• Title/Summary/Keyword: National health

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Inhibitory Effects of Anthocyanins Isolated from Black Soybean (Glycine max L.) Seed Coat on Degranulation and Cytokine Generation in RBL-2H3 Cells (검정콩 껍질 유래 안토시아닌의 RBL-2H3 세포에서 탈과립화와 사이토카인 생성 저해 효과)

  • Chung, Mi-Ja;Ha, Tae-Joung;Choi, Ha-Na;Lee, Ji-Sun;Park, Yong-Il
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.12
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    • pp.1662-1667
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    • 2011
  • Anthocyanins belong to a group of flavonoid compounds and are well known for their various health beneficial effects, which include antioxidative activities. Among them, the major anthocyanins isolated from seed coat of black soybean (Glycine max L.) were previously characterized as glycosides containing glucopyranose. Asthma is an allergic disease that is strongly associated with various immune cells, including basophils and mast cells. Eosinophils, basophils, and mast cells play important roles in allergic asthma through the release of inflammatory mediators such as asthma-specific T-helper 2 (Th2) cytokines and subsequent amplification of asthma symptoms via degranulation. Rat basophilic leukemia RBL-2H3 cells are the most common in vitro models for evaluating allergic reactions. In this study, we examined the effects of anthocyanin from seed coat of black soybean on antigen-stimulated degranulation and Th2 cytokine production in RBL-2H3 cells. Cell degranulation was evaluated by measuring the release of ${\beta}$-hexosaminidase. ${\beta}$-Hexosaminidase release and Th2 cytokine production in RBL-2H3 cells was much higher upon stimulation with IgE-antigen complex than those in untreated control cells. Anthocyanins significantly suppressed IgE-antigen complex-induced degranulation of RBL-2H3 cells and inhibited IgE-antigen complex-mediated interleukin (IL)-4, IL-13, and tumor necrosis factor ${\alpha}$ (TNF-${\alpha}$) production in RBL-2H3 cells. These findings suggest that anthocyanins from seed coat of black soybean effectively inhibit allergic reactions and may have beneficial effects against allergic asthma.

Evaluation of Insecticidal and Antifeeding Activities of Eco-friendly Organic Insecticides Against Agricultural Insect Pests (농업해충에 대한 친환경유기농자재들의 살충력 및 섭식저해력 평가)

  • Kim, Yoo Hwa;Na, Young-Eun;Kim, Min Joon;Choi, Byung Ryul;Jo, Hyeong-Chan;Kim, Soon-Il
    • Korean journal of applied entomology
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    • v.54 no.2
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    • pp.99-109
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    • 2015
  • Insecticidal and antifeeding activities of 29 commercialized eco-friendly organic products for managing plant diseases and insect pests against Plutella xylostella larvae, Spodoptera exigua larvae, Frankliniella occidentalis adults, and Myzus persicae adults were tested using spraying and leaf dipping bioassays under laboratory conditions. Products containing 60% Sophora extract (EOIS) and mixtures (EOISm) with Sophora extract, Stemona japonica extract, Melia azedarach extract, and Nepeta cataria extract as well as mixtures (EOISc) with Sophora extract, Chenopodium ambrosioides extract, and Melia azedarach extract as active ingredients showed strong insecticidal activity at recommended concentration against P. xylostella larvae. At half concentration, their insecticidal activities were decreased under 50%. The EOIS gave good insecticidal activity against S. exigua larvae and also showed 85% and 95% insecticidal activity at 24 and 48 hours after treatment to F. occidentalis adults, respectively. For M. persicae adults, EOISm and mixtures (EOIR) containing rape seed extract, neem extract, and castar oil produced 93% and 68% insecticidal activity, but their activities did not be increased at double concentration. EOISm only showed 100% contact toxicity against M. persicae adults exposed to dipping leaves. Interestingly, the insecticidal activity of EOIR and EOICi (citronella oil and derris extract) against M. persicae adults was increased with exposed time and concentration. In addition, EOICe (cedar oil), EOIS, EOISm, EOISc, EOIM (microorganism), EOIR, EOIPe (plant extract), and EOIT (tea tree extract) gave strong antifeeding activity against S. exigua and P. xylostella larvae. EOIB, EOIBs, EOIM, EOICi, and EOIMc showed above 70% antifeeding activity to the lepidopteran larvae. These results indicate that mixtures containing 2 to 3 plant extracts with Sophora extract show good activities against insect pests, although the difference of insecticidal and antifeeding activities was produced depending on both a tested insect species and an active ingredient or concentration.

