• Quality Improvement in Health Care
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• v.7 no.1
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.619-626
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• 2010

Background: The indications and the optimal time of surgery of infective endocarditis are controversial. We report the surgical results of our hospital during the last 10 years with literature review. Material and Method: Between January 2000 and December 2009, we enrolled 23 infective endocarditis patients who underwent surgery, and analyzed retrospectively. In the preoperative blood culture, 8 cases (34.8%) were positive. The average preoperative antibiotics treatment period was $20.78{\pm}16.00$ days. There were 12 (52.2%) urgent operations. The average follow up period was $49.26{\pm}33.21$ months. Result: 20 mechanical valve replacements were performed, 9 in aortic position, 8 in mitral position and 3 in the both positions. The other procedures were one mitral valvuloplasty, one infected myxoma extirpation, and one infected pacemaker lead removal with debridement. The average period of postoperative intravenous antibiotic treatment was $24.39{\pm}15.98$ days. There were 5 complications, including 2 cases of postoperative bleeding, one postcardiotomy syndrome, one cerebral ischemia, and a low cardiac output syndrome. There were statistically significant postoperative improvement in NYHA class, left ventricle end diastolic/end systolic volume, and left atrium size (p-value < 0.05). Conclusion: We could obtain the satisfactory results without any moftalities by using sufficient preoperative antibiotics in hemodynamically stable patients, and by prompt surgery in unstable patients.

• The korean journal of orthodontics
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• v.27 no.5 s.64
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• pp.815-824
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• 1997

The purpose of this study is to develop the basic algorithm for the finite element method modeling of individual malocclusions. Usually, a great deal of time is spent in preprocessing. To reduce the time required, we developed a standardized procedure for measuring the position of each tooth and a program to automatically preprocess. The following procedures were carried to complete this study. 1. Twenty-eight teeth morphologies were constructed three-dimensionally for the finite element analysis and saved as separate files. 2. Standard brackets were attached so that the FA points coincide with the center of the brackets. 3. The study model of a patient was made. 4. Using the study model, the crown inclination, angulation, and the vertical distance from the tip of a tooth was measured by using specially designed tools. 5. The arch form was determined from a picture of the model with an image processing technique. 6. The measured data were input as a rotational matrix. 7. The program provides an output file containing the necessary information about the three-dimensional position of teeth, which is applicable to several finite element programs commonly used. The program for a basic algorithm was made with Turbo-C and the subsequent outfile was applied to ANSYS. This standardized model measuring procedure and the program reduce the time required, especially for preprocessing and can be applied to other malocclusions easily.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.12 no.3
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• pp.217-233
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• 2014

Securing the radiological safety is a prerequisite for the safe management of the naturally occurring radioactive materials (NORM) which cannot be reused. This becomes a crucial focus of our R&D efforts upon the implementation of the Act on Protective Action Guidelines against Radiation in the Natural Environment. To secure the safety, the establishment of technical bases and procedures for securing radiological safety related to the disposal of NORM is required. Thus, it is necessary to analyze the characteristics, to collect the data, to have the radiological safety assessment methodologies and tools, to investigate disposal methods and facilities, and to study the effects of the input data on the safety for the NORM wastes. Here, we assess the environmental impact of the NORM waste disposal with respect to the major domestic and foreign NORM characteristics. The data associated with major industries are collected/analyzed and the status of disposal facilities and methodologies relevant to the NORM wastes is investigated. We also suggest the conceptual design concept of a landfill disposal facility and the management plan with respect to the major NORM wastes characteristics. The radionuclide pathways are identified for the atmospheric transport and leachate release and the environmental impact assessment methodology for the NORM waste disposal is established using a relevant code. The assessment and analysis on the exposure doses and excessive cancer risks for the NORM waste disposal are performed using the characteristics of the representative domestic NORM wastes including flying ash, phosphor gypsum, and redmud. The results show that the exposure dose and the excessive cancer risks are very low to consider any radiation effects. This study will contribute to development in the areas of the regulatory technology for securing radiological safety relevant to NORM waste disposal and to the implementation technology for the Act.

