• Title/Summary/Keyword: under-nutrition

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Comparison of Reconstruction Methods after Distal Gsstrectomy for Gastric Carcinoma in Terms of the Long Term Physiologic Function and Nutritional Status; Billroth I Gastroduodenostomy versus Roux-en Y Gastrojejunostomy (수술 후 장기적인 생리적 기능과 영양적 측면에서 본 원위부위절제술 후 재건술식의 비교; Billroth I 위십이지장문합술과 Roux-en Y 위공장문합술의 비교)

  • Jeong, Oh;Oh, Sung-Tae;Yuk, Jung-Hwan;Choi, Ji-Eun;Kim, Kab-Jung;Lim, Jung-Taek;Park, Gun-Chun;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.88-96
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    • 2007
  • Purpose: The only curative treatment for gastric carcinoma is surgery and it is still under debate which reconstruction method is better after performing gastrectomy for gastric carcinoma. The typical reconstruction methods after distal gastrectomy are Billroth I, Billroth II and Roux-en Y reconstruction. Yet it is difficult to compare these methods and not so much is known about which reconstruction is better in terms of the physiologic and nutritional function. With this background, we compared two reconstruction methods after distal gastrectomy (Billroth I versus Roux-en Y reconstruction) in terms of the long term physiologic function and nutritional status to create a reference for selecting reconstruction methods after distal gastrectomy. Materials and Methods: Between 1999 and 2002, 663 patients who underwent distal gastrectomy for early gastric carcinoma filled out questionnaires every six months after operation, and these questionnaires evaluated the physiologic function. To evaluate their nutritional status, blood tests were performed every six months to check their albumin, protein and hemoglobin levels, and we checked the body weight every 6 months as well. Results: The total score of the 15 questions on the questionnaire concerned with the physiologic function showed no difference between the two groups at every evaluation time, and both groups showed very low total scores, indicating tolerable physiologic function after operation. When comparing each question between two the groups, only symptoms of regurgitation and food passage showed a difference between the two groups, showing that the Roux-en Y group had better function in terms of these two symptoms. The Billroth I group showed a better nutrition status, indicating that the level of albumin, protein and hemoglobin were higher in the Billroth I group, with statistical significance. Body weight loss was severe in the Roux-en Y group. Conclusion: The physiologic function is slightly better in the Roux-en Y group in terms of some symptoms such as regurgitation and food passage. However, the nutritional status is better in the Billroth I group. In conclusion, because we cannot definitely ascertain which reconstruction is better when we consider both the physiologic and nutritional functions, it is reasonable that surgeon should choose reconstruction methods according to their experience and preference.

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Review of Production, Husbandry and Sustainability of Free-range Pig Production Systems

  • Miao, Z.H.;Glatz, P.C.;Ru, Y.J.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.11
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    • pp.1615-1634
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    • 2004
  • A review was undertaken to obtain information on the sustainability of pig free-range production systems including the management, performance and health of pigs in the system. Modern outdoor rearing systems requires simple portable and flexible housing with low cost fencing. Local pig breeds and outdoor-adapted breeds for certain environment are generally more suitable for free-range systems. Free-range farms should be located in a low rainfall area and paddocks should be relatively flat, with light topsoil overlying free-draining subsoil with the absence of sharp stones that can cause foot damage. Huts or shelters are crucial for protecting pigs from direct sun burn and heat stress, especially when shade from trees and other facilities is not available. Pigs commonly graze on strip pastures and are rotated between paddocks. The zones of thermal comfort for the sow and piglet differ markedly; between 12-22$^{\circ}C$ for the sow and 30-37$^{\circ}C$ for piglets. Offering wallows for free-range pigs meets their behavioural requirements, and also overcomes the effects of high ambient temperatures on feed intake. Pigs can increase their evaporative heat loss via an increase in the proportion of wet skin by using a wallow, or through water drips and spray. Mud from wallows can also coat the skin of pigs, preventing sunburn. Under grazing conditions, it is difficult to control the fibre intake of pigs although a high energy, low fibre diet can be used. In some countries outdoor sows are fitted with nose rings to prevent them from uprooting the grass. This reduces nutrient leaching of the land due to less rooting. In general, free-range pigs have a higher mortality compared to intensively housed pigs. Many factors can contribute to the death of the piglet including crushing, disease, heat stress and poor nutrition. With successful management, free-range pigs can have similar production to door pigs, although the growth rate of the litters is affected by season. Piglets grow quicker indoors during the cold season compared to outdoor systems. Pigs reared outdoors show calmer behaviour. Aggressive interactions during feeding are lower compared to indoor pigs while outdoor sows are more active than indoor sows. Outdoor pigs have a higher parasite burden, which increases the nutrient requirement for maintenance and reduces their feed utilization efficiency. Parasite infections in free-range pigs also risks the image of free-range pork as a clean and safe product. Diseases can be controlled to a certain degree by grazing management. Frequent rotation is required although most farmers are keeping their pigs for a longer period before rotating. The concept of using pasture species to minimise nematode infections in grazing pigs looks promising. Plants that can be grown locally and used as part of the normal feeding regime are most likely to be acceptable to farmers, particularly organic farmers. However, one of the key concerns from the public for free-range pig production system is the impact on the environment. In the past, the pigs were held in the same paddock at a high stocking rate, which resulted in damage to the vegetation, nutrient loading in the soil, nitrate leaching and gas emission. To avoid this, outdoor pigs should be integrated in the cropping pasture system, the stock should be mobile and stocking rate related to the amount of feed given to the animals.

