• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• 한국보건간호학회지
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• 제21권2호
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• pp.241-251
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• 2007

Purpose: To identify the effects on tuberculosis mortality of a tuberculosis control program conducted at 108 community health centers in terms of structure and process. Methods: The dependent variable was tuberculosis mortality, and the independent variables were the structure(type of centers, staff, nurses, doctors, budget) and process(chest X-ray checking, immunization, case detection, health education, patients registering & managing) of the tuberculosis control programs at the community health centers. Data were analyzed using descriptive analysis and stepwise regression analysis. Result: Tuberculosis morality was positively correlated with type of centers(rural area)(p<0.01), but negatively correlated with type of centers(large cities) (p<0.01), (middle cities)(p<0.05), staff FTE(p<0.05), and number of nurses(p<0.05). Regression analysis indicated that type of centers(rural area)($\beta$=0.457) and case detection($\beta$=0.234) had a significant effect on tuberculosis mortality. Conclusion: Ultimately, this study will provide information to improve the effectiveness of tuberculosis control programs in community health centers.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1349-1353
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• 2012

Increasing evidence has revealed that thy-1 was a potential stem cell marker of liver cancer, but no data have been shown on how thy-1 regulates the pathophysiology of liver cancer, such as proliferation, apoptosis, invasion and migration. We previously demonstrated that thy-1 was expressed in about 1% of hepg2 cells, thy-1+hepg2 cells, but not thy-1-, demonstrating high tumorigenesis on inoculation $0.5{\times}10^5$ cells per BACA/LA mouse after 2 months. In the present study, our results showed that higher expression of thy-1 occurs in 72% (36/50 cases) of neoplastic hepatic tissues as compared to 40% (20/50 cases) of control tissues, and the expression of thy-1 is higher in poorly differentiated liver tumors than in the well-differentiated ones. In addition, thy-1 expression was detected in 85% of blood samples from liver cancer patients, but none in normal subjects or patients with cirrhosis or hepatitis. There was a significant negative correlation between thy-1expression and E-cadherin expression (a marker of invasion and migraton), but not between thy-1 expression and AFP expression in all the liver cancer and blood samples. We further investigated the relationship between thy-1 and E-cadherin in liver cancer hepg2 cell line which was transfected with pReceiver-M29/thy-1 eukaryotic expression vector followed by aspirin treatment. Lower expression of E-cadherin but higher expressions of thy-1 were detected in hepg2 cells transfected with pReceiver-M29/thy-1. Taken together, our study suggested that thy-1 probably regulates liver cancer invasion and migration.

• 생약학회지
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• 제12권3호
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• pp.119-124
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• 1981

In our country, in order to cure diseases, a large number of crude drug preparations has been available. Nevertheless, the development of crude drug preparations have been inhibited, because the quality control is not completed so far. Therefore, we have eontinued on studing the quality control method by Zig-zag TLC. profile analysis. The water extract of 'Samyo-Tang' and componental crude drug (Glycyrrhizae Radix, Ephedrae Herba, Armenicae Semen) were developed on Silica gel $60F_{254}\;plate\;(E.\;Merck)$ useing elution solvent. The developed plate were examined useing Dual Wavelength Zig-zag Scanner (Shimadzu). According to the results of the experiment, it could be summarized as follow: 1) Original patterns of TLC profiles of 'Samyo-Tang' componental crude drug and mixing two crude drugs of 'Samyo-Tang' were observed. 2) Original patterns TLC profile of each extract after spraying with 2% ninhydrine were observed. 3) In the extract of addition and subtraction of Ephedrae Herba, peak area of Rf 0.48 and Rf 0.60 were varied quantitatively.

• Archives of Plastic Surgery
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• 제44권5호
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• pp.378-383
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• 2017

Background This study aimed to assess the effects of the topical application of tamoxifen on wound healing of burned skin in Wistar rats by evaluating 3 healing characteristics: fibrotic tissue thickness (FTT), scar surface area (SSA), and angiogenesis in the healed scar tissue. Methods Eighteen male Wistar rats were used in this study. A third-degree burn wound was made on the shaved animals' back, measuring $2{\times}2{\times}2cm$. In the first group, a 2% tamoxifen ointment was applied to the wound twice daily for 8 weeks. The second group received a placebo ointment during the same period. The third group did not receive any treatment and served as the control group. Results The median (interquartile range=[Q1, Q3]) FTT was 1.35 (1.15, 1.62) mm, 1.00 (0.95, 1.02) mm, and 1.25 (0.8, 1.5) mm in the control, tamoxifen, and placebo groups, respectively (P=0.069). However, the FTT in the tamoxifen group was less than in the placebo and control groups. The median angiogenesis was 3.5 (3.00, 6.25), 8.00 (6.75, 9.25), and 7.00 (5.50, 8.25) vessels per high-power field for the control, tamoxifen, and placebo groups, respectively (P=0.067). However, the median angiogenesis was higher in the tamoxifen group than in the control group. No significant difference was observed in the mean SSA between the tamoxifen group and the control group (P=0.990). Conclusions Local application of tamoxifen increased angiogenesis and decreased the FTT, with no change in the SSA in burned skin areas. These effects are expected to expedite the wound healing process, reducing contracture and preventing hypertrophic scar and keloid formation.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제8권3호
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• pp.762-777
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• 2014

