• Journal of Biomedical Engineering Research
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• v.25 no.5
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• pp.421-430
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• 2004

Clinically, it is almost impossible for a physician to distinguish subtle changes of frequency spectrum by using a stethoscope alone especially in the early stage of thrombus formation. Considering that reliability of mechanical valve is paramount because the failure might end up with patient death, early detection of valve thrombus using noninvasive technique is important. Thus the study was designed to provide a tool for early noninvasive detection of valve thrombus by observing shift of frequency spectrum of acoustic signals with computer aid diagnosis system. A thrombus model was constructed on commercialized mechanical valves using polyurethane or silicon. Polyurethane coating was made on the valve surface, and silicon coating on the sewing ring of the valve. To simulate pannus formation, which is fibrous tissue overgrowth obstructing the valve orifice, the degree of silicone coating on the sewing ring varied from 20％, 40％, 60％ of orifice obstruction. In experiment system, acoustic signals from the valve were measured using microphone and amplifier. The microphone was attached to a coupler to remove environmental noise. Acoustic signals were sampled by an AID converter, frequency spectrum was obtained by the algorithm of spectral analysis. To quantitatively distinguish the frequency peak of the normal valve from that of the thrombosed valves, analysis using a neural network was employed. A return map was applied to evaluate continuous monitoring of valve motion cycle. The in-vivo data also obtained from animals with mechanical valves in circulatory devices as well as patients with mechanical valve replacement for 1 year or longer before. Each spectrum wave showed a primary and secondary peak. The secondary peak showed changes according to the thrombus model. In the mock as well as the animal study, both spectral analysis and 3-layer neural network could differentiate the normal valves from thrombosed valves. In the human study, one of 10 patients showed shift of frequency spectrum, however the presence of valve thrombus was yet to be determined. Conclusively, acoustic signal measurement can be of suggestive as a noninvasive diagnostic tool in early detection of mechanical valve thrombosis.

• Journal of the Korean Society for Marine Environment & Energy
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• v.8 no.2
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• pp.83-99
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• 2005

To evaluate environmental charateristics of the South Sea and East China Sea on summer, water and sediment quality were measured in June 2001-2003. Surface layer was affceted by Warm water originated from the high temperature and salinity-Tsushima Warm Current, on the other hand, Yellow Sea Cold Water was spread to the bottom layer in the south-western part of the Jeju island, and salinity at stations near the Yangtze River was decreased below 29psu because of a enormous freshwater discharges. Thermocline-depth was formed at about 10m, and chlorophyll maximum layer was existed in and below the thermocline. COD(Chemical Oxygen Demand), TN(Total Nitrogen), and TP(Total Phosphorus) concentrations showed seawater quality grade II in surface layer of the most area, but concentrations of such as COD, Chl. a, TSS(Total Suspended Solid), and nutrients were greatly increased in the effect area of Yangtze River discharges. Correlations between dissolved inorganic nitrogen, Chl. a and salinity were negative patterns strongly, in contrast, those of inorganic phosphorus, COD and Chl. a were positive, which indicates that phytoplankton biomass and phosphorus are considered as important factors of organic matter distribution and algal growth, respectively. in the study area. The distribution of ignition loss, COD, and $H_2S$ of surface sediment were in the ranges of 2.61-8.81%, $0.64-11.86mgO_2/g-dry$, and ND-0.25 mgS/g-dry, respectively, with relatively high concentration in the eastern part of the study area. Therefore, to effective and sustainable use and management of this area, continuous monitoring and countermeasures about major input sources to the water and sediment, and prediction according to the environmental variation, are necessary.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.126-130
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• 2012

