This study was conducted to investigate the degree of utilization of outsourcing in large hospitals in Korea. We also investigated the outcome and the level of satisfaction for adopting outsourcing in these hospitals. Types of work areas that were currently operated by outsourcing and were planned to adopt outsourcing in the future were identified. A total of 83 hospitals were eligible for this study, which had more than 500 beds, and were identified from the 2003 National Hospital List published by the Korean Hospital Association. A self-administered Questionnaire survey was conducted between April 25th and May 20th in 2003 with a personnel being charged of arrangement of outsourcing in each hospital. Among the 58 hospitals responding the survey(response rate=69.9%), 49 hospitals(84.5%) utilized outsourcing in at least one work field in their organizations. The largest proportion of the hospitals(85.7%) using outsourcing responded that the biggest outcome after introducing outsourcing were cost reduction(49.0%), followed by improved efficiency in operating the organization or human resources(34.7%) and the improved quality of the work(6.1%). The degree of satisfaction for outsourcing among the hospital managers(3.43) was significantly higher than that among the employees(3.l4) on a S-point Likert-type scale(p<0.05). Among the 7 work areas, the hospitals used outsourcing most frequently in facility management(housekeeping, building maintenance, hospital security and parking management), followed by non-medical profit business(funeral, convenient store, and cafeteria), logistics(provision of patient meal, in-house delivery, and purchasing), and information and computing system(hospital information system, maintenance of personal computers and printers). The work areas that the hospitals planned to adopt or expand the outsourcing in the future most frequently were facility management, non-medical profit business, logistics, and information and computing systems. In conclusion, outsourcing was highly diffused in large Korean hospitals, particularly in the work field of facility management and non-medical profit business. The satisfaction for outsourcing was not high yet in Korean hospitals.
An Byung-Mo;Heo Min-Suk;Lee Seung-Pyo;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won;Kim Jong-Dae
Imaging Science in Dentistry
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v.32
no.2
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pp.75-79
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2002
Purpose : To evaluate the effect of exposure time and image resolution on fractal dimension calculations for determining the optimal range of these two variances. Materials and Methods : Thirty-one radiographs of the mandibular angle area of sixteen human dry mandibles were taken at different exposure times (0.01, 0.08, 0.16, 0.25, 0.40, 0.64, and 0.80 s). Each radiograph was digitized at 1200 dpi, 8 bit, 256 gray level using a film scanner. We selected an Region of Interest (ROI) that corresponded to the same region as in each radiograph, but the resolution of ROI was degraded to 1000, 800, 600, 500, 400, 300, 200, and 100 dpi. The fractal dimension was calculated by using the tile-counting method for each image, and the calculated values were then compared statistically. Results: As the exposure time and the image resolution increased, the mean value of the fractal dimension decreased, except the case where exposure time was set at 0.01 seconds (α = 0.05). The exposure time and image resolution affected the fractal dimension by interaction (p<0.001). When the exposure time was set to either 0.64 seconds or 0.80 seconds, the resulting fractal dimensions were lower, irrespective of image resolution, than at shorter exposure times (α = 0.05). The optimal range for exposure time and resolution was determined to be 0.08- 0.40 seconds and from 400-1000 dpi, respectively. Conclusion : Adequate exposure time and image resolution is essential for acquiring the fractal dimension using tile-counting method for evaluation of the mandible.
The purpose of this study was to investigate and compare the frequence of 4 periodontal pathogens in the supra- and subgingival plaque in periodontally healthy subjects. Twenty adult individuals aged 22 to 28 years (mean age 23.65 years) participated in this study. All subjects had no pocket sites more than 3 mm deep, and the sites selected for sampling were all negative for bleeding. After drying and isolation of the sites with cotton rolls, supragingival plaque was sampled using sterile periodontal curette. Each plaque sample was placed in individual tubes containing 500 ml of 1X PBS. After removal of the supragingival sample and any remaining supragingival plaque, subgingival plaque samples were taken from the same sites using sterile curette and placed in similar individual tubes. Identification of 4 putative periodontal pathogens from the samples was performed by polymerase chain reaction based on 16S rDNA. Chi-square test was employed to identify significant explanatory variables for the presence of the 4 periodontal pathogens. The data show that Actinobacillus actinmycetemcomitans, Porphyromonanas gingivalis, Bacteroides forsythus, and Fusobacterium nucleatum occurred in 16.9%, 14.4%, 52.5%, and 80.6%, respectively. No significant differences were noted in the periodontal pathogens between supra- and subgingival plaques according to the kind of teeth. However, the incisors were at higher risk for harboring F. nucleatum (p <0.05). Conclusion: These results reveal that anaerobic periodontal pathogens can be detected in supragingival plaques. Supragingival plaque may function as a reservoir of peri-odotopathogens.