• Journal of Global Scholars of Marketing Science
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• v.19 no.3
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• pp.37-48
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• 2009

The standardization of marketing has been one of the most focused research topics in international marketing. The term "global marketing" was often used to mean an internationally standardized marketing strategy based on similarities between foreign markets. Marketing standardization was discussed only within the context of traditional physical marketplaces. Since then, the digital "marketspace" of the Internet had emerged in the 90's, and it became one of the most important drivers of the globalization process opening new opportunities for the standardization of global marketing activities. On the other hand, the opinion that a greater adoption of the Internet by customers may lead to a higher degree of customization and differentiation of products rather than standardization is also quite popular. Considering this disagreement, it is notable that comprehensive studies which focus upon the marketing standardization especially in the context of global e-commerce are missing to a high degree. On this background, the two basic research questions being addressed in this study are: (1) To what extent do companies standardize their marketing in international e-commerce? (2) Is there an impact of marketing standardization on the performance (or success) of these companies? Following research hypotheses were generated based upon literature review: H 1: Internationally engaged e-commerce firms show a growing readiness for marketing standardization. H 2: Marketing standardization exerts positive effects on the success of companies in international e-commerce. H 3: In international e-commerce, marketing mix standardization exerts a stronger positive effect on the economic as well as the non-economic success of companies than marketing process standardization. H 4: The higher the non-economic success in international e-commerce firms, the higher the economic success. The data for this research were obtained from a questionnaire survey conducted from February to April 2005. The international e-commerce companies of various industries in Germany and all subsidiaries or headquarters of foreign e-commerce companies based in Germany were included in the survey. 118 out of 801 companies responded to the questionnaire. For structural equation modelling (SEM), the Partial-Least. Squares (PLS) approach in the version PLS-Graph 3.0 was applied (Chin 1998a; 2001). All of four research hypotheses were supported by result of data analysis. The results show that companies engaged in international e-commerce standardize in particular brand name, web page design, product positioning, and the product program to a high degree. The companies intend to intensify their efforts for marketing mix standardization in the future. In addition they want to standardize their marketing processes also to a higher degree, especially within the range of information systems, corporate language and online marketing control procedures. In this study, marketing standardization exerts a positive overall impact on company performance in international e-commerce. Standardization of marketing mix exerts a stronger positive impact on the non-economic success than standardization of marketing processes, which in turn contributes slightly stronger to the economic success. Furthermore, our findings give clear support to the assumption that the non-economic success is highly relevant to the economic success of the firm in international e-commerce. The empirical findings indicate that marketing standardization is relevant to the companies' success in international e-commerce. But marketing mix and marketing process standardization contribute to the firms' economic and non-economic success in different ways. The findings indicate that companies do standardize numerous elements of their marketing mix on the Internet. This practice is in part contrary to the popular concept of a "differentiated standardization" which argues that some elements of the marketing mix should be adapted locally and others should be standardized internationally. Furthermore, the findings suggest that the overall standardization of marketing -rather than the standardization of one particular marketing mix element - is what brings about a positive overall impact on success.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.517-523
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• 2001

Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.

• The Korean Journal of Elementary Counseling
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• v.6 no.1
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• pp.141-169
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• 2007