Purpose : Methode an effective block was investigated to deal with volatile radioactive gas, short lived radioactive waste generated as a result of the routinely produced radiopharmaceuticals FDG (2-deoxy-2-[$^{18}F$]fluoro-D-glucose) and compound with $^{11}C$. Materials and Methods : All components of the radiation stack monitoring and data management system for continuous radioactive gas detection in the air extract system purchase from fixed noble gas monitor of Berthold company. TEDLAR gas sampling bags purchase from the Dongbanghitech company. TEDLAR gas sampling bags (volume: 10 L) connected via paraflex or PTFE tubing and Teflon 3 way stopcock. When installing TEDLAR gas sampling bags in Hot cell on the inside and not radioactive gas concentrations were compared. According to whether the Hot cell inside a activated carbon filter installed, compare the difference in concentration of the radioactive gas $^{18}F$. Comparison of radiation emission concentration difference of module a FASTlab and TRACElab. Results : Activated carbon filter are installed in the Hot cell, a measure of the concentration of radioactive gas was 8 $Bq/m^3$. Without activated carbone filter in the hot cell was 300 $Bq/m^3$. Tedlar bag prior to installation of the radioactive gases a measure of the concentration was 3,500 $Bq/m^3$, $^{11}C$ synthesis of the measured concentration was 27,000 $Bq/m^3$. After installed a Tedlar bag and a measure concentration of the radioactive gases was 300 $Bq/m^3$ and $^{11}C$ synthesis was 1,000$Bq/m^3$. Conclusion : $^{11}C$ radioactive gas that was ejected out of the Hot cell, with the use of a Tedlar gas sampling bag stored inside. A compound of 11C is not absorbed onto activated carbon filter. But can block the release out by storing in a Tedlar gas sampling bag. We was able to reduce the radiation exposure of the worker by efficient radiation protection.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.225-232
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• 2000

Purpose : The use antimicrobial agents is one of the important strategies for the treatment and prophylaxis of microbial infections. But injudicious abuse and misuse of antimicrobial agents is problem to add an extra weight on medical fee, increase of resistant bacteria and side effects according to the antibiotic use. This study was performed to establish the pertinent use of antimicrobial agent in Chonbuk National University Hospital(CNUH). Characteristics of antibiotics use was analysis by reviewing the medical records of patients admitted to CNUH during the period of May 1998. Methods : One thousand eight hundred and thirty three patients were enrolled in this study(medical division 1,014 cases, surgical division 819 cases). Medical records were retrospectively reviewed to classify the rate of antibiotics use, name of antibiotics used, appropriateness of antibiotics use. Results : The overall rate of antibiotic usage in CNUH was 67.2%(1,231/1,833), showing higher rate in surgical division(89.6%) compare to that of medical division(49.0%). Among 1,231 patients to whom antimicrobial agents were given, only 125(10.2%) were treated with single antimicrobial agents. 311(25.3%) were treated with two antimicrobial agents, and 795(64.5%) patients received 3 or more antibiotics. ${\beta}$-lactams(56.4%) were most frequently used followed by aminoglycosides(35.3%), the others(4.9%) and quinolons(3.4%). Amoxicillin-clavulanate was the mostly commonly used antibiotics followed by amoxicillin and unasyn. Prophylactic use of antibiotics was carried in seven hundred six patients(57.4%), mostly in surgical division, which can be considered somewhat inappropriate in the initiation time and duration of antibiotic use. Conclusion : Importance of monotherapy and appropriate prophylactic antibiotic use should be emphasized. Strategies of antibiotics use, such as restriction of drug use, continuous monitoring system, flow sheet system should be considered to reduce antibiotics use and establish the appropriate use of antibiotics as well as inhibiting the occurrence of resistant strains.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.177-192
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• 2021

The Development Assistance Committee of the Organization for Economic Cooperation and Development discusses the reorganization of the five evaluation criteria of the Public Development Assistance Committee, which are used internationally, and the five evaluation criteria including adequacy, efficiency, effectiveness, impact, and sustainability when assessing public development assistance in 1991. This study is to derive alternatives by applying the evaluation criteria of the Development Assistance Committee of the Organization for Economic Cooperation and Development in the evaluation of the inclusive business program being implemented in Nepal since 2019. As a result of the study, the adequacy of Nepal's inclusive business program was consistent with continuous employment and job creation for vulnerable groups such as disabled and orphan women. Efficiency can be said to be efficient in that processes such as work order and work confirmation are made with an electronic management tool, and delivery of the result is transmitted online, saving time and cost compared to other industries. The effectiveness of this project can be said to be an effective program in that it provides high-quality jobs such as providing specialized computer graphics education for the vulnerable, such as disabled and orphan women in Nepal, and hiring graduates as employees. Sustainability is the point that KOICA's inclusive business program has enabled vulnerable groups in the existing fields of agriculture and manufacturing to engage in the computer graphics industry, and the scalability of movies, characters, education businesses, and role models in other countries.However, considering that the scale of public development assistance will continue to increase in the future, it is necessary to establish a systematic monitoring system and a recirculation system so that the project between the donor and recipient countries can continue.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.1
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• pp.93-106
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• 2014

