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EFFECTS OF SUBINHIBITORY CONCENTRATIONS OF ANTIMICROBIAL AGENTS ON CELL SURFACE PROPERTIES AND VIRULENCE FACTORS OF MUTANS STREPTOCOCCI (아저해농도(亞沮害濃度)의 항균물질이 mutans streptococci의 세포표면성질과 독력인자에 미치는 영향)

  • Kim, Young-Jae;Hahn, Se-Hyun;Lee, Sang-Hoon;Jang, Ki-Taeg;Kim, Chol-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.605-616
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    • 2004
  • Subinhibitory concentrations (sub-MICs) refer to concentrations below minimum inhibitory concentrations (MICs). The antimicrobial agents may be present at relatively high concentration, at least higher than bacterial MIC and thereafter be deserted off a surface and function at sub-MICs, perhaps by interfering with bacterial metabolism. Consequently, the aim of this study was to determine the effects of growth, in the presence of sub-MICs of antimicrobial agents, on the cell surface properties and virulence factors of mutans streptococci and to investigate the efficacy of a chemical approach in vitro. Streptococcus mutans Ingbritt and Streptococcus sobrinus 6715-7 were used. Eight antimicrobial agents (Sanguinaria extract;SG, Chlorhexidine digluconate;CHX, Fluoride;F, Propolis;PP, Hydrogen peroxide;HP, Triclosan;TC, Sodium dodecyl sulfate;SDS Cetylpyridinium chloride; CC) were diluted serially in broth to determine MICs and to compare the growth rate, acid production, hydrophobicity, adhesion activity to saliva coated hydroxyapatite, glucan synthesis and cellular aggregation of experiment groups (in the presence of sub-MICs) with those of control (in the absence of antimicrobial agents). Sub-MICs of antimicrobial agents affected the growth of cells, hydrophobicity, and adhesion of bacteria to saliva coated hydroxyapatite and glucan synthesis. They also resulted in a significant reduction in pH after 12 hours (p<0.05). By cells pretreated with proteinase K, either the aggregation induced by antimicrobial agents was completely inhibited or the aggregation titers were markedly increased. According to the results of the present study, each antimicrobial agent at sub-MICs could affect similar as its known action mechanism and could continually inhibit cariogenic bacteria at such concentrations. Thus, the use of these antimicrobial agents would be one of the effective methods to prevent dental caries.

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A Study on the Status and Management Plan of Naturalized Plant in Area of Scenic Site at Mt. Maisan, Jinan (진안 마이산 명승구역 내 귀화식물 현황 및 관리방안)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Han, Sang-Yub;Choi, Yung-Hyun;Kim, Eun-Ok
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.3
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    • pp.100-114
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    • 2018
  • Nationally designated Cultural Properties 'Scenic site No.12 Maisan Mountain, Jinan' designated areas and some protected areas, and taking into account the dynamics of naturalized plants causing problems, we will restore the original vegetation scenery of Mt. Maisan. The results of this study are as follows. A total of 76 families, 192 genera, 286 taxa, and inland and inhabited areas, 76 and 138 genera and 163 taxa were identified in the areas of Ammaibong. The total number of naturalized plants identified in this study area is 28 taxa total, which corresponds to 7.1% naturalization rate(NR) among the vascular plants of all 395 taxa, and the urbanization index(UI) corresponds to 8.4% of the 333 taxa of Korean naturalized plants. Ecosystem disturbance plants identified in the survey area were Ambrosia artemisiifolia 1 taxa. The naturalized plants controlled and managed by separate anthropogenic vegetation management within the designation and protection area of Maisan scenic place are three species of herbaceous Rumex acetosella, A. artemisiifolia and Festuca arundinacea. It was identified as a breed. Indigofera bungeana and F. arundinacea communities around the stairway and Amorpha fruticosa, I. bungeana, A. artemisiifolia and Amaranthus patulus of the top of Am-Maibong were selected as the first priority sites for exclusion of exotic species in Maisan area and target naturalized plants species to the Ammaibong peak. In addition, R. acetosella community around the temple was suggested to be removed first to preserve endemic species. For the restoration of vegetation, we suggest that Stephanandra incisa, Spiraea blumei, Weigela subsessilis, etc. should be planted after removal of I. bungeana, and F. arundinacea, C. lanceolata, Carex callitrichos var. nana.

