• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Food Science of Animal Resources
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• v.29 no.1
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• pp.108-113
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• 2009

Apolipoprotein E (APOE) is a plasma lipoprotein in mammals and plays an important role in the transport and metabolism of lipids such as phospholipids and triglycerides. Therefore, the APOE gene could be a candidate gene controlling lipid metabolism in beef cattle. This study was performed to identify single nucleotide polymorphisms (SNP) in the APOE gene and to investigate the effects of SNP genotype on the carcass traits such as meat quantity and quality in Korean cattle. For PCR amplification, pooled DNA made from unrelated 60 individuals was prepared and primer pairs were designed based on the cDNA sequence of exon 4 region of the bovine APOE gene. A SNP was identified at position 2034 (T/C substitution) of the exon 4 region in the APOE gene. PCR-RFLP procedure with restriction enzyme ACC I was developed for determining the SNP genotype for each of a total of 309 animals with pedigree information and performance records through the national progeny testing program. The frequencies of the genotypes TT, TC and CC were 10.9, 46.9 and 42.2%. Gene frequencies were 0.344 for T allele and 0.656 for C allele. The g.2034T>C SNP genotype showed a significant effect (p<0.05) on dressing percentage and meat color, respectively. Animals with the TT genotype showed higher dressing percentage than those with the CC genotype, and TT genotype had desirable meat color compared with CC genotype. These results suggest that the g.2034T>C SNP genotype of the APOE gene may be useful as a DNA marker for meat quantity index and dressing percentage in Korean cattle.

• Korean Journal of Medicinal Crop Science
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• v.9 no.2
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• pp.99-107
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• 2001

Germination of Codonopsis pilosula seeds and afterward their seedling emergence have been occasionally very poor due to their dormancy and structural defects. The study was done to determine the treatment effects of priming, $GA_3$, agitation and washing during and after priming, drying and water imbibition after drying on germination of its seeds and then of the successive three combined treatment after priming on the its seedling emergence to model its presown seed treatment. While agitation at the speed of 10 rpm was made or not, priming using $Ca(NO_3)_2$ and $GA_3$ under their different concentrations and light quality illuminated for 12 hours a day were done separately. Then their two best results were compared to determine the better one. Using the above determined best result, washing was done 3 minutes in the tap water or not, and drying of washed seeds was made under 4 different lights, and water imbibition of the dried seeds with differed period were successively done to deduce its presown seed treatment. In the comparison of the best germination rate of priming and $GA_3$, the former showed considerably higher rate than the latter; the priming treatment was done at agitated $Ca(NO_3)_2$ 150 mM solution under darkness or 12 hour red light illumination a day for 2 days. Washing after priming enhanced the rate compared to no-washing. Drying was the best way at which seeds washed were desiccated under $35^{\circ}C$ and 4 hour red light illumination. Water imbibition immediately before sowing must be made for 2 days. Seedling emergence rate was the highest at the seeds from successive 4 treatments, priming, washing, drying and water imbibition before sowing of two others, the priming and washing, or the priming, washing and water imbibition, meaning that its presown seed treatment must follow the procedure of the above 4 successive ones.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.2
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• pp.131-141
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• 2008

Objective: To compare the outcomes of intracytoplasmic sperm injection (ICSI) with fresh and cryopreserved-thawed testicular spermatozoa in patients with azoospermia. Methods: One hundred and nine cycles (66 couples) where ICSI was planned with fresh or cryopreserved-thawed testicular spermatozoa were included in this study; Ninety two cycles (61 couples) with fresh testicular spermatozoa (fresh group) and seventeen cycles (13 couples) with cryopreserved-thawed testicular spermatozoa (cryopreserved-thawed group). We compared ICSI outcomes such as fertilization rate, implantation rate, pregnancy rate and miscarriage rate, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: In 9 out of the 92 cycles where ICSI was planned with fresh testicular spermatozoa, testicular spermatozoa could not be retrieved. Fertilization rate tended to be higher in the fresh group than in the cryopreserved-thawed group ($58.0{\pm}27.8%$ vs. $45.9{\pm}25.0%$, p=0.076). The number of high quality embryos was significantly higher in the fresh group ($0.9{\pm}1.2$ vs. $0.2{\pm}0.5$, p=0.002). However, there were no significant differences in clinical pregnancy rate, implantation rate and miscarriage rate between the two groups. Conclusion: The results of this study suggest that although the use of cryopreserved-thawed testicular sperm for ICSI in patients with azoospermia may reduce fertilization capacity and embryo quality, it may not affect pregnancy rate, implantation rate and miscarriage rate. If testicular sperm can be obtained before ICSI procedure, the use of cryopreserved-thawed testicular sperm may also avoid unnecessary controlled ovarian hyperstimulation and cancellation of oocyte retrieval when spermatozoa cannot be retrieved as well as damage on testicular function by repeated TESE.

