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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Comparison of Tension Type Headache Associated with Pericranial Tenderness and Headache Attributed to Temporomandibular Joint Disorder Using RDC/TMD Axis II (두개주변압통과 관련된 긴장성 두통과 측두하악장애에 기인한 두통과의 RDC/TMD Axis II에 따른 비교)

  • Park, Hyung-Yun;Bae, Sung-Jae;Yoo, Sang-Hoon;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.123-133
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    • 2010
  • The purpose of this study is to investigate Tension-type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder among Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score using RDC/TMD Axis II. Eighty five patients who visited the Kyung Hee University Dental Hospital were diagnosed as Tension-type headache associated with pericranial tenderness(n=48) and Headache attributed to temporomandibular joint disorder(n=37) by the International Classification of Headache Disorders, 2nd Edition, and were administered the Korean versions of the RDC/TMD Axis II- Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score. Then it was analyzed statistically by SPSS(ver. 10.0). T-test, The Wilcoxon-signed rank test and Mann-Whitney U test (p<0.05) were used. There were no significant differences in Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score between two groups. Tension type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder showed similar Axis II feature. Tension-type headache associated with pericranial tenderness may be related to Headache attributed to temporomandibular joint disorder.

Photosynthetic Characteristics and Chlorophyll Content of Rhododendron micranthum by the Natural Habitat (자생지에 따른 꼬리진달래의 광합성 특성 및 엽록소 함량)

  • Kim, Nam-Young;Lee, Kyeong-Cheol;Han, Sang-Sub;Lee, Hee-Bong;Park, Wan-Geun
    • Journal of Bio-Environment Control
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    • v.21 no.2
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    • pp.147-152
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    • 2012
  • This study was conducted to investigate the photosynthetic R. micranthum by natural habitats. In the results, natural habitats didn't affect values of light saturated point, light compensation point and photosynthetic capacity of R. micranthum. We investigated light response curve and chlorophyll content at each habitat. Light compensation points were 11.8 ${\mu}mol\;m^{-2}\;s^{-1}$, 11.5 ${\mu}mol\;m^{-2}\;s^{-1}$ and 10.4 ${\mu}mol\;m^{-2}\;s^{-1}$ in Seokpo-ri, Yeonha-ri, and Mt. Worak. Light saturation points showed that R. micranthum is shade tolerant specie which has the light saturation point approximately 500~600 ${\mu}mol\;m^{-2}\;s^{-1}$. Photosynthetic rates of R. micranthum leaves were 5.5 ${\mu}mol\;m^{-2}\;s^{-1}$, 5.4 ${\mu}mol\;m^{-2}\;s^{-1}$ and 5.6 ${\mu}mol\;m^{-2}\;s^{-1}$ in Seokpo-ri, Yeonha-ri and Mt. Worak. On the other hand, since between $20^{\circ}C$ and $30^{\circ}C$, it appeared that the values of net photosynthetic rates of R. micranthum leaves in all sites were high. Especially, the rates were highest at $25^{\circ}C$. Because of low stomatal transpiration rate in saturation radiance, the moisture utilization efficiency in Yeonha-ri was lower than other habitats. Rates of chlorophyll a, chlorophyll b, and total chlorophyll content in Mt. Worak were no significant difference. Therefore R. micranthum has characteristic of shade tolerant species. The moderate temperature for R. micranthum is between $20^{\circ}C$ and $30^{\circ}C$.

Effect of Aqueous Extracts from Rubus coreanus Miquel and Angelica gigas Nakai on Anti-tumor and Anti-stress activities in mice (복분자와 당귀 열수추출물의 마우스를 이용한 항암 및 항스트레스 효과)