Microarray analysis of gene expression has become a powerful approach for exploring the biological effects of drugs, particularly at the stage of toxicology and safety assessment. Acetaminophen (APAP) has been known to induce necrosis in liver, but the molecular mechanism involved has not been fully understood. In this study, we investigated gene expression changes of APAP using microarray technology. APAP was orally administered with a single dose of 50 mg/kg or 500 mg/kg into ICR mice and the animals were sacrificed at 6, 24 and 72 h of APAP administration. Serum biochemical markers for liver toxicity were measured to estimate the maximal toxic time and hepatic gene expression was assessed using high-density oligonucleotide microarrays capable of determining the expression profile of >30,000 well-substantiated mouse genes. Significant alterations in gene expression were noted in the liver of APAP-administered mice. The most notable changes in APAP-administered mice were the expression of genes involved in apoptosis, cell cycle, and calcium signaling pathway, cystein metabolism, glutatione metabolism, and MAPK pathway. The majority of the genes upregulated included insulin-like growth factor binding protein 1, heme oxygenase 1, metallothionein 1, S100 calcium binding protein, caspase 4, and P21. The upregulation of apoptosis and cell cycle-related genes were paralleled to response to APAP. Most of the affected gene expressions were returned to control levels after 72 hr. In conclusion, we identified potential hepatotoxicity makers, and these expressions profiling lead to a better understanding of the molecular basis of APAP-induced hapatotoxicity.
This study was conducted to detect the serum antibodies in the experimentally toxoplasma infected dogs and street dogs by use the of an enzyme-linked immunosorbent assay (ELISA). And this test was performed on the polystylene microplate by coating with the tachyzoites soluble antigen of T gondii (RH strain), incubated with sera diluted then, added with HPO-conjugated rabbit anti-dog IgG and o-phenylenediamine used as a substrate. Tachyzoites of T gondii harvested from mouse peritoneal cavity were purified by 30, 40 and 50% Percoll density gradient centrifugation and used as the source of antigen. The results obtained were summarized as follows; 1. The highest ratio of positive to negative (P/N ratio) was obtained at the level of $l{\mu}g/ml$ protein concentration of antigen with the 1/4000 dilution of the conjugate measured by checker-board titration. It was regarded as the optimum concentration of the antigen and conjugate. 2. Cut-off value in this IgG ELISA was 0.375 that was determined by mean absorbance (at 492nm) of IFA negative serum added with the dauble value of the standard deviation $(mean{\pm}2S.D.)$. 3. Serum ELISA IgG antibodies to T gondii in the exyerimentally infected dogs were detected firstly at the Week 3 after inoculation and the highest titer was recognized at the Week 4, 5 and 6 after inoculation. 4. Stability of the antigen absorbed in the microplates that were preserved at $4^{\circ}C$ and $-25^{\circ}C$ separately were prolonged up to 3 weeks and 10 weeks at $4^{\circ}C$ and $-25^{\circ}C$, respectively. However the reproducibility was not reliable after the preservation of 4 weeks and longer. 5. Positive rate of the specific antibodies in 312 test sera was 28.5% and there was no significant differences between the male (27.8%) and female (29.5%), respectively. 6. The IgG ELISA was proved to be a specific procedure for the detection of antibodies to canine toxoplasma infection and also evaluated as a screening test for the large scale of test samples in laboratory.
