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The Critical Factors on Improvement of Medical institution Competitiveness (의료기관 경쟁력 향상에 영향을 미치는 핵심 요인)

  • Yeom, Jae-Kwang;Kang, Chang-Yeol
    • Korea Journal of Hospital Management
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    • v.12 no.1
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    • pp.1-30
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    • 2007
  • The study carried out a survey with employees of hospitals located in Daejeon, Chungnam, and Chungbuk from Sep. 12 to Sep. 30, 2005 in order to derive primary elements that affect the improvement of hospital's competitiveness. The study investigated and analyzed the employees' recognition on the change of competitive environment caused by the change of medical environment. The study also analyzed the elements that affect the hospital's competitiveness and the competitive strategies of the hospitals. The conclusion of this study can be summarized as follows. 1. Summary 1) Most of the employees responded that there is a rival in the competitive environment and the competitive is intense. Especially when the employees are married, live in urban areas, have an education level of university graduate or are managers, they tend to think the competitive is very intense. Also, they said that the competitive is based upon the quality of medical service. They mentioned the element that has the biggest effect on the competitiveness is the element of medical consumer and they recognized that the medical services in university and general hospitals have more competitiveness than the one-department hospitals. 2) It was investigated that the medical technique service has the most effect on the hospital's competitiveness. Also, the external service of medical techniques also has a large effect on the hospital's competitiveness. 3) When they were asked for the factors that affect the patients' decision on selecting a hospital, most of them responded "capability and technique of the medical staffs." Also, they said that "sufficient explanation from doctors" and "special center and clinic" are the factors that have big effects on the patients' decision. 4) In the SWOT analysis, most of them responded that the strength is the hospital's characteristics and the weakness is insufficient and obsolete equipment. They said the opportunity is the demands for professional medical service and the risk is the intense competitive among the hospitals. 5) In the SWOT strategy, they emphasized the strategy that uses the opportunity and the strength and the strategy that uses the opportunity while overcoming the weakness. 6) As for the basic competition strategy, most of them thought of the strategy of professionalizing the medical service most importantly. Next, they focused on the strategy of distinct service and the strategy of lower prime cost. 2. Conclusion 1) Because service competition between hospitals is happening seriously, need competitiveness security through right awareness transfer and satisfaction upgrade about medical consumer. 2) For medical technique service upgrade that equip Hospital's competitiveness but affects most, must solidify the countermeasure because professionalizing the medical service and newest medical technique induction should be achieved first, and compose task force for the external service of medical techniques improvement. 3) To improve SWOT of hospital, opportunity and the strength strategy choice that rescue hospital's characteristics heightening professionalizing the medical service level is fancied. 4) As for the basic competition strategy, will have to try in phase triangular position of hospital which is trusted medical level upgrade and excellent manpower security and finance independence through upgrade. The study was only done with hospitals in Daejeon, Chungnam and Chungbuk. Also, it is a study from the side of suppliers of medical service so there are limitations. However, the significance of the study is to present the basic data for improvement of hospital's competitiveness by examining the importance of medical techniques and external service of medical techniques that are the main effects on the improvement of hospital's competitiveness.

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Effects Of Cultured Bone Cell On The Regeneration Of Alveolar Bone (배양골세포 이식이 치조골재생에 미치는 영향)

