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Resistance and Susceptibility of Diamondback Moth, Plutella xylostella Strains Collected from Different Region in Korea to Bacillus thuringiensis (국내 지역별 채집계통 및 감수성계통 배추좀나방에 대한 Bacillus thuringiensis 제품의 생물활성 비교)

  • Kim, Young-Rim;Cho, Min-Su;Oh, Se-Mun;Kim, Sung-Woo;Youn, Young-Nam;Yu, Yong-Man
    • The Korean Journal of Pesticide Science
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    • v.14 no.2
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    • pp.123-132
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    • 2010
  • Six populations of the diamondback moth, Plutella xylostella, were collected from the different national areas for resistance and reared in laboratory for two sensitive population. These populations of P. xylostella were examined the developed resistance against commercial products of Bacillus thuringiensis. There were 3 products with B. thuringiensis subsp. kurstaki including Tyuneup$^{(R)}$, Thuricide$^{(R)}$ and Geumulmang$^{(R)}$ and 2 products with B. thuringiensis subsp. aizawai including Tobagi$^{(R)}$ and Scorpion$^{(R)}$. The sensitive population of diamondback moths were provided from National Academy of Agricultural Science (NP) and Highland Agriculture Research Center (GR population) and field populations were caught from 6 different national areas. Resistance against Tyuneup$^{(R)}$ was developed 4.8 and 2.5 times in SP and HS compared with GR population of diamondback moth, respectively. In case of Geumulmang$^{(R)}$, it was developed 9.9 and 6.8 times in SP and NM population compared with NP population, respectively. Otherwise, Tobagi$^{(R)}$ was showed higher resistance in HS than any other population compared with GR population, however, Scorpion$^{(R)}$ that is a same strain with Tobagi$^{(R)}$, was showed only double resistance to SP population. It was supposed that the development of resistance to B. thuringiensis might be caused by the continuous application of the specific commercial product at the specific area. So, we need to use the commercial products of B. thuringiensis in rotation with different B. thuringiensis strains. In the other hand, when HS population with highest resistance were reared in laboratory, their resistance ratio was rapidly dropped to 1.1 times at second generation. We have to examined the resistance mechanism of the diamondback moth to B. thuringiensis strains.

A Study on the Determinants of Consumer-Oriented Nursing Service Quality;SERVQUAL Model based (소비자 중심의 간호서비스 질 결정요인에 관한 연구;SERVQUAL모형을 중심으로)

  • Joo, Mee-Kyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.169-191
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    • 2002
  • As the tendency of the society is centralized into consumers and services, patients are getting to ask better medical services. The consumers influenced from various social surroundings became to have some expectation of nursing service. Compared with their expectation, the quality of the services which they virtually get may be recognized and evaluated. So it is necessary to know exactly what the consumers want in nursing services. The purpose of this study is to examine the determinants which can evaluate the quality of nursing services by researching into consumers' expectation and perception of the nursing services depending on the consumer-oriented attributions on the basis of the model of SERVQUAL. 1,144 of outpatients were selected as the subjects for this research. They used to continuously visit the same hospital after being hospitalized and nursed in 9 hospitals randomly selected among the second-level medical organizations in Seoul from January to February, 2001. The collected data are analyzed into the Descriptive Statistics, t-test, GLM and Multiple Regression through the SAS program. Delphi was used for the research tool and the results of the research are as follows; the determinants in evaluating the quality of nursing services consist of 5 categories such as Tangibility, Reliability, Responsiveness, Assurance, Empathy. The values of Cronbach' $\alpha$ appeared to be 0.96 in the expectation of nursing services, 0.94 in the perception of nursing services and 0.96 in the importance of nursing services. The determinants in the expectation of nursing services were ranged in the order of Assurance, Empathy, Reliability, Responsiveness and Tangibility. And those in the perception of nursing services were in the order of Assurance, Empathy, Reliability, Tangibility and Responsiveness. Those in the importance of nursing service were in the order of Empathy, Assurance, Reliability, Tangibility and Responsiveness. Finally, those in the quality of nursing service were in the order of Tangibility, Responsiveness, Empathy, Reliability and Assurance. Each expectation of nursing services appeared different depending on the subjects' age, gender, clinical department and reason for hospitalization. The hypothesis examined in this research shows that the group having higher personal needs shows meaningful differences in the expectation of nursing services, and the subjects who have had external communication show higher perception of nursing service than uncommunicative ones. After all, we can see that the statistical differences in the perception of nursing services depend on whether the subjects have external communications or not. The determinants in the expectation of nursing services can explain the quality of nursing service up to 14.96%. The statistically meaningful determinants in the expectation could be arranged in the order of Reliability, Assurance and Tangibility. And the more expectation brings about the lower evaluation of the quality of nursing services. The determinants in the perception of nursing service can explain the quality of nursing services up to 29.85%. The statistically meaningful determinants in the perception could be arranged in the order of Responsiveness, Reliability, Tangibility, Empathy, and Assurance. And the more perception brings about the higher evaluation of the quality of nursing services. According to the result of the above research, I would like to propose as follows. As long as this research is oriented to get knowledge of the consumer-oriented nursing services, it should be continued to draw the other elements determining the quality of the nursing services. Furthermore, this research is based upon the Parasuraman, A., et al.'s SERVQUAL Model(1991), which deals only expectation, perception and quality of consumer-oriented nursing services, so it will be necessary to inspect and verify it through the other models containing the offerers of nursing services in the future. On the other hand, as this research evaluates the actual quality of nursing services based on the expectation and perception of nursing services, it can be utilized as fundamental data to develop the marketing strategies and to estimate the qualities as well. I hope this research will be periodically estimated to be the useful data to develop the marketing strategies in the nursing service area.

