Choi, Young Hyun;Na, Baeg Ju;Lee, Jin Yong;Hwang, Ji Hye;Lim, Nam Gu;Lee, Seong Ki
Journal of agricultural medicine and community health
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v.38
no.1
/
pp.14-24
/
2013
Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).
Journal of agricultural medicine and community health
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v.38
no.2
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pp.130-141
/
2013
Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.
Song, Hoon Sub;Kwon, Soon Jin;Epling, William S.;Croiset, Eric;Nam, Sung Chan;Yi, Kwang Bok
Clean Technology
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v.20
no.2
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pp.189-201
/
2014
Partial oxidation, $CO_2$ reforming and the oxidative $CO_2$ reforming of $CH_4$ to produce synthesis gas over supported Ni hydrotalcite-type ($Ni_{0.5}Ca_{2.5}Al$ catalyst) catalysts were carried out and the effects of metal supports (i.e.; Mg and Ca) on the formation of a stable double-layer structure on the catalysts were evaluated. The $CH_4$ reforming stability was determined to be affected by the differences in the interaction strength between the active Ni ions and support metal ions. Only a Ni-Mg-Al composition produced a highly stable hydrotalcite-type double-layered structure; while the Ni-Ca-Al-type composition did not. Such structure provides excellent stability for the catalyst (-80% efficiency) as confirmed by the long-term $CO_2$ reforming test (-100 h), while the Ni-Ca-Al catalyst exhibited deactivation phases starting at the beginning of the reaction. The interaction strength between the active metal (Ni) and the supporting components (Mg and Al) was determined by temperature-programed reduction (TPR) analyses. The affinity was also confirmed by the TPR temperature because the Ni-Mg-Al catalyst required a higher temperature to reduce the Ni relative to the Ni-Ca-Al catalyst. The highest initial activity for synthesis gas production was observed for the $Ni_{0.5}Ca_{2.5}Al$ catalyst; however, this activity decreased quickly due to coke formation. The $Ni_{0.5}Ca_{2.5}Al$ catalyst exhibited a high reactivity and was more stable than the other catalysts because it had a higher resistance to coke formation.
Importance has been increased on farming mechanization in harvesting, handling and processing of forage in Korea. Small grasslands are most spread and popular in Korea in comparison with those of Europe and America. Therefore shearing characteristics of some major forage crops should be studied to be contributed to the basic data to develop a moderate size forage harvester being suitable to the small grassland. They were studied on six kinds of forage crops - reed canarygrass, alfalfa, red clover, orchardgrass, meadow fescue and birdsfoot trefoil-in regarding with moisture content levels and shearing angles. The results were as follows; 1. The increase rate of the linear density in relation to the diameter was greater in red clover than other kinds, and order of increase rate in greatness was reed canarygrass, alfalfa and meadow fescue. 2. The increase rates of the maximum shear forces were high in relation to their cross - sectional area in alfalfa and birdsfoot trefoil with hard stems, and the shear energy were comparatively large in orchardgrass and meadow fescue with soft stems, also reed canarygrass and red clover had high values in both the maximum shear force and the shear energy. 3. The shear energy per unit area or shear strength in relation to moisture content showed concave curves with the minimum values at about 70%w. b. which was in the beginning stage of drying in meadow fescue and orchardgrass, nevertheless reed canarygrass and red clover had convex curves with the maximum values at about 40%w.b. 4. The shear force in relation to the shear angle decreased generally with decrease of shear angle from $90^{\circ}$ to $70^{\circ}$ or $50^{\circ}$.
This study is aiming at identifying the foreward and backward lingkage effects of the farm land base development project. Korean Government has continuously carried out farmland base development projets including the integrated agricultural development projects. large and medium scale irrigation projects and the comprehensive development of the four big river basin including tidal land reclamation and estuary dam construction for the all weather farming since 1962. the starting year of the five year economic development plans. Consequently the irrigation rate of paddy fields in Korea reached to 75% in 1998 and to escalate the irrigation rate, the Government had procured heavy investment fund from IBRD. IMF and OECF etc. To cope with the agricultural problems like trade liberalization in accordance with WTO policy, the government has tried to solve such problems as new farmland base development policy, preservation of the farmland and expansion of farmland to meet self-sufficiency of foods in the future. Especially, farmland base development projects have been challanged to environmental and ecological problems in evaluating economic benefits and costs where the value of non-market goods have not been included in those. Up to data, in evaluating benefits and costs of the projects, farmland base development projects have been confined to direct incremental value of farm products and it's related costs. Therefore the projects'efficiency as a decision making criteria has shown the low level of economic efficiencies. In estimating economic efficiencies including Leontiefs input-output analysis of the projects could not be founded in Korea at present. Accordingly this study is aimed at achieving and identifying the following objectives. (1) To identify the problems related to the financial supports of the Government in implementing the proposed projects. (2) To estimated backward and foreward linkage effects of the proposed project from the view point of national economy as a whole. To achieve the objectives, Hwangrak benefited area with reservoir which is located in Seosan-haemi Disticts, Chungnam Province were selected as a case study. The main results of the study are summarized as follows : a. The present value of investment and O & M cost were amounted to 3,510million won and the present value of the value added in related industries was estimated at 5.913million won for the period of economic life of 70 years. b. The total discounted value of farm products in the concerned industries derived by the project was estimated at 10,495million won and the foreward and backward linkage effects of the project were amounted to 6,760 and 5,126million won respectively. c. The total number of employment opportunities derived from the related industries for the period of project life were 3,136 man/year. d. Farmland base development projects were showed that the backward linkage effects estimated by index of the sensitivity dispersion were larger than the forward linkage effect estimated by index of the power of dispersion. On the other hand, the forward linkage effect of rice production value during project life was larger than the backward linkage effect e. The rate of creation of new job opportunity by means of implementing civil engineering works were shown high in itself rather than any other fields. and the linkage effects of production of the project investment were mainly derived from the metal and non-metal fields. f. According to the industrial linkage effect analysis, farmland base development projects were identified economically feasible from the view point of national economy as a whole even though the economic efficiencies of the project was outstandingly decreased owing to delaying construction period and increasing project costs.
