• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.172-179
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• 2016

Purpose: Bacillus cereus has been reported as the cause of nosocomial infections in cancer patients. In our pediatric cancer ward, a sudden rise in the number of patients with B. cereus bacteremia was observed in 2013 to 2014. This study was performed to investigate the molecular epidemiology of increased B. cereus bacteremia cases in our center. Methods: Pediatric cancer patients who developed B. cereus bacteremia were identified from January 2001 to June 2014. The B. cereus bacteremia in this study was defined as a case in which at least one B. cereus identified in blood cultures, regardless of true bacteremia. Available isolates were further tested by multilocus sequence typing (MLST) analysis. A retrospective chart review was performed. Results: Nineteen patients developed B. cereus bacteremia during the study period. However, in 2013, a sudden increase in the number of patients with B. cereus bacteremia was observed. In addition, three patients developed B. cereus bacteremia within 1 week in July and the other three patients within 1 week in October, respectively, during emergency room renovation. However, MLST analysis revealed different sequence types without consistent patterns. Before 2013, five tested isolates were ST18, ST26, ST177, and ST147-like type, and ST219-like type. Isolates from 2013 were ST18, ST73, ST90, ST427, ST784, ST34-like type, and ST130-like type. Conclusions: MLST analyses showed variable ST distribution of B. cereus isolates. Based on this study, there was no significant evidence suggesting a true outbreak caused by a single ST among patients who developed B. cereus bacteremia.

• The Journal of Engineering Geology
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• v.9 no.2
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• pp.161-176
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• 1999

The objectives of this study are to analyze the changes of geo-surface topography in the Siwha embankment and the Ahsan city area by the image processing of Landsat Thematic Mapper data, and to estimate the reclaimed amount of the exposed tidal flat in the Siwha area using the GIS. False color composite, Tasseled cap, NVDI(normalized difference vegetation index), and supervised classification techniques were used to analyze the distribution of sediments and the aspect of topographical variations caused by artificial human actions. The total amount of the exposed tidal flat was estimated on the basis of the database snch as aerial photography, hydrographic chart, geological map, and scheme drawing in the Siwha area. The possible excavation regions for a seawall were predicted analyzing the supervised classification image of Landsat TM data. Tasseled cap images were used to observe the distribution of sediments. The difference of the NDVI images between spring and summer seasons indicates that deciduous and coniferous forests were distributed over the whole areas. The total fill-volume of the exposed Siwha tidal flat and the fill-volume of the construction planning seawall were calculated as $581,485,354\textrm{m}^3{\;}and{\;}3,387,360\textrm{m}^3$, respectively, from the digital terrain analysis. Daebu Island, Sunkam Island, and the part of Songsan-myeon were chosen as the cut area to make the seawall, and their cut-volumes were estimated as $5,229,576\textrm{m}^3,{\;}79,227,072\textrm{m}^3,{\;}and{\;}47,026,008\textrm{m}^3$, respectively. Therefore, the cut-volume of Daebu Island alone among three areas was sufficient to make the seawall.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.38 no.2
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• pp.95-107
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• 2020

The purpose of this study is to provide the basic data by analyzing and analysing the Growth Conditions of old Trees in Yangdong village. This study investigated about the conducted on tree information, soil information, and tree health. The result are as follows. The trees information in Yangdong Village consists of Juniperus chinensis, Salix chaenomeloides, Salix pseudolasiogyne, Celtis sinensis, Zelkova serrata, Gleditsia japonica, and Gleditsia sinensis trees, The range of height was 4.0~17.0m, and the diameter was 0.51~1.34m, Juniperus chinensis trees of No.17 was most large. In the results of soil analysis, there showed that acidity was pH4.1~6.3, hardness of 5~48mm, organic matter content of 21.2~29.1g/kg, electrical conductivity(EC) of 0.34~1.76dS/m, available P₂O₅ of 79.8~451.6mg/kg, exchangeable K of 0.22~1.71cmol+/kg, exchangeable Ca of 4.98~7.44cmol+/kg, exchangeable Mg of 0.67~2.19cmol+/kg, exchangeable Na of 0.19~1.04cmol+/kg and cation exchange capacity(C.E.C) of 7.23~13.02cmol+/kg. As a result, the highest number of tree health levels is 8 of 11trees of Celtis sinensis, 2 of 7trees of Zelkova serrata, and 3 of Gleditsia sinensis, and 13 of 30 trees of health levels, The Older trees with high infection, spoil and hollowed part were the remaining trees except for the healthy part. Relatively, more than half of the number of targets is infected, decay, and the hollowed site, and it is necessary to perform surgery on the damaged area. In addition, preservation and protection measures should be implemented by supplying root nutrients for trees, controlling nutrients in the body to prevent secondary and tertiary damages that cause the infection site to metastasize to the health site, In order to continually monitor the trees, measures to improve the location environment and management of the trees should be sought.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.13 no.2
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• pp.111-119
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• 2013

