• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.41-47
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• 2002

Objectives: In a number of simulated night shift studies, timed exposure to bright light improves sleep quality and work performance. We evaluated the effect of bright light on adaptation to night shift work with a field study. Methods: Five female nurses working shifts at Korea University Hospital were recruited for participation in this study. We investigated two series of six consecutive shift rotations comprising three day and three night shifts, using wrist Actigraphy, the Stanford Sleepiness Scale, Visual-analogue scales, STIM and tympanic membrane temperature for daytime sleep quality, alertness, subjective feeling, attention performance, and temperature rhythm. The subjects were exposed to bright light (2,500 lux) from 24:00 to 04:00 a.m. on three consecutive night shifts during the second series, whereas they worked under normal lightening (650 lux) conditions during the first series. Results: Actigraphic assessment of daytime sleep showed no significant difference between the first and third night shift in both baseline and light exposure phase. The mean lowest temperature shifted earlier during baseline phase but not during the light exposure phase. Also, the score for subjective feelings of depression, anxiety, physical discomfort and sleepiness was significantly higher in the third night shift than the first during baseline phase but not during the light exposure phase. Attention and attention switching ability was significantly improved in the third night shift compared to the first night during the light exposure phase but there were no significant changes during the baseline phase. Conclusion: This result suggests that there were no significant differences between the two phases in measures of quality of daytime sleep, but subjective feelings, attention and alertness were enhanced during light exposure. Although some placebo effects and learning effects might influence this result, bright light exposure between midnight and 4:00 a.m. may improve adaptation to night shift. In future, further controlled studies with a larger sample size, including melatonin measurement, are needed for real shift workers.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.334-345
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• 2001

Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

• Asia pacific journal of information systems
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• v.21 no.3
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• pp.71-96
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• 2011

Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

• Korean Journal of Ecology and Environment
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• v.41 no.3
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• pp.348-359
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• 2008

The objectives of the study were to elucidate functional modifications in relation to hydrological, physico-chemical and ecological aspects in Daechung Reservoir by the upper dam constructions of Youngdam Reservoir and analyze temporal and spatial dynamic patterns using trophic parameters of TN, TP, chlorophyll (CHL), and Secchi depth (SD). Hydrological data such as inflow, precipitation, and water levels before (BDC, 1995$\sim$2000) and after (ADC, 2001$\sim$2006) the dam construction showed that precipitation had greater correlations with inflow volume in the BDC (r=0.964, p=0.002) than in the ADC (r=0.857, p=0.029). This outcome indicates that the upper dam construction influenced the inflow and water level of Daechung Reservoir. One of the greatest changes after the dam construction was decreases of nutrient contents (TN, TP) and increases of algal biomass (as CHL) as the water residence time increases. Values of CHL had greater relations with TP in the ADC (r=0.412, p<0.001) than the BDC (r=0.249, p<0.001), indicating that CHL had greater response at a given phosphorus in the ADC. Thus, algal yield at a given TP (CHL : TP ratios) increased in the ADC, resulting in a greater CHL-TP relations. Long-term interannual TP, TN, SD, and CHL showed greater variations in the riverine zone (RZ) than any other transition (TZ) and lacustrine zones (LZ). This phenomenon was mainly attributed to rapid hydrological response in the riverine zone (RZ) to flow reductions (short water residence time) from the upper dam, resulting in ambient contents of nutrients and light regime along with functional relations of CHL-TP.

• Journal of Animal Environmental Science
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• v.18 no.3
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• pp.257-266
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• 2012

Near infrared reflectance spectroscopy (NIRS) has become increasingly used as a rapid, accurate method of evaluating some chemical constituents in cereal and dired animal forages. Analysis of forage quality by NIRS usually involves dry grinding samples. Costs might be reduced if samples could be analyzed without drying or grinding. The objective of this study was to investigate effect of sample preparations on prediction ability of chemical composition and fermentation parameter for Italian ryegrass silages by NIRS. A population of 147 Italian ryegrass silages representing a wide range in chemical parameters were used in this investigation. Samples were scanned at 1nm intervals over the wavelength range 680-2500 nm and the optical data recorded as log 1/Reflectance (log 1/R) and scanned in oven-dried grinding and fresh ungrinding condition. The spectral data were regressed against a range of chemical parameters using partial least squares (PLS) multivariate analysis in conjunction with four spectral math treatments to reduced the effect of extraneous noise. The optimum calibrations were selected on the basis of minimizing the standard error of cross validation (SECV) and maximizing the correlation coefficient of cross validation (${R^2}_{CV}$). The results of this study show that NIRS predicted the chemical parameters with high degree of accuracy in oven-dried grinding treatment except for moisture contents. Prediction accuracy of the moisture contents was better for fresh ungrinding treatment (SECV 1.37%, $R^2$ 0.96) than for oven-dried grinding treatments (SECV 4.31%, $R^2$ 0.68). Although the statistical indexes for accuracy of the prediction were the lower in fresh ungrinding treatment, fresh treatment may be acceptable when processing is costly or when some changes in component due to the processing are expected. Results of this experiment showed the possibility of NIRS method to predict the chemical composition and fermentation parameter of Italian ryegrass silages as routine analysis method in feeding value evaluation and for farmer advice.