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Quality Characteristics of Cookies with Hot Water Extract of Seamustad (Undaria pinnatifida) Sporophylls and Treated with Gamma Irradiation (감마선 조사된 미역귀(Undaria pinnatifida Sporophyll) 열수추출물을 첨가한 쿠키의 품질 특성)

  • Kim, Da-Mi;Kim, Kyoung-Hee;Yun, Young-Sik;Kim, Jae-Hun;Lee, Ju-Woon;Yook, Hong-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.11
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    • pp.1604-1611
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    • 2011
  • In this study we assessed the effects of gamma irradiation (50 kGy) on cookies to which was added various concentrations (1%, 3%, 5%, 7%) of hot water extract from seamustad (Undaria pinnatifida) sporophylls (WEUS) for future industry use. The pH of the dough went down significantly with the addition of WEUS. However, density was not related to that. The spread ratio of the cookies increased significantly as more WEUS was added to the cookie recipe, and cookies containing gamma-irradiated extract were taller than non-irradiated cookies with the same concentration. The loss rate of cookies was the same between control and experiment groups. On the other hand, the leavening rate significantly increased upon the addition of WEUS, and gamma-irradiated cookies were higher than non-irradiated cookies in the same concentration. The L value of cookies was much reduced with higher WEUS content, but the b value showed no significant differences between the control and experiment groups. The a value showed no significant difference for non-irradiated groups, but did for gamma-irradiated groups. Upon the addition of WEUS, hardness was shown to be higher than the control. The antioxidant activity, DPPH radical scavenging, was significantly higher with the control cookies, and upon the addition of WEUS, the gamma-irradiated cookies had higher antioxidant effects than non-irradiated cookies. The sensory evaluation showed that cookies made with WEUS have a positive impact in color, smell, taste, texture, and overall acceptability, but the sensory evaluation worsened with a lot of WEUS. The results of acceptability were higher in cookies with 3% the non-irradiated group and 1% the gamma-irradiated group. These results suggest that the 1% gamma-irradiated group was in the best condition to use in the industry since just a little of it makes exceptional quality, sensory properties, and functionality.

