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Postprandial hypoglycemic effects of mulberry twig and root bark in vivo and in vitro (In vivo와 in vitro에서 상지 및 상백피 에탄올추출물이 식후 혈당 상승 억제 조절에 미치는 영향)

  • Park, Soo Yeon;Jin, Bo Ra;Lee, Yu Rim;Kim, You Jin;Park, Jeong Bin;Jeon, Young Hee;Choi, Sang Won;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.49 no.1
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    • pp.18-27
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    • 2016
  • Purpose: Our previous study demonstrated the hypoglycemic effects of mulberry (Morus alba L.) leaf and the underlying mechanisms. Here we explored the potency of mulberry twigs (TW) and root barks (RB) in postprandial hypoglycemic effects in vitro and in vivo. Methods: The major components of TW and RB were determined by high performance liquid chromatography (HPLC). Alpha-glucosidase inhibition and glucose/fructose uptake inhibition in Caco-2 cells were determined for TW, RB, and their major components, followed by an oral sugar tolerance test (OSTT) in streptozotocin-induced diabetic rats. Male Wistar rats were fed a high-fat diet for 2 weeks and then a single dose of streptozotocin (35 mg/kg B.W) was administered by intraperitoneal injection. Rats with fasting blood glucose levels above 126 mg/dL were randomly divided into 5 groups (n = 8/group) for the following treatments by gavage for 4 weeks: vehicle (normal control and diabetic control), 200 mg/kg B.W of TW or RB or 100 mg/kg B.W of oxyresveratrol (OXY). Results: OXY and mulberroside A were identified as the major components of TW and OXY, mongolicin, and kuwanon H for RB. A significant inhibitory activity on ${\alpha}-glucosidase$ was found for TW, RB, and OXY (p = 0.0099). There was a dose-dependent inhibition of TW and RB on the intestinal sugar uptakes in Caco-2 cells, showing a greater impact on fructose compared to glucose. The OSTT showed that TW and RB significantly delayed time to maximal concentration (p = 0.0088) and decreased maximal concentration (p = 0.0043) compared to the control group. Conclusion: These results suggest that TW and RB may have a postprandial hypoglycemic effect, particularly in the case of high fructose or sucrose intake. OXY was suggested as a contributor to the hypoglycemic effect of TW and RB. Further studies are needed for the systemic effect of TW and RB in circulation.

Effects of Ouabain and Vanadate on the Spontaneous Contractions and Electrical Activity in Guinea-pig Taenia Coli (결장뉴 전기활동도에 대한 Ouabain과 Vanadate의 작용)

  • Park, Jong-Kyou;Kim, Ki-Whan;So, In-Suk
    • The Korean Journal of Physiology
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    • v.22 no.2
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    • pp.189-206
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    • 1988
  • The effects of ouabain on the contractile and electrical activities were investigated in the isolated preparations of guinea-pig taenia coli, and compared with those of vanadate. Spontaneous contractions were recorded with force transducer, and electrical activites were measured by use of suction electrode, or single sucrose-gap technique. The contractions were induced by the electrical stimulation for 5 seconds every 1 minute with alternating current (60 Hz, 3.0 V/cm) through the platinum electrodes located in parallel with the long axis of the preparation. All experiments were performed in tris-buffered Tyrode solution which was aerated with $100%{\;}O_2$ and kept at $35^{\circ}C$. The results obtained were as follows: 1) Responses of spontaneous contractions to ouabain were concentration-dependent; $10^{-7}M$ ouabain caused a rise of basal tone. Above the concentration of $10^{-6}M$ ouabain, an initial increase followed by a decrease in tension was observed. 2) A continuous spike discharge was induced by the administration of $10^{-7}M$ ouabain. Above $10^{-6}M$ ouabain, a transient initial increase followed by a decrease in spike frequency and amplitude was produced, and finally membrane potential was sustained at a certain level without a spike discharge. 3) The characteristic response to $10^{-7}M$ ouabain was not blocked by the pretreatment with $10^{-7}M$ atropine. 4) The electrically induced contractions were completely suppressed at the concentration of $2{\times}10^{-7}M$ ouabain. These contractions were blocked more rapidly in paralled with the increase in ouabain concentration. 5) Effects of vanadate on the spontaneous activities were quite different from those of ouabain; $10^{-6}M$ vanadate increased the amplitude of contractions and $10^{-5}M$ vanadate increased slightly both amplitude and frequency of spontaneous contractions. $10^{-4}M$ vanadate showed irregular phasic contractions superimposed on the increased basal tone. 6) $10^{-5}M$ vanadate depolarized the membrane potential and shortened the interval between the bursts of spike discharge, whereas $10^{-4}M$ vanadate induced continuous spike discharge with membrane depolarization. 7) Vanadate caused a characteristic inhibitory response to the contractions induced by electrical stimulation; An initial rapid inhibition of tension development and then gradual recovery to a certain level. From the above results, the following conclusions could be made: 1) The rise of basal tone at $10^{-7}M$ ouabain is due to continuous spike discharge without a silent period. The continuous spike discharge is likely to be associated with a slight membrane depolarization caused by the blockage of Na pump. 2) The biphasic response induced by above $10^{-6}M$ ouabain seems to occur by the different mechanisms. The initial increase in tension is associated with depolarization along with an increase in spike frquency, whereas the subsequent relaxation occurs through a non-electrical mechanism. 3) The characteristic response to $10^{-7}M$ ouabain is resulted not from the action on intrinsic nerve terminal, but from its direct action on the membrane of smooth muscle cells. 4) The phasic contractions superimposed on the increased basal tone at the concentration of $10^{-4}M$ vanadate is resulted from the continuous spike discharge with membrane depolarization, of which mechanism remains unknown. 5) The inhibitory action of ouabain on the electrically induced contractions suggests that the increasein intracellular Na in some way inhibits the electrically induced $Ca^{2+}$ influx. The mechanism of vanadate action on the induced contractions remains unknown.