The study was undertaken to determine the effect of dietary magnesium on the eggshell quality and other performance in laying Tsaiya ducks and Leghorn hens. Twenty-five Tsaiya ducks and 25 Leghorn hens were raised in individual cages. The basal diet was mainly consisted of corn starch and isolated soybean protein. At the beginning of the experiments, birds were fed for 10 days with the basal diet supplemented with 500 mg/kg Mg (1070 mg/kg in total by analysis) in order to allow the birds adapting to the new diet. Both Tsaiya ducks and Leghorn hens were then each randomly divided into five groups and each group of five birds were fed with the experimental diets containing 690, 1070, 1690, 2150 or 2380 mg/kg Mg, respectively for 21 days. Eggs were collected in order to measure eggshell quality, Mg and Ca content of the eggshell. At the end of the experiments, blood samples of all birds were taken from their brachial veins for measuring the concentration of Mg and Ca in the plasma. Experimental results appeared that the dietary Mg content did not significantly affect egg production, egg weight, eggshell breaking strength and thickness in both Tsaiya ducks and Leghorn hens. In Tsaiya ducks, however, the plasma Mg concentration was affected by the dietary Mg content, but the plasma Mg almost reached a plateau (4.66 mg/dl) as long as the dietary Mg level was over 1070 mg/kg. In Leghorn hens, the plasma Mg level was significantly increased from 1.66 mg/dl to 4.03 mg/dl when the dietary Mg content in the diet had been increased from 690 mg/kg to 2380 mg/kg, suggesting that the plasma Mg concentration seems to be directly influenced by the Mg absorbed in the intestine. In the Tsaiya ducks, however, the dietary Mg level did not significantly affect the eggshell Mg content (from 0.113% to 0.123%). Whereas, there was a negative correlation between the eggshell thickness and eggshell Mg content (r = -0.50, p<0.01), revealing that the increase in eggshell Mg content probably associated with the impairment of eggshell quality in Tsaiya ducks. In Leghorn hens, however, there was no significant correlation between eggshell quality and eggshell Mg content, although the Mg content in the eggshell was also increased from 0.279% to 0.427% when the dietary Mg had been elevated from 690 mg/kg to 2380 mg/kg.
Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.
Distal-extension removable partial dentures have long been implicated in the increase in mobility and the destruction of the supporting structures of the primary abutment teeth. Various clasping systems have traditionally been used to retain distal extension removable partial dentures, and other designs have been proposed to minimize torquing forces on the abutment teeth. Most recent studies investigating the effects of removable partial dentures on abutment teeth have been performed in it laboratory setting. Results obtained from in vitro research have given dentists insight into removable partial denture design, but laboratory test model cannot be constructed that simulates actual functional or parafunctiona1 movements and forces. The purpose of this study was to clinically evaluate the degree of tooth mobility produced by two clasping systems (suprabulge type and infrabulge type) used for distal extension removable partial dentures. Akers clasp and R.P.I. system were selected for the evaluation, and four patients required a distal extension removable partial denture on the mandibular arch were selected for participation in the study. Two partial dentures were constructed in the same condition expect the design of clasp. All abutments in the study were mandibular first or second premolars. Measurements of mobility were made with a research tool designed by $M\"{u}hlemann$. This instrument, periodontometer, measures tooth mobility in the mouth by means of a dial gauge accurated to 0.01mm when the tooth is stressed with a force meter. Lingual and buccal deflection of abutment tooth was measured using buccal and lingual pressure. The amount of force applied was 500gm. Tooth mobility tests were made at four key stages; 1. Before insertion of the first removable partial denture, baseline mobility was establsihed. 2. After wearing of the first prosthesis, measurement was made at weekly intervals for 4 weeks. 3. The removable partial denture was then taken from the patient, and tooth mobility was measured again at weekly intervals until the patient's established baseline mobility had returned. 4. The second prosthesis of different clasp design was worn for a month and evaluated in the same manner as the first. The sequence of placement of clasping system was alternated between patients. The following results were obtained from this study; 1. The mobility of abutment tooth increased during the initial stage of wear and returned to baseline mobility after removal of removable partial dentures. 2. The mobility of abutment tooth showed no difference between Akers clasp and I-bar clasp during the 4-week test period. 3. All teeth tested showed greater mobility toward the buccal than the lingual direction.