• Journal of Food Hygiene and Safety
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• v.29 no.1
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• pp.1-5
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• 2014

Many community gardens in large cities worldwide grow vegetables; however, no information regarding the levels of sanitary indicator bacteria and prevalence of foodborne pathogens in vegetables grown in urban community gardens is available. To evaluate the microbiological quality of vegetables from urban community gardens in Korea, 530 samples (nine types of vegetable, including Chinese cabbage, lettuce, radish leaves, spinach, mustard leaves, crown daisy, leek, Korean cabbage, and chicory) were collected at 11 urban community gardens in Seoul, Korea from September through October 2012. The levels of total aerobic bacteria, Escherichia coli, total coliforms, Salmonella spp. Listeria monocytogenes, and E. coli O157:H7 were evaluated quantitatively and/or qualitatively. The mean numbers of total aerobic bacteria and coliforms were 6.3 log CFU/g (range 3.8-8.1 log CFU/g) and 4.3 log CFU/g (range 2.1-6.4 log CFU/g), respectively. Total coliforms were detected on 67% of whole vegetables. Chicory showed the highest number of total aerobic bacteria and coliforms, whereas the lowest number of coliforms was detected on leeks. E. coli was detected on 2.3% of whole vegetables, including lettuce, radish leaves, mustard leaves, and chicory; however, foodborne pathogenic bacteria were not detected on any of the vegetable samples using this highly sensitive and validated procedure. Based on these findings, the presence of coliforms and E. coli demonstrates that opportunity for improvement of microbiological safety exists throughout the produce production chain, although no major foodborne pathogens were present in vegetables grown in urban community gardens.

• Journal of Food Hygiene and Safety
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• v.36 no.5
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• pp.400-406
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• 2021

The purpose of this study was to evaluate the microbial contamination level of Korean traditional rice cakes (Garaetteok, Injeolmi, Gyeongdan), as well as manufacturing environment of small-sized businesses in Korea. The contamination levels of total aerobic bacteria, coliforms, and Bacillus cereus in raw materials were 3.76-4.48, 2.21-4.14, and 1.02-1.15 log CFU/g respectively. On the other hand, Escherichia coli was not found. It has been found that the contamination level of total aerobic bacteria, coliforms, and B. cereus in the raw material decreased after the washing process, but it increased again during the soaking and grinding process. However, after the steaming stage, the contamination level increased again during the molding and cooling process, suggesting the need to take cautions in managing cooling water and molded rice cakes in the process. These results suggest that the safe management of cooling water and taking cautions in the drying process after steaming of rice cakes are necessary for controlling cross-contamination. No E. coli was detected during the manufacturing process involving all tested rice cakes. The microbial contamination level of manufacturing environment such as rice grinder and rice cake forming machine was high. Therefore, in terms of food safety strategy, it is necessary to consider introducing systematic cleansing and disinfection procedure to processing equipment and environment for the sake of reducing microbiological risks.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.29-34
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• 2019