The Effects of Dietary Enzyme Mixture Fortified with β-Glucanase Activity on the Growth Performance, Serum Components, and Meat Quality of Broiler Chicks (사료 내 β-Glucanase 활성이 강화된 복합효소제 급여가 육계의 생산성과 혈청성분 및 육질에 미치는 영향)

  • Cho, Jin-Kook;Jung, Soo-Jin;Joo, Eun-Jeong;Choi, Jin-Young;Kim, Byoung-Suk;Youn, Byeng-Sun;Nam, Ki-Taek;Hwang, Seong-Gu
    • Food Science of Animal Resources
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    • v.27 no.4
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    • pp.409-415
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    • 2007
  • This experiment was conducted to investigate the effects of dietary enzyme mixture fortified with ${\beta}-glucanase$ on the growth performance, serum components and meat quality of broiler chicks. 31,800 Ross 208 male broiler chicks were randomly allotted into 2 groups, the control and 0.3% enzyme diet with ${\beta}-glucanase$ supplementation groups. Control group chicks were fed the control (corn-soybean meal based) diet and the treatment group chicks were fed the 0.3% enzyme mixture supplemented with ${\beta}-glucanase$. The growth performance, serum components and meat qualities such as pH, color, water holding capacity, cooking loss, and shearing force of meats were investigated. The results showed that the growth performance of chicks fed the 0.3% enzyme mixture diet were improved compared to that of the control group, as much as 5% in growth rate, 19% in average weight, 6.8% in performance index, and 5.5% in feed efficiency. Although, there were no significant differences in the muscle color degrees ($L^*a^*b^*$) and shearing force between the control group and experimental group, the water holding capacity and cooking loss of the experimental group were significantly higher than those of control group (p<0.05). The antibody titers in serum against the antigens of Newcastle disease and Infectious Bursal disease were higher in the experimental group than in the control group. Altogether, these suggest that the broiler diet containing 0.3% enzyme mixture fortified with ${\beta}-glucanase$ activity can improve the growth performance, immune reaction, and meat quality of broiler chicks.

The Effect of Curiosity and Need for Uniqueness on Emotional Responses to Art Collaborated Products including Moderating Effect of Gender (독특성 추구성향과 호기심이 아트 콜라보레이션 제품에 대한 소비자의 감정에 미치는 영향: 성별에 따른 조절효과)

