• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.191-197
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• 1999

Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.16-20
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• 2004

Purpose : To assess perceptual, acoustic and aerodynamic measure of voice quality in patients with unilateral vocal cord paralysis before and after type I thyroplasty. Methods : The clinical records of patients operated type I thyroplasty in the Departement of otorhinoalryngolgy, Yongdong Severance hospital from November 2001 to November 2003 were reviewed. All patients uderwent a vocal function evaluation including perceptual, acoustic and aerodynamic measures of voice preoperative and on $60^{th}$ postoperative day. The perceptual and acoustic measures were obtained from recording of patients' reading a 'Sanchak' passage. The perceptual evaluation was performed by 2 speech pathologist using a 4-point rating scale. Acoustic parameters(voice range profile low(RAL), voice range profile high(RAH), average fundamental frequency(AFX), closed quotient, harmonic to noise ratio, jitter and shimmer) were investigated by Lx speech studio. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured using the Phonatory function analyzer. The maximum phonation time was also measured. The data were statistically analyzed. A paired t-test (p<0.1) was used to compare preoperative and postoperative results. And multiple regression test was used to find which parameter was most correlated to improvement of postoperative voice quality. Results : Among aerodynamic parameters, Psub $(88.11mmH_2O{\rightarrow}58.7mmH_2O)$, MPT(7.87sec${\rightarrow}$12.53sec), MFR (359.8ml/sec${\rightarrow}$161.06ml/sec) were statistically improved. AFx(205.5Hz${\rightarrow}$163.27Hz), AQx(23.9%${\rightarrow}$48.3%), RAL, RAH. Jotter and shimmer were improved. In multiple regression test, AFx and AQx was noted as the two meost correlated parameters to improvement of postoperative breathiness. But general grade of voice quality was more correlated to Psub and shimmer. Conclusion : Vocal fold medialization procedures effectively reduce glottic gap. Increasing of contact area of both vocal folds induced improvement in aerodynamic parameters and leaded stabilizing of vocal fold vibration. That effect results in improvement in acoustic parameters (shimmer, jitter, signal-to-noise ratio, voice range profile) and voice quality.

• Korean Journal of Community Nutrition
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• v.11 no.1
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• pp.39-51
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• 2006

This study was conducted to investigate the differences in daily nutrient intakes, dietary habits and nutrition knowledge between male and female college students. Male undergraduate students 004 subjects) and female undergraduate students (229 subjects) , enrolled at H University in Daejeon, were recruited for this study. The mean age of the subjects was 22.9 year in male and 20.4 year in female students. Daily intakes of energy and nutrients were calculated from the records of one day of dietary food intakes by 24-hour recall method, and general information, dietary habits and attitudes, food intake frequency and food preferences and knowledge for food and nutrition were surveyed through a questionnaire. About $70.1\%$ of male and $66.1\%$ of female students were in the normal range of BMI (18.5 - 23), and $25.2\%$ of male students were over-weighted in contrast to $27.7\%$ of female students were underweight. Males and females were taking $77.2\%$ and $77.9\%$ of RDA for energy, respectively, and $54.8\%$ of male and $48.0\%$ of female students were taking energy under $75\%$ of RDA. Many of them showed deficient intakes of calcium, iron, vitamin A and riboflavin. Average of MAR was 0.75 in male and 0.72 in female students. NAR for calcium, iron, vitamin A and riboflavin in male students were 0.55, 0.69,0.75 and 0.61, respectively, compared to 0.53, 0.51, 0.70 and 0.67 in female students. The nutrients, which have INQ less than 1, were calcium and riboflavin in male, compared to calcium, iron, and riboflavin in female students. There were no gender differences in meal regularity and meal skipping rates, but female students showed higher rates of skipping dinner than males (p < 0.001) About $50.8\%$ of female students were ingesting snacks 1 - 2 time/day, compared to $27.1\%$ of male students. For the food intake frequency, fruit group was significantly eating more for female than male students (p< 0.001) Though female students got higher scores for nutritional knowledge test (p < 0.001) than male students, they did not show better dietary habits or dietary attitudes than male students actually. Therefore, a more active and actual education program accustomed to the different genders and ages with focus on real changing of dietary behaviors needs to be developed and run in schools and local departments.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.6
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• pp.2078-2087
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• 2010

This study conducted a chi-square test and a logistic regression analysis by not only using a investigation data of discharged patients with damages from 2004 to 2006, but also using a census and a research data on the actual condition from health care system. The result follows; First, the centralization of medical utilization of operation patients is becoming apparent, centrally the capital area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments. Second, propelling localization policy of certain diseases for the localization of medical utilization is needed as the rate of non-residential of operation patients that have diseases of the eye and adnexa, or cancers is high. Third, a localization policy for patients with damages is needed as the rate of treatments in other regions of operation patients with industrial accidents is increasing day by day.