  • Jeong, Soon-Joon;Herr, Yeek;Park, Joon-Bong;Lee, Man-Sup;Kwon, Young-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.1-26
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    • 1996
  • This study was performed to estimate the effects of cultured bone cell inoculated on porous type hydroxyaptite for the regeneration of the artificial alveolar bone defect. In this experiment 3 beagle dogs were used, and each of them were divided into right and left mandible. Every surgical intervention were performed under the general anesthesia by using with intravenous injection of Pentobarbital sodium(30mg/Kg). To reduce the gingival bleeding during surgery, operative site was injected with Lidocaine hydrochloride(l:80,000 Epinephrine) as local anesthesia. After surgery experimental animal were feeded with soft dietl Mighty dog, Frisies Co., U.S.A.) for 1 weeks to avoid irritaion to soft tissue by food. 2 months before surgery both side of mandibular 1st premolar were extracted and bone chips from mandibular body were obtained from all animals. Bone cells were cultured from bone chips obtained from mandible with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. Porous type hydroxyapatite were immerse into the high concentrated cell suspension solution, and put 4 hours for attachin the cells on the surface of hydroxyapatite. Graft material were inserted on the artificial bone defect after 3 days of culture. Before insertion of cellinoculated graft material, scanning electronic microscopic observation were performed to confirm the attachment and spreading of cell on the hydroxyapatite surface. 3 artificial bone defects were made with bone trephine drill on the both side of mandible of the experimental animal. First defect was designed without insertion of graft material as negative control, second was filled with porous replamineform hydroxyapatite inoculated with cultured bone marrow cells as expermiental site, and third was filled with graft materials only as positive control. The size of every artificial bone defect was 3mm in diameter and 3mm in depth. After the every surgical intervention of animals, oral hygiene program were performed with 1.0% chlorhexidine digluconate. All of the animals were sacrificed at 2, 4, 6 weeks after surgery. For obtaining histological section, tissus were fixed in 10% Buffered formalin and decalcified with Planko - Rycho Solution for 72hr. Tissue embeding was performed in paraffin and cut parallel to the surface of mandibular body. Section in 8um thickness of tissue was done and stained with Hematoxylin - Eosin. All the specimens were observed under the light microscopy. The following results were obtained : 1. In the case of control site which has no graft material, less inflammatory cell infiltration and rapid new bone forming tendency were revealed compared with experimental groups. But bone surface were observed depression pattern on defect area because of soft tissue invasion into the artificial bone defect during the experimental period. 2. In the porous hydroxyapatite only group, inflammatory cell infiltration was prominet and dense connective tissue were encapsulated around grafted materials. osteoblastic activity in the early stage after surgery was low to compared with grafted with bone cells. 3. In the case of porous hydroxyapatite inoculated with bone cell, less inflammatory cell infiltration and rapid new bone formation activity was revealed than hydroxyapatite only group. Active new bone formation were observed in the early stage of control group. 4. The origin of new bone forming was revealed not from the center of defected area but from the surface of preexisting bony wall on every specimen. 5. In this experiment, osteoclastic cell was not found around grafted materials, and fibrovascular invasion into regions with no noticeable foreign body reaction. Conclusively, the cultured bone cell inoculated onto the porous hydroxyapatite may have an important role of regeneration of artificial bone defects of alveolar bone.

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A Study on Ancestral Service Preparation and Sacrificial Consciousness of Housekeepers Living in Pusan and Yeosu Area (부산지역과 전남 여수지역 주부들의 제례준비 및 제례의식 조사 연구)

  • 정복미;정해옥;김은실
    • Culinary science and hospitality research
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    • v.10 no.3
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    • pp.135-154
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    • 2004
  • This study surveyed ancestral service preparation and sacrificial consciousness of housewives living in Pusan and Yeosu area. Statistical analysis of chi-square test was carried out by using SAS program. The results are summarized as follows. l. In major general characteristics of subjects, the forties(35.56%), Buddhism (57.79%), high school education(52.54%), a couple with children(63.45%) were the most abundant. 2. The time of sacrificial rites in both areas was usually hold from 23:00 to 01:00 (47.16%). The housewives having a job hold earlier the service than the full-time housewives(p<0.05). 3. The range of ancestor-memorial rites was usually up to 3rd generation(34.47%). The leader of sacrificial ceremony was mainly the eldest grandson by the eldest son (78.28%) in the old subjects and a person of wealth in the young subjects(p<0.05). 4. There were more positive answers for the necessity of a sacrificial ceremony (57.32%). Older than 50 years of subjects thought the sacrificial rites should be held(70.77%), while as the age of subjects was younger, they realized less necessity for that(p<0.05). Sacrificial consciousness was higher in Buddhists than the other religionists(p<0.0001). The sacrificial rites was thought to be needed for their harmonious family(50.43%). Younger subjects thought that it is necessary to succeed that as the tradition, while older housewives thought that it would contribute toward peace in their family(p<0.05). Buddhists and Christians answered that it was good for harmonious family, and Catholics and the others for tradition(p<0.01). Their consideration of sacrificial rites in the future was higher in keeping the traditional practice (37.04%) and Buddhists took higher these consideration(43.17%). Considering the sacrificial consciousness, there were statistical differences among the religionists (p<0.0001). The eldest daughter-in-raw had a different opinion about the following up the method of sacrificial ceremony from second eldest daughter-in-raw and the next one(p<0.05). The housewives in Pusan were showing more the affirmative attitudes to keep the traditional practice than those in Yeosu.

