• Journal of Chest Surgery
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• v.41 no.5
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• pp.610-618
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• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

• Journal of Pharmacopuncture
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• v.5 no.1 s.8
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• pp.113-133
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• 2002

Objective: To investigate effects of Cervi Cornu on Adjuvant Athritis in rats, the edema inhibit rate, the anaJgesic effects, the number of WBC, RA facter, Platelet, the quantity of CRP, total protein, albumin and globuline in the blood serum were measured in the arthritis part. Results: The results obtained as fonows ; 1. After arthritis of Sprague dawley(SD) rats was induced by injecting Freund's complete adjuvant for 2 weeks, any treatment was not for Control group, acupunctured for Treat Ⅰ group. normal saJine was ora] administrated for the Treat Ⅱ group, Cervi Cornu Ex. was oral administrated for Treat Ⅲ, and Cervi Cornu Herbal-acupullcture was injected for Trea Ⅳ group during 2 weeks every other day. Selected point was on pressure pain point in both groups. And then the edema inhibit rate were checked. The edema inhibit rate was $46.03\%$ in Treat I group, $43.24\%$ Treat IV group, $37.44\%$ in Treat III. there was significance in the edema inhibit rate between Control group and Treat group, in order of Treat Ⅰ, Ⅳ, Ⅲ.(p<0.05) 2. The analgesic effects was $7.58{\pm}1.80$(${\times}10$gm) in Control group. $11.00{\pm}1.10$(${\times}10$gm) in Treat Ⅰ group. $99.92{\pm}1.28$(${\times}10$gm) in Treat Ⅲ group and $14.67{\pm}1.03$(${\times}10$gm) in Treat Ⅳ group. There was significance in the analgesic effects between Control group and Treat group(p<0.05) 3. The number of WBC was $14.72{\pm}1.48$(${\times}10^3$㎕) in control Group, $10.26{\pm}1.13$(${\times}10^3$㎕) in Treat Ⅰ group, $11.00{\pm}1.13$(${\times}103$㎕) in Treat Ⅱ Group and $9.63{\pm}1.75$(${\times}10^3$㎕) in Treat Ⅳ group. There was significance in the number of WBC between Control group and Treat group(p<0.05) 4. The content of total protein in the blood serum were $6.13{\pm}0.05$g/dl in control group, $5.73{\pm}0.14$g/dl in Treat I group, $5.88{\pm}0.13$g/dl in Treat Ⅲ group and $5.90{\pm}0.13$g/dl in Treat IV group. There was significance in The content of total protein in the blood serum between Control group and Treat group(p<0.05) 5. The contests of albumin in the blood serum were $2.32{\pm}0.12$g/dl in the Control group, $2.35{\pm}0.05$g/dl in Treat Ⅰ group, $2.35{\pm}0.05$g/dl in Treat Ⅱ group, $2.30{\pm}0.06$g/dl in Treat Ⅲ group, $2.42{\pm}0.08$g/dl in Treat IV group. There was no significance in The content of albumin in the blood serum between Control group and Treat group(p<0.05) 6. The contests of globulin in the blood semm were $3.68{\pm}0.08$g/dl in the Control group, $3.43{\pm}0.12$g/dl in Treat Ⅰ group, $3.55{\pm}0.10$g/dl in Treat IV group. There was significance in The content of globulin in the blood serum between Control group and Treat group(p<0.05) 7. The numbers of RA factor were $3.47{\pm}0.54$IU/ml in Control group and $2.38{\pm}0.50$IU/ml in Treat Ⅱ group. There was significance inThe numbers of RA factor between Control group and Treat group(p<0.05) 8. The numbers of platelet were $1126.33{\pm}1126.33{\pm}85.93{times}10^3$/㎕ in Control group, $1043.33{\pm}80.80{times}10^3$/㎕ in Treat Ⅰ group, $1116.82{\pm}77.93{times}10^3$/㎕ in Treat Ⅱ group, $1164.17{\pm}94.02{times}10^3$/㎕l in Treat Ⅲ group, $1076.67{\pm}54.84{times}10^3$/㎕ in Treat Ⅳ group. There was no significance in The numbers of platelet between Control group and Treat group(p<0.05) 9. The quantity of CRP were $0.05{\pm}0.01$mg/ml in Control group, $0.05{\pm}0.01$mg/ml in Treat Ⅰ group, $0.06{\pm}0.01$mg/ml in Treat Ⅱ group, $0.05{\pm}0.00$mg/ml in Treat Ⅲ group, $0.05{\pm}0.00$mg/ml in Treat Ⅳ group. There was no significance in The quantity of CRP between Control group and Treat group(p<0.05) Concluslon : From these results, it is shown Cervi Comu Herbal-acupuncture more efffective thaJJ Cervi Cornu Ex. on Adjuvant Arthritis in rats.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.576-587
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• 2009

