• Journal of Food Hygiene and Safety
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• v.27 no.3
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• pp.215-223
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• 2012

This study was performed to investigate hygienic behavior of food workers on the awareness of hand-washing, and the microbial load of their hands. This study focused on the comparison of fast food restaurant workers and full-service restaurant workers. A questionnaire survey and microbiological analysis were carried out for thirty fast food restaurant workers and forty full-service restaurant workers. Samples for microbiological analysis were collected through the glove-juice method from the hands of the food workers, and were analyzed for the presence of aerobic plate counts, total coliforms, fecal coliforms, Escherichia coli, Staphylococcus aureus, and Salmonella spp. Microbiological analysis was done according to the Food Code of Korea. In the survey, significant differences (p < 0.05) were found between the fast food restaurant workers and full-service restaurant workers in the use of hand washing tools and method of turning off water. More full-service restaurant workers responded to wash their hands after touching face, hair, or clothes; after handling raw food materials, and more fast food restaurant workers periodically (p < 0.05). Aerobic plate counts were higher in fast food restaurant workers while total coliforms were higher in full-service restaurant workers (p < 0.05). No remarkable difference was found between the two groups in the load of fecal coliforms, E. coli, S. aureus, and Salmonella spp. Poor hand hygiene practices were indicated by the positive results for E. coli, S. aureus, and Salmonella spp. on the hands of some food workers in both groups. The findings of this study emphasize the need for strict adherence to hand hygiene compliance among the food workers.

• Korean Journal of Food Science and Technology
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• v.27 no.5
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• pp.716-723
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• 1995

The fucoidan purified from Korean brown seaweed, Ecklonia stolonifera was characterized on molecular structure and blood anticoagulant activities. Extraction was conducted at $100^{\circ}C$ with water and repeated twice. The crude fucodian was 151.1g out of 20.0 kg of Ecklonia stolonifera. The Fucoidan-1, which was purified from crude fucoidan using calcium chloride and cetyl pyridium chloride (CPC), was 35.2% against crude fucoidan. Fucoidan-5 was obtained approximately 28.1% from Fucoidan-1 through DEAE-Toyopearl 650 M ion-exchange column chromatography and showed one band by cellulose acetate electrophoresis. The molecular weight of Fucoidan-5 was estimated to be about 21,000∼23,000 dalton by Sephacryl S-300 gel filtration chromatography. Fucoidan-5 consists of 35.7% of fucose and 4.3% of galactose and the molar ratio of fucose and sulfate was about one to one. IR spectrum of Fucoidan-5 showed absorption at $1240\;cm^{-1}\;and\;850\;cm^{-1}$ and specific rotation value, $[\alpha]$, was $[\alpha]$. These results suggests that the sulfate maybe bind at $C_{4}$ carbon on ${\alpha}-L-fucose$. Gas chromatograph of methyl alditol acetate revealed that Fucoidan-5 is a fucose containing sulfated polysaccharide with $({\alpha}l-2)\;or\;({\alpha}l-2)$ glycosidic linkage. Anti-thrombin activity of the Fucoidan-5 was estimated as 1.4 time stronger than heparin. From above results, the purification methods using CPC and ion exchange chromatography is effective tools for obtaining highly purified fucoidan from Gompi, Ecklonia stolonifera.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.206-225
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• 2012

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.75-82
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• 2007

Purpose : Human metapneumovirus (hMPV) is a newly identified paramyxovirus that causes a variety of clinical syndromes in children, including upper and lower respiratory tract illnesses. hMPV is considered an ubiquitous virus causing respiratory tract diseases among children especially during late winter and spring seasons. We report clinical features of human metapneumovirus infection in Korean children. Methods : hMPV infection was diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR) in respiratory specimens obtained from patients with acute respiratory tract infections from October, 2004 to May, 2005. Medical records of all hMPV-positive patients were reviewed, retrospectively. Results : A total of 15 hMPV were identified from 443 nasopharyngeal aspirations by RT-PCR (3.4%). The range of age of the patients with hMPV infection was from 1 month to 62 months (median age, 31.5 months), with similar numbers of females (8/15) and males (7/15). Among hMPV-positive children, 53.3% (8/15) were aged less than 24 months. Fever, cough, rhinorrhea, vomiting, diarrhea, tachypnea, and chest wall retractions were common findings. Most common clinical diagnosis was pneumonia (60%). Two of the 15 hMPV-positive patients were also positive for adenovirus. Fever persisted from 0 to 10 days (mean 4.9 days). The duration of hospitalization ranged from 4 to 7 days (mean 5.6 days). Conclusion : hMPV accounted for a small but significant proportion of respiratory tract infection in infants and children. Future development and application of diagnostic tools will determine the burden of disease caused by this newly discovered pathogen.