With the increasing usage of cloud applications such as MapReduce and social networking, the amount of data traffic in data center networks continues to grow. Moreover, these appli-cations follow the incast traffic pattern, where a large burst of traffic sent by a number of senders, accumulates simultaneously at the shallow-buffered data center switches. This causes severe packet losses. The currently deployed TCP is custom-tailored for the wide-area Internet. This causes cloud applications to suffer long completion times towing to the packet losses, and hence, results in a poor quality of service. An Explicit Congestion Notification (ECN)-based approach is an attractive solution that conservatively adjusts to the network congestion in advance. This legacy approach, however, lacks scalability in terms of the number of flows. In this paper, we reveal the primary cause of the scalability issue through analysis, and propose a new congestion-control algorithm called FaST. FaST employs a novel, virtual congestion window to conduct fine-grained congestion control that results in improved scalability. Fur-thermore, FaST is easy to deploy since it requires only a few software modifications at the server-side. Through ns-3 simulations, we show that FaST improves the scalability of data center networks compared with the existing approaches.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.5110-5116
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• 2011

본 논문에서는 산업용 필드 버스 프로토콜 중 신호적으로 가장 안정하다고 알려져 있는 CAN(Controller Area Network) 프로토콜을 이용하여 자동차용 전동 거울의 멀티플렉싱 제어 시스템을 제안하고자 한다. 이를 위하여 하나의 마스터 컨트롤러와 입/출력을 각각 담당하는 2개의 슬레이브 컨트롤러를 설계하여 구현하고(H/W), 이러한 각 서브 시스템 들의 효과적인 동작과 통신을 위한 Application Layer를 구현(S/W)하였다. 구현된 전체 시스템은 실제 자동차용 전동 거울에 장착하여 실험함으로써 최소한의 전장 요소들만으로 효과적인 시스템의 운용 및 제어가 가능함을 보이고자 한다.

• 대한화장품학회:학술대회논문집
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• 대한화장품학회 2003년도 IFSCC Conference Proceeding Book I
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• pp.686-697
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• 2003

A new colloidal silver (Ag) system is present in which a fine colloidal Ag is in situ deposited onto functionalized porous poly (ethylene glycol dimethacrylate) (poly (EGDMA)) microspheres. The effectiveness of Ag deposition was investigated considering the surface characteristics of poly (EGDMA) microspheres. The result reported in this study illustrates that the control of surface area and surface functionality (in this study, a hydroxyl group) of poly (EGDMA) microspheres is an important factor that determines practically the degree of deposition of colloidal Ag. The x-ray analysis showed that Ag nanoparticles were dispersed evenly inner and outer surfaces and had a face center cubic (fee) phase. In the preservative efficacy test, the Ag-containing poly (EGDMA) microspheres had a powerful anti-bacterial activity, showing a high potential for a new preservative in cosmetic industry.

• 한국대기환경학회지
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• 제29권4호
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• pp.477-485
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• 2013

The major source of harmful air pollutants in Korea have been shifted as economy grows. Particulate matter(PM) and Sulfur dioxide ($SO_2$) emitted from industries and coal-fired domestic sectors were important pollutants in 1970's and later industrializing period of Korea. Then the characteristic of pollution was changed into so-called "developed country type pollution". Vehicles have been responsible for significant amount of Nitric oxide ($NO_x$) pollution and consequent Ozone formation in urban area since 1990's. Variety of control measures have been introduced to deal with the vehicle emissions in Seoul Metropolitan Area (SMA). Emission control technologies have successfully reduced pollutants from vehicles. Three-way catalyst for vehicles fueled by gasoline and liquefied petroleum gas (LPG), for example, has achieved large amount of pollutants. Compressed natural gas (CNG) urban bus have penetrated existing diesel bus market and reduces PM and $NO_x$ emissions in many Korean cities. However, diesel vehicles are still reaming as a critical emission source of urban area. Diesel vehicles gain more popularity than ever because of their better fuel efficiency and driving power. Unfortunately, it is widely known that the pollutant emissions of diesel vehicles are much larger than those of gasoline and LPG vehicles. In this note, we briefly introduce the trends of emission control strategies which are accomplished by automotive industries for about last ten years. Emission regulation, cleaner fuel, diesel particulate filter (DPF) and other measures are discussed from technical as well as legislative perspectives.

• 한국농촌간호학회지
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• 제18권1호
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• pp.1-10
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• 2023

Purpose: This study was to evaluate the effects of a social prescribing program on cognitive function and depression of the elderly in the rural community. Methods: A non-equivalent control group pretest-posttest design was used for this study. The experimental group (n=76) completed a 8-week intervention of social prescribing, while the control group (n=39) only participated in pre- and post- need assessment from April 2021 to October 2022. A Wilcoxon signed rank test was conducted to evaluate the effectiveness of a social prescribing program on the level of cognitive function and depression of the participants. Results: The level of cognitive function was improved significantly in the experimental group (p<.05) while there was no significant change in the control group. Depression has been significantly decreased in the experimental group (p<.01), but there was no statistically significant change in the control group. Conclusion: The results of this study suggest that the social prescribing program is effective for improving cognitive function and reducing depression of the elderly living in the rural area. Therefore, a social prescribing program can be utilized as a preventive program for dementia and depression of the elderly.