• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.135-152
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• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.609-622
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• 1997

Nitrogen dioxide $(NO_2)$ has been regarded as one of the main elements among air pollutants, and we measured $NO_2$ levels of near gas range, kitchen, living room and outdoor on 489 apartments in Pusan area. $NO_2$ were sampled by using Palmes tubes (diffusion tube sampler) during August 16-25, 1995 (summer) and January 15-29, 1996 (winter), respectively. Authors wanted to know comparison of $NO_2$ levels in summer and winter, $NO_2$ levels categorized by variables, and variables affected to $NO_2$ levels. According to this study, we conducted to establish the degree of indoor-outdoor air pollution of urban apartments in Korea and methods to reduce indoor air pollution. The results of this study were summarized as follows: 1) Mean $NO_2$ levels of near gas range, kitchen, living room, and outdoor were $25.9{\pm}10.0ppb,\;23.3{\pm}8.0ppb,\;19.9{\pm}6.1ppb,\;and\;19.0{\pm}6.0ppb$ in summer, and $34.5{\pm}16.8ppb,\;28.2{\pm}13.4ppb,\;25.3{\pm}12.5ppb,\;21.8{\pm}9.8ppb$ in winter, respectively. 2) Mean $NO_2$ levels according to the floor levels were not significantly different in summer, and in winter, $NO_2$ levels were decreased as the floor levels were increasing, but those were increased above 16th floor. 3) Variables showing significant correlation(p<0.05) with $NO_2$ levels were as follows; Summer: floor level, family size, number of family during a meal, number using gas range during rice cooking per day, and natural ventilation. Winter: floor level, family size, number of person who have been respiratory disease in a house, number of family during a meal, total number of meals, and number using gas range during rice or side-dish cooking per day. 4) We suggest that the methods of reducing indoor $NO_2$ levels are ventilation during cooking, complete combustion, decreasing number and time of cooking, and substitution of fuels.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.21-30
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• 2005

Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.92-100
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• 2013

Purpose: To investigate the clinicopathologic effects of cyclosporine A (CsA) in children with diseases characterized by mesangial immunoglobulin A deposits such as immunoglobulin A nephropathy (IgAN) and Henoch-Sch$\ddot{o}$nlein purpura nephritis (HSPN). Methods: We retrospectively reviewed the clinicopathologic outcomes of 54 children (IgAN, 36; HSPN, 18) treated with CsA. The starting dose of CsA was 5 mg/kg per day, and it was administered in 2 divided doses. The degree of proteinuria and pathologic changes in renal biopsies were evaluated before and after CsA treatment. Results: The mean protein to creatinine ratio decreased from $3.7{\pm}1.5$ to $0.6{\pm}0.4$(P <0.001), and 32 (59.2%) children achieved complete remission of proteinuria after 1-year CsA treatment. Among the 54 children, 24 maintained normal renal function and 25 exhibited microscopic hematuria or proteinuria at the end of CsA treatment. In the HSPN group, 3 children whose initial biopsies indicated class IIIb disease showed class II disease on follow-up, and the follow-up biopsies of 2 children who had class II disease indicated the same class II disease. In the IgAN group, cortical tubular atrophy occurred in 1 child, and no child with IgAN had cortical interstitial fibrosis or tubular atrophy after 1-year CsA treatment. No significant complications were found in the children treated with CsA. Conclusion: Our findings indicate that CsA treatment is effective and beneficial in reducing massive proteinuria and preventing progression to end-stage renal failure in children with glomerular diseases characterized by IgA deposits, such as IgAN and HSPN, within 1 year of treatment.

• Journal of Life Science
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• v.13 no.4
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• pp.433-440
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• 2003

Osmotic and solid matrix priming treatments enhanced germination performance. We compared osmotic with solid matrix priming to determine the more effective treatment for improving seed germination in pepper and tomato. Seed hydration was immediately observed after osmotic priming and solid matrix priming treatment. The moisture content of solid matrix primed seeds was lower than that of osmotic primed seeds in the two vegetable crops. Osmotic priming and solid matrix priming did not increased percent germination, but showed shorter number of days to 50% of the final germination percentage ($T_{50}$) compared with untreated seeds, regardless of germination temperature. $T_{50}$ value was reduced in osmotic or solid matrix primed pepper seeds about 6.0, 5.0, 4.6 and 4.0 days compared with untreated seeds at 15, 20, 25, and $30^{\circ}C$, respectively. While, that in tomato seeds was reduced about 3.3, 5.0, 4.6 and 4.0 days compared with untreated seeds at 15, 20, 25, and $30^{\circ}C$, respectively. The effectiveness of osmotic priming or solid matrix priming in reducing the $T_{50}$ was greater when the seeds were germinated at $15^{\circ}C$ than at temperature of higher than $20^{\circ}C$. Solid matrix primed seeds germinated faster than osmotic primed seeds at all temperature in pepper. However, there was no significant difference on the percentage germination between solid matrix and osmotic primed seeds in tomato. After priming, dried-bark seeds showed faster germination than surface-dried seeds in pepper. On the other hand, there was no significant difference in tomato. Emergence of pepper and tomato seeds was markedly enhanced by osmotic priming or SMP treatment although the final emergence percentage was not significantly influenced. On the other hand, early growth was not significantly influenced by osmotic priming or SMP treatment of pepper and tomato seeds.

