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A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

Removal of ${\alpha}$-Gal Epitopes in Aortic Valve and Pericardium of Pig Using Green Coffee Bean ${\alpha}$-Galactosidase (돼지의 대동맥 판막 및 심낭에서 녹색콩 알파-갈락토시다아제를 이용한 알파-갈 항원결정인자 제거)

  • Park, Seong-Sik;Kim, Woong-Han;Kim, Kyung-Hwan;Lee, Chang-Ha;Choi, Sun-Young;Lee, Cheul;Oh, Sam-Sae;Kim, Kwan-Chang;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.12-24
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    • 2008
  • Background: It is currently thought that tissue valve degeneration is related to an animal's immune response, which is mainly due to cell surface ${\alpha}$-Gal epitopes. Cell surface ${\alpha}$-Gal epitopes are known to be degraded by the enzyme called green coffee bean ${\alpha}$-Galactosidase. It is also well known that ${\alpha}$-Gal epitopes are immunologically stained by Griffonia Simplicifolia isolectin type B4. We know that many commercially available tissue valves are made of aortic valves and pericardial tissue of pig. So, we investigated whether ${\alpha}$-Gal epitopes of the aortic valve and pericardial tissue of a pig can be removed by green coffee bean ${\alpha}$-Galactosidase, and we did so by comparing immunologic staining of the tissues before and after the enzyme treatment. Material and method: After treating fresh porcine aortic valve and pericardial tissue with green coffee bean ${\alpha}$-Galactosidase at concentrations of 0.5 unit/mL, 1.0 unit/mL, 2.0 unit/mL, respectively, under the condition of pH 6.5, temperature. $4^{\circ}C$ and 24 hours of incubation, each sample was stained with Griffonia Simplicifolia isolectin type B4 immunpfluorescent labeling. We then examined whether the ${\alpha}$-Gal epitopes were reduced or abolished in each consecutive. concentration of green coffee bean ${\alpha}$-Galactosidase by comparing the degree of the Griffonia Simplicifolia isolectin B4 staining in each sample. Result: In the pig aortic valve tissue, a 1.0 unit/mL concentration of green coffee bean ${\alpha}$-Galactosidase at pH 6.5, $4^{\circ}C$ and reaction for 24 hours was enough for complete removal of ${\alpha}$-Gal epitopes from the cell sur face on the immunostaining with Griffonia Simplicifolia isolectin B4. On the other hand, more ${\alpha}$-Gal epitopes were present in the pig pericardial tissue on Griffonia Simplicifolia isolectin B4 staining before the enzyme treatment, and 1.0 unit/mL of galactosidase was not sufficient for complete removal of ${\alpha}$-Gal from the tissue. 2.0 units/mL of green coffee bean ${\alpha}$-Galactosidase was needed to completely remove the ${\alpha}$-Gal epitopes from the pericardial tissue on immunostaining. Conclusion: The ${\alpha}$-Gal epitopes of the pig's aortic valve and pericardial tissue were successfully stained with Griffonia Simplicifolia isolectin B4. We could remove nearly all the ${\alpha}$-Gal epitopes using green coffee bean ${\alpha}$-Galactosidase at the concentration of 1.0 unit/mL in the aortic valve. Of pig, and 2.0 unit/mL was need to nearly completely remove all the ${\alpha}$-Gal epitopes in the pericardial tissue of pig under the condition of pH 6.5, $4^{\circ}C$ and 24 hours of reaction time. In the near future, removal of ${\alpha}$-Gal epitapes in the pig's aortic valve and pericardial tissue will become a powerful tool for the improvement of the tissue valve durability. It needs to be determined if ${\alpha}$-galactosidase treated pig tissue is immune to human anti-Gal antibody or anit-Gal mooclonal antibodies.

The Effect of Lime Application after Cultivating Winter Forage Crops on the Change of Major Characters and Yield of Peanut (동계사료작물 재배후 석회물질 시용이 땅콩의 주요 형질 및 수량에 미치는 영향)

