Obstetrics and Gynecology include gynecology which is concerned with the treatment for the disease based on physiology and pathology of women, and obstetrics which is concerned with pregnancy delivery. These obstetics and gynecology can be said to date from the birth of human beings. This paper has carried on the studies about the generating and developing process of obstetics and gynecology. The results of this study are as follows : Distinction in Northern and Southern Dynasties were much more Obstetrics and Gynecology studying the Obstetrics and Gynecology books in that time, the study about "oncosis" (腫瘤) and forms of drug, pill, powder, pIaster were carried on. The highest distinction in Sui age were research and development on pathogenesis and cause of disease about Obstetrics and Gynecology disease and it was appeared representatively in "Zhubingyuanhoulun""諸病源候論" which was special book on cause of disease and pathogenesis and syndrome, And it was explained about abnormal vaginal discharge in this book. Obstetrics and Bynecology were developed on theory and clincis in Tang age when "Taiyshu"(太醫暑) was established. "Taiyshu"(太醫暑) taked complete charge of medical operation and education, published much excellent Obstetrics and Gynecology books than the past. Among them specially "Qianjinyaofang""千金要方" explained Obstetrics and Gynecology matter first in three volumes and "Qianjinyifang""千金翼方" explained this matter first in four volumes. This point indicate that Obstetrics and Gynecology's importance was established in Tang age, so Obstetrics and Gynecology's developmental history, Song age was the acme period. "Taiyju"(太醫局) was established in "xining""熙?" 9 year and Obstetrics belonged to one of nine departments under "Taiyun"(太醫局), so Obstetrics and Gynecology was separated from the other medical parts and it was prepared of it's progressing bases independently and appeared of changes in quality and increase in quantity about theory and prescription of Obstetrics and Gynecology, specially determination of treatment based on the differentiation of symptoms and sighs was taked a serious view. Besides four great physicians in Jing and Yuan dynasies diversified Obstetrics and Gynecology contents through their only medical theory and clinical treatment.
Besides using for hair removal, depilatory agents have been considered to be used as a penetration enhancer for transepidermal drug delivery. To examine the effect in hair follicles (HFs), two commercially available depilatory creams were tested on the dorsal skin of mice to monitor the effect deep into the skin structure. Fifteen male BALB/c mice were used in this study. Depilatory creams were applied to the dorsal skin of the same animal using shaved and untouched treatments as controls to minimize individual differences. Skin samples were collected at three days, one week and two weeks (n = 5 for each) after the treatment, and subjected for hematoxylin-eosin staining, and immunohistochemical analysis for proinflammatory cytokines. The morphological examination showed an increase in the thickness of epidermal layer of the depilatory cream-treated skin at early time points and in the subcutis at two weeks. Depilatory cream promoted entry of anagen phase and increased the number of hair follicles in the subcutis at one and two weeks. Immunohistochemistry showed elevated percentages of dermal fibroblasts expressing interleukin-6, tumor necrosis factor-α, and tumor necrosis factor-β. Shaving process increased the thickness of epidermis and dermis as depilatory creams did, but did neither induce the expression of proinflammatory cytokines in the dermal fibroblasts nor the number of HFs. The results suggested that the commercially available depilatory creams caused a transient minor inflammatory response of the skin and increased the levels of cytokines that might subsequently affect hair growth.