  • Kim, Jung-Hwa;Kim, Cheol-Hee;Kim, Hyou-Sung;Kwon, Min-Chul;Song, Young-Kyu;Seong, Nak-Sul;Lee, Seung-Eun;Yi, Jae-Seon;Kwon, Oh-Woung;Lee, Hyeon-Yong
    • Korean Journal of Medicinal Crop Science
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    • v.14 no.4
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    • pp.206-211
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    • 2006
  • This study was performed to examine antitumor activities of Rubus coreanus Miquel and Angelica gigas Nakai extracts against sarcoma-180 and anti-stress activities in ICR mice. The variation of body weights of the 20 days of Rubus coreanus extracts-administrated mice group was very low. The survival rate (T/C %) of Rubus coreanus extract administrated group was 161% after 50 days from the inoculation of sarcoma-180 and the increment of their body weights was suppressed. Anti-stress effect of the extracts of R. coreanus and A. gigas were estimated by maeasuring blood chemical value and internal organs weight in ICR mice. The extracts of R. coreanus reduced the cholesterol and glucose to the normal level in the all stress animal models. The extracts of R. coreanus reduced the hypertrophy of the internal organs such as adrenal, spleen and liver to the regular level.

A Study on Antecedents of Ethical Leadership of Power Retailers, : Focusing on the Relationship between Discount Stores and Their Suppliers (대형 유통업체 윤리적 리더십의 선행변수에 관한 연구 : 할인점과 공급업체 간 관계를 중심으로)

  • Kim, Sang-Deok
    • Journal of Distribution Research
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    • v.17 no.3
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    • pp.59-92
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    • 2012
  • With accumulated research evidence, there is little doubt that leadership behavior is related to a wide variety of positive individual and organizational outcomes. Indeed, leadership behavior has been empirically linked to increased employee satisfaction, organizational commitment, extra effort, turnover intention, organizational citizenship behavior, and overall employee performance. Although leadership behavior has been linked to a number of positive organizational outcomes, research regarding the antecedents of such behavior is limited. Especially there is little research dealing with the antecedents of inter-organizational leadership behavior. This study interests in inter-organizational ethical leadership among marketing channel members. In both the mass media and the academic association, there has been a surge in interest in the ethical and unethical behavior of leaders. Although the corporate scandals in recent years may explain much of the mass media and popular focus, academics' interest has been limited by evidence that ethical leadership behavior is associated with both positive and negative inter-organizational processes and performances. This study tried to contribute to this body of knowledge by examining antecedents of ethical leadership. Ethical leadership is defined "the demonstration of normatively appropriate conduct through personal actions and interpersonal relationships, and the promotion of such conduct to followers through two-way communication, reinforcement, and decision-making." Ethical leaders not only inform individuals of the behefits of ethical behavior and the cost of inappropriate behavior, such leaders also set clear standards and use rewards and fair and balanced punishment to hold followers accountable for their ethical conduct. Despite the assume importance and prominence of ethical leadership among organizations, there are still many questions relating to its antecedents and consequences. One is whether the likelihood of an leading organization being perceived as an ethical leader among other following organizations in marketing channels can be predicted using its characteristics and inter-organizational relationship maintenance skills. Identifying trait and skill antecedents will aid in the development of strategies for selecting and developing ethical leaders and determining the best means to reinforce ethical behaviors. The purpose of this study is to investigate the effects of three categorized variables on ethical leadership of channel leader. To be concrete, this study develops a model of the antecedents of three conceptually distinct forms of channel leader characteristics, such as organizational traits, inter-organizational relationship maintenance strategies, and supplier management strategies, and tests the hypothesized differential effects on ethical leadership of marketing channel leaders. The reason why this study deals with discount store channel is that there is very strong inter-dependence between a discount store and its suppliers. Their strong inter-dependence makes their relationship as the relationship between a leader and suppliers and creates an atmosphere that leadership occur without difficulty. The research model is as follows. For the purpose of empirical testing, 295 respondents of suppliers of discount store channel in Korea were surveyed. The procedures included scale reliability, and discriminant and convergent validity were used to validate measures. Also, the reliability measurements traditionally employed, such as the Cronbach's alpha, were used. All the reliabilities were greater than .70. This study conducted confirmatory factor analyses to assess the validity of our measurements. All items loaded significantly on their respective constructs(with the lowest t-value being 15.2), providing support for convergent validity. We then examined composite reliability and average variance extracted(AVE). The composite reliability of each construct was greater than .70. The AVE of each construct was greater than .50. This study tested research model using Partial Least Square(PLS). The estimation of the structural equation model revealed an acceptable fit of the model to the data($r^2$=.851). Thus, This study concluded that the model fit was considered acceptable. The results of PLS are as follows. The results indicated that conscientiousness, openness, conflict management, social networks, training, fair reward had positive effects on ethical leadership of channel leaders. On the other hand, emotional insecure had negative effect and agreeableness, assurance, and inter-organizational communication had no significant effect on supply chain leadership.