Purpose: Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disorder caused by deficiency of the enzyme ${\alpha}$-L-iduronidase, which leads to a broad spectrum of multisystemic manifestations. Short stature and decreased growth velocity are prominent features of MPS I. The aim of the present study was to evaluate the effect of enzyme replacement therapy (ERT) on growth of Korean MPS I patients from a single center. Methods: Height data were obtained by retrospective chart review of 10 Korean patients with MPS I who had received ERT for a minimum of 3 years. Height was expressed as standard deviation scores (SDS) based on normative data. Annual growth rates were calculated before and during ERT. A piecewise regression model was used to analyze height z-scores before and after treatment. Individual analysis was performed for impact of phenotype [(severe (Hurler) versus attenuated (Hurler-Scheie, Scheie)] on growth. Results: Annual growth was 3.3 cm (z-score= -0.21) in the year before ERT and 6.2 cm (z-score= 0.17), 5.8 cm (z-score= 0.07), and 3.8 cm (z-score= -0.4) in the first, second, and third years of ERT, respectively. Regression analysis showed improvement in the slope after ERT (difference= 0.04; P=0.022). Estimated slope differences between severe and attenuated phenotypes were statistically significant before (P=0.001) and after treatment (P<0.0001), although no significant difference was noted when stratified by phenotype. Conclusion: ERT with aldurazyme appears to have a positive impact on linear growth in patients with MPS I.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.215-220
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• 2018

Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.143-153
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• 2020

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion: Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.1
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• pp.10-18
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• 2023

Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

• Magazine of the Korean Society of Agricultural Engineers
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• v.19 no.1
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• pp.4296-4311
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• 1977