• Asian-Australasian Journal of Animal Sciences
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• v.26 no.9
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• pp.1237-1246
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• 2013

The objective of this study was to estimate variance components and genetic parameters for lactation milk yield (LY), lactation length (LL), average milk yield per day (YD), initial milk yield (IY), peak milk yield (PY), days to peak (DP) and parameters (ln(a) and c) of the modified incomplete gamma function (MIG) in an Ethiopian multibreed dairy cattle population. The dataset was composed of 5,507 lactation records collected from 1,639 cows in three locations (Bako, Debre Zeit and Holetta) in Ethiopia from 1977 to 2010. Parameters for MIG were obtained from regression analysis of monthly test-day milk data on days in milk. The cows were purebred (Bos indicus) Boran (B) and Horro (H) and their crosses with different fractions of Friesian (F), Jersey (J) and Simmental (S). There were 23 breed groups (B, H, and their crossbreds with F, J, and S) in the population. Fixed and mixed models were used to analyse the data. The fixed model considered herd-year-season, parity and breed group as fixed effects, and residual as random. The single and two-traits mixed animal repeatability models, considered the fixed effects of herd-year-season and parity subclasses, breed as a function of cow H, F, J, and S breed fractions and general heterosis as a function of heterozygosity, and the random additive animal, permanent environment, and residual effects. For the analysis of LY, LL was added as a fixed covariate to all models. Variance components and genetic parameters were estimated using average information restricted maximum likelihood procedures. The results indicated that all traits were affected (p<0.001) by the considered fixed effects. High grade $B{\times}F$ cows (3/16B 13/16F) had the highest least squares means (LSM) for LY ($2,490{\pm}178.9kg$), IY ($10.5{\pm}0.8kg$), PY ($12.7{\pm}0.9kg$), YD ($7.6{\pm}0.55kg$) and LL ($361.4{\pm}31.2d$), while B cows had the lowest LSM values for these traits. The LSM of LY, IY, YD, and PY tended to increase from the first to the fifth parity. Single-trait analyses yielded low heritability ($0.03{\pm}0.03$ and $0.08{\pm}0.02$) and repeatability ($0.14{\pm}0.01$ to $0.24{\pm}0.02$) estimates for LL, DP and parameter c. Medium heritability ($0.21{\pm}0.03$ to $0.33{\pm}0.04$) and repeatability ($0.27{\pm}0.02$ to $0.53{\pm}0.01$) estimates were obtained for LY, IY, PY, YD and ln(a). Genetic correlations between LY, IY, PY, YD, ln(a), and LL ranged from 0.59 to 0.99. Spearman's rank correlations between sire estimated breeding values for LY, LL, IY, PY, YD, ln(a) and c were positive (0.67 to 0.99, p<0.001). These results suggested that selection for IY, PY, YD, or LY would genetically improve lactation milk yield in this Ethiopian dairy cattle population.

• Journal of the Korean Society of Food Science and Nutrition
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• v.24 no.4
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• pp.510-516
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• 1995

A multidisciplinary weight control program was conducted for obese women. The major components of the program included low calorie diet therapy, exercise, behavior modification and nutritional education and counseling. Sixteen healthy volunteers in excess of body fat, above 30%, were enrolled in the group support program. But 5 person were dropped out in the 2nd week of treatment. During the 1st week of group orientation, individual cause of obesity was assessed through a computer program including survey of dietary intake, activity, eating habits and life styles. During the 5 weeks of treatment, 4.8kg of average weight loss was accomplished using a following program ; low calorie diet(1200kcal/day with all essential nutrients), low impact aerobic exercise(50~60% of $VO_{2max}$, 1 hour/day in a group, 3~5 days/week), behavior modification of individual life styles and eating habits causing obesity and nutritional education concerning nutrition, role of exercise such as brisk walking, importance of slow eating in regular meal pattern and internal motivation for weight reduction, health risk of obesity and rapid weight loss, weight recycling and yo-yo syndrome, etc. Nutritional conseling was conducted 3 times per week with checking self-records of foods, activity, emotional state and tiredness. Before and immediately after 5 weeks of treatment, blood pressure, fasting blood glucose, cholesterol and triglyceride were measured and comparied with paired t-test. After 5 weeks of treatment, body weight, body mass index, body fat and circumferences of waist, upper arm and hip were significantly decreased. Also LDL-cholesterol was significantly decreased after obesity treatment.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.848-854
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• 2007

Purpose : The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus. Methods : Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method : breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13). Results : There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group ($8.7{\pm}3.6day$) compared to mixed feeding group ($6.0{\pm}1.9$) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test.Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002). Conclusion : Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

• Journal of Animal Science and Technology
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• v.55 no.1
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• pp.1-6
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• 2013

This study was aimed to solve the problems of current national genetic evaluation systems in Korea and its development to pass the verification processes as required by International Bull Evaluation Service (Interbull). This will enable Korea to participate in international genetic evaluation program. A total of 1,416,589 test-day milk records with calving dates used in this study were collected by National Agricultural Cooperative Federation from 2001 to 2009. Parity was limited up to fifth calving and milk production records were adjusted to cumulative 305 day lactation. The pedigree consisted of 2,279,741 animals where 2,467 bulls had 535,409 parents. A newly developed multiple trait model was used in calculation of breeding values for milk yield, milk fat, and protein yield. Data were edited with SAS (version 9.2) and R programs, and genetic parameters were estimated using VCE 6.0. Results showed a continuous increase in genetic potentials, in general, and no remarkable differences were found between performances by parity. Except fat yield, potentials in milk yield and protein yield were well calculated. We found an increased number of daughters per each top ranked 1,000 bulls in recent years of calf births compared to the cases of previous evaluations. Of the bulls ranked top 100 by our new models (multiple-trait models) we found that increased numbers of bulls were included. Of twenty eight bulls born in 2006, twenty bulls born in 2007 and eight bulls born in 2008 that were listed by new models, only 23, 12, and 2 bulls born in respective years were represented on top 100 by old single-trait models. Re-ranking of the daughters or sires by multiple-trait models suggest that this new multiple trait approach should be used for dairy cattle genetic evaluation and seed-stock selection in the future to increase the accuracy of multiple trait selection. Breeding values for these traits should also be calculated by new method for international genetic evaluation.

• Journal of Home Health Care Nursing
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• v.7 no.1
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.