Background: The up-regulation of the nitric oxide (NO)-cGMP pathway might be involved in the change of vascular reactivity in rats 3 days after they suffer acute myocardial infarction. However, the underlying mechanism for this has not been clarified. Material and Method: Acute myocardial infarction (AMI) was induced by occluding the left anterior descending coronary artery (LAD) for 30 min (Group AMI), whereas the sham-operated control rats were treated similarly without LAD occlusion (Group SHAM), The concentration-response relationships for phenylephrine (PE), KCl, acetylcholine (Ach) and sodium nitroprusside (SNP) were determined in the endothelium intact E(+) and endothelium denuded E(-) thoracic aortic rings from the rats 3 days after AMI or a SHAM operation. The concentration-response relationships of PE in the E(+) rings from the AMI rats were compared with those relationships in the rings pretreated with nitric oxide synthase (NOS) inhibitor $N{\omega}$-nitro-L-arginine methyl ester (L-NAME) or the cyclooxygenase inhibitor indomethacin. The plasma nitrite/nitrate concentrations were checked via a Griess reaction. The cyclic GMP content in the thoracic aortic rings was measured by radioimmunoassay and the endothelial nitric oxide synthase (eNOS) mRNA expression was assessed by real time PCR. Result: The mean infarct size (%) in the rats with AMI was $21.3{\pm}0.62%$. The heart rate and the systolic and diastolic blood pressure were not significantly changed in the AMI rats. The sensitivity of the contractile response to PE and KCl was significantly decreased in both the E(+) and E(-) aortic rings of the AMI group (p<0.05). L-NAME completely reversed these contractile responses whereas indomethacin did not (p<0.05). Moreover, the sensitivity of the relaxation response to Ach was also significantly decreased in the AMI group (p<0.05). The plasma nitrite and nitrate content (p<0.05), the basal cGMP content (p<0.05) and the eNOS mRNA expression (p=0.056) in the AMI rats were increased as compared with the SHAM group. Conclusion: Our findings indicate that the increased eNOS activity and the up-regulation of the NO-cGMP pathway can be attributed to the decreased contractile or relaxation response in the rat thoracic aorta 3 days after AMI.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.177-185
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• 1994

Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

• Korean Journal of Food Science and Technology
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• v.42 no.4
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• pp.475-480
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• 2010

The fruit of Actinidia polygama, Mock-chun-ryo in Korea, has been used as traditional medicine for abdominal pain, rheumatic arthritis, and stroke. In a previous study, the ethanol extract of A. polygama Max. showed antiinflammatory activity in RAW 264.7 cells. In this study, we investigated the anti-inflammatory and anti-atherosclerosis effects of supercritical fluid marc extracts from A. polygama Max. Anti-inflammatory extracts were produced from supercritical fluid extraction of the silver vine under the following conditions; pressure, 1,500-4,500 psi, temperature $35-55^{\circ}C$ and extraction time 1-2 hr. To evaluate the anti-inflammatory and anti-atherosclerotic effects of the extracts, we studied nitric oxide (NO), prostaglandin $E_2$ ($PGE_2$), and tumor necrosis factor-alpha (TNF-$\alpha$) levels in RAW 264.7 cells and MMP-9 activity in human aortic smooth muscle cells (HASMC). The Marc 11 extract inhibited the production of NO, $PGE_2$, and TNF-$\alpha$ by lipopolysaccharide in RAW 264.7 cells. Moreover, the marc 11 extract inhibited TNF-$\alpha$-induced MMP-9 activity in HASMC. These results indicate that the Marc 11 extract of A. polygama Max. has the potential for use as an anti-atherosclerosis agent.

• Sleep Medicine and Psychophysiology
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• v.6 no.2
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• pp.126-132
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• 1999

Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.

• Journal of the Korean Society of Radiology
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• v.15 no.5
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• pp.629-636
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• 2021

The purpose of this study was to identify the effects of mammo pad made of different kinds of materials on the reduced inconvenience and compression pains of patients to examine plausible interchangeability of existing pads made of single kind of material, and to examine the changes in pains of patients taking mammography and various factors therein. The high-hardness and highly-elastic mammo pressure pads, capable of replacing existing mammo pad of "H" company, were manufactured, and the display quality of mammography obtained from respective mammo pad were compared to each other to appraise the availability of manufactured mammo pad. In addition, 200 patients, who came to a general hospital in Seoul, were selected as subjects for the survey employing a questionnaire which was distributed to the subjects from December 2018 to March 2020 to identify the factors involved with the mammo pad of patients while taking mammography. The results of mammography obtained from both of the existing and newly manufactured mammo pad revealed appropriate display qualities fell within the range of clinical criteria. Besides, the factors associated with changing compression pains of patients taking mammography were analyzed wherefrom the general factors in the following order of age, height, and BMI index appeared, while the experiential and female factors appeared as in the following order: presence of menstruation, experience of child-birth, experience of breast feeding, menopause, grade of breast, shape of breast, and experience of mammography. In conclusion, the following factors comprising the age, experience of breast feeding, experience of mammography, and menopause rendered approximately 54% of power of explaining the degree of changing pains during mammography. Regarding the changes in compression pains while taking mammography, the increasing experience of mammography of patients rendered approximately 0.26 times more at the intermediate range of compression pains and approximately 0.14 times more at the range of severe pains.