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Evaluation of Greenhouse Gas Emissions in Cropland Sector on Local Government Levels based on 2006 IPCC Guideline (2006 IPCC 가이드라인을 적용한 지자체별 경종부문 온실가스 배출량 평가)

  • Jeong, Hyun-Cheol;Kim, Gun-Yeob;Lee, Seul-Bi;Lee, Jong-Sik;Lee, Jung-Hwan;So, Kyu-Ho
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.5
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    • pp.842-847
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    • 2012
  • This study was conducted to estimate the greenhouse gas emissions on local government levels from 1990 to 2010 using 2006 IPCC guideline methodology. To calculate greenhouse gas emissions based on the 16 local governments, emission factor and scaling factor were used with default value and activity data came from the food, agricultural, forestry and fisheries statistical yearbook of MIFAFF (Ministry for Food, Agriculture, Forestry, and Fisheries). The total emissions in crop sector gradually decreased from 1990 to 2010 due to a decline in agricultural land and nitrogen fertilizer usage. The annual average emission of greenhouse gas was the highest in Jeonnam (JN) with 1,698 Gg $CO_2$-eq and following Chungnam (CN), Gyungbuk (GB), Jeonbuk (JB) and Gyunggi (GG). The sum of top-six locals emission had occupied 83.4% of the total emission in cropland sector. The annual average emissions in 1990 by applying 2006 IPCC guideline were approximately 43% less than the national greenhouse gas inventory by 1996 IPCC guideline. Jeonnam (JN) province occupied also the highest results of greenhouse gas emission estimated by gas types (methane, nitrous oxide and carbon dioxide) and emission sources such as rice cultivation, agricultural soil, field burning of crop residue and urea fertilizer.

THE ANTICANCER EFFECT OF PACLITAXEL($Taxol^{(R)}$) IN ORAL SQUAMOUS CELL CARCINOMA XENOGRAFT (이종 이식된 구강편평세포 암종에서 Paclitaxel ($Taxol^{(R)}$)의 항암 효과)