The Patient Recognition, Acceptability and Evaluation of Feasibility for Day Surgery (종합병원 일부 입원환자의 당일수술에 대한 태도와 당일수술 적용 가능성 평가)

  • Beak, Young-Ran;Lee, Kyeong-Soo;Kim, Seok-Beom;Kang, Pock-Soo;Kang, Young-Ah
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.334-342
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    • 2000
  • Objectives . This study was conducted in order to investigate the degree of recognition, acceptability, and altitude towards day surgery of patients who were hospitalized with diseases that were candidates for day surgery; in order to analyze the average length of stay for treatment of the ailments; and to analyze the percentage of patients who could be discharged on the same day after the surgery ,using the post-anesthesia discharge scoring system. Methods : Data was collected between February 1 and March 31, 1999 from 353 patients who received surgery for cataract, adenoid hypertrophy, inguinal hernia, strabismus, ptosis, cholelithiasis, hemorrhoid, or anal fistula, at a general hospital in Daegu city. The patients were interviewed and surveyed by a post-anesthesia discharge scoring system(PADS) in order to collect data on patient condition such as vital signs, activity and mental status, pain, nausea and vomiting, surgical bleeding, intake and output after the surgery. Results : Among the 353 patients, 52.7% were after of the day surgery and 52.7% were interested in day surgery. Of the respondents, 43.1% said 'my ailment was not serious and the surgery was simple' and 30.4% said 'according to my condition rest at home was desirable' as the reasons for wanting day surgery Alternatively, 56.5% of those declining day surgery said the 'uncertainty of staying home' was the reason. The greatest concern in discharging within 24 hours after surgery was a post-op emergency situation. On the other hand, the shortened hospitalization was the largest advantage of day surgery with 39.1% responding this way, followed by the savings in hospitalization costs (25.8%) and emotional stability (13.7%). The majority of those surveyed (47.6%) believed that discharge should be determined within 1-2 days after the surgery. The average hospital stay was 3.1 days for dischargeable ailments. Pain (45.6%), nausea and vomiting (10.5%), and headache (7.9%) were the common symptoms following surgery. The percentage of patients who were able to be discharged within 24 hours after surgery revealed 95.2% were dischargeable after approximately 3 hours, 99.2% dischargeable after 12 hours, and 100% dischargeable after 24 hours. Conclusions : According to the PADS score, the cataract extract and strabismus correction patients were eligible for day surgery and the further evaluation concerning the reason for delayed recovery of the other diseases is needed.

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A study on the Physical, Mental and Social Factors Influencing the Health Status of Aged Women in Korea (여성노인의 건강상태와 신체적.심리적.사회적 요소들과의 관계연구)

  • Ro, Seung-Ok
    • Women's Health Nursing
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    • v.2 no.1
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    • pp.53-67
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    • 1996
  • A total health state evaluation of Korean female elderlies was made by using the questionary scheme measuring the physical, mental and social functions of the elderlies, in order to investigate the critical factors for the health maintenance of female elderlies and to develop their preventive nursing program. A total of 280 subjects over 65 years old living in Seoul and the suburban area were selected and interviewed during the period of September and October in 1995. The materials collected were analyzed statistically by using SAS data processing program, and the results and recommendations are summarized as follows. 1. The physical health state of Korean elderly women was evaluated to be satisfactory by showing an average score of 3.722 in 5.0 full-score scale. But this score was lower than those evaluated for the elderlies combined both sexes(4.054). The mental health state of the subjects was also evaluated as high scoring 3.484, possibly due to the fact that 78% of the subjects lived together with their children's family. On the other hand, the social health state of the subjects was relatively low scoring 2.585, mainly due to that 80% of them was widows which was resulted by the 6-7 years longer life-expectancy of Korean women. 2. A significant differences in the physical health state scores between different age groups was observed, indicating the rapid ageing process occurring in this age group. The family structure was appeared to be an important factor influencing the physical health state of the female elderlies ; the physical health score of the women with her husband only was higher than that of those living with children's families, and the lowest score was obtained from those living alone. 3. The age was the most important factor determining the mental health state of the subjects, while the religion, educational status, marriage state and family structure did not significantly influenced the mental health state of the aged women. 4. The social health state of the subject was deeply influenced by the marriage state and family structure, showing significantly lower scores with widowers compared to the married couples. Those living with their married spouse only obtained the highest social health score, while those living along showed the lowest score. The parent and grandparentship of those living with their children and the religion, especially Catholic and Protestant, had positive influence on the social health state of the aged women. 5. The mental health state of aged women showed significant correlation with the factors determining the physical health, except for digestive system related ability and sexual ability and the highest extra home ability. 6. The mental health state of aged women showed significant correlation with the factors determining social health, especially with the parent and grandparentship and the family relative's role. From these results, the following recommendations are made. 1. Since the physical, mental and social health states of aged people are deeply influenced by the sex and the average values of the both sex can create misleading figures, the health evaluation of the elderlies should be made separately by sex. 2. Since the health state of aged women is highly influenced by their family structure, the spouse's role and living with married couple only should be emphasized in respect of preventive health care. 3. The social activity programs and grandparentship teaching programs should be prepared in the nursing care program for aged people.