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Effect of Relative Humidity on the Changes of Lipids in Freeze-Dried Fish during Storage (동결건조 어육지질의 변화에 미치는 상대습도의 영향)

  • LEE Hyeung-Il;PARK Yeung-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.6
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    • pp.519-528
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    • 1985
  • Fillets of mackerel (Scomber japonicus) and flounder (Xystrias grigorjewi) which, are representatives in red fleshed fish and white fleshed fish, respectively, were freeze-dried and stored in tightly sealed containers which were controlled to different relative humidity at $25^{\circ}C$. The changes of lipids were examined periodically by measuring the peroxide value (POV), the thiobarbituric acid (TBA) and the acid value (AV). And the fatty acid composition of lipids was investigated by gas-liquid chromatography (GLC). The results obtained are summarized as foollows: From the changes of POV and TBA value during storage, the oxidation of lipids was distinct at the lower relative humidities, $0\%\;and\;23\%$, while inhibited at the higher relative humidities, $52\%\;and\;81\%$. The changes in acid value during storage were more prominent at the hifger relative himidites than at the lower relative humidities. The content of $C_{16:0},\;C_{18:0}\;and\;C_{22:6}$ acids in the fatty acid composition of total lipids was abundant in both fleshed fishes. The content of $C_{18:1}$ acid in the nonpolar lipid and that of $C_{16:0}$ acid in the polar lipid were higher than other fatty acids. In the fatty acid composition of total lipids during storage, polyenoic acids decreased with storage period at $0\%\;and\;23\%$ relative humidities, while the fatty acid composition didn't show a great change at $52\%\;and\;81\%$ relative humidities. In the non-polar lipid, polyenoic acids coherently decreased under all the conditions of relative humidities but the saturated acids and the monoenoic acids increased. In the polar lipid, polyenoic acids decreased at $0\%\;and\;23\%$ relative humidities, while the saturated acids and monoenoic acids decreased at $52\%\;and\;81\%$ relative humidities. On the other hand, the oxidation of lipids was more significant in mackerel than in the flounder, and the changes of fatty acid composition were shown a similar pattern.

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Changes of Street Patterns in Central Part of Taegu City (大邱市 都心部의 街路網 變化)

  • Choi, Seok-Joo
    • Journal of the Korean Geographical Society
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    • v.31 no.3
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    • pp.593-612
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    • 1996
  • This study concern with the changes of street from the Choseon Dynasty to present days around Old-Boundary in Taegu, analyzing the backgrounds of change factors and development trends of the Taegu City. The basis element of a city structure is the street. Therefore, in this study, a chage of street space of a city was investigted. Historically, Taegu was a walled city and had a Mono-nucleus which was restricted by the castle, and served as a starting point of formation of spatial structuure. The form of the artery street took a "T" pattern, othe streets were formed in irregular shapes. As the city grew gradually, the castle was removed on account of diversification in traffic network, change of socio-economic organization in traffic network, change of socio-economic organization, formation of industrial bases and functional distribution. CBD of this city has been located within the area surrounded by these streets. This is a kind of general pattern of traditional walled cities through the world in both Western and Oriental societies. A s the begining of this centry, a 'Dark Ages' descended upon Korea because the country was under the Japanese-Korean Annexation, and, throughout this period, the urban planning was planned exclusively for Japanese. The street pattern within residential areas of Korea took the maze type, in contrast with Japanese residential areas which showed grid pattern of streets. This is another general pattern of almost of all colonial cities especially in Asia. High class residential areas were planned and built by Japanese, and they were located within 5-10 minutes' on-foot distance from the CBD hard core. This high prestige has continued until the 1980s when it occurred land use succession which commerical functions invaded into residential areas. Back in the colonial period, there was a between two hetrogeneous groups due to the fact that the Japanese lived mainly oriented the new railway system but that Koreans still lived along the old highway system which ran through the Korea Peninsula. Street netwook formed in the above process has maintained its shape without great changes after the liberation form the Japanese Colony. Taegu has, accordingly, developed ring-radial network system which has been a combination of radial and ring facilities. The present conditions of street patterns in Taegy mainly depend on 4 rings and 8 radius, with grid pattern street able to be found in Old Boundary.