  • Ju, Seon Hee;Koo, Dong-Mo
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.97-125
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    • 2012
  • Companies recently introduce art collaborated products incorporating culture into a product. Art collaborated products include incorporating famous movies and/or design of an artist into a newly launched product. The introduction of art collaborated products are gradually increasing. However, research for this trend is relatively scarce. Although research concerning design has discussed a number of different factors as playing a role in influencing responses to design including culture, fashion, innate preferences, etc.), only limited attention has been paid to the processes by which consumers generate responses to product designs. People with different characteristics may respond differently. When people encounter these art products, they may become curious, may think that these products are unique, novel and innovative. People tend to show different levels of curiosity when they encounter new and novel objects, which they have rarely seen or experienced. Curiosity is defined as a desire for acquiring new knowledge and new sensory experience. Previous studies demonstrated that curiosity motivates individuals to engage in exploratory behaviors. People also show different levels of need for uniqueness, which is defined as being different from others or becoming distinctive among a larger group. Individual's need for uniqueness results from signals conveyed by the material objects that individuals choose to display. Recently, researcher have developed the need for uniqueness with three distinct constructs. These three concepts include creative choice, unpopular choice, and avoidance of similarity. Creative choice is a trait tendency of an individual by expressing or differentiating himself from others through consumptions of unique products. Unpopular choice is related to an individual's tendency to consume products, which deviates from group norms. Avoidance of similarity is linked to the avoidance of consumption behavior of products that are not famous. Past research implies that people with different levels of need for uniqueness show different motivational processes. Previous research also demonstrates that different customer emotions may be derived when consumers are exposed to these art collaborated products. Research tradition has been investigated three different emotional responses such as pleasure, arousal, and dominance. Pleasure is defined as the degree to which a person feels good, joyful, happy, or satisfied in a situation. Arousal is defined as the extent to which a person feels stimulated, active, or excited. Dominance is defined as the extent that a person feels powerful vis-a-vis the environment that surrounds him/her. Previous research show that complex, speedy, and surprising stimuli may excite consumers and thus make them more pleased and engaged in their approach behavior. However, the current study identified these emotional responses as positive emotion, negative emotion, and arousal. These derived emotions may lead consumers to approach and/or avoidance behaviors. In addition, males and females tend to respond differently when they are exposed to art collaboration products. Building on this research tradition, the current study aims to investigate the inter-relationships between individual traits such as curiosity and need for uniqueness and individual's emotional responses including positive and negative emotion and arousal when people encounter various art collaborated products. Emotional responses are proposed to influence purchase intention. Additionally, previous studies show that male and females respond differently to similar stimuli. Accordingly, gender difference are proposed to moderate the links between individual traits and emotional responses. These research aims of the current study may contribute to extending our knowledge in terms of (1) which individual characteristics are related to different emotions, and (2) how these different emotional responses inter-connected to future purchase intention of arts collaborated products. In addition, (3) the different responses to these arts collaborated products by males and females will guide managers how to concoct different strategies to these segments. The questionnaire for the present study was adopted from the previous literature and validated with a pilot test. The survey was conducted in Daegu, a third largest city in South Korea, for three weeks during June and July 2011. Most respondents were in their twenties and thirties. 350 questionnaires were distributed and among them 300 were proved to be valid (valid response rate of 85.7%). Survey questionnaires from valid 300 respondents are used to test hypotheses proposed. The structural equation model (SEM) was used to validate the research model. The measurement and structural model was tested using LISREL 8.7. The measurement model test demonstrated that consistency, convergent validity, and discriminat validity of the measurement items were acceptable. The results from the structural model demonstrate that curiosity has a positive impact on positive emotion, but not on negative emotion and arousal. Need for uniqueness has three different sub-concepts such as creative choice, unpopular choice, and avoidance of similarity. The results show that creative choice has a positive effect on arousal and positive emotion, but has a negative impact on negative emotion. Unpopular choice has a positive effect on arousal, but on neither positive nor negative emotions. Avoidance of similarity has no impact on neither emotions nor arousal. The results also demonstrated that gender has a moderating influence. Males show more negative emotion to creative and unpopular choices. Implications and future research directions are discussed in conclusion.

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Studies on Sclerotium rolfsii Sacc. isolated from Magnolia kobus DC. in Korea (목련(Magnolia kobus DC.)에서 분리한 흰비단병균(Sclerotium rolfsii Sacc.)에 관한 연구)