• Journal of Life Science
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• v.7 no.2
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• pp.142-148
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• 1997

This study was carried out to clarify seasonal changes of chemical compositions and their interrelation in leaves, shoots and berries treated with gibberellin($GA$_{3}$)for seedless grapes in ‘Delaware’grapevines. the clusters were dipped twice with 100ppm $GA_{3}$: 10 days befor and after the full bloom. The reaults obtained as follows; 1. Cumulative growth curve of berry fresh weight showed a double sigmoid curve and the characteristics of three distinctive growth stages(I, II, III)were weekened with $GA_{3}$ treatment. 2. while the contents of ash, total carbon, total nitrogen and total carbohydratd had little reation with edvelopment and ripeness of berries, those of total sugar and starch jad close relation, viz., they decreased with enlargement and maturity fo berries, but increased rapidly after harvest in leaves and shoots. Especially, total sugars in leaves and shoots decreased coincidently with starch-increasing in shoots at November. 3. The contents of total soluble solid and reducing sugar in berries increased rapidly at growth stage III, but those of total titratable acidity and organic acid decreased coincidently with sugar-increasing. 4. The berry-hardness increased until growth stage I, and then stagnated until gtowth stage II, and then increased rapidly at growth stage III. pH of berry-juice decreased until growth stageII, afterwards increased at growth stage III. 5. By correlation and path coefficient analysis between qualitative characters and the ratio of total soluble solid to titratable acidity($^{\circ}$Brix/Acidity), total correlation coefficients were all highly significant. Of these characters, pH and viscosity of berry-juice were positive, but brightness and hardness of berry, negative. The direct effect of pH on $^{\circ}$Brix/Acidity ratio, p4y=0.9090, was large positively and those of berry-hardness and juice-viscosity, p1y=0, 5938, median and, p2y=0, 3550, small, respectively. Direct effect of brightness was negatively small.

• Journal of Life Science
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• v.23 no.2
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• pp.228-236
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• 2013

This study was aimed at investigating whether dietary therapy using medicinal enzyme powder is effective in reducing constipation caused by loperamide in rats. Nine-week-old male Sprague Dawley were subdivided into 4 groups: normal diet group (C), loperamide treatment and normal diet (CL), medicinal enzyme powder diet (E), and loperamide treatment and medicinal enzyme powder diet (EL). Constipation was induced by subcutaneous injection of loperamide (1.5 mg/kg) 3 days prior to sacrifice. The treatment with loperamide led to an increase in weight gain, a decrease in the number and wet weight of fecal pellets, and a decrease in intestinal motility. The administration of the medicinal enzyme powder significantly reduced weight gain but increased intestinal mobility compared with the loperamide-treated group. The treatment with loperamide in the normal diet group reduced the activities of both suggesting that constipation may be involved in the low level of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT). Additionally, the loperamide treatment in the medicinal enzyme powder diet group increased the level of GOT, but reduced the level of GPT. Loperamide treatment also reduced cholesterol and increased the atherogenic index (AI) and cardiac risk factors (CRFs). Interestingly, the treatment with the medicinal enzyme powder effectively attenuated both the increase in AI and the reduction in high density lipopretein (HDL)-cholesterol, caused by the treatment with loperamide. Although there were no significant differences in the blood protein level, including hemoglobin and hematocrit, between the normal diet group and the loperamide-treated group, the administration of the medicinal enzyme powder to the loperamide-treated group effectively increased the levels of both hemoglobin and hematocrit. Collectively, the results demonstrate that the medicinal enzyme powder can help to combat the negative events caused by constipation.

• Asia pacific journal of information systems
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• v.23 no.4
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• pp.103-128
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• 2013