  • Kim, Dae-Hyang;Chim, Jae-Seong
    • The Journal of Natural Sciences
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    • v.7
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    • pp.103-114
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    • 1995
  • These experiments were conducted for decrease of injury by continuous cropping in the peanut fields of Chonbuk Wangkungarea. The continuous cropping field for four years was used in this experiment. Italian ryegrass and rye were cultivated andlime materials were distributed for improvement of soil fertility. The results were as follows; 1. Forage crops were cultivatedand lime materials were distributed on the continuous cropping field of peanut. The organic matter content of the expermentalplot cultivating Italian ryegrass was only 1.25%. The organic matter content of soil cultivated Italian ryegrass after distributedmagnesium lime was 1.37% and that of soil cultivated Italian ryegrass after distributed gypsum was 1.30%. It was highcontent comparing to that of soil distributed lime materials only. The organic matter content of soil cultivated rye after distributed gypsum was 1.77%. 2. The phosphate content of soil cutivated Italian ryegrass was 332ppm. The phosphate content ofsoil cultivated Italian ryegrass after distributed magnesium lime was 34Oppm and that of soil cultivated Italian ryegrass afterdistributed gypsum was 31 2ppm. The phosphate content of soil cultivated rye only was 386ppm. The phosphate content ofsoil cultivated rye after distributed gypsum was 41 8ppm. This phosphate content was lower than that of soil distributed limematerials only. 3. The phytotoxin content of soil cultivated Italian ryegrass after distributed magnesium lime was decreased to17.7% and that of soil cultivated Italian ryegrass after distributed gypsum was decreased to 25.3%. The phytotoxin content ofsoil cultivated rye after distributed magnesium lime was decreased to 12.0% and that of soil cultivated rye after distributedgypsum was decreased to 12.8% comparing to the phytotoxin content of soil distributed lime materials only. Italian ryegrasswas effective to decrease phytotoxin among the forage crops and gypsum was effective among the lime materials. 4. Abacterial wilt and a late spot of peanut which were known as, main reason of continuous cropping failure were surveyed.lnccidence of a bacterial wilt was 3.4% in the plot cultivated Italian ryegrass only and that was 2.9% in the plot cultivated ryeonly. lnccidence of a bacterial wilt was 2.5% in the plot cultivated Italian ryegrass after distributed magnesium lime and thatwas 2.3% in the plot cultivated rye after distributed gypsum. Inccidence plot cultivated forage crops was lower than that of plotdistributed lime materials. 5. Inccidence of a late spot was high in the plot cultivated forage crops ony, but it was low in the plotcultivated forage crops after distributed lime materials comparing to that of the control plot. 6. The growth and yield of peanutwere bad in the plot cultivated forage crops only comparing to the control plot distributed lime materials only. These resultswere same in the plot cultivated rye after distributed lime materials, but the growth and yield were grown up in the plotcultured Italian ryegrass after distributed lime materials.

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Developing the Process and Characteristics of Preservation of Area-Based Heritage Sites in Japan (일본 면형 유산 보존제도의 확산과정과 특성)

  • Sung, Wonseok;Kang, Dongjin
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.32-59
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    • 2020
  • South Korea's area-based heritage preservation system originates from the "Preservation of Traditional Buildings Act" enacted in 1984. However, this system was abolished in 1996. As there was a need for protection of ancient cities in the 1960s, Japan enacted the Historic City Preservation Act in 1966, and 'Preservation Areas for Historic Landscapes' and 'Special Preservation Districts for Historic Landscapes' were introduced. For the preservation of area-based heritage sites, the 'Important Preservation Districts for Groups of Traditional Buildings' system introduced as part of the revision of the Cultural Heritage Protection Act in 1975 was the beginning. Then, in the early-2000s, discussions on the preservation of area-based heritage sites began in earnest, and the 'Important Cultural Landscape' system was introduced for protection of the space and context between heritage sites. Also, '33 Groups of Modernization Industry Heritage Sites' were designated in 2007, covering various material and immaterial resources related to the modernization of Japan, and '100 Beautiful Historic Landscapes of Japan' were selected for protection of local landscapes with historic value in the same year. In 2015, the "Japanese Heritage" system was established for the integrated preservation and management of tangible and intangible heritage aspects located in specific areas; in 2016, the "Japanese Agricultural Heritage" system was established for the succession and fostering of the disappearing agriculture and fishery industries; and in 2017, "the 20th Century Heritage," was established, representing evidence of modern and contemporary Japanese technologies in the 20th century. As a result, presently (in September 2020), 30 'Historic Landscape Preservation Areas', 60 'Historic Landscape Special Districts,' 120 'Important Preservation Districts for Groups of Traditional Buildings," 65 'Important Cultural Landscapes,' 66 'Groups of Modernization Industry Heritage Sites,' 264 "100 Beautiful Historic Landscapes of Japan,' 104 'Japanese Heritage Sites,' and 15 'Japanese Agricultural Heritage Sites' have been designated. According to this perception of situations, the research process for this study with its basic purpose of extracting the general characteristics of Japan's area-based heritage preservation system, has sequentially spread since 1976 as follows. First, this study investigates Japan's area-based heritage site preservation system and sets the scope of research through discussions of literature and preceding studies. Second, this study investigates the process of the spread of the area-based heritage site preservation system and analyzes the relationship between the systems according to their development, in order to draw upon their characteristics. Third, to concretize content related to relationships and characteristics, this study involves in-depth analysis of three representative examples and sums them up to identify the characteristics of Japan's area-based heritage system. A noticeable characteristic of Japan's area-based heritage site preservation system drawn from this is that new heritage sites are born each year. Consequently, an overlapping phenomenon takes place between heritage sites, and such phenomena occur alongside revitalization of related industries, traditional industry, and cultural tourism and the improvement of localities as well as the preservation of area-based heritage. These characteristics can be applied as suggestions for the revitalization of the 'modern historical and cultural space' system implemented by South Korea.