  • Kim, Ki-Hwan;Kim, Chul-Hwan;Han, Se-Jin;Lee, Jae-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.95-110
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    • 2006
  • The treatment for oral and maxillofacial carcinoma with chemotherapeutic agents is evaluated by many effective methods to reduce the tumor mass and cancer cell proliferation. However these chemotherapy have many serious side effects, such as bone marrow suppression, renal toxicity, G-I troubles. Therefore a possible approach to develop a clinically applicable chemotherapeutic agent is to screen anticancer activity of Taxol which is known to have very little side effect and have been used to breast cancer and ovarian carcinoma. Taxol is a new anti-microtubular anti-cancer agent extracted from the bark of the Pacific yew, Taxus brevifolia. Paclitaxel(Taxol) acts by promoting tubulin polymerization and over stabilizing microtubules agianst depolymerization. Despite the constant improvements of methods of the cancer treatment especially chemotherapy, the rate of cancer metastasis and recurrent are not decreased. Thus the investigation of new drug which have very little side effect and a possible clinically application continues to be a high priority. Considering that the Taxol have shown very effective chemotherapeutic agent with relatively low toxicity in many solid tumors, it deserves to evaluate its efficacy in oral squamous cell carcinoma. In this study, to investigate the in-vivo and in-vitro anti-cancer efficacy of Taxol in oral squamous cell carcinoma and lastly, the potency of Paclitaxel in the clinical application for oral cancer was evaluated. In vivo study, after HN22 cell line were xenografted in nude mice, the growth of tumor mass was observed, 3 mg/Kg taxol was injected intraperitoneally into nude mice containing tumor mass. The methods of these study were measurement of total volume of tumor mass, histopathologic study, immunohistochemical study, drug resistance assay, growth curve, MTT assay, flow cytometry, cDNA microarray in vivo and in vitro. The results were obtained as following. 1. The visual inspection of the experimental group showed that the volume of the tumor mass was slightly decreased but no significant difference with control group. 2. Ki-67 index was decreased at weeks 4 in experimental group. 3. Microscopic view of the xenografted tumor mass showed well differentiated squamous cell carcinoma and after Taxol injection, some necrotic tissue was seen weeks 4. 4. The growth curve of the tumor cells were decreased after 1day Taxol treatment. 5. According to the MTT assay, HN22 cell line showed relative drug resistancy above $5\;{\mu}g/ml$ concentrations of Taxol. 6. In drug resistance assay, the decrease of cell counts was seen relatively according to concentration. 7. In Flow cytometry, G2M phase cell arrests were seen in low concentration of the Taxol, while S phase cell arrests were seen in high concentration of the Taxol. 8. Using cDNA microarray technique, variable gene expression of ANGPTL4, TXNRD1, FAS, RRAGA, CTGF, CYCLINEA, P19, DUSP5, CEBPG, BTG1 were detacted in the oral squamous cell carcinoma cell after taxol treatment. In this study paclitaxel is effective against oral squamous cell carcinoma cell lines in vitro, but week effect was observed in vivo. So we need continuous study about anticancer effect of taxol in vivo in oral squamous cell carcinoma.

EMG AND CEPHALOMETRIC STUDY ON CHANCES IN UPPER AIRWAY STRUCTURES AND MUSCLE ACTIVITIES ACCORDING TO THE USE OF MANDIBULAR REPOSITIONING APPLIANCE AND BODY POSTURE IN OSA PATIENTS (폐쇄성 수면 무호흡증 환자에 있어서 하악 재위치 장치 장착과 체위에 따른 상기도 구조와 근활성도의 변화에 관한 EMG 및 두부방사선학적 연구)

  • Park, Young-Chel;Pae, Eung-Kwon;Lee, Jeung-Gweon;Lee, Jong-Suk;Kim, Tae-Kwan
    • The korean journal of orthodontics
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    • v.28 no.4 s.69
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    • pp.547-561
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    • 1998
  • Obstructive sleep apnea (OSA) is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effcts on the occurrence of apnea and that the genioglossus muscle also plays an important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital, Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the placement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. We also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyogram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft Palate and SPAS, MAS, VAL, H-H1, MP-H showed statistically significant differences between the normal and OSA groups, but the IAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the IAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

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The Effect of Platelet Derived Growth Factor - BB Loaded Chitosan/Calcium Metaphosphate on Bone Regeneration (혈소판유래성장인자를 함유한 Chitosan/Calcium Metaphosphate의 골조직재생효과에 관한 연구)

  • Lee, Seung-Yeol;Seol, Yang-Jo;Lee, Yong-Moo;Lee, Ju-Yeon;Lee, Seung-Jin;Kim, Suk-Young;Ku, Young;Rhyu, In-Chul;Han, Soo-Boo;Choi, Sang-Mook;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.1-23
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    • 2001
  • Chitosan is biodegradable natural polymer that has been demonstrated its ability to improve wound healing, and calcium metaphosphate(CMP) is a unique class of phosphate minerals having a polymeric structure. In this study, chitosan/CMP and platelet derived growth factor(PDGF-BB) loaded chitosan/CMP sponges were developed, and the effect of the sponges on bone regeneration and their possibility as scaffolds for bone formation by three-dimensional osteoblast culture were examined. PDGF-BB loaded chitosan/CMP sponges were prepared by freeze-drying of a mixture of chitosan solution and CMP powder, and soaking in a PDGF-BB solution. Fabricated sponge retained its 3-dimensional porous structure with $100-200\;{\mu}m$ pores. The release kinetics of PDGF-BB loaded onto the sponge were measured in vitro with $^{125}I-labeled$ PDGF-BB. In order to examine their possibility as scaffolds for bone formation, fetal rat calvarial osteoblastic cells were isolated, cultured, and seeded into the sponges. The cell-sponge constructs were cultured for 28 days. Cell proliferation, alkaline phosphatase activity were measured at 1, 7, 14 and 28 days, and histologic examination was performed. In order to examine the effect on the healing of bone defect, the sponges were implanted into rat calvarial defects. Rats were sacrificed 2 and 4 weeks after implantation and histologic and histomorphometrical examination were performed. An effective therapeutic concentration of PDGF-BB following a high initial burst release was maintained throughout the examination period. PDGF-BB loaded chitosan/CMP sponges supported the proliferation of seeded osteoblastic cells as well as their differentiation as indicated by high alkaline phosphatase activities. Histologic findings indicated that seeded osteoblastic cells well attached to sponge matrices and proliferated in a multi-layer fashion. In the experiments of implantation in rat calvarial defects, histologic and histomorphometric examination revealed that chitosan/CMP sponge promoted osseous healing as compared to controls. PDGF-BB loaded chitosan/CMP sponge further echanced bone regeneration. These results suggested that PDGF-BB loaded chitosan/CMP sponge was a feasable scaffolding material to grow osteoblast in a three-dimentional structure for transplantation into a site for bone regeneration.