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Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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The Effect of a Chest CT Scan on the Treatment and Diagnosis of Major Blunt Chest Trauma (흉부 둔상환자에서 흉부전산화단층촬영이 진단과 치료에 미치는 영향)

  • Park, Il-Hwan;Oh, Joong-Hwan;Lee, Chong-Kook
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.226-232
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    • 2009
  • Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

Evaluation of Environmental and Economic Impacts of Advanced Wastewater Treatment Plants with Life Cycle Assessment (고도 하수처리장의 전과정평가에 따른 환경성 및 경제성 평가)

  • Pyo, SeHee;Kim, MinJeong;Lee, SeungChul;Yoo, ChangKyoo
    • Korean Chemical Engineering Research
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    • v.52 no.4
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    • pp.503-515
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    • 2014
  • A lot of existing wastewater treatment plants (WWTPs) are rebuilt or retrofitted for advanced wastewater treatment processes to cope with reinforced effluent criteria of nitrogen and phosphorous. Moreover, how to treat the wasted sludge from WWTPs has been also issued since the discharge of the wasted sludge into ocean is impossible from 2011 due to the London Convention 97 protocol. These trend changes of WWTPs get a motivation to assess environmental and economic impacts from the construction stage to the waste stage in WWTPs. Therefore, this study focuses on evaluation of environmental and economic impacts of the advanced wastewater treatment processes and waste sludge treatment process by using life cycle assessment. Four advanced wastewater treatment processes of Anaerobic/Anoxic/Oxic ($A_2O$), 5 stages-Bamard Denitrification Phosphate (Bardenpho), Virginia Initiative Plant (VIP), and Modified University of Cape Town (MUCT) are chosen to compare the conventional activated sludge (CAS) and three waste sludge treatment methods of land fill, incineration, and composting are used. To evaluate environmental and economic impacts of each advanced wastewater treatment processes, life cycle assessment (LCA) and life cycle cost (LCC) are conducted based on International organization for standardization (ISO) guidelines. The results clearly represent that the $A_2O$ process with composting shows 52% reduction in the environmental impact than the CAS process with landfill. On the other hand, the MUCT process with composting is able to save 62% of the life cycle cost comparing with the CAS process with landfill. This result suggested the qualitative and quantitative criteria for evaluating eco-environmental and economic technologies of advanced treatment processes and also sludge treatment method, where their main influence factors on environmental and economic impacts are analyzed, respectively. The proposed method could be useful for selecting the most efficient and eco-friendly wastewater treatment process and sludge treatment method when retrofitting the existing WWTPs to advanced treatments.

The Assessment of the Breath Hold and the Free Breath Methods about the Blood Flow Evaluation by Using Phase Contrast MRI (위상대조도 자기공명영상을 이용한 심장 혈류평가에 있어서 호흡정지 기법과 비 호흡정지 기법의 비교평가)

  • Kim, Seong-Ho
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.149-156
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    • 2016
  • Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were $96.17{\pm}19.12ml/sec$, $17.04{\pm}4.12cm/sec$ respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of $72.31{\pm}13.27ml$ and $12.32{\pm}3.85$. On the other hand, the average 2NEX blood flow and mean flow velocity is $101.90{\pm}24.09$, $16.84{\pm}4.32$, 3NEX $103.06{\pm}25.49$, $16.88{\pm}4.19$ did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were $76.68{\pm}19.72ml/s$, and $22.23{\pm}4.8$, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

An Evaluative Study on Physician's Health Education Activities in Outpatient Medical Care (종합병원 외래환자 진료시 의사의 보건교육활동 평가)

  • 김숙자
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.56-80
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    • 1984
  • The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.

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