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Why Your Manuscripts Were Rejected or Required a Major Revision: An Analysis of Asia Pacific Journal if Information Systems (MIS 논문의 '게재 불가' 및 '수정 후 재심사' 사유: Asia Pacific Journal of Information Systems 심사소견서 분석)

  • Lee, Choong-C.;Yun, Hae-Jung;Hwang, Seong-Hoon
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.179-193
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    • 2009
  • As the common saying attests, a publish-or-perish world, publishing is absolutely critical for academic researchers' successful careers. It is the most objectively-accepted academic performance criteria and the most viable way to attain public and academic recognition. Asia Pacific Journal of Information Systems(APJIS) has been recognized as the most influential domestic journal in Korean MIS field since July, 1991. Therefore, publishing in APJIS means your research is original, valid, and contributive. While most researchers learn how to publish an article in APJIS through a repetitive review process, thereby improving their chance of the' accepted' through their personal trial and error experiences, such valuable lessons and know-how tend to be kept personally and rarely shared. However, useful insights into research and publication skills could be also gained from sharing others' errors, neglect, and misjudgments which are equally critical in improving researchers' knowledge in the field (Murthy and Wiggins, 2002). For this reason, other academic disciplines make systematic efforts to examine the paper review process of major journals and share the findings from these studies with the rest of the research community members (Beyer et al., 1995; Cummings et al, 1985; Daft, 1995; Jauch and Wall, 1989; Murthy and Wiggins, 2002). Recognizing the urgent need to provide such type of information to MIS research community in Korea, we have chosen the most influential academic journal, APJIS with an intention to share the answer to the following research question: "What are the common problems found in the manuscripts either 'rejected' or 'required a major revision' by APJIS reviewers?" This study analyzes the review results of manuscripts submitted to APJIS (from January, 2006 to October, 2008), particularly those that were 'rejected' or required a 'major revision' at the first round. Based on Daft's(1995) study, twelve most-likelihood problems were defined and used to analyze the reviews. The twelve criteria for classification, or "twelve problems", are as follows: No theory, Concepts and operationalization not in alignment, Insufficient definition--theory, Insufficient rationale--design, Macrostructure--organization and flow, Amateur style and tone, Inadequate research design, Not relevant to the field, Overengineering, Conclusions not in alignment, Cutting up the data, and Poor editorial practice. Upon the approval of the editorial board of APJIS, the total 252 reviews, including 11 cases of 2005 and 241 cases from July, 2006 to October, 2008, were received without any information about manuscripts, authors, or reviewers. Eleven cases of 2005 were used in the pilot test because the data of 2005 were not in complete enumeration, and the 241 reviews (113 cases of 'rejection' and 128 ones of 'major revision') of 2006, 2007, and 2008 were examined in this study. Our findings show that insufficient rationale-design(20.25%), no theory(18.45%), and insufficient definition--theory(15.69%) were the three leading reasons of 'rejection' and 'major revision.' Between these two results, the former followed the same order of three major reasons as an overall analysis (insufficient rationale-design, no theory, and insufficient definition-theory), but the latter followed the order of insufficient rationale--design, insufficient definition--theory, and no theory. Using Daft's three major skills-- 'theory skills', 'design skills', and 'communication skills'-- twelve criteria were reclassified into 'theory problems', 'design problems', and 'communication problems' to derive more practical implications of our findings. Our findings show that 'theory problems' occupied 43.48%, 'design problems' were 30.86%, and 'communication problems' were 25.86%. In general, the APJIS reviewers weigh each of these three problem areas almost equally. Comparing to other disciplines like management field shown in Daft's study, the portion of 'design problems' and 'communication problems' are much higher in manuscripts submitted to the APJIS than in those of Administrative Science Quarterly and Academy of Management Journal even though 'theory problems' are the most predominant in both disciplines.