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A Study on the effect of Friend-praise activity program of Elementary students for Self-esteem and Personal Relationship (초등학생의 또래 칭찬활동 프로그램이 자아존중감 및 대인관계에 미치는 효과)

  • Oh, Eun-Ju
    • The Korean Journal of Elementary Counseling
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    • v.5 no.1
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    • pp.159-184
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    • 2006
  • Lately, the rapid social and family system change, the entrance examination-centered circumstance in education have a negative influence not only on making up the affirmative self-esteem but also on building up the personal relationship through mutual communication with friends of the same age. Making children adapt well to school life and develop a good relationship in the class is an important subject in educational field. Thus, various school activities should offer lots of opportunities to increase their affirmative self-esteem and more specified performance-centered programs are required toform a harmonious relationship among parties of students. The purpose of this study is to improve an affirmative self-esteern and a desirable personal relationship of children through developing friend-praise program and adapting it to children. Based on the above purpose, the following subjects for this study 'are suggested. Firstly, is the friend-praise program effective in forming an affirmative self-esteem of elementary students? Secondly, is the friend-praise program successful in improving a desirable personal relationship in an elementary school? In addition, two hypotheses of study are decided on the basis of theoretical background and the former study. Hypothesis 1. The friend-praise program will have a meaningful effect on improving an affirmative self-esteem. Hypothesis 2. The friend-praise program will have a meaningful effect on improving a desirable personal relationship. In order to improve the above hypotheses, the experiment was carried out with two classes on the fourth grade in M elementary school in Wonju with being divided into one experimental group and the other comparative group. The friend-praise program which was adapted to the experimental group was composed with four steps as 'introduction', 'preparation', 'operation' and 'closing'. This program which has twelve categories was executed once or twice in a week and each class was continued for forty or sixty minutes. Contrastively, comparative group had no application of the main program. For the purpose of proving the hypotheses after adapting the program to students, I have executed both self-esteem test and personal relationship test. The tests were performed with using SPSS/Windows V10.0 and the statistic was conducted through independant sample t-test for the difference between groups and contrastive sample t-test for the individual difference in each group. The results of this study can be summarized like the followings: Firstly, from the result of previous and after tests, there was no meaningful change in the comparative group, but the experimental group showed meaningful difference in all categories of self-esteem(t=-4.496, p=.000). Especially, the general self-esteem(t=-3.216, p=.003), social self-esteem(t=-2.680, p=.012), homely self-esteem(t=-3.732, p=.001), and school self-esteem(t=-3.902, p=.000) showed a meaningful difference. At the same time, the experimental group also showed meaningful difference with the comparative group in self-esteem(t=-4.758, p=.000). Especially, the general self-esteem(t=2.581, p=.017), social self-esteem(t=3.160, p=.003), homely self-esteem(t=4.283, p=.000), and school self-esteem(t=4.110, p=.000) showed a meaningful difference. As a result of this experiment, the friend-praise program will have a meaningful effect on improving an affirmative self-esteem was proved. Secondly, there was no meaningful change in the comparative group, but the experimental group showed meaningful difference in all categories of personal relationship(t=-4.131, p=.000). Specifically, satisfaction(t=-2.113, p=.045), communication(t=-3.381, p=.002), confidence(t=-3.517, p=.001), intimacy(t=-3.958, p=.000), sensibility(t=-2.955, p=.006), openness(t=-4.318, p=.000) and interest(t=-2.941, p=.000) showed a meaningful difference. In the same instant, the experimental group also showed meaningful difference with the comparative group in all categories of personal relationship(t=3.897, p=.000). Especially, satisfaction(t=2.257, p=.003), communication(t=3.527, p=.001), confidence(t=3.704, p=.001), intimacy(t=3.904, p=.000), sensibility (t=4.382, p=.000), openness(t=2.648, p=.013) and interest(t=2.944, p=.006) showed a meaningful difference. Accordingly, the friend-praise program will have a meaningful effect on improving a desirable personal relationship was proved. Judging from all these results, we should provide primary students with various opportunities to take part in active programs which help them to set up their righteous sense of value, to solve their own problems and to develop their potentials. Consequently, many kinds of practice-centered program like the friend-praise program should be developed more systematically and teachers should apply all those programs to students according to their individual level and developmental stage.