THE TASTE COMPOUNDS FERMENTED ACETES CHINENSIS (새우젓의 정미성분에 관한 연구)

  • CHUNG Seung-Yong;LEE Eung-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.9 no.2
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    • pp.79-110
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    • 1976
  • In Korea fermented fish and shellfish have traditionally been favored and consumed as seasonings or further processed for fish sauce. Three major items in production quantity among more than thirty kinds which are presently available in the market are fermented anchovy, oyster and small shrimp. They are usually used as a seasoning mixture of Kimchi in order to provide a distinctive flavor. Fermented small shrimp, Acetes chinensis is most widely and largely used ana occupies an important position in food industry of this country. But no study on its taste compounds has been reported. This study was attempted to establish the basic data for evaluating taste compounds of fermented small shrimp. The changes of such compounds during fermentation as free amino acids, nucleotides and their related compounds, TMAO, TMA, and betaine were analysed. In addition, change in microflora during the fermentation under the halophilic circumstance was also investigated. The samples were prepared with three different salt contents of 20, 30 and $40\%$ to obtain the proper degree of fermentation at a controlled tempeature of $20{\pm}2^{\circ}C$. The results are summarized as follows: Volatile basic nitrogen increased rapidly until 108 days of fermentation and afterwards it tended to increase slowly. Amino nitrogen also increased rapidly until 43 days of fermentation and then increased slowly. Extract nitrogen increased and marked the maximum value at 72 day fermentation and then decreased slowly. ADP, AMP and IMP tended to degrade rapidly while hypoxanthine increased remarkably at 27 day fermentation but slightly decreased at 72 day fermentation. It is presumed that the characteristic flavor of fermented small shrimp might be attributed to the relatively higher content of hypoxanthine. In the free amino acid composition of fresh small shrimp abundant amino acids were proline, arginine, alanine, glycine, lysine, glutamic acid, leucine, valine and threonine in order. Such amino acids like serine, methionine, isoleucine, phenylalanine, aspartic acid, tyrosine and histidine were poor. In small shrimp extract, proline, arginine, alanine, glycine, lysine and glutamic acid were dominant holding $18.5\%,\;14.6\%,\;10.8\%,\;8.7\%,\;8.1\%\;and\;7.7\%$ of total free amino acids respectively. The total free amino acid nitrogen in fresh small shrimp was $63.9\%$ of its extract nitrogen. The change of free amino acid composition in the extract of small shrimp during fermentation was not observed. Lysine, alanine glutamic acid, proline, glycine and leucine were abundant in both fresh sample and fermented products. The increase of total free amino acids during 72 day fermentation reached approximately more than 2 times as compared with that of fresh sample and then decreased slowly. Fermented small shrimp with $40\%$ of salt was too salty to be commercial quality as the results of organoleptic test showed. It is found that 72 day fermentation with $20\%\;and\;30\%$ of salt gave the most favorable flavor. It is convinced that the characteristic flavor of fermented small shrimp was also attributed to such amino acids as lysine, proline, alanine, glycine and serine known as sweet compounds, as glutamic acid with meaty taste, and as leucine known as bitter taste. The amount of betaine increased during fermentation and reached the maximum at 72 day fermentation and then decreased slowly TMA increased while TMAO decreased during fermentation. The amount of TMAO nitrogen in fermented small shrimp was $200mg\%$ on moisture and salt free base. Betaine and TMAO known as sweet compounds were abundant in fermented small shrimp. It is supposed that these compounds could also play a role as important taste compounds of fermented small shrimp. At the initial stage of fermentation, Achromobacter, Pseudomonas, Micrococcus denitrificans which belong to marine bacteria were isolated. After 40 day fermentation, they disappeared rapidly while Halabacterium, Pediococcus, Sarcian, Micrococcus morrhuae and the yeasts such as Saccharomyces sp. and Torulopsis sp. dominated. It is concluded that the most important taste compounds of fermented small shrimp were amino acids such as lysine, proline, alanine, glycine, serine, glutamic acid, and leucine, betaine, TMAO and hypoxanthine.