Standard Performance Measurements of GE $Advance^{TM}$ Positron Emission Tomography (GE $Advance^{TM}$ 양전자방출단층촬영기의 표준 성능평가)

  • Jeong, Ha-Kyu;Kim, Hee-Joung;Son, Hye-Kyung;Bong, Jung-Kyun;Jung, Hai-Jo;Jeon, Tae-Joo;Kim, Jae-Sam;Lee, Jong-Doo;Yoo, Hyung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.2
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    • pp.100-112
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    • 2001
  • Purpose: The purpose of this study was to establish optimal imaging acquisition conditions for the GE $Advance^{TM}$ PET imaging system by performing the acceptance tests designed by National Electrical Manufacturers Association (NEMA) protocol and General Electric Medical Systems (GEMS) test procedures. Materials and Methods: Performance tests were carried out with $^{18}FDG$ radioactivity source and phantoms by using a standard acquisition mode. Transaxial resolution and scatter traction tests were performed with a line source and axial resolution with a point source, respectively. A cylindrical phantom made of polymethylmethacrylate (PMMA) was used to measure sensitivity, count rate losses and randoms, uniformity correction, and attenuation inserts were added to measure remaining tests. The test results were acquired in a diagnostic acquisition mode and analyzed mainly on high sensitivity mode. Results: Transaxial resolution and axial resolution were measured as average of 4.65 mm and 3.98 mm at 0 cm, and 6.02 mm and 6.71 mm at 20 cm on high sensitivity mode, respectively. Average scatter fraction was 9.87%, and sensitivity was $225.8kcps/{\mu}Ci/cc$ of trues. Activity at 50% deadtime was $4.6{\mu}Ci/cc$, and the error of count rate correction at that activity was from 1.49% to 3.83%. Average nonuniformity for total slice w3s 8.37%. The accuracy of scatter correction was -0.95%. The accuracies of attenuation correction were 5.68% for air, 0.04% for water and -6.51% for polytetrafluoroethylene (PTFE). Conclusion: The results satisfied most acceptance criteria, indicating that the GE $Advance^{TM}$ PET system can be optimally used for clinical applications.

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Irradiation Preservation of Korean Fish 1. Kadurization of croaker, yellow corvenia and roundnose flounder (방사선조사에 의한 한국산어류의 품질보존에 관한 연구 1. 민어, 참조기 및 물가자미의 감마선 조사 후의 보존특성)