• Applied Microscopy
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• v.38 no.3
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• pp.175-183
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• 2008

Liver regeneration is a result of highly coordinated proliferation of hepatocytes and non-parenchymal liver cells. At this process, induction of metallothionein (MT), which is low molecular and cysteine rich, has been reported. The present study was carried to find the ultrastructure of hepatocytes and determine the expression of MT in regenerating rat liver after partial hepatectomy. As a result, the remnant liver after PH grew fast from 1 day until 7 days. Various changes were morphologically observed. Disintegration of cell plates and liver lobule appeared shortly after PH. And hepatocytes showed the rapid proliferation, characterized by high nuclear cytoplasmic ratio, weak intercellular junctional complexes, chromatin condensation, increase of ribosomes and mitochondria, and temporary increase of lipid droplets. Finally, remodeling of the liver lobule was completed through the rearrangement of blood vessels and cell plates by 7 days after PH. On histochemistry, immunoreactivity indicating the presence of MT appeared moderately throughout the cytoplasm of control rat hepatocyte. After PH, positive reactions for MT increased at the cytoplasm and the nucleus. These results suggest that the remnant liver cells immediately entered cell proliferation and increase of MT expression after PH. It is thought that MT protein might be associated with transfer of some factors needed to cell division from the cytoplasm to the nucleus for regeneration of the liver after PH.

• Korean Journal of Poultry Science
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• v.34 no.2
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• pp.91-97
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• 2007

To evaluate the physiological status of laying flocks, the blood chemistry values were measured and analyzed in various ages under different feeding conditions. Total 671 birds from 48 Hyline brown hens flocks from 13 different poultry farms were bled at the ages of day(s) 1, 11, 21, 50, 80, 120, 180, 240, 300, 400, and 500. The 17 blood chemistries including glucose, lipids, proteins, enzymes, electrolytes and metabolic by-products were measured with an autoanalyzer. Blood glucose showed the highest at the hatching day not relate with the dietary carbohydrates and energy, but tended to decrease during the rest of growth stage in hens. Total blood protein, albumin and globulin increased depending on the ages even though dietary protein was decreased. Blood lipid was greatly changed at different growth stages. Cholesterol was the highest at hatching period and maintained consistently until the 120 days of age. It was increased in birds after 180 days of age. HDL was also highest in hatchery, but decreased greatly after 180 days of age. However, TG was the lowest at one day old, but was increased up to 10 times after 180 days of age compared to that of one day old. The enzyme activities were different. AST, ALT, and GGT showed comparatively contained consistently, whereas amylase was slowly decreased. Blood P, Na, K and Cl showed consistency, but Ca content was increased upto two times of the one day of age. The results from this study showed that the blood chemistry values were affected by the general metabolic status of the host with ages not by feeding conditions. Further, the standard data of age-dependent blood chemistry values in the laying flocks were obtained, which can be utilized for early detection of the changes in the physiological status occurred by the infectious or metabolic diseases. The results of these analyses seemed to be useful to increase the productivity of laying flocks through rapid and proper veterinary medical treatments.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.267-275
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• 1998

Purpose : We have studied the changes of cardiac troponin I(cTnI) level and left ventricular ejection fraction(LVEF) before and after treatment of IVGG to evaluate the efficacy of single high dose of intravenous gammaglobulin(IVGG)(2.0gm/kg) therapy for improving cardiac function and clinical symptoms and signs in patients with clinically suspected acute myocarditis. Methods : The patients consisted of 18 cases who admitted increased cTnI with clinically suspected acute myocarditis caused by viral infection, Kawasaki disease and fever unknown origin(FUO) from Jan. 1995 to Jun. 1998. The control group consisted of 20 cases suffered from hand-foot-mouth disease, herpangina and high fever with rash. The level of cTnI was measured by Chemiluminiscent immunoassay method(normal<0.1ng/ml) and cardiac function was evaluated by left ventricular ejection fraction(LVEF)(normal 64~83%) by echocardiogram. Results : The level of cTnI increased to $0.306{\pm}0.209ng/ml$ and LVEF decreased to $60.1{\pm}1.6%$ before treatment of IVGG significantly as compared with control group(P<0.05). All cases were returned to normal range of LVEF($71.4{\pm}3.7%$) and decreased cTnI significantly($0.089{\pm}0.082ng/ml$) after treated with IVGG within 1 week in patients group(P<0.05). Conclusion : The single high dose of IVGG(2.0gm/kg) therapy was rapid and effective improvement of cardiac function and clinical symptoms and signs of acute myocarditis, and the measurement of serum cTnI and LVEF may help to diagnose and evaluate efficacy of IVGG on it.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.441-446
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• 2001