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Distribution of Trypsin Indigestible Substrate(TI) in Seafoods and Its Changes during Processing 3. Changes in TI and Protein Quality of Salted and Dried Yellow Corvenia(Pseudosciaena manchurica) during Processing and Storage (어견류의 Trypsin활성 저해물질의 분포와 가공중의 변화 3. 염건조기 가공저장중의 TI 및 단백질품질변화)

  • LEE Kang-Ho;KWON Hae-Ran;RYU Hong-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.17 no.2
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    • pp.109-116
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    • 1984
  • In order to assess the protein nutritional quality of salted and dried yellow corvenia, which was prepared using the different salting methods like dry and brine salting, the changes of trypsin indigestible substrate(TI) and in vitro apparent protein digestibility were studied during storage at room temperature($24{\pm}1^{\circ}C$). It was also examined the retention of available lysine and formation of nonenzymatic brown pigments under the same conditions of preparing and storage mentioned above and confirmed the relationship between in vitro digestibility and the antinutritional factors, such as nonenzymatic browning, unavailability of lysine and TI content, TI content was gradually increased during the storage and in showed $1.5{\sim}2$ times more after 57 days storage than at the initial stage which ranged from 0.11 to 0.17mg/g solid. Of all the products, $25\%$ brine salting product contained the least TI content in 0.21 mg/g solid, while $10\%$ dry salting products was the most abundant in 0.30 mg/g solid using Hamerstrand method(1981). In vitro protein digestibility of all dried products was decreased significantly up to 30 days as the contents of TI increased, except $25\%$ brine salted products. After storing for 57 days, the in vitro digestibility was only $4\%$ drip showed in $25\%$ brine salted products. The nonenzymatic brown pigments were also developed on the level of available lysine reduced as in vitro protein digestibility was decreased throughout storage. Of all the various salted and dried products of yellow corvenia, $25\%$ salting product showed the lowest rate of browning development and loss of available lysine. Therefore, it was revealed that unavailability of lysine and development of nonenzymatic brown pigments were major factors influencing the protein quality in salted and dried yellow corvenia.

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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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Microwave Vacuum Drying of Germinated Colored Rice as an Enzymic Health Food (효소식품으로서 발아유색미의 마이크로파 진공건조)

  • Kim, Suk-Shin;Kim, Sang-Yong;Noh, Bong-Soo;Chang, Kyu-Seob
    • Korean Journal of Food Science and Technology
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    • v.31 no.3
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    • pp.619-624
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    • 1999
  • This work was to study the potential health food use of germinated colored rice after germinating and drying using microwave under vacuum. Colored rice was soaked in water at $15^{\circ}C$ for 2 days and then germinated at $25^{\circ}C$ for $3{\sim}4\;days$. The germinated colored rice was dried by different drying methods: microwave vacuum drying 1, microwave vacuum drying $2\;(drying{\rightarrow}crushing{\rightarrow}drying)$, hot air drying, vacuum drying and freeze drying. Each drier except freeze drier was set to maintain the sample temperature at $60^{\circ}C$. During microwave vacuum drying 1 or 2, the sample reached $60^{\circ}C$ much faster (within 5 min) and was dried much faster ($2{\sim}3\;hrs$ than the other drying methods. The initial drying rate of microwave vacuum drying was ten times faster than that of hot air drying. The microwave vacuum drying 2 retained the highest ${\alpha}-amylase$ activity, followed by microwave vacuum drying 1, freeze drying, vacuum drying, and hot air drying.