This study was conducted to derive an Instantaneous Unit Hydrograph for the accurate and reliable unitgraph which can be used to the estimation and control of flood for the development of agricultural water resources and rational design of hydraulic structures. Eight small watersheds were selected as studying basins from Han, Geum, Nakdong, Yeongsan and Inchon River systems which may be considered as a main river systems in Korea. The area of small watersheds are within the range of 85 to 470$\textrm{km}^2$. It is to derive an accurate Instantaneous Unit Hydrograph under the condition of having a short duration of heavy rain and uniform rainfall intensity with the basic and reliable data of rainfall records, pluviographs, records of river stages and of the main river systems mentioned above. Investigation was carried out for the relations between measurable unitgraph and watershed characteristics such as watershed area, A, river length L, and centroid distance of the watershed area, Lca. Especially, this study laid emphasis on the derivation and application of Instantaneous Unit Hydrograph (IUH) by applying Nash's conceptual model and by using an electronic computer. I U H by Nash's conceptual model and I U H by flood routing which can be applied to the ungaged small watersheds were derived and compared with each other to the observed unitgraph. 1 U H for each small watersheds can be solved by using an electronic computer. The results summarized for these studies are as follows; 1. Distribution of uniform rainfall intensity appears in the analysis for the temporal rainfall pattern of selected heavy rainfall event. 2. Mean value of recession constants, Kl, is 0.931 in all watersheds observed. 3. Time to peak discharge, Tp, occurs at the position of 0.02 Tb, base length of hlrdrograph with an indication of lower value than that in larger watersheds. 4. Peak discharge, Qp, in relation to the watershed area, A, and effective rainfall, R, is found to be {{{{ { Q}_{ p} = { 0.895} over { { A}^{0.145 } } }}}} AR having high significance of correlation coefficient, 0.927, between peak discharge, Qp, and effective rainfall, R. Design chart for the peak discharge (refer to Fig. 15) with watershed area and effective rainfall was established by the author. 5. The mean slopes of main streams within the range of 1.46 meters per kilometer to 13.6 meter per kilometer. These indicate higher slopes in the small watersheds than those in larger watersheds. Lengths of main streams are within the range of 9.4 kilometer to 41.75 kilometer, which can be regarded as a short distance. It is remarkable thing that the time of flood concentration was more rapid in the small watersheds than that in the other larger watersheds. 6. Length of main stream, L, in relation to the watershed area, A, is found to be L=2.044A0.48 having a high significance of correlation coefficient, 0.968. 7. Watershed lag, Lg, in hrs in relation to the watershed area, A, and length of main stream, L, was derived as Lg=3.228 A0.904 L-1.293 with a high significance. On the other hand, It was found that watershed lag, Lg, could also be expressed as {{{{Lg=0.247 { ( { LLca} over { SQRT { S} } )}^{ 0.604} }}}} in connection with the product of main stream length and the centroid length of the basin of the watershed area, LLca which could be expressed as a measure of the shape and the size of the watershed with the slopes except watershed area, A. But the latter showed a lower correlation than that of the former in the significance test. Therefore, it can be concluded that watershed lag, Lg, is more closely related with the such watersheds characteristics as watershed area and length of main stream in the small watersheds. Empirical formula for the peak discharge per unit area, qp, ㎥/sec/$\textrm{km}^2$, was derived as qp=10-0.389-0.0424Lg with a high significance, r=0.91. This indicates that the peak discharge per unit area of the unitgraph is in inverse proportion to the watershed lag time. 8. The base length of the unitgraph, Tb, in connection with the watershed lag, Lg, was extra.essed as {{{{ { T}_{ b} =1.14+0.564( { Lg} over {24 } )}}}} which has defined with a high significance. 9. For the derivation of IUH by applying linear conceptual model, the storage constant, K, with the length of main stream, L, and slopes, S, was adopted as {{{{K=0.1197( {L } over { SQRT {S } } )}}}} with a highly significant correlation coefficient, 0.90. Gamma function argument, N, derived with such watershed characteristics as watershed area, A, river length, L, centroid distance of the basin of the watershed area, Lca, and slopes, S, was found to be N=49.2 A1.481L-2.202 Lca-1.297 S-0.112 with a high significance having the F value, 4.83, through analysis of variance. 10. According to the linear conceptual model, Formular established in relation to the time distribution, Peak discharge and time to peak discharge for instantaneous Unit Hydrograph when unit effective rainfall of unitgraph and dimension of watershed area are applied as 10mm, and $\textrm{km}^2$ respectively are as follows; Time distribution of IUH {{{{u(0, t)= { 2.78A} over {K GAMMA (N) } { e}^{-t/k } { (t.K)}^{N-1 } }}}} (㎥/sec) Peak discharge of IUH {{{{ {u(0, t) }_{max } = { 2.78A} over {K GAMMA (N) } { e}^{-(N-1) } { (N-1)}^{N-1 } }}}} (㎥/sec) Time to peak discharge of IUH tp=(N-1)K (hrs) 11. Through mathematical analysis in the recession curve of Hydrograph, It was confirmed that empirical formula of Gamma function argument, N, had connection with recession constant, Kl, peak discharge, QP, and time to peak discharge, tp, as {{{{{ K'} over { { t}_{ p} } = { 1} over {N-1 } - { ln { t} over { { t}_{p } } } over {ln { Q} over { { Q}_{p } } } }}}} where {{{{K'= { 1} over { { lnK}_{1 } } }}}} 12. Linking the two, empirical formulars for storage constant, K, and Gamma function argument, N, into closer relations with each other, derivation of unit hydrograph for the ungaged small watersheds can be established by having formulars for the time distribution and peak discharge of IUH as follows. Time distribution of IUH u(0, t)=23.2 A L-1S1/2 F(N, K, t) (㎥/sec) where {{{{F(N, K, t)= { { e}^{-t/k } { (t/K)}^{N-1 } } over { GAMMA (N) } }}}} Peak discharge of IUH) u(0, t)max=23.2 A L-1S1/2 F(N) (㎥/sec) where {{{{F(N)= { { e}^{-(N-1) } { (N-1)}^{N-1 } } over { GAMMA (N) } }}}} 13. The base length of the Time-Area Diagram for the IUH was given by {{{{C=0.778 { ( { LLca} over { SQRT { S} } )}^{0.423 } }}}} with correlation coefficient, 0.85, which has an indication of the relations to the length of main stream, L, centroid distance of the basin of the watershed area, Lca, and slopes, S. 14. Relative errors in the peak discharge of the IUH by using linear conceptual model and IUH by routing showed to be 2.5 and 16.9 percent respectively to the peak of observed unitgraph. Therefore, it confirmed that the accuracy of IUH using linear conceptual model was approaching more closely to the observed unitgraph than that of the flood routing in the small watersheds.

• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.9-33
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• 2007

In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.2
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• pp.249-263
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• 1998

The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.