Community Characteristics and Biological Quality Assessment on Benthic Macroinvertebrates of Bongseonsa Stream in Gwangneung Forest, South Korea (광릉숲 내 봉선사천의 저서성 대형무척추동물의 군집 특성 및 생물학적 하천평가)

  • Jung, Sang-Woo;Cho, Yong-Chan;Lee, Hwang-Goo
    • Korean Journal of Environment and Ecology
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    • v.31 no.6
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    • pp.508-519
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    • 2017
  • There have been many studies on monitoring of biodiversity changes and preservation of Gwangneung Forest Biosphere Reserve (GFBR) in South Korea in recognition of the rare ecosystem that has been preserved for a long period. However, there are few studies on diversity and community characteristics of benthic macroinvertebrates as an indicator of stream health of GFBR. The purpose of this study was to assess the water quality of Bongseonsa Stream that penetrated through Gwangneung Forest and the nearby torrents by analyzing the benthic macroinvertebrates community during April to September 2016. The investigation collected a total of 114 species of benthic macroinvertebrates belonging to 56 families, 17 orders, 8 classes, and 5 phyla from the Bongseonsa Stream and Kwangneung Stream. Ephemeroptera and Trichoptera were the largest groups in species diversity with 30 species (32.3%) and 16 species (17.2%), respectively, and Tubificidae sp., Baetis fuscatus, Antocha KUa, and Cheumatopsyche brevilineata, which usually habit in contaminated streams, appeared frequently. Among the feeding function groups, the gatherers and hunters appeared relatively frequently, and the shredders and scrapers appeared frequently in the torrents. Among the habitat oriented groups, the clingers and burrower appeared more frequently and represented the microhabitats in the shallow areas. The result of the analysis of benthic macroinvertebrates community showed that the dominant index was $0.48{\pm}0.10$ in average while it was lowest with 0.33 in GS 8 of the Gwangneung Forest torrent and highest in BS 1 of Bongseonsa Stream. The diversity and richness indices were inversely proportional to the dominant index and were 2.53 and 4.22, respectively, in GS 8 where the dominant index was low. The result of the analysis of community stability showed that area I, which had high resistance and restoration, was high in Bongseonsa Stream while the area III, which had low resistance and restoration, was high in Gwangneung Forest, indicating that the water system in Gwangneung Forest had a wider distribution of specifies sensitive to agitation. The biological water quality assessment showed ESB of $50.88{\pm}17.69$, KSI of $1.11{\pm}0.57$, and BMI of $78.55{\pm}11.05$. GS 8 of Gwangneung Forest torrent was judged to be the highest priority protective water area with the best water environment and I class water quality with ESB of 63, KSI of 0.55, and BMI of 89.9. On the contrary, BS 1 of Bongseonsa Stream was judged to be the high priority improvement area that had the lowest water quality rating of III with ESB of 25, KSI of 2.13, and BMI of 62.7. Although the diversity of water beetle was higher in the water system of nearby Bongseonsa Stream than the water system inside the Gwangneung Forest, the annual community structure appeared to have distinct differences.