Purpose An examination guide is a useful medium to provide the patient with an overview, pre- and post-test preparation, and precautions of nuclear testing. The design and arrangement of existing written texts and announcements were evaluated to elucidate the comprehension of patients undergoing testing. Materials and Methods Informational material describing bone scanning and $^{201}thallium$ myocardium perfusion single-photon emission computed tomography (SPECT), as a secondary examination, which accounts for the largest portion of gamma imaging at Asan Hospital (Seoul, South Korea), was selected as an improvement target in consultation with a national innovation center. Existing informational material was dispensed to patients scheduled for bone scans from November 2016 to February 2017 and the revised material was issued from March 2017 to May 2017. A survey was conducted of 200 patients who underwent $^{201}thallium$ myocardium perfusion SPECT before and after the revisions (n = 100 each time period) to assess the patients' understanding of the informational material. Results When comparing the use of the conventional vs. revised material, the number of patients who received treatment before bone scanning had decreased from 130 to 60, while the number of those who required additional imaging decreased from 53 to 14. Prior to the revision, 43% of patients underwent testing before preparation and 18% underwent additional testing. The decreased need for additional image acquisition after revision of the informational material resulted in a decrease in acquisition time of about 2 min, from 16.5 to 14.2 min. In the case of $^{201}thallium$ myocardium perfusion SPECT, patient comprehension of all five items surveyed had increased, while the number of patients who had repeatedly asked about various facets of the procedure pre- and post-testing had decreased from 36% to 16% and 31% to 14%, respectively. Conclusion Lower patient comprehension is accompanied by a decrease in image quality due to non-compliance during pre-testing and may lead to repetitive questions from the patient, which may also negatively affect the fatigue and work efficiency of the examiner. Improved readability and visibility of informational material through visualization was correlated with greater patient comprehension as well as improved image quality and acquisition time.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.13 no.1
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• pp.67-82
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• 2008

This study was performed to investigate changes in benthic environment and macrobenthic polychaete communities in Gamak Bay where various environmental quality improvement projects have been implemented in recent years. Field surveys were carried out in February, 2005 and February, 2006 and twenty stations were selected to explore whether or not there were between-year differences in biotic and abiotic variables. Of 10 environmental variables measured, only three variables including dissolved oxygen (DO), total ignition loss (IL), acid volatile sulfide (AVS) showed significant between-year differences. Specifically, IL and AVS were, on average, 1.5 and 3 times lower in 2006 compared to those in 2005, respectively, which was more pronounced in the northern part of the bay. A total of 95 polychaete species was sampled from the two sampling occasions. Between-year differences in the number of species, abundance, and diversity were varied from place to place. In the northern part of the bay, fewer species were found in 2006 rather than in 2005, but diversity increased in 2006 due to the reduction in dominance of a few species. On the contrary, in the central part of the bay, the number of species, abundance and diversity prominently increased in 2006. In the southern part of the bay, all the biological indices maintained similarly during the two years. Dominant species in 2005 were such opportunistic or organic pollution indicator species as Lumbrineris longifolia, Capitella capitata, Mediomastus californiensis, Pseudopolydora paucibranchiata, etc. and most of them were mainly distributed in the northern part of the bay and in the proximity of it. In 2006, however, Euchone alicaudata, L. longifolia, Paraprionospio pinnata, Flabelligeridae sp., etc. were dominant and distributed mainly in the central part of the bay. Multivariate analyses showed that the whole polychaete community could be divided into 5 groups reflecting the geographical positions of the sampling stations and temporal variation particularly in the northern part of the bay. According to the results of BIO-ENV procedure, TOC (${\rho}=0.52$) and AVS (${\rho}=0.49$) as a single variable best explained the polychaete community structure. The best combination was made by such variables as TOC, AVS, sorting coefficient, and water temperature (${\rho}=0.60$). In conclusion, between-year differences in biotic and abiotic variables imply that recent efforts for the environmental improvement produced positive influences on the benthic environment of Gamak Bay, particularly the northern part of the bay.

• Progress in Medical Physics
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• v.27 no.2
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• pp.64-71
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• 2016