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Preblending Effects of Curing Agents on the Characteristics of Mechanically Deboned Chicken Meat (염지제 종류와 혼합에 따른 기계발골 계육의 가공 특성과 저장성)

  • Kang, Soo-Yong;Park, Ki-Soo;Choi, Yang-Il;Lee, Sang-Hwa;Auh, Joong-Hyuck
    • Food Science of Animal Resources
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    • v.29 no.2
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    • pp.220-228
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    • 2009
  • This study was conducted to determine the preblending effect of curing agents on the characteristics of mechanically deboned chicken meat (MDCM), including the pH, water-holding capacity (WHC), and stability under refrigeration conditions. MDCM was preblended with different curing agents [NaCl, 0.75 or 1.5%; sodium tripolyphosphate (STPP), 0.25 or 0.5%; ascorbic acid, 250 or 500 ppm; sodium nitrite, 75 or 150 ppm] and were stored at $4^{\circ}C$ overnight. The preblending of NaCl was found to have improved the WHC and emulsion stability; STPP was found to have improved the pH, WHC, and emulsion stability; and ascorbic acid or sodium nitrite did not affect the pH, WHC, and emulsion stability. The addition of ascorbic acid or sodium nitrite, however, decreased the 2-thiobarbituric acid (TBA) and volatile basic nitrogen (VBN) values of the preblended MDCM through the antioxidizing properties. The mixing effects of different curing agents on MDCM were also evaluated with nine different conditions. Among the treatments, the mixture of NaCl and STPP improved the WHC and emulsion stability due to the increased solubility of salt-soluble protein in the preblended MDCM. The mixture of NaCl, STPP, and ascorbic acid increased the pH, WHC, and emulsion stability, but the mixture of NaCl, STPP, ascorbic acid, and sodium nitrite improved the WHC, emulsion stability, and redness of the surface color with improved storage stability due to the decreased VBN and TBA values. As a result, the mixture of 1.5% NaCl, 0.5% STPP, 500 ppm ascorbic acid, and 75 ppm sodium nitrite showed the best properties as curing agents for MDCM preblending.

Methods of Application and Beneficial Effects of Silicate-Coating Rice Seeds (볍씨의 규산코팅방법에 따른 이용특성과 육묘효과)

  • Kang, Yang-Soon;Kim, Wan Joong;Hwang, Duck Sang;Kim, Hee Kyu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.65 no.1
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    • pp.30-39
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    • 2020
  • A new silicate coating technology was developed which reduces the impact of dust and loosening during seeding compared to existing silicate-coatings (Seed/Si/Zeolite), and therefore can lower the production costs of rice cultivation. In this method, 100 g of rice seed is coated with 18 mL of liquid silicic acid and then dressed with a mixture containing 80 g of dolomite and 5 g of iron. To determine the most effective method of application and ensure that seedlings developed healthily, a series of experiments were carried out. Infected seeds scattered in seedling boxes and pots (soil and hydroponic) were coated dry, without disinfection. In comparison to the seed which were not treated with the silicate-coating, the new seed (A) were 1.84 times heavier in weight, and were also improved in terms of coating strength and coating color. Compared to the seedlings grown from the non-coated seed, those grown from the new silicate-coated seed were of significantly higher quality (weight/length) and had erect, dark greenish leaves, which are ideal plant characteristics. This was most likely due to increased silicate uptake. The symptoms of bakanae disease in the non-coated seed peaked after 38 days to 54.2%, whereas the control value was 68.8% in the new silicate-coated seed (A). In the infected seedlings grown from the new silicate-coated rice seed, subnormal macro-conidia, namely, a sickle shape spore without a septum; a straight oblong shape spore without a septum and with a thick cell wall; and inter-septal necrosis of a normal spore were detected. It is believed that the strong alkalinity of silicic acid have acted as unfavorable conditions for pathogenicity. In seedlings grown from the new silicate coated rice seed under hydroponic conditions without nutrients, normal root activity and growth was maintained without leaf senescence. Therefore, it was possible to reduce the rate of fertilization. In the future, a new silicate-coated rice seed was required for the study of minimal nutrition for anti-aging of seedlings.