Gopalakrishnan, Avanthika;Xu, Chang-Jiang;Nair, Sujit S.;Chen, Chi;Hebbar, Vidya;Kong, Ah-Ng Tony
Archives of Pharmacal Research
/
v.29
no.8
/
pp.633-644
/
2006
In last couple of decades the use of natural compounds like flavonoids as chemopreventive agents has gained much attention. Our current study focuses on identifying chemopreventive flavonoids and their mechanism of action on human prostate cancer cells. Human prostate cancer cells (PC3), stably transfected with activator protein 1 (AP-1) luciferase reporter gene were treated with four main classes of flavonoids namely flavonols, flavones, flavonones, and isoflavones. The maximum AP-1 luciferase induction of about 3 fold over control was observed with $20\;{\mu}M$ concentrations of quercetin, chrysin and genistein and $50\;{\mu}M$ concentration of kaempferol. At higher concentrations, most of the flavonoids demonstrated inhibition of AP-1 activity. The MTS assay for cell viability at 24 h showed that even at a very high concentration $(500\;{\mu}M)$, cell death was minimal for most of the flavonoids. To determine the role of MAPK pathway in the induction of AP-1 by flavonoids, Western blot of phospho MAPK proteins was performed. Four out of the eight flavonoids namely kaempferol, apigenin, genistein and naringenin were used for the Western Blot analysis. Induction of phospho-JNK and phospho-ERK activity was observed after two hour incubation of PC3-AP1 cells with flavonoids. However no induction of phospho-p38 activity was observed. Furthermore, pretreating the cells with specific inhibitors of JNK reduced the AP-1 luciferase activity that was induced by genistein while pretreatment with MEK inhibitor reduced the AP-1 luciferase activity induced by kaempferol. The pharmacological inhibitors did not affect the AP-1 luciferase activity induced by apigenin and naringenin. These results suggest the possible involvement of JNK pathway in genistein induced AP-1 activity while the ERK pathway seems to play an important role in kaempferol induced AP-1 activity.
Park, Jae-Han;Lim, Ki-Jung;Kim, Sang-Mok;Kim, Byung-Ock;Han, Kyung-Yoon
Journal of Periodontal and Implant Science
/
v.30
no.1
/
pp.187-203
/
2000
The precipitation of calcium phosphate on implant surface has been known to accelerate osseointegration and to enhance osseous adaptation. The present study was performed to examine whether the precipitation of calcium phosphate on Ti-6Al-4V alloy could be affected by the immersion in NaOH solution and heat treatment. Ti-6Al-4V alloy plates of $15{\times}3.5{\times}1mm$ in dimension were polished sequentially from #240 to #2,000 emery paper and one surface of each specimen was additionally polished with $0.1{\mu}m$ alumina paste. Polished specimens were soaked in various concentrations of NaOH solution(0.1, 1.0, 3.0, 5.0, 7.0, 10.0 M) at $60^{\circ}C$ for 24 hours for alkali treatment, and 5.0 M NaOH treated specimens were heated for 1 hour at each temperature of 400, 500, 600, 700, $800^{\circ}C$. After the alkali and heat treatments, specimens were soaked in the Hank's solution with pH 7.4 at $36.5^{\circ}C$ for 30days.The surface ingredient change of Ti-6Al-4V alloy was evaluated by thin-film X-ray diffractometer(TF-XRD) and the surface microstructure was observed by scanning electron microscope(SEM), and the elements of surface were analyzed by X-ray photoelectron spectroscopy(XPS). The results were obtained as follows ; 1. The precipitation of calcium phosphate on Ti-6Al-4V alloy was accelerated by the immersion in NaOH solution and heat treatment. 2. In Alkali treatment for the precipitation of calcium phosphate on Ti-6Al-4V alloy, the optimal concentration of NaOH solution was 5.0 M. 3. In heat treatment after alkali treatment in 5.0 M NaOH solution, the crystal formation on alloy surface was enhanced by increasing temperature. In heat treated alloys at $600^{\circ}C$, latticed structure and prominences of calcium phosphate layer were most dense. On heat treated alloy surface at the higher temperature(${\geq}700^{\circ}C$), main crystal form was titanium oxide rather than apatite. The above results suggested that the precipitation of calcium phosphate on the surface of Ti-6Al-4V alloy could be induced by alkali treatment in 5.0 M-NaOH solution and by heat treatment at $600^{\circ}C$.
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