Comparison of CT based-CTV plan and CT based-ICRU38 plan in Brachytherapy Planning of Uterine Cervix Cancer (자궁경부암 강내조사 시 CT를 이용한 CTV에 근거한 치료계획과 ICRU 38에 근거한 치료계획의 비교)

  • Cho, Jung-Ken;Han, Tae-Jong
    • Journal of Radiation Protection and Research
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    • v.32 no.3
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    • pp.105-110
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    • 2007
  • Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as Point A, is still used widely. A 3-dimensional ICR plan based on CT image provides dose-volume histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planing system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume$(average{\pm}SD)$ of CTV, rectum and bladder in all of 11 patients is $21.8{\pm}6.6cm^3,\;60.9{\pm}25.0cm^3,\;111.6{\pm}40.1cm^3$ respectively. The volume covered by 100% isodose curve is $126.7{\pm}18.9cm^3$ in ICRU plan and $98.2{\pm}74.5cm^3$ in CTV plan(p=0.0001), respectively. In (On) ICRU planning, $22.0cm^3$ of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of $62.2{\pm}4.8cm^3$ other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was $90.1{\pm}21.3%$ and $68.7{\pm}26.6%$ in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was $86.4{\pm}18.3%$ and $76.9{\pm}15.6%$ in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was $137.2{\pm}50.1%,\;101.1{\pm}41.8%$ in ICRU plan and $107.6{\pm}47.9%,\;86.9{\pm}30.8%$ in CTV plan, respectively. Therefore, the radiation dose to normal organ was lower in CTV plan than in ICRU plan. But the normal tissue dose was remarkably higher than a recommended dose in CTV plan in one patient whose residual tumor size was greater than 4cm. The volume of rectum receiving more than 80% isodose (V80rec) was $1.8{\pm}2.4cm^3$ in ICRU plan and $0.7{\pm}1.0cm^3$ in CTV plan(p=0.02). The volume of bladder receiving more than 80% isodose(V80bla) was $12.2{\pm}8.9cm^3$ in ICRU plan and $3.5{\pm}4.1cm^3$ in CTV plan(p=0.005). According to these parameters, CTV plan could also save more normal tissue compared to ICRU38 plan. Conclusion : An unnecessary excessive radiation dose is irradiated to normal tissues within 100% isodose area in the traditional ICRU plan in case of a small size of cervix cancer, but if we use CTV plan based on CT image, the normal tissue dose could be reduced remarkably without a compromise of tumor dose. However, in a large tumor case, we need more research on an effective 3D-planing to reduce the normal tissue dose.

Current and Future Operation of Menu Management in the School Foodservices of Chungbuk (1) - Menu Planning - (충북지역 학교급식 영양(교)사의 식단관리 운영실태 및 개선방안(1) - 식단계획 -)

  • Ahn, Yoon-Ju;Lee, Young-Eun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.8
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    • pp.1118-1133
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    • 2012
  • This research aimed to suggest an efficient improvement plan for school food services by investigating the operating situation and recognition of menu management in school food services for school food service dietitians (and nutrition teachers) in Chungbuk. A total of 328 questionnaires were distributed to school food service dietitians (and nutrition teachers) in Chungbuk by e-mail in September, 2010. A total of 265 questionnaires (80.8%) were used for the analysis. The highest allocation of nutrients and calories per day in school food services was 1:1.5:1.5 (breakfast : lunch : dinner) (38.5%). The reasoning for applying a flexible allocation of nutrients and calories per day was 'considering the ratio of students who do not eat breakfast' (59.2%). And the way to apply the flexible allocation for nutrients and calories per day was 'by agreement from the school operating committee in arbitrary data without situation surveys' (86 respondents, 49.4%), and 'by agreement from the school operating committee in analysis data through situation surveys' (80 respondents, 46.0%). The operational method of standardized recipes was 'cooking management site of national education information systems' (87.5%) and the items included in standardized recipes were menu name, food material name, portion size, cooking method, nutrition analysis, and critical control point in HACCP. The main reason for not utilizing all items of a cooking management site of the national education information system was 'no big trouble in menu management even though it is used partly (29.1%). In addition, the highest use of standardized recipe was for 'maintaining consistency of food production quantity' (74.0%).