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Fundamental Studies on the Development of Axial-Flow Combine(I) -Evaluation of the Design Parameters of Grain-Straw Separator- (축류(軸流) 콤바인의 개발(開發)에 관(關)한 기초(基礎) 연구(硏究)(I) -조선별장치(粗選別裝置)의 설계변수(設計變數)의 평가(評價)-)

  • Lee, S.K.;Kim, S.T.;Choi, K.H.
    • Journal of Biosystems Engineering
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    • v.11 no.2
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    • pp.31-40
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    • 1986
  • Cylindrical and conical types of grain-straw separation equipment which has a stationary crimped sieve drum with rotating inner rotor were constructed. The developed equipments were tested to investigate the characteristics of separating performance under various mechanical conditions and crop conditions. As increase of the inclination of equipment and decrease of pitch of cover vane, the grain recovery was increased while straw rejection was decreased. The grain recovery and overall efficiency were decreased as the rotor speed and feeding velocity were increased for both varieties of rice, moisture contents, and test equipments. Conical prototype equipment performed higher straw rejection, lower grain recovery, and lower power requirement. However, separation performance of conical type equipment was more widely varied with various test conditions compared to cylindrical one. The performance of both equipments showed relatively insensitive to crop feedrate and crop properties, such as variety, moisture content, and grain-to-straw ratio.

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Nutritional Composition and Physico-chemical Meat Quality Properties of Korean Hanwoo Bull Beef (한우수소의 부위별 영양성분조성 및 이화학적 육질특성)

  • Cho, S.H.;Park, B.Y.;Kim, J.H.;Choi, Y.H.;Seong, P.N.;Chung, W.T.;Chung, M.O.;Kim, D.H.;Ahn, C.N.
    • Journal of Animal Science and Technology
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    • v.49 no.6
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    • pp.871-880
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    • 2007
  • This study was conducted to investigate the relationship between the socio-demographic factors and the Korean consumers’ palatability evaluation and to collect the sensory information for development of prediction palatability model of Hanwoo beef. Ten cuts〔Abjin (short plate), Bosup (top sirloin), Cheggt (striploin), Dngsim (loin), Guri (chuck tender), Hongduke (eye of round), Moksim (chuck roll), Sulgit (bottom round), Udoon (top round), Yangi (brisket)〕 were separated from 10 Hanwoo bulls beef(~24 months old) and prepared with the same manner for 3 different cooking methods such as boiling, grilling and roasting. The cooked beef samples were served to 650 consumers recruited from Seoul, Joongbu, Honam and Youngnam locations and evaluated tenderness, juiciness, flavor and overall acceptability. The living location, age, gender, occupation, eating habit and cut were significantly related with the sensory properties when bull beef were cooked as boiled cooking(p<0.05). In grill cooking, only occupation, income and cut had the significant effect on the overall acceptability of Hanwoo bull beef(p<0.01). When bull beef were cooked as Korean traditional roast cooking, consumer’s sensory properties were significantly different by the living location, age, occupation, income, eating habit of consumers and cut(p<0.05). Also, results from the principal component analysis showed that palatability scores of Korean consumers were decided with different contribution scores of tenderness, juiciness, flavor and overall acceptability of cut depending on cooking methods. In conclusion, Korean consumers’ palatability for Hanwoo bull beef were related with the socio-demographic factors and the sensory results were different by cut and cooking methods.

Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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