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Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V (우리나라 성인남녀의 골밀도 관련요인: 국민건강영양조사 제 5기 1, 2차 년도(2010년, 2011년))

  • Kim, Kyung Sook
    • Journal of agricultural medicine and community health
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    • v.39 no.4
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    • pp.240-255
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    • 2014
  • Objective: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. Methods: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010~2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. Results: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. Conclusion: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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Expiration-Day Effects: The Korean Evidence (주가지수 선물과 옵션의 만기일이 주식시장에 미치는 영향: 개별 종목 분석을 중심으로)

  • Choe, Hyuk;Eom, Yun-Sung
    • The Korean Journal of Financial Management
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    • v.24 no.2
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    • pp.41-79
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    • 2007
  • This study examines the expiration-day effects of stock index futures and options in the Korean stock market. The so-called 'expiration-day effects', which are the abnormal stock price movements on derivatives expiration days, arise mainly from cash settlement. Index arbitragers have to bear the risk of their positions unless they liquidate their index stocks on the expiration day. If many arbitragers execute large buy or sell orders on the expiration day, abnormal trading volumes are likely to be observed. If a lot of arbitragers unwind positions in the same direction, temporary trading imbalances induce abnormal stock market volatility. By contrast, if some information arrives at market, the abnormal trading activity must be considered a normal process of price discovery. Stoll and Whaley(1987) investigated the aggregate price and volume effects of the S&P 500 index on the expiration day. In a related study, Stoll and Whaley(1990) found a similarity between the price behavior of stocks that are subject to program trading and of the stocks that are not. Thus far, there have been few studies about the expiration-day effects in the Korean stock market. While previous Korean studies use the KOSPI 200 index data, we analyze the price and trading volume behavior of individual stocks as well as the index. Analyzing individual stocks is important for two reasons. First, stock index is a market average. Consequently, it cannot reflect the behavior of many individual stocks. For example, if the expiration-day effects are mainly related to a specific group, it cannot be said that the expiration of derivatives itself destabilizes the stock market. Analyzing individual stocks enables us to investigate the scope of the expiration-day effects. Second, we can find the relationship between the firm characteristics and the expiration-day effects. For example, if the expiration-day effects exist in large stocks not belonging to the KOSPI 200 index, program trading may not be related to the expiration-day effects. The examination of individual stocks has led us to the cause of the expiration-day effects. Using the intraday data during the period May 3, 1996 through December 30, 2003, we first examine the price and volume effects of the KOSPI 200 and NON-KOSPI 200 index following the Stoll and Whaley(1987) methodology. We calculate the NON-KOSPI 200 index by using the returns and market capitalization of the KOSPI and KOSPI 200 index. In individual stocks, we divide KOSPI 200 stocks by size into three groups and match NON-KOSPI 200 stocks with KOSPI 200 stocks having the closest firm characteristics. We compare KOSPI 200 stocks with NON-KOSPI 200 stocks. To test whether the expiration-day effects are related to order imbalances or new information, we check price reversals on the next day. Finally, we perform a cross-sectional regression analysis to elaborate on the impact of the firm characteristics on price reversals. The main results seem to support the expiration-day effects, especially on stock index futures expiration days. The price behavior of stocks that are subject to program trading is shown to have price effects, abnormal return volatility, and large volumes during the last half hour of trading on the expiration day. Return reversals are also found in the KOSPI 200 index and stocks. However, there is no evidence of abnormal trading volume, or price reversals in the NON-KOSPI 200 index and stocks. The expiration-day effects are proportional to the size of stocks and the nearness to the settlement time. Since program trading is often said to be concentrated in high capitalization stocks, these results imply that the expiration-day effects seem to be associated with program trading and the settlement price determination procedure. In summary, the expiration-day effects in the Korean stock market do not exist in all stocks, but in large capitalization stocks belonging to the KOSPI 200 index. Additionally, the expiration-day effects in the Korean stock market are generally due, not to information, but to trading imbalances.

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