  • CHUNG Jong Rak;KIM Su Ill;LEE Min Chul
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.9 no.2
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    • pp.129-142
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    • 1976
  • Optimum doses The optimum dose that may be defined as the dose below the maximum permissible dose, yet would bring about a significant storage life extension at refrigerated temperatures, varied with species of fish as well as with the postirradiation storage temperatures. Thus the dose of 0. 1 Mrad was considered to be optimum for the croaker and yellow corvenia at $0^{\circ}C$, while at $5^{\circ}C$ the dose of 0.2 Mrad would be suitable for both species. The roundnose flounder was more radiosensitive and even at the dose of 0.1 Mrad a slight irradiation odor was detected immediately after the radiation treatment. Such degree of irradiation odor disappeared upon storage, therefore, the dose of 0.1 Mrad was considered to be optimum for the roundnose flounder at both $0^{\circ}\;and\;5^{\circ}C$. Storage life extension The croaker meats irradiated at 0.1 Mrad could be held at $0^{\circ}C$ as long as 5 weeks in good acceptable conditions, while the unirradiated control became unacceptable within 2 weeks-3-4 for extension of storage life at $0^{\circ}C$. At the storage temperature of $5^{\circ}C$, the storage life of 0.2 Mrad irradiated samples was extended from less than one week to 4 weeks--4-5 fold extension. The storage life extension of 0.1 Mrad irradiated yellow corvenia at $0^{\circ}C$ was from less than 2 weeks for the unirradiated to 4 weeks-approximately a-s folds and that of 0.2 Mrad irradiated samples stored at $5^{\circ}C$ was from 5 days to 3 weeks 4-5 folds. The roundnose flounder meats irradiated at 0.1 Mrad could held at $0^{\circ}C$ for 3-4 weeks as compared to less than 1 week for the unirradiated and at $5^{\circ}C$ the storage life could be extended from less than 3 days to up to 3 weeks. Thus the storage life extension by 4-5 folds and by 6-7 folds was possible at $0^{\circ}C\;and\;5^{\circ}C$ storage, respectively. Postirradiation storage microbiology and biochemistry In general 10 fold reduction of initial microflora was realized as a result of irradiating fish samples at 0.1 Mrad. The extent of microflora reduction increased with increasing doses applied, but not proportionately dependent. The microbial growth in the irradiated was severely retarded during the subsequent storage period, lagging far behind that of the irradiated control samples except in the late storage phase, when the levels of microflora of the irradiated either approached to or rose above the levels of the unirradiated. The microbiological changes caused by irradiation was reflected in the pronounced suppression of TVB and TMA accumulation during the storage period. This suggests that irradiation treatment brought about both quantitative and qualitative changes in microflora initially present and it is reasonable to suggest that the microflora removed by irradiation in fact represent most of the flora capable of producing TVB and TMA in normal fish spoilage process.

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Analysis of Aconitine Contents in Aconiti Radix Lateralis Preparata and Sambutang-P that Contains Aconiti Radix Lateralis Preparata and Single Oral Toxicity Test (포제부자(炮製附子) 및 포제부자(炮製附子) 함유 삼부탕(蔘附湯)의 aconitine 함량 분석과 단회투여 독성시험)

  • Bae, Jeong Hu;Kim, Gyeong Cheol;Shin, Soon Shik;Hwang, Won Deuk
    • Herbal Formula Science
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    • v.25 no.1
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    • pp.11-28
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    • 2017
  • Objectives : The contents of aconitine in aconiti radix lateralis preparata, purified hot water extract of Aconiti Radix lateralis preparata, and purified hot water extract of Sambutang-P that contains Aconiti Radix lateralis preparata was analyzed to compare toxicity. Toxicity of Sambutang-P that contains Aconiti Radix lateralis preparata was assessed with a single oral toxicity test on 6-week-old male and female Sprague-Dawley rats. Methods : 1. The contents of aconitine in Aconiti Radix lateralis preparata, purified hot water extract of Aconiti Radix lateralis preparata, and purified hot water extract of Sambutang-P that contains Aconiti Radix lateralis preparata was analyzed using the purity test according to the "Korean Herbal Pharmacopoeia". 2. 2,000mg/kg was injected for the single oral toxicity test of purified hot water extract of Sambutang-P that contains Aconiti Radix lateralis preparata, and the test was done for a test group (injection) and a control group, each with 5 male and 5 female rats. For 14 days after injection, rats were observed for general symptoms and changes in weight. Afterwards, blood biochemical test, autopsy, and histophathological exam of the liver was conducted. Results : 1. The contents of aconitine was 0.0785% for Aconiti Radix lateralis preparata, 0.1510% for purified hot water extract of Aconiti Radix lateralis preparata, and 0.1248% for purified hot water extract of Sambutang-P that contains Aconiti Radix lateralis preparata. 2. There was no death of either male or female rats in both the control group and the test group (injection of 2,000mg/kg). 3. No unusual symptom was observed in both the control group and the test group (injection of 2,000mg/kg). 4. No significant change in weight was observed for both male and female rats in the test group (2,000mg/kg). 5. The histopathological exam of ALT, AST, ALP, GGT and LDH showed no significant changes for both male and female rats in the test group (2,000mg/kg). 6. According to the autopsy results, no visible abnormality of organs or tissues was found in both the control group and the test group (2,000mg/kg). 7. According to the histopathological exam of the liver, the effect of the injected material was not observed for either male or female rats in the test group (2,000mg/kg). Conclusions : The contents of aconitine in Aconiti Radix lateralis preparata was lower for decoction of Sambutang-P with ginseng radix alba than for decoction of only Aconiti Radix lateralis preparata. This suggests that ginseng radix alba can dilute toxicity of Aconiti Radix lateralis preparata. As for a single oral toxicity test of Sambutang-P that contains Aconiti Radix lateralis preparata, no abnormal reaction was observed even when the injection amount far exceeded a toxic dose or a lethal dose. Thus, it is deemed that using Sambutang-P at a clinically prescribed dose would not lead to hepatoxicity.