In the meantime, research on corporate informatization focuses on the completeness of information technology itself and its financial effects, so there is insufficient research on whether information technology can support business strategy. It is necessary to verify whether the management strategy implementation of the company can be led through the informatization of the enterprise and the relation between the main mechanism factors and the informatization performance. In this study, what a mechanism factor is applied in the process of result creation of informatization from three mechanism perspectives such as selecting mechanism, learning mechanism and coordinating mechanism with cases of representative domestic IT company and what an importance mechanism factors have been ascertained. This study results in 8 propositions. For a main agent of companies, securement of information capability of organizations has been selected to realize informatization results and investment of informatization has been selected to solve organizational decentralization problems as the most important factor. Additionally, as competition in the industry gets fierce, investment on informatization has been changed to a utility way of implementation of strategies and decision on investment has been made through the official process and information technology. Differentiated company capability has been made based on acquisition of technical knowledge and company information has been expanded to its whole employees through the information system. Also, informatization change management and outside subcontractor management have been acknowledged as an important adjustment factor of company. The first implication of this study is that since case studies on mechanism factors that preceding studies on informatization results did not empirically cover have directly been dealt with based on experiences of executives in charge of business and in charge of informatization, this study can provide practical views about factors that should be mainly managed for informatization results of IT companies. Secondly, since ser-M framework has been applied for IT companies for the first time, this study can academically contribute to companies in other fields about main mechanism factors for result creation of informatization based on deeper understanding and empirical cases.
The functional derangement of skeletal muscles which may be attributed to chronic hypoxia has been accepted as a possible mechanism of exercise impairment in patients with chronic obstructive pulmonary disease (COPD). The metabolic changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation, early activation of anaerobic glycolysis and excessive lactate and hydrogen ion production with exercise. But the cause of exercise limitation in patients with chronic lung disease without hypoxia has not been known. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the exercise limitation in chronic lung disease patients without hypoxia, we compared the muscular metabolic data of seven male patients which had been derived from noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) with those of five age-matched normal male control persons. $^{31}P$ MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and the 30% of MVC force was constantly loaded to each patient during the isometric exercise. There were no differences of intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr) at baseline, exhaustion state and recovery period between two groups. But pHi during the exercise was lower in patients group than the control group (p < 0.05). Pi/PCr during the exercise did not show significant difference between two groups. These results suggest that the exercise limitation in chronic lung disease patients without hypoxia also could be attributed to the abnormalities in the skeletal muscle metabolism.
Park, Seung-Kyu;Choi, In-Hwan;Kim, Cheon-Tae;Song, Sun-Dae
Tuberculosis and Respiratory Diseases
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v.44
no.6
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pp.1234-1244
/
1997
Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.
Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.
Background : Examining the biological susceptibility of Mycobacterium tuberculosis to pyrazinamide (PZA) in vitro is very difficult as PZA is inactive under normal culture conditions. The biological susceptibility test, an enzyme assay for Pzase activity, and a genetic test for pncA gene mutations, were performed in order to predict PZA resistance. Methods : 28 cultured clinical isolates of Mycobacterium tuberculosis were tested. The biological susceptibility was performed by the absolute concentration method using Lowenstein-Jensen media. The PZase activity was tested by means of Wayne's method. A 710-bp region includes the entire open reading frame of pncA was amplified and sequenced. Results : All six strains with positive PZase activity exhibited no pncA mutations with one strain showing a false resistance in the biological susceptibility test. Among the 22 strains with no PZase activity, 21 exhibited showed pncA mutations. In the biological susceptibility test, 20 strains were resistant, and one was susceptible, and the other flied to test. The mutation types varied with ten missense, one silent and one nonsense mutation 1 slipped-strand mispairing, and 6 frameshift mutations. Three strains had an adenine to guanine mutation at position -11 upstream of the start codon. Conclusion : The mutation at the pncA promotor region is frequent at -11 upstream position. Automatic sequencing of pncA is a useful tool for rapid and accurate detection of PZA resistant M. tuberculosis, and for demonstrating the epidemiological relatedness of the PZA resistant M. tuberculosis strains.
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