When a consumer needs a product or service and multiple sellers are available online, the process of selecting a seller to buy online from is complex since the process involves many behavioral dimensions that have to be taken into account. As a part of this selection process, consumers may set minimum trust expectation that can be used to screen out less trustworthy sellers. In the previous research, the level of consumers' trust expectation has been anchored on two important factors: product involvement and perceived risk. Product involvement refers to the extent to which a consumer perceives a specific product important. Thus, the higher product involvement may result in the higher trust expectation in sellers. On the other hand, other related studies found that when consumers perceived a higher level of risk (e.g., credit card fraud risk), they set higher trust expectation as well. While abundant research exists addressing the relationship between product involvement and perceived risk, little attention has been paid to the integrative view of the link between the two constructs and their impacts on the trust expectation. The present paper is a step toward filling this research gap. The purpose of this paper is to understand the process by which a consumer chooses an online merchant by examining the relationships among product involvement, perceived risk, trust expectation, and intention to buy from an e-tailer. We specifically focus on the mediating role of perceived risk in the relationships between enduring product involvement and the trust expectation. That is, we question whether product involvement affects the trust expectation directly without mediation or indirectly mediated by perceived risk. The research model with four hypotheses was initially tested using data gathered from 635 respondents through an online survey method. The structural equation modeling technique with partial least square was used to validate the instrument and the proposed model. The results showed that three out of the four hypotheses formulated were supported. First, we found that the intention to buy from a digital storefront is positively and significantly influenced by the trust expectation, providing support for H4 (trust expectation ${\rightarrow}$ purchase intention). Second, perceived risk was found to be a strong predictor of trust expectation, supporting H2 as well (perceived risk ${\rightarrow}$ trust expectation). Third, we did not find any evidence of direct influence of product involvement, which caused H3 to be rejected (product involvement ${\rightarrow}$ trust expectation). Finally, we found significant positive relationship between product involvement and perceived risk (H1: product involvement ${\rightarrow}$ perceived risk), which suggests that the possibility of complete mediation of perceived risk in the relationship between enduring product involvement and the trust expectation. As a result, we conducted an additional test for the mediation effect by comparing the original model with the revised model without the mediator variable of perceived risk. Indeed, we found that there exists a strong influence of product involvement on the trust expectation (by intentionally eliminating the variable of perceived risk) that was suppressed (i.e., mediated) by the perceived risk in the original model. The Sobel test statistically confirmed the complete mediation effect. Results of this study offer the following key findings. First, enduring product involvement is positively related to perceived risk, implying that the higher a consumer is enduringly involved with a given product, the greater risk he or she is likely to perceive with regards to the online purchase of the product. Second, perceived risk is positively related to trust expectation. A consumer with great risk perceptions concerning the online purchase is likely to buy from a highly trustworthy online merchant, thereby mitigating potential risks. Finally, product involvement was found to have no direct influence on trust expectation, but the relationship between the two constructs was indirect and mediated by the perceived risk. This is perhaps an important theoretical integration of two separate streams of literature on product involvement and perceived risk. The present research also provides useful implications for practitioners as well as academicians. First, one implication for practicing managers in online retail stores is that they should invest in reducing the perceived risk of consumers in order to lower down the trust expectation and thus increasing the consumer's intention to purchase products or services. Second, an academic implication is that perceived risk mediates the relationship between enduring product involvement and trust expectation. Further research is needed to elaborate the theoretical relationships among the constructs under consideration.

• The Korean Journal of Nuclear Medicine
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• v.36 no.6
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• pp.333-343
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• 2002

Purpose: A new linker, hydrazino nicotinamide (HYNIC), was recently introduced for labelling of liposome with $^{99m}Tc$. In this study we synthesized HYNIC derivatized PEG (polyethylene glycol)-liposomes radiolabeled with $^{99m}Tc$. Materials and Methods: In order to synthesize HYNIC-DSPE (distearoyl phosphatidyl ethanolamine) which is a crucial component for $^{99m}Tc$ chelation, first of all succinimidyl 6-BOC-hydrazinopyridine-3-carboxylic acid was synthesized from 6-chloronicotinic acid by three sequential reactions. A DSPE derivative of succinimidyl 6-BOC-hydrazinopyridine-3-carboxylic acid was transformed into HYNIC-DSPE by HCI/dioxane. HYNIC-PEG-liposomes were prepared by hydration of the dried lipid mixture of EPC (egg phosphatidyl choline): PEG-DSPE : HYNIC-DSPE:cholesterol (1.85:0.15:0.07:1, molar ratio). The HYNIC-PEG-liposomes were labeled with $^{99m}Tc$ in the presence of $SnCl_2{\cdot}2H_2O$ (a reducing agent) and tricine (a coligand). To investigate the level of in vivo transchelation of $^{99m}Tc$ in the liposomes, the $^{99m}Tc$-HYNiC-PES-liposomes were incubated with a molar excess of DTPA, cysteine or glutathione solutions at $37^{\circ}C$ for 1 hour. The radiolabeled liposomes were also incubated in the presence of human serum at $37^{\circ}C$ for 24 hours. Results: 6-BOC-hydrazinopyridine-3-carboxylic acid was synthesized with 77.3% overall yield. The HYNIC concentration in the PEG-coated liposome dispersion was 1.08 mM. In condition of considering the measured liposomal size of 106 nm, the phospholipid concentration of $77.5\;{\mu}mol/m{\ell}$ and the liposomal particle number of $5.2{\times}10^{14}$ liposomes/ml, it is corresponded to approximate 1,250 nicotinyl hydrazine group per liposome in HYNIC-PEG-liposome. The removal of free $^{99m}Tc$ was not necessary because the labeling efficiency were above 99%. The radiolabeled liposomes maintained 98%, 96% and 99%, respectively, of radioactivity after incubation with transchelators. The radiolabeled liposomes possessed above 90% of the radioactivity in serum. Conclusion: These results suggest that the HYNIC can be synthesized easily and applied in labelling of PEG-liposomes with $^{99m}Tc$.

• The Korean Journal of Nuclear Medicine
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• v.36 no.6
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• pp.368-380
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• 2002

Purpose: Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Materials and Methods: Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Results: Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions on FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had S hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. Conclusion: FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.