Benthic Marine Algae in the East Coast of Korea : Flora, Distribution and Community Structure (한국 동해 연안역의 저서 해조류 : 해조상, 분포 및 군집구조)

  • NAM Ki Wan;KIM Young Sik;KIM Young Hwan;SOHN Chul Hyun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.29 no.5
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    • pp.727-743
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    • 1996
  • To know the floristic composition, vortical distribution and community structure of marine benthic algae inhabiting in the intertidal and subtidal zones of Yongil Bay, east coast of Korea, the study has performed using the quadrat method along a transect line from July, 1995 to June, 1996. In this area, a total of 144 species including 2 new red algae to Korea was found: 5 blue-green, 18 green, 20 brown and 101 red algae. The representative species throughout the year were Ulva pertusa, Gelidium amansii and Symphyocladia latiuscula. Dominant species were Sargassum thunbergii in spring, U. pertusa in summer and autumn. In winter, Chondrus ocellatus and Monostroma grevillei occurred dominantly. The standing crop exhibited mean value as $185.8g/m^2$ dry weight. Maximum value was recorded in spring $(267.3g/m^2)$ and minimum was observed in winter $(93.7g/m^2)$. Shannon's species diversity (H') and evenness (J') as maximum value were recorded in spring, whereas minimum values were shown in winter. Vertical distribution, rerognized by cluster analysis based on relative coverage of the species, could be divided into two or three algal groups except spring. In general, green algae (M. grevillei, Capsosiphon fulvescens, U. pefusa, Enteromorpha compressa) and brown algae (Sargassum fulvellum, S. thunbergii) were represented in the upper and middle zone and red algae (G. amansii, C. ocellatus, S. latiuscula, Crateloupia okamurae, Pachymeniopsis eilliptica) in the lower zone. The algal community varied according to season and environmental conditions. Particularly, seasonal variation of vortical distribution seemed to be affected primarily by water temperature. Also seasonal tidal level and tolerance of algal species to desiccation appeared to be associated with it in this area.