Flumazenil is a competitive antagonist of benzodiazepines. It is usually administered intravenously. However, if the intravenous route is not available then other routes of drug administration should be considered. This study was designed to evaluate the reversal effects of flumazenil after nasal administration. Twenty-five young, healthy adult volunteers participated in this clinical trial. The dosage of 0.08mg/kg midazolam was administered intravenously to induce deep sedation. Ten minutes after midazolam administration, 0.5mg of flumazenil was dropped nasally, over a period of one minute. Blood samples were taken to measure the concentration of midazolam and flumazenil at 0, 5, 10, and 20min after nasal administration of flumazenil, using High Performance Liquid Chromatography. The degree of sedation was evaluated with sedation score and bispectral index (BIS), Statistical analysis was performed by multivariate ANOVA and correlation analysis (P<0.05). Peak serum flumazenil concentration was reached in 10min. Sedation score decreased after midazolam administration and showed a significant increase after flumazenil administration. However, BIS decreased during the first 10min after midazolam administration and then no significant changes after flumazenil administration. There were two instances representing rapid and complete reversal of midazolam after intranasal administration of flumazenil. In conclusion, intranasal flumazenil administration may be effective in some patients when intravenous route is not available in condition of benzodiazepine overdose.

• The Korean Journal of Air & Space Law and Policy
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• v.4
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• pp.7-35
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• 1992

The expansion of air transport on a global scale with ever increasing traffic densities has brought about problems that must be solved through new multilateral mechanisms. Looking to the immediate future, air transport will require new forms of international cooperation in technical and economic areas. Air transport by its very nature should have been a counterforce to nationalism. Yet, the regulatory system in civil aviation is still as firmly rooted in the principle of national sovereignty as when it was first proclaimed at t-11e Paris Convention of 1919 and reaffirmed in the Chicago Convention. Sovereignty over the airspace has remained the cornerstone of relations between states in all respects of air transport. The importance of sovereignty over air space embodied in article 1 of the Chicago Conrenton also is responsible for restricting the authority of ICAO as an intergovernmental regulatory agency. The Orgenization, for all its extensive efforts, has only limited authority. ICAO sets standards but cannot enforce them; it devises solutions but cannot impose them. To implement its rules ICAO most rely not so much on legal requirements as on the goodwill of states. It has been forty-eight years since international community set the foundations of the international system in civil aviation action. Profound political, economic and technological changes have taken place in air transport. The Chicago Convention is living proof that staes can work together to make air transport a safe mode of travel. The law governing international civil auiation is principally based on international treaties and on other regulation agreed to by governments, for the most part through the mechanism of ICAO. The role of ICAO international standards and recommended practices and procedures dealing with a broad range of technical matters could hardly be overestimated. The organization's ability to develop these standards and procedures, to adapt them continuously to the rapid sate of change and development of air transport, should be particularly stressed. The role of ICAO in the area of the development of multilateral conventions on international air law has been successful but to a certain degree. From the modest starting-point of the Tokyo Convention, we have seen more adequate international instruments prepared within the scope of ICAO activities, adopted: the Hague Convention of 1970 for the suppression of Unlawful Seizure of Aircraft and the Montreal Convention of 1971 for the Suppression of Unlawful Acts against the Safety of Civil Aviation. The work of ICAO in the new domain of international law conventions concerning what has been loosely termed above as the criminal problems connected with international air transport, in particular the problem of armed aggression against aircraft, should be positively appreciated. But ICAO records in the domain of developing a uniform legal system of international carriage by air are rather disappointing. The problem of maintaining and developing the uniformity of this regulation exceeds the scope of interest and competence of governmental transport agencies. The expectations of mankind linked to it are too great to give up trying to restore the uniform legal system of international air carriage that would create proper conditions for its further growth. It appears that ICAO has, at present, a good opportunity for doing this. The hasty preparation of ICAO draft conventions should be definitely excluded. Every Preliminary draft convention ought to be sent to Governments of all member-States for consideration, So that they could in form ICAO in due time of their observation. The problom of harmonizing a uniform law of international air carriage with that of other branches of international transport should demand more and more of its attention. ICAO cooperation with other international arganization, especially these working in the field of international transport, should be strengthened. ICAO is supposed to act as a link and a mediator among, at times the conflicting interests of member States, serving the happiness and peace of all of the world. The transformation of the contemporary world of developing international relations, stimulated by steadily growing international cooperation in its various dimensions, political, economic, scientific, technological, social and cultural, continuously confronts ICAO with new task.