To ensure the microbiological safety of food items prepared after cooking process, this study was aimed to identify the hazards related with cooked foods donated to foodbanks through quantitative microbial analysis. Five foodbanks located in Incheon and Gyeonggi area among government-dominant foodbanks were surveyed from February to June, 2007. Manager, recipient, donator, type and quantity of donated foot and facility and equipment were examined for the general characteristics of foodbank. The time and temperature of food md environment were measured at steps from after-production to before-distribution, and the microbial analysis was performed mainly with indicator organism and major pathogens. The amount of cooked foods donated to each foodbank was about 20 to 30 servings and consisted of 80% of total donated foods. Only three foodbanks had separate offices for foodbank operation and four institutions had at least one temperature-controlled vehicle. The flow of donated foods was gone through the steps; production, meal service and holding at donator, collection by foodbank, transport (or holding after transport) and distribution to recipients. It took about 3.8 to 6.5 hours at room temperature from after-production to before-distribution. Only aerobic plate counts (APC) and coliforms were found in microbial analysis. The APC after production were relatively high in $8.2{\times}10^5,\;7.4{\times}10^5,\;6.9{\times}10^5$ and $4.2{\times}10^5 CFU/g$ while $2.8{\times}10^6, \;9.4{\times}10^5,\;1.0{\times}10^6$ and $5.4{\times}10^5CFU/g$ before distribution in mixed Pimpinella brachycarpa, mixed chard mixed amaranth and mixed spinach, respectively. The levels of coliforms in mixed chard and mixed spinach were complied with the standards of the Ministry of Education and Human Resources Management The level of APC in boiled pork was increased from $< 1.0{\times}10 CFU/g$ to $4.0{\times}10^2 CFU/g$. One of delivery vessels was shown $6.2{\times}10^3 CFU/100 cm^2$ in APC, which was over the standards for environment. One of serving tables also showed the high level of $1.2{\times}10^3 CFU/100 cm^2$ in APC and $6.6{\times}10^2 CFU/100 cm^2$ in coliforms. These results suggest the sanitary management of holding at donator and the time-temperature control are key factors to ensure the safety of cooked foods donated to foodbank.
Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
Journal of Home Health Care Nursing
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v.7
no.1
/
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.
A pathogenic free-living amoeba, Naegleria fowleri, causes primary amoebic meningoencephalitis to human and experimental animals. This infection is rare, but the mortality is very high. Nowadays, drug treatment or active immunization of human or mice are being tried with partial effectiveness. This study shows passive immunization effect by transfer of immunized spleen cells, serum, or milk from immunized mother in mouse experimental model. Young BALB/c mice were immunized intraperitoneally with $2~3{\times}10^{6}$ trophozoites of N. fowleri, and spleen cells and sera were collected for injection to recipient mice. There were seven transfer groups, i.e., immunized mouse serum, spleen cells, serum and spleen cells, normal mouse serum, spleen cells, serum and spleen cells, and control group. Three days later, BALB/c mice were inoculated with $1{\times}10^{4}$ trophozoites of N. fowleri intranasally. After infection, decreased mortality ana prolonged survival time of mice were noted in immunized Bloops compared with non.immuniBed control group. The groups Injected with immunized spleen cells or normal serum shewed lower moltality than that of controls bult showed no changes of Serum IgG level. The groups injected with immunized serum or normal spleen cells showed increased serum IgG level after immunization but hundred percent mortality was observed. Mother mice were ifnfnunised increperitqneeliy with $2~3{\times}10^{6}$ trephozoites of N. fowleri at the end of pregnancy and weaning Period. Soon after the delivery, Jitters born of non-immunszed mother were matched with immunized mother for feeding immune milk. After three weeks, the litters were infected with $1{\times}10^{4}$ trophozeites of N. fowleri or sacrificed for serum collection to measure the IgG levels. The results show that anti-JV. fowleri IgG from mother was transferred to litter through milk but this IgG did not inauence the mortality or survival time of the infected mice.
Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.