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Developing and testing the reliability of a measurement tool for an urban area food environment in Korea - Focusing on food stores - (우리나라 도시지역의 식환경 측정을 위한 조사도구 개발 및 신뢰도 검정 - 식품상점을 중심으로 -)

  • Jang, Mi Jin;Shin, Sangah;Kim, Seong-Ah;Chung, Sangwon;Paik, Hee Young;Choe, Jeong-Sook;Hong, Eun Joo;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.47 no.5
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    • pp.351-363
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    • 2014
  • Purpose: The aim of this study was to develop a reliable measurement tool to assess the urban food environment, particularly focusing on food stores in Korea. Methods: The items for the measurement tool were selected through systematic literature reviews and adjusted to the Korean food environment. A total of 25 food stores in an urban area were recruited for the pilot test to evaluate the time required for completion of the survey, ease of response, willingness to participate, difficulties in conducting the survey, and appropriateness, and 34 food stores were recruited for assessment of the reliability of the tool using percent agreement and kappa value. Results: The measurement tool is composed of questions regarding food store characteristics, accessibility, and food availability. On average, 26 minutes was required to survey a single food store, and the subjects and interviewers answered that the process was not difficult for the survey. The percent agreement for the inter-rater and test-retest reliability ranged from 93.9~98.8% and 91.9~97.9, respectively. The kappa values ranged from 0.78 to 0.97, which was very high. Percent agreement and kappa value of food with healthy option were lower than those of the general food in the inter-rater reliability (p = 0.0027, p = 0.0095 respectively) as well as in the test-retest reliability (p = 0.0081, p = 0.0290, respectively), although they were still high enough (86.4~98.0% for percent agreement, 0.64~0.96 for kappa value). Conclusion: The newly developed measurement tool for assessment of food store environment appears to be feasible and reliable; therefore, it can be applied to research on the association between food environment and dietary behaviors as well as health outcomes.

The Closure Stage of Cranial Sutures in Correlation with Age (증령적 변화로서의 두개골 봉합의 유합 상태)

  • Ahn, Hyoung-Joon;Sin, Kyoung-Jin;Kwon, Jeong-Seung;Do, Hyung-Joo;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.26 no.4
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    • pp.377-393
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    • 2001
  • In order to study the closure stage of cranial sutures and its correlations with age, the ectocranial closure stage of coronal suture, sagittal suture, and lambdoidal suture of 67 skulls was measured. Among the skulls kept at the department of anatomy, college of medicine, Yonsei University, the ones with ages identified were used for this study. These measurements of suture closure were conducted by 4 examiners independently. The sutures were further divided by Frederic's method into 16 suture parts. The closure stages were classified by five stages of Broca-Ribbe. The following results were obtained: 1. The inter-observer reliability among 4 examiners showed high intraclass correlation coefficient of over 0.75(mean : 0.856) in all suture parts. Therefore, the determination of closure stage wasn't influenced by the subjective view of each examiner. 2. In all suture parts, the closure stage increased proportionally with age.(p<0.01) In terms of each suture part, the S2 part of sagittal suture showed the highest correlation(68.1%) while the L1-R part of lambdoidal suture showed the lowest correlation(51.3%). In addition, in terms of suture types, the correlation with age decreased in the order of sagittal suture(60.0%), coronal suture(57.7%), and lambdoidal suture (55.7%). In general, the average value of suture closure stages had 57.8% correlation with age(p<0.01). 3. The most frequent suture closure stage according to age group was '0' for ages below 30, '0' and '1' for ages within the 30's, '1' and '2' for ages within the 40's, and '2' for ages within the 50's. With older age groups, the frequency of '3' and '4' increased, and the suture closure stage increased proportionally with age. 4. The mean age by closure stage of each suture were within the 40's for the closure stage of '1', within the 50's for the closure stage of '2', and from 50's through 60's for the closure stage of '3'. The standard deviation was over 10 for all closure stages. In addition, at the same suture closure stage, the mean age according to the coronal suture was higher than the ages according to the sagittal suture or lambdoidal suture. Especially, C1-R, C1-L, C2-R, and C2-L parts showed the highest age when at the same suture closure stage. 5. The values appropriate for age estimations using suture closure stages of 16 suture parts were calculated, and a calculator for age estimation ($R^2=0.6944$, p<0.01) by ectocranial suture closure stage for Koreans is presented. From the above results, the method of using the closure stage of sutures of the skull to estimate age can be useful in individual identification of forensic science. Further extensive and accurate research using larger samples would be worthy of study.

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