• Korea Journal of Hospital Management
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• v.9 no.1
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• pp.66-94
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• 2004

The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.56-62
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• 2005

Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

• The Korean Nurse
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• v.31 no.2
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• pp.51-69
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• 1992

Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

• 모자간호학회지
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• v.2 no.1
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• pp.21-33
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• 1992

This study was done to investigate how importantly midwives thought of Lamaze Method of Childbirth, how satisfactorily they performed their Lamaze Method of Childbirth and what inhibited their activities from being performed if not done satisfactorily. The subjects of this study were 76midwives at midwifery in Pusan, Deagu, Kyungnam and Kyungbok. Data were collected by using questionaire from Sep. 1 to Sep.30, 1991. The measurement tools was maded by the researcher based on Kim's scale for prenatal nursing activities. The statistical analysis was done with based statistical values likes frequencies, means, standard deviations and advanced methods such as Pearson's correlation coefficient, 1-test, F-test, F-test by using SPSS package program. The results of this study can be summarized as follows ; 1. The results of Investigating perception according to importance degree and performance degree of Lamaze Method of Childbring showed that midwives were slightly below both perception according to importance(2.17) and performance(2.16) of Lamaze Method of Childbirth 2. Inhibiting factors of Lamaze Method of Childbirth were abscence of husband(3.08), lack of teaching room(2.71), and lack of books or literature of Lamaze Method (2.58). 3. There appears to be a positive relation between perception according to importance degree and performance degree of Lamaze Method of Childbirth (r=0.69, P<0.01). There appears to be a negative relation between perception according to importance degree and inhibit factors of performance (r=-0.38, P<0.01). There appears to be a negative relation between performance and inhibit factors of performance (r=-0.22. P<0.01). 4. The item of highest perception defree in prenatal education is 1st, Consultation about sexual life (2.53), End, illustration of the importance of a bath and perinal cleanliness and Avoidance of excessive respiration method and also its comfortable application during uterine contractility(2.45). The item of lowest perception degree is about pregnant symptom sign and predicted date of birth (E.D.C.). On the other hand, The item of highest performance degree is education about nurtrition during pregnacy. 2nd, Illustration of the Importance of a bath and perineal cleanness(2.45). The lowest one is leaching the pregnant woman and her family about the role of husband and her family and also teaching the couple to learn exercise and respiration method (1.84). Though importance perception degree and performance degree is low. Midwives who wert subject in this research shoves that they perform general items concerning prenatal education well. 5. In the relationship between perception according to importance degree of Lamaze Method of Childbirth and the general characteristics of subjects, the differences in mean number of visiting pregnacies for 1 month. 6. In the relationship between performance degree of Lamaze Method of Childbirth and the general characteristics of subjects, the differences in age, marriage, and mean number of visiting pregnancies for 1 month. With the above information we see the importance of midwife prenatal care education and high correlation between performance degree and perception degree. When Lamaze prenatal education is well performed the number of pregnant woman who have follow-up, check-ups increase. Therefore in this research we can validity that there is a relation between Lamaze prenatal education and patient follow-up. This research showes in a situation where if one does not maximally perform a prenatal education there is a possibility that the popular use of midwife activities may encounter obstacles so the education to save new knowledge and training for prenatal education is needed as a function of Lamaze prenatal education, when a special Lamaze education is well performed for the pregnant woman, who follows-up at amidwife clinic. With the above conclusion we can suggest : 1. Continued research which minimized obstacles to Lamaze prenatal education is needed. 2. The official method of midwives is necessary.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.119-127
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• 2009

Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.

• Progress in Medical Physics
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• v.18 no.2
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• pp.98-106
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• 2007

In June 2005, Yonsei University Medical Center, Severance Hospital upgraded a full-PACS system by adding twenty (5 mega pixels) Totoku ME511L flat panel LCD display devices for diagnostic interpretation purposes. Here we report upon the quantitative (or visual) acceptance testing of the twenty Totoku ME511L display devices for reflection, luminance response, luminance spatial dependency, resolution, noise, veiling glare, and display chromaticity based on AAPM TG 18 report. The tools used in the tests included a telescopic photometer, which was used as a colorimeter, illuminance meter, light sources for reflection assessment, light-blocking devices, and digital TG18 test patterns. For selected 8 flat panel displays, mean diffuse reflection coefficient ($R_d$) was $0.019{\pm}0.02sr^{-1}$. In the luminance response test, luminance ratio (LR), maximum luminance difference ($L_{max}$), and deviation of contrast response were $550{\pm}100,\;2.0{\pm}1.9%\;and\;5.8{\pm}1.8%$, respectively. In the luminance uniformity test, maximum luminance deviation was $14.3{\pm}5.5%$ for the 10% luminance of the TG18-UNL10 test pattern. In the resolution test with luminance measurement method, percent luminance (${\Dalta}L$) at the center was $0.94{\pm}0.64%$. In all cases of noise testing, rectangular target In every square in the three quadrants was visible and all 15 targets except the smallest one in the every corner pattern and the center pattern. The glare ratio (GR) was $12,346{\pm}1,995$. The color uniformity, (u',v'), was $0.0025{\pm}0.0008$. Also, the research results of qualify control guideline of primary disply devices suitable for domestic circumstance are presented All test results are in-line with the criteria recommended by AAPM TG18 report and are thus fully acceptable for diagnostic image interpretation. As a result, the acceptance testing schedule described provides not only an acceptance standard but also guidelines for quality control, optimized viewing conditions, and a means for determining the upgrading time of LCD display devices for diagnostic interpretation.