• Korean Journal of Heritage: History & Science
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• v.50 no.4
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• pp.122-147
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• 2017

The Jungsandong sites are distributed across quartz and mica schist formations in Precambrian, and weathering layers include large amounts of non-plastic minerals such as mica, quartz, felspar, amphibole, chlorite and so on, which form the ground of the site. Neolithic pottery from Jungsandong exhibits various brown colors, and black core is developed along the inner part for some samples, and sharp comb-pattern and hand pressure marks can be observed. Their non-plastic particles have various composition, size distribution, sorting and roundness, so they are classified into four types by their characteristic mineral compositions. I-type (feldspar pottery) is including feldspar as the pain component or mica and quartz. II-type (mica pottery) is the combination of chloritized mica, talc, tremolite and diopside. III-type (talc pottery) is with a very small amount of quartz and mica. IV-type (asbestos pottery) is containing tremolite and a very small amount of talc. The inner and outer colors of Jungsandong pottery are somewhat heterogeneous. I-type pottery group shows differences in red and yellow degree, depending on the content of feldspar, and is similar to III-type pottery. II-type is similar to IV-type, because its red degree is somewhat high. The soil of the site is higher in red and yellow degree than pottery from it. The magnetic susceptibility has very wide range of 0.088 to 7.360(${\times}10^{-3}$ SI unit), but is differentiated according to minerals, main components in each type. The ranges of bulk density and absorption ratio of pottery seem to be 1.6 to 1.7 and 13.1 to 26.0%, respectively. Each type of pottery shows distinct section difference, as porosity and absorption ratio increase in the order as follows: I-type (organic matter fixed sample) < III-type and IV-type < I-type < II-type (including IV-type of IJP-15). The reason is that differences in physical property occur according to kind and size of non-plastic particles. Although Jungsandong pottery consists of mixtures of various materials, the site pottery has a geological condition on which all mineral composition of Jungsandong pottery can be provided. There, it is thought that raw materials can be supplied from weathered zone of quartz and mica schist, around the site. However, different constituent minerals, size and rock fragments are shown, suggesting the possibility that there can be more raw material pits. Thus, it is estimated that there may be difference in clay and weathering degree.

• Journal of Ginseng Research
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• v.48 no.5
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• pp.504-510
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• 2024

Background: As a physiological function of body, immunity can maintain health by identifying itself and excluding others. With economic development and increasingly fierce social competition, the number of sub-healthy population is gradually increasing, and the most basic problem exposed is human hypoimmunity. Hypoimmunity can be manifested as often feeling tired, catching colds, mental depression, etc. In order to enhance immunity, eating healthy foods with the effect of enhancing immunity may become an effective choice. KRG has pharmacological effects of enhancing immunity. Because the screening and evaluation method of immune population are not unified, there are relatively few KRG immunity tests for sub-health population. It is of great significance to study the effect of KRG on people with hypoimmunity to improve sub-health status. Methods: This was a 180-day, randomized, double-blind, placebo-controlled clinical trial. According to the trial scheme design, 119 qualified subjects were included and randomly divided into the test group taking KRG and the placebo control group. Subjects need to check safety indicators (blood pressure and heart rate, blood routine, liver and kidney function, urine routine and stool routine) and efficacy indicators (main and secondary) inspection at baseline, efficacy indicators inspection during the mid-term of the test (90th days of administration), safety and efficacy indicators inspection after the test (180th days of administration). Results: After the test, the safety indicators of placebo control group and KRG test group were basically within the normal range, and there is no significant difference in fireness score between the two groups. Through follow-up interviews, it was found that the subjects in the test group and the control group had no adverse reactions and allergic reactions such as nausea, flatulence, diarrhea, and abdominal pain during the test period. Self-comparison of the test group, the results of the main efficacy indicators: (1) immune related health scores were significantly improved in the mid-term and after the test (P < 0.01), (2) CD3 and CD4/CD8 increased significantly after the test (P < 0.05), (3) IgG, IgA, IgM and WBC increased significantly in the mid-term and after the test (P < 0.01); the results of the secondary efficacy indicators: (1) TNF-α decreased significantly in the midterm (P < 0.05), IFN-γ decreased significantly in the mid-term (P < 0.01), (2) NK increased significantly in the mid-term and after the test (P < 0.05), (3) monocyte increased significantly in the mid-term and after the test (P < 0.01). Inter-group comparison of the test group and the control group, the results of the main efficacy indicators: (1) immune related health scores were higher than that of the control group in the mid-term and after the test (P < 0.01), (2) IgA of the test group was higher than that of the control group in the mid-term and after the test (P < 0.05); the results of the secondary efficacy indicators: (1) WBC of the test group was higher than that of the control group in the mid-term (P < 0.05); (2) monocytes of the test group were higher than that of the control group in the mid-term and after the test (P < 0.05), neutrophils of the test group were higher than that of the control group in the mid-term (P < 0.05). Conclusion: Taking KRG has no adverse effects on the health of the subjects. According to the standard of clinical trial scheme, the immune related health scores and IgA in the main efficacy indicators were positive, which shows that KRG is helpful in enhancing human immunity.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.