Differences in Sleep Patterns are Related to Behavior, Emotional Problems, Attention and Academic Performance in Elementary School Students of a South Korean Metropolitan City (일 도시의 초등학교 학생의 수면습관과 행동, 정서, 주의력, 학습과의 관계)

  • Tak, Hee-Jong;Lee, Ji-Ho;Lee, Chang-Myung;Chung, Seok-Hoon;Lee, Jae-Won;Sim, Chang-Sun;Yoon, Jae-Goog;Sung, Joo-Hyeon;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.3
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    • pp.182-191
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    • 2011
  • Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient (어린이 영양지수 (nutrition quotient)를 이용한 제주 지역 일부 초등학생의 식습관 및 영양 상태 평가)

  • Boo, Mi Na;Cho, Su Kyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.48 no.4
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    • pp.335-343
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    • 2015
  • Purpose: The aim of this study was to evaluate the food behavior and nutritional status of elementary school students in the Jeju area using Nutrition Quotient (NQ). Methods: The subjects were 440 students (235 boys and 205 girls) in the fifth and sixth grade at four elementary schools located in Jeju. Demographic, lifestyle, and environmental information was collected using a self-reported questionnaire. The food behavior checklist for children's Nutrition Quotient (NQ), consisting of 19 items, and nutrition education related information were also obtained. Results: The mean score of the children's NQ was poor, reaching 60.3 points. The percentage distribution of NQ grade was 19.8% (lowest), 18.6% (low), 45.0% (medium), 10.7% (high), and 5.9% (highest) and the factor scores for balance, diversity, abstinence, regularity, and practice were 56.6, 68.4, 71.3, 57.4, and 54.8 points, respectively. Compared with the NQ cut-off points for defining malnutrition (balance; 57, diversity; 87, abstinence; 66, regularity; 69, and practice; 67 point), average score of abstinence factor was only above the cut-off point and scores of the other factors were below the cut-off point. Subjects with higher NQ scores tended to have higher levels of exercise activity (p < 0.001), frequency of family meals (p < 0.01), and father's educational levels (p < 0.01) compared to those with lower NQ score. NQ score showed positive association with nutrition education experience and practice (p < 0.001). Conclusion: NQ score of elementary school students residing in Jeju was lower than the national average. More opportunities should be provided for participation in nutrition education, which incorporates a range of program strategies, as well as communication and education activities.

Analysis of the Correlation of Job Satisfaction to Turnover Among Dental Hygienists in the Region of J (J지역 치과위생사의 직무만족과 이직의 상관관계 분석)

  • Ju, On-Ju;Kim, Kyeong-Seon;Lee, Hyun-Ok
    • Journal of dental hygiene science
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    • v.7 no.4
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    • pp.251-256
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    • 2007
  • The purpose of this study was to examine what induced dental hygienists to take up another employment and whether their job satisfaction had anything to do with it in an attempt to help curtail their turnover rate. The subjects in this study were approximately 200 dental hygienists who worked in dental institutions. A survey was conducted from July 24 through September 24, 2006, by using structured, self-administered questionnaires. For data analysis, SPSS 11.5 program was employed to see if their turnover experience was linked to their general characteristics, why they took up another employment, how long they wanted to do that and how their job satisfaction was related to that. The findings of the study were as follows: 1. In regard to turnover experience by age, marital status and career, those who had ever changed their employment accounted for 36.2 percent of the age group from 24 to 26, 83.0 percent of the unmarried ones and 50.0 percent of those whose career was less than one to three years (p < 0.001). By monthly mean income, 50.0 percent of the dental hygienists whose monthly mean income ranged from 1.0 to 1.29 million won had that experience(p < 0.05). The gap between these groups and the others was statistically significant. 2. As for the reason of turnover, working environments were cited most often(28.1%), followed by possibilities(18.0%), relationship with supervisors and colleagues(12.4%), and compensation(4.5%). 3. Concerning a preferred new workplace, 66.2 percent of the dental hygienists who worked in dentist's offices hoped to be newly hired by public dental clinics(p < 0.001). By education, 64.3 percent of the college-educated dental hygienists wanted to work at public dental clinics as well(p < 0.01). 4. The change of employment was under the greatest influence of the possibilities of workplace, followed by workload, pay and relationship with colleagues. All the factors had a negative impact on their turnover. Those who were less satisfied sought new employment more often, and job satisfaction made a statistically significant difference to that. The job satisfaction factors made a prediction of their turnover intention ($R^2=.254$).