  • Kim Kichung
    • Korean journal of applied entomology
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    • v.13 no.3 s.20
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    • pp.105-133
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    • 1974
  • The present study is an attempt to solve the basic problems involved in the control of the Sclerotium disease. The biologic stranis of Sclerotium rolfsii Sacc., pathogen of Sclerotium disease of Magnolia kobus, were differentiated, and the effects of vitamins, various nitrogen and carbon sources on its mycelial growth and sclerotial production have been investigated. In addition the relationship between the cultural filtrate of Penicillium sp. and the growth of Sclerotium rolfsii, the tolerance of its mycelia or sclerotia to moist heat or drought and to Benlate (methyl-(butylcarbamoy 1)-2-benzimidazole carbamate), Tachigaren (3-hydroxy-5-methylisoxazole) and other chemicals were also clarified. The results are summarizee as follows: 1. There were two biologic strains, Type-l and Type-2 among isolates. They differed from each other in the mode of growth and colonial appearance on the media, aversion phenomenon and in their pathogenicity. These two types had similar pathogenicity to the Magnolia kobus and Robinia pseudoacasia, but behaved somewhat differently to the soybaen and cucumber, the Type-l being more virulent. 2. Except potassium nitrite, sodium nitrite and glycine, all of the 12 nitrogen sources tested were utilized for the mycelial growth and sclerotial production of this fungus when 10r/l of thiamine hydrochloride was added in the culture solution. Considering the forms of nitrogen, ammonium nitrogen was more available than nitrate nitrogen for the growth of mycelia, but nitrate nitrogen was better for sclerotia formation. Organic nitrogen showed different availabilities according to compounds used. While nitrite nitrogen was unavailable for both mycelial growth and sclerotial formation whether thiamine hydrochlioride was added or not. 3. Seven kinds of carbon sources examined were not effective in general, as long as thiamine hydrochloride was not added. When thiamine hydrochloride was added, glucose and saccharose exhibited mycelial growth, while rnaltose and soluble starch gave lesser, and xylose, lactose, and glycine showed no effect at all,. In the sclerotial production, all the tested carbon sources, except lactose, were effective, and glucose, maltose, saccharose, and soluble starch gave better results. 4. At the same level of nitrogen, the amount of mycelial growth increased as more carbon Sources were applied but decreased with the increase of nitrogen above 0.5g/1. The amount of sclerotial production decreased wi th the increase of carbon sources. 5. Sclerotium rolfsii was thiamine-defficient and required thiamine 20r/l for maximun growth of mycelia. At a higher concentration of more than 20r/l, however, mycelial growth decreased as the concentration increased, and was inhibited at l50r/l to such a degree of thiamine-free. 6. The effect of the nitrogen sources on the mycelial growth under the presence of thiamine were recognized in the decreasing order of $NH_4NO_3,\;(NH_4)_2SO_4,\;asparagine,\;KNO_3$, and their effects on the sclerotial production in the order of $KNO_3,\;NH_4NO_3,\;asparagine,\;(NH_4)_2SO_4$. The optimum concentration of thiamine was about 12r/l in $KNO_3$ and about 16r/l in asparagine for the growth of mycelia; about 8r/l in $KNO_3$ and $NH_4NO_3$, and 16r/l in asparagine for the production of sclerotia. 7. After the fungus started to grow, the pH value of cultural filtrate rapidly dropped to about 3.5. Hereafter, its rate slowed down as the growth amount increased and did not depreciated below pH2.2. 8. The role of thiamine in the growth of the organism was vital. If thiamine was not added, the combination of biotin, pyridoxine, and inositol did not show any effects on the growth of the organism at all. Equivalent or better mycelial growth was recognized in the combination of thiamine+pyridoxine, thiamine+inositol, thiamine+biotin+pyridoxine, and thiamine+biotin+pyridoxine+inositol, as compared with thiamine alone. In the combinations of thiamine+biotin and thiamine+biotin+inositol, mycelial growth was inhibited. Sclerotial production in dry weight increased more in these combinations than in the medium of thiamine alone. 9. The stimulating effects of the Penicillium cultural filtrate on the mycelial growth was noticed. It increased linearly with the increase of filtrate concentration up to 6-15 ml/50ml basal medium solution. 10. $NH_4NO_3$. as a nitrogen source for mycelial growth was more effective than asparasine regardless of the concentration of cultural filtrate. 