One of the most common feelings in everyday life is anger. Anger plays an important role in activating emotional energy and increasing intolerance when confronted with hardships, frustration and improper treatments. And it provides us with controlling interpersonal behavior, organizing internal, physiological, psychological process and various adaptive functions. If anger is not properly expressed, it brings about offensive attitude, leading to not only physical impairment but also anxiety in interpersonal relations and maladaptive to everyday life. For elementary school students, frequent quarrels, abusive words and defiant attitude toward adults are also caused by students' anger. Therefore, students' anger is one of the most difficult problems to be dealt with not only psychologically but also in elementary schools. In this respect, after investigating frequently experienced anger- inducing situations and inventing anger-inducing situation questionnaire, we postulated specific situations changing irrational belief into rational one. Based on these situations, we accounted for how to cope with anger inducing factors and change irrational belief into rational one, introducing several strategies needed to control anger, invented cognitive behavioral anger control program and tried to clarify the relationship between anger inducing experience and anger regulation ability. In order to derive usual anger-inducing situations, we made 180 students with fifth and sixth grade to record the reason why he/she got angry, mood, thought, behavior and result. Through this process, we could derive 47 situations bringing about anger and prepared anger-inducing situation questionnaire. It can be divided into 3 anger inducing situations by using factor analysis into 500 elementary students of fifth and sixth grade. Cognitive behavioral anger control program used in this study consists of 13 sessions. From first to fifth session, it is composed of 10 anger control methods to make students be aware of and control their anger. From sixth through thirteenth session, the relationship between irrational belief and anger inducing is introduced is focused on how irrational belief is changed into rational one. To examine the effects of the program, high anger students and the students lacking anger control are selected. Thirty students through pre-test using anger-inducing questionnaire and anger control ability questionnaire are taught the goals and procedures. Volunteer students and students with parents' consent allocated to experimental group (12 students) and the rest of the students are control group (12 students). Cognitive Behavioral Anger Control Program are applied every 50 minutes twice a week for 7 weeks and 4 weeks before and after this program, anger-inducing situation questionnaire and anger control ability questionnaire are practiced. Data collected in this study analyzed by SPSS and Kwakstat. In the middle of this program, quarterly reports and satisfaction measuratings were evaluated to examine whether there is verbal and non-verbal behavior change and students feel satisfied with the program. The results of this study are as follows: First, Cognitive-behavioral anger control program used in this study effectively reduced anger experience and lasted for 4 weeks. Second, cognitive behavioral anger control program increased students' ability to control anger inducing situations and also effective for 4 weeks. And its effect on verbal and non-verbal behaviour was very impressive Students come to realize that irrational belief is the cause of their anger and actively apply cognitive-behavioral anger control technique to themselves as well. Students became improved in their peer relations and felt confident in everyday life. The overall evaluation of this program can be listed as follows; "very satisfactory (91.67%)", "satisfactory (8.33%)", "very helpful (91.67%)", "helpful (8.33%). In this study we first investigated several anger-inducing situations and invented anger-inducing situation questionnaire and then applied cognitive behavioral anger control program in order to control their. anger and not to experience it. By creating workbooks and manuals this method can easily be used in school education settings.

• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.473-480
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• 2005

Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

• Journal of Food Hygiene and Safety
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• v.29 no.3
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• pp.202-206
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• 2014

In this study, the bacteriological survey was examined on ice creams at manufacturing factories in Korea during the summer season of 2011. The nineteen selected among 166 samples by preliminary test were collected from 11 different manufacturing factories in four major manufacturers in May 2011. Samples from ice milk, ice creams, sherbets, and non milk fat ice creams were tested for the total aerobic bacteria, coliform bacteria, and five food borne pathogens, respectively. The results showed that the coliforms including E. coli O157:H7, Salmonella spp., Staphylococcus aureus, Clostridium perfringens, and Listeria monocytogenes were not detected on all the ice creams. The total aerobic bacteria of the packed samples examined ranged between $2.5{\times}10^3$ and $5.5{\times}10^5cfu/g$. One ice cream, two sherbets, and four ice milk samples exceeded the acceptable limits of total aerobic bacteria according to the Korean standards for ice cream ($1.0{\times}10^5cfu/g$) and others ($5.0{\times}10^4cfu/g$). The levels of these microorganisms from ice creams were higher in three original equipment manufacturers than seven self-manufacturers. Three of ten ice creams (30.0%), three of six ice milks (50.0%), and one of two sherbets (50%) exceeded the acceptable limits of total aerobic bacteria, respectively. The personnel hygiene procedures with chocolate and vanilla chip addition from the manufacturing process were the main sources of the microbial contamination of stick-bar type ice creams when being produced in a factory. Improvement of the hazard analysis critical control points (HACCP) system should be introduced into the ice cream factory to improve the microbial quality of the ice cream products in Korea.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.142-149
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• 2003

To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.