Current Status and Prospects of Various Methods used for Screening Probiotic Microorganisms (Probiotic 미생물 검사에 사용되는 다양한 방법들에 대한 현황과 향후 전망)

  • Kim, Dong-Hyeon;Kim, Hong-Seok;Jeong, Dana;Chon, Jung-Whan;Kim, Hyunsook;Kim, Young-Ji;Kang, Il-Byung;Lee, Soo-Kyung;Song, Kwang-Young;Park, Jin-Hyeong;Chang, Ho-Seok;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.4
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    • pp.203-216
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    • 2016
  • Probiotic microorganisms are thought to provide health benefits when consumed. In 2001, the World Health Organization defined probiotics as "live microorganisms which confer a health benefit on the host, when administered in adequate amounts." Three methods for screening potential probiotics have currently widely available. (1) In vitro assays of potential probiotics are preferred because of their simplicity and low cost. (2) The use of in vivo approaches for exploring various potential probiotics reflects the enormous diversity in biological models with various complex mechanisms. (3) Potential probiotics have been analyzed using several genetic and omics technologies to identify gene expression or protein production patterns under various conditions. However, there is no ideal procedure for selecting potential probiotics than testing cadidate strains on the target population. Hence, in this review, we provide an overview of the different methodologies used to identify new probiotic strains. Furthermore, we describe futre perspectives for the use of in vitro, in vivo and omics in probiotic research.

A study on the menarche of middle school girls in Seoul (여학생의 초경에 관한 조사 연구 (서울시내 여자중학생을 대상으로))

  • Kim, Mi-Hwa
    • Korean Journal of Health Education and Promotion
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    • v.1 no.1
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    • pp.21-36
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    • 1983
  • It is assumed that menarche is affected not only by the biological factors such as nutrition and genetic heritage, but also it is affected by other socio-cultural environmental factors including weather, geographic location, education and level of modernization. Also recent trend of menarche in Korea indicates that a lot of discussion are being generated to the need of sex education as a part of formal school education. The purpose of this study is to develop the school health education program by determine the age of menarche, the factors relavant to time of menarche and psycho-mental state of students at the time in menarche and investigate the present state of school health education relate to menarche of adolescents. The total number of 732 girls was drown from first, second and third grades of 4 middle schools in Seoul. For the data collection the survey was conducted during the period from May 1 to May 20, 1982 by using prepared questionair. The major results are summarized as follow; 1. Mean age at menarche and the percent distribution of menarche experienced. It was observed that about 68.7% of sampled students have been experienced menarche at the time interviewed. For the each group, age at menarche is revealed that among the students about 37.8% are experienced menarche for under 12 years old group, 62.1% for 13 year-old group, 80.6% for 14 year-old group and 95.5% for over 15 years old. In sum it was found that the mean age at menarche was 12.3 years old, ranged from age at 10 as earlist the age at 15 as latest. 2. Variables associated with age at menarche. 1) There was tendency those student who belong to upper class economic status have had menarche earlier than those student who belong to lower class. Therefore, economic status is closely related to age at menarche. 2) In time of mother's education level, it is also found that those students whose mother's education levels from high school and college are experienced menarche earlier than those students whose mother's education levels from primary school and no-education. 3) However, in connection with home discipline, there was no significant relationship between age at menarche and home disciplines which are being treated "Rigid", "Moderated ", "Indifferent". 4) Degree of communication between parents and daughter about sex matters was found to be associated each others in determination of age at menarche. 5) It was found that high association between mother's menarche age and their daughter's menarche age was observed. Mother's age at menarche earlier trend to be shown also as earlier of their daughters. 6) Those students belong to "D & E" of physical substantiality index are trend to be earlier in menarche than those students in the index "A & B". 3. Psycho-mental state at the time of menarche. Out of the total students 68.2% had at least one or more than one of subjective symptoms. Shyness was shown as most higher prevalent symptom and others are fear, emotional instability, unpleasant feeling, depression, radical behavior, inferior complex and satisfaction appeared. Very few cases are appeared be guilty and stealing feeling. 4. The present status of school health education program related to menarche. As to the source of information about menarche, teacher was a main source with average index 5.88 and the other informants were mother & family member, friends, books and magagines, movies, television, and radio. For the problem solving at menarche, mother & family members were subject to discussion with an average index 6.02 as high. The others for discuss and knowledge about menarche were books, magagine, friends, teachers, and self-learning based on own experienced. The time of learning about menarche, it was learned as highest percentage with 43.2% at a 6 grades of primary school, middle school with 34.4%, 5 grade of primary school with 18.2%, and 4 grade of primary school with 4.0% respectively.

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