11. In the series of fractionations of the cultural filtrate, mycelial growth occured in unvolatile, ether insoluble cation-adsorbed or anion-unadsorbed substance fractions among the fractions of volatile, unvolatile acids, ether soluble organic acids, ether insoluble, cation-adsorbed, cation-unadsorbed, anion-adsorbed and anion-unadsorbed. and anion-un-adsorbed substance tested. Sclerotia were produced only in cation-adsorbed fraction. 12. According to the above results, it was assumed that substances for the mycelial growth and sclerotial formation and inhibitor of sclerotial formation were include::! in cultural filtrate and they were quite different from each other. I was further assumed that the former two substances are un volatile, ether insotuble, and adsorbed to cation-exchange resin, but not adsorbed to anion, whereas the latter is unvolatile, ether insoluble, and not adsorbed to cation or anion-exchange resin. 13. Seven amino acids-aspartic acid, cystine, glysine, histidine, Iycine, tyrosine and dinitroaniline-were detected in the fractions adsorbed to cation-exchange resin by applying the paper chromatography improved with DNP-amino acids. 14. Mycelial growth or sclerotial production was not stimulated significantly by separate or combined application of glutamic acid, aspartic acid, cystine, histidine, and glysine. Tyrosine gave the stimulating effect when applied .alone and when combined with other amino acids in some cases. 15. The tolerance of sclerotia to moist heat varied according to their water content, that was, the dried sclerotia are more tolerant than wet ones. The sclerotia harvested directly from the media, both Type-1 and Type-2, lost viability within 5 minutes at $52^{\circ}C$. Sclerotia dried for 155 days at$26^{\circ}C$ had more tolerance: sclerotia of Type-l were killed in 15 mins. at $52^{\circ}C$ and in 5 mins. at $57^{\circ}C$, and sclerotia of Type-2 were killed in 10 mins. both at $52^{\circ}C$ or $57^{\circ}C$. 16. Cultural sclerotia of both strains maintained good germinability for 132 days at$26^{\circ}C$. Natural sclerotia of them stored for 283 days under air dry condition still had good germinability, even for 443 days: type-l and type-2 maintained $20\%$ and $26.9\%$ germinability, respectively. 17. The tolerance to low temperature increased in the order of mycelia, felts and sclerotia. Mycelia completely lost the ability to grow within 1 week at $7-8^{\circ}C$> below zero, while mycelial felts still maintained the viability after .3 weeks at $7-20^{\circ}C$ below zero, and sclerotia were even more tolerant. 18. Sclerotia of type-l and type-2 were killed when dipped into the $0.05\%$ solution of mercury chloride for 180 mins. and 240 mins. respectively: and in the $0.1\%$ solution, Type-l for 60 mins. and Type-2 for 30 mins. In the $0.125\%$ uspulun solution, Type-l sclerotia were killed in 180 mins., and those of Type-2 were killed for 90 mins. in the$0.125\%$solution. Dipping into the $5\%$ copper sulphate solution or $0.2\%$ solution of Ceresan lime or Mercron for 240 mins. failed to kill sclerotia of either Type-l or Type-2. 19. Inhibitory effect on mycelial growth of Benlate or Tachi-garen in the liquid culture increased as the concentration increased. 6 days after application, obvious inhibitory effects were found in all treatments except Benlate 0.5ppm; but after 12 days, distingushed diflerences were shown among the different concentrations. As compared with the control, mycelial growth was inhibited by $66\%$ at 0.5ppm and by $92\%$ at 2.0ppm of Benlate, and by$54\%$ at 1ppm and about $77\%$ at 1.5ppm or 2.0ppm of Tachigaren. The mycelial growth was inhibited completely at 500ppm of both fungicides, and the formation of sclerotia was checked at 1,000ppm of Benlate ant at 500ppm or 1,000ppm of Tachigaren. 20. Consumptions of glucose or ammonium nitrogen in the culture solution usually increased with the increment of mycelial growth, but when Benlate or Tachigaren were applied, consumptions of glucose or ammonium nitrogen were inhibited with the increment of concentration of the fungicides. At the low concentrations of Benlate (0.5ppm or 1ppm), however, ammonium nitrogen consumption was higher than that of the ontrol. 21. The amount of mycelia produced by consuming 1mg of glucose or ammonium nitrogen in the culture solution was lowered markedly by Benlate or Tachigaren. Such effects were the severest on the third day after their treatment in all concentrations, and then gradually recovered with the progress of time. 22. In the sand culture, mycelial growth was not inhibited. It was indirectly estimated by the amount of $CO_2$ evolved at any concentrations, except in the Tachigaren 100mg/g sand in which mycelial growth was inhibited significantly. Sclerotial production was completely depressed in the 10mg/g sand of Benlate or Tachigaren. 23. There was no visible inhibitory effect on the germination of sclerotia when the sclerotia were dipped in the solution 0.1, 1.0, 100, 1.000ppm of Benlate or Tachigaren for 10 minutes or even 20 minutes.

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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