidal hypertrophy. Rhinitis group were 45(30.5%); 13 have adenoidal hypertrophy and 32 were negative. 2. Male were 98(sinusitis 65, rhinitis 33), female were 49(sinusitis 37, rhinitis 12). 3. Patients who had experienced past western therapy were 120(sinusitis 81, rhinitis 39), no experienced patients were 27(sinusitis 21, rhinitis 6). 4. Distribution on age of sinusitis was 1(1 yr), 2(2 yrs), 3(3 yrs), 15(4 yrs), 15(5 yrs), 23(6 yrs), 13(7 yrs), 12(8 yrs), 8(9 yrs), 5(10 yrs), 1(11 yrs), 4(12 yrs). Distribution on age of rhinitis was 1(1 yr), 0(2 yrs), 1(3 yrs), 1(4 yrs), 9(5 yrs), 5(6 yrs), 3(7 yrs), 5(8 yrs), 1(9 yrs), 8(10 yrs), 6(11 yrs), 5(12 yrs), 5. Duration of sinusitis was 20(<2 months), 6($2{\sim}3$ months), 11($3\sim6$ months), 34($6\sim12$ months), 31(>12 months) and of Rhinitis was 11(<2 months), 0($2\sim3$ months), 5($3\sim6$ months), 18($6\sim12$ months), 11(>12 months) 6. Distribution on symptoms, sinusitis patients were 86(nasal obstruction), 52(purulent rhinorrhea), 46(cough & sneezing), 38(watery rhinorrhea), 41(postnasal drip), 23(sputum), 18(head problem), 15(snoring & throat discomfort), 6(epistaxis). The each symptom and sinusitis have no relation by chi-square test. 7. The number of patients who were 0 $\sim$ 7 years old was 92: sinusitis 72(49%), non-sinusitis 20(13.6%). The number of patients who were 8 $\sim$ 12 years old was 58: sinusitis 30(20.4%), non-sinusitis 25(l7%). By chi-square test(confidence level 95%), sinusitis and age under 7 have a significant relation(p=0.003). Conclusions : There is no relation between rhinologic symptoms and sinusitis. Patients under 7 years old with rhinologic symptoms tend to have sinusitis.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.