Bae, Soo Youn;Kim, Ku Sang;Kim, Jeong-Soo;Lee, Sae Byul;Park, Byeong-Woo;Lee, Seok Won;Lee, Hyouk Jin;Kim, Hong Kyu;You, Ji-Young;Jung, Seung Pil;Korean Breast Cancer Society
Journal of Breast Cancer
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v.21
no.4
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pp.425-432
/
2018
Purpose: Pregnancy-associated breast cancer (PABC) is rare, and its cause and prognosis are not well known. Additionally, treatment is limited with respect to the risk to the fetus. The purpose of this study was to investigate the characteristics and treatment trends of PABC and the survival rate according to the treatment. Methods: In the Korean Breast Cancer Society Registry database, women younger than 50 years and who were diagnosed with breast cancer from 1996 to 2015 were included. PABC was defined as breast cancer diagnosed during pregnancy or within 1 year after delivery. Results: We examined 411 patients with PABC and 83,381 patients with non-PABC. Over time, the proportions of patients undergoing breast-conserving surgery and sentinel lymph node biopsy increased, and neoadjuvant chemotherapy and radiation therapy administration rates also increased. In the past, the overall survival of patients with PABC was poorer than that of patients with non-PABC, but there was no difference in overall survival rates in more recent years. There was no difference in overall survival rates between patients who received neoadjuvant chemotherapy (hazard ratio [HR], 1.28; 95% confidence interval [CI], 0.66-2.49; p=0.459), but PABC conferred poorer prognosis than non-PABC in patients receiving adjuvant chemotherapy (HR, 1.63; 95% CI, 1.27-2.08; p<0.001). Conclusion: There was no difference in the prognosis between patients with PABC and those with non-PABC receiving neoadjuvant chemotherapy. The increase in neoadjuvant chemotherapy according to current treatment guidelines is expected to improve the survival rate of patients with PABC.
Adeno-associated virus (AAV) has been considered to be a very safe and efficient gene delivery system. However, the major obstacles to therapeutic usage of AAV have been to achieve highly efficient and reproducible production processes, and also to develop a reliable quantifying method of various serotypes with a simple protocol. We compared the efficiency of the conventional production protocol of AAV2 and adenovirus (Ad) co-infection to that of a new method containing AAV2 infection followed by pHelper transfection. We tested HEK293 and 293T, and further examined the time-dependent changes of AAV2 production. The new method of AAV2 and pHelper DNA gave about ten times higher production efficiency than that of the conventional protocol. The highest production efficiency in 293T was achieved as $1.61{\times}10^5$ virus genomes (v.g.)/cell by the new method of 10 MOI of AAV2 infection and 5 days post-infection. This protocol of the highest efficiency was then applied to produce various AAV serotypes and showed the efficiencies higher than $10^5$ v.g./cell. Next, we designed the universal PCR primers of highly conserved regions for various AAV serotypes to develop a simple and reliable titration method. The universal primers could amplify all the tested AAV serotypes with similar sensitivities by ten molecular copies. Therefore, this pair of universal primers can be further utilized to detect AAV contaminants in therapeutic adenoviral vectors.
This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.
Roh, Sung Woo;Kim, Young Soo;Yoon, Do Heum;Rhim, Seung Chul;Kong, Kyung Yup;Park, Sung Hye;Lee, Kyung Hee
Journal of Korean Neurosurgical Society
/
v.29
no.9
/
pp.1153-1160
/
2000
Objectives : This study was undertaken to investigate the effect of noncompetitive NMDA receptor blocker, MK801 on motor recovery, SSEP and pathology in spinal cord injured rat. Methods : The effects of MK801 on neuronal function protection, SSEP, and pathology were measured on spinal cord injury rats which were divided into 6 groups according to dose, time of drug delivery and magnitude of injury. Spinal cord injury was made with the magnitude of 25gm-cm and 50gm-cm on 42 rats. BBB locomotor function test was performed to evaluate the motor power recovery in hindlimb for 2 weeks after injury. After motor function test was completed, SSEP was measured. Amplitude and latency of the P1, N1 peak was measured and compared between groups. Finally rats were sacrificed, and pathologic findings including measurement of area of necrotic cord were studied and compared between groups. Results : Motor recovery at 2 weeks was better in MK801 group comparing to saline control group. SSEP at 2 weeks showed no difference in N1, P1 latencies, but significantly greater amplitude in MK801 group, compared to saline control group. On light microscope, there was no specific histologic differences between experimental groups. The cystic necrotic area in coronal plane was measured and compared in each group. The necrotic area was significantly smaller in MK801 1mg/kg group(delivered after injury) than vehicle group. The necrotic area in MK801 5mg/kg group and MK801 1mg/kg group(delivered before injury) was smaller than vehicle group even though it was not statistically significant. Conclusion : From the above result, it is speculated that NMDA blocker, MK801 can improve impaired neuronal function in spinal cord injury.
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