We develop a manufacture procedure for the production of a patient specific customized bolus (PSCB) using a 3D printer (3DP). The dosimetric accuracy of the 3D-PSCB is evaluated for electron beam therapy. In order to cover the required planning target volume (PTV), we select the proper electron beam energy and the field size through initial dose calculation using a treatment planning system. The PSCB is delineated based on the initial dose distribution. The dose calculation is repeated after applying the PSCB. We iteratively fine-tune the PSCB shape until the plan quality is sufficient to meet the required clinical criteria. Then the contour data of the PSCB is transferred to an in-house conversion software through the DICOMRT protocol. This contour data is converted into the 3DP data format, STereoLithography data format and then printed using a 3DP. Two virtual patients, having concave and convex shapes, were generated with a virtual PTV and an organ at risk (OAR). Then, two corresponding electron treatment plans with and without a PSCB were generated to evaluate the dosimetric effect of the PSCB. The dosimetric characteristics and dose volume histograms for the PTV and OAR are compared in both plans. Film dosimetry is performed to verify the dosimetric accuracy of the 3D-PSCB. The calculated planar dose distribution is compared to that measured using film dosimetry taken from the beam central axis. We compare the percent depth dose curve and gamma analysis (the dose difference is 3%, and the distance to agreement is 3 mm) results. No significant difference in the PTV dose is observed in the plan with the PSCB compared to that without the PSCB. The maximum, minimum, and mean doses of the OAR in the plan with the PSCB were significantly reduced by 9.7%, 36.6%, and 28.3%, respectively, compared to those in the plan without the PSCB. By applying the PSCB, the OAR volumes receiving 90% and 80% of the prescribed dose were reduced from $14.40cm^3$ to $0.1cm^3$ and from $42.6cm^3$ to $3.7cm^3$, respectively, in comparison to that without using the PSCB. The gamma pass rates of the concave and convex plans were 95% and 98%, respectively. A new procedure of the fabrication of a PSCB is developed using a 3DP. We confirm the usefulness and dosimetric accuracy of the 3D-PSCB for the clinical use. Thus, rapidly advancing 3DP technology is able to ease and expand clinical implementation of the PSCB.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.49-61
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• 2014

Purpose: With the aging of the population, the attack rate of osteoporotic vertebral compression fracture is in the increasing trend, and percutaneous vertebroplasty (PVP) is the most commonly performed standardized treatment. Although there is a research report of the excellence of usefulness of the SPECT/CT examination in terns of the exact diagnosis before and after the procedure, the bone cement material used in the procedure influences the image quality by forming an artifact in the CT image. Therefore, the objective of the research lies on evaluating the effect the bone cement gives to a SPECT/CT image. Materials and Methods: The images were acquired by inserting a model cement to each cylinder, after setting the background (3.6 kBq/mL), hot cylinder (29.6 kBq/mL) and cold cylinder (water) to the NEMA-1994 phantom. It was reconstructed with Astonish (Iterative: 4 Subset: 16), and non attenuation correction (NAC), attenuation correction (AC+SC-) and attenuation and scatter correction (AC+SC+) were used for the CT correction method. The mean count by each correction method and the count change ratio by the existence of the cement material were compared and the contrast recovery coefficient (CRC) was obtained. Additionally, the bone/soft tissue ratio (B/S ratio) was obtained after measuring the mean count of the 4 places including the soft tissue(spine erector muscle) after dividing the vertebral body into fracture region, normal region and cement by selecting the 20 patients those have performed PVP from the 107 patients diagnosed of compression fracture. Results: The mean count by the existence of a cement material showed the rate of increase of 12.4%, 6.5%, 1.5% at the hot cylinder of the phantom by NAC, AC+SC- and AC+SC+ when cement existed, 75.2%, 85.4%, 102.9% at the cold cylinder, 13.6%, 18.2%, 9.1% at the background, 33.1%, 41.4%, 63.5% at the fracture region of the clinical image, 53.1%, 61.6%, 67.7% at the normal region and 10.0%, 4.7%, 3.6% at the soft tissue. Meanwhile, a relative count reduction could be verified at the cement adjacent part at the inside of the cylinder, and the phantom image on the lesion and the count increase ratio of the clinical image showed a contrary phase. CRC implying the contrast ratio and B/S ratio was improved in the order of NAC, AC+SC-, AC+SC+, and was constant without a big change in the cold cylinder of the phantom. AC+SC- for the quantitative count, and AC+SC+ for the contrast ratio was analyzed to be the highest. Conclusion: It is considered to be useful in a clinical diagnosis if the application of AC+SC+ that improves the contrast ratio is combined, as it increases the noise count of the soft tissue and the scatter region as well along with the effect of the bone cement in contrast to the fact that the use of AC+SC- in the spine SPECT/CT examination of a PVP performed patient drastically increases the image count and enables a high density of image of the lesion(fracture).