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Allium hookeri Extract Improves Type 2 Diabetes Mellitus in C57BL/KSJ Db/db Obese Mouse via Regulation of Hepatic Lipogenesis and Glucose Metabolism (삼채 추출물의 인슐린 저항성 개선 효과 및 기전 탐색)

  • Kim, Ji-Soo;Heo, Jin-Sun;Choi, Jong-Won;Kim, Gun-Do;Sohn, Kie-Ho
    • Journal of Life Science
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    • v.25 no.10
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    • pp.1081-1090
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    • 2015
  • Diabetes has been one of major health risks in industrialized countries. Allium hookeri is a wild herb distributed in India and Myanmar. The root of the plant has been used as food and medicine in Southeast Asia. We investigated Allium hookeri extract improves type 2 diabetes mellitus in C57BL/KSJ db/db obese mouse. C57BL/KSJ db/db obese mouse arise out of Type 2 diabetes and we treated Allium hookeri methanol extract 400 mg/kg (AH 400), 800 mg/kg (AH 800), positive control group (thiazolidinedine;TZDs) were administered orally for 8weeks. AH treated group normalized lipid enzyme system (triglyceride, total cholesterol, HDL-cholesterol and LDL-cholesterol) and serum glucose, HbA1c and plasma insulin level. AH treated group recovered β-cell damage by hyperglycemia and fatty liver disease. AH treated group significantly up regulated expression of Peroxisome proliferator-activated receptor gamma (PPAR-γ), pyruvate dehydrogenase kinase4 (PDK4), Sterol regulatory element-binding protein 1c (SREBP 1) and fork head box O1 (FOX 01) proteins in C57BL/KSJ db/db obese mouse liver. And we found that AH treated group decreased hepatic malondialdehyde formation in C57BL/KSJ db/db obese mouse liver. These results indicate that Allium hookeri methanol extract might be a potential anti-diabetic agent and could be useful in the treatment of type 2 diabetes mellitus.

Effect of Cytarabine, Melphalan, and Total Body Irradiation as Conditioning for Autologous Stem Cell Transplantation for Patients with AML in First Remission (1차 관해된 급성 골수성 백혈병에서 자가 조혈모세포 이식을 위한 Cytarabine, Melphalan, 전신 방사선치료의 효과)

  • Kang Ki Mun;Choi Byung Ock;Chai Gyu Young;Kang Young Nam;Jang Hong Sek;Kim Hee Jae;Min Wo Sung;Kim Chun Choo;Choi Ihl Bohng
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.192-198
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    • 2003
  • Purpose: Current results of autologous stem cell transplantation (SCT) suggest that this procedure may prolong disease free survival In patients with acute myeloid leukemia (AML). Autologous SCT is increasingly used as treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous SCT for patients with AML in first remission treated by autologous SCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen. Materials and Methods: Between January 1995 and December 1999, 29 patients with AML in first remission underwent autologous SCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine ($3.0\;gm/m^2$ for 3 days), melphalan ($100\;gm/m^2$ for 1 day) and TBI (total 1000 cGy in five fractions over 3 days). Results: The median follow up was 40 months with a range of 3 to 58 months. The 4-year cumulative probability of disease free survival was 69.0%, and median survival was 41.5 months. The 4-year relapse rate was 27.6%. The factor Influencing disease free survival and relapse rate was the French-American-British (FAB) classification ($M_3$ group vs. other groups; p=0.048, p=0.043). One patient died from treatment-related toxicity. Conclusion:: Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBI as a conditioning regimen for autologous SCT for AML on first remission appears to be safe and effective.

Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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A Study of The Nursing Education Concerning Two Years Associate Degree Nursing Program (간호 교육에 대한 일 연구 -2년제 초급대학 과정 중심으로-)

  • 변창자
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.63-79
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    • 1974
  • 1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

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