In this study, Analyze environment of location, investigation into vegetation resources, survey management status and establish to classify the management area for Natural monument No.374 Pyengdae-ri Torreya nucifera forest. The results were as follows: First, Torreya nucifera forest is concerned about influence of development caused by utilization of land changes to agricultural region. Thus, establish to preservation management plan for preservation of prototypical and should be excluded development activity to cause the change of terrain that Gotjawal in the Torreya nucifera forest is factor of base for generating species diversity. Secondly, Torreya nucifera forest summarized as 402 taxa composed 91 familly 263 genus, 353 species, 41 varieties and 8 forms. The distribution of plants for the first grade & second grade appear of endangered plant to Ministry of Environment specify. But, critically endangered in forest by changes in habitat, diseases and illegal overcatching. Therefore, when establishing forest management plan should be considered for put priority on protection. Thirdly, Torreya nucifera representing the upper layer of the vegetation structure. But, old tree oriented management and conservation strategy result in poor age structure. Furthermore, desiccation of forest on artificial management and decline in Torreya nucifera habitat on ecological succession can indicate a problem in forest. Therefore, establish plan such as regulation of population density and sapling tree proliferation for sustainable characteristics of the Torreya nucifera forest. Fourth, Appear to damaged of trails caused by use. Especially, Scoria way occurs a lot of damaged and higher than the share ratio of each section. Therefore, share ratio reduction Plan should be considered through the additional development of tourism routes rather than the replacement of Scoria. Fifth, Representing high preference of the Torreya nucifera forest tourist factor confirmed the plant elements. It is sensitive to usage pressure. And requires continuous monitoring by characteristic of Non-permanent. In addition, need an additional plan such as additional development of tourism elements and active utilizing an element of high preference. Sixth, Strength of protected should be differently accordance with importance. First grade area have to maintenance of plant population and natural habitats. Set the direction of the management. Second grade areas focus on annual regeneration of the forest. Third grade area should be utilized demonstration forest or set to the area for proliferate sapling. Fourth grade areas require the introduced of partial rest system that disturbance are often found in proper vegetation. Fifth grade area appropriate to the service area for promoting tourism by utilizing natural resources in Torreya nucifera forest. Furthermore, installation of a buffer zone in relatively low ratings area and periodic monitoring to the improvement of edge effect that adjacent areas of different class.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.3
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• pp.92-95
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• 2017

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by an ${\alpha}$-galactosidase A (GLA, MIM 300644) enzyme deficiency due to pathogenic variants in the ${\alpha}$-galactosidase A gene (GLA). The disease leads to accumulation of globotriaosylceramide (Gb3) and related glycophospholipids affecting nearly all major organ systems, with the primary sites damaged by Gb3 including renal glomeruli, myocardium, neurons of the dorsal ganglion and autonomic nervous system, and vascular endothelial and smooth muscle. Progressive deposition in these organ systems present with various clinical manifestations including acroparesthesia, renal failure and heart failure. Here, we report a Chinese male diagnosed with Fabry disease in his late $4^{th}$ decades showing improvement of acroparesthesia during enzyme replacement therapy (ERT). A 48-year-old Chinese man who presented with chronic recurrent severe burning pain in his fingers and toes since the age of 10, with worse involvement of the former visited to our clinic for further evaluation. His medical history included a transient ischemic attack aged 40 and diagnosed with stage 4-5 chronic kidney disease aged 47. In the family history, the patient's brother was found to be have Fabry disease 1 month before his visit. Except for his brother, all other members of the family are healthy. Based on his medical history and family history, he was strongly suspicious for Fabry disease. He was found to have a galactose-alpha-1,3-galactose level 4.96 (Reference range, 42.5-67.9) suggestive of Fabry disease. The followed sequencing of GLA coding region in our patient revealed hemizyosity for the mutation c.988C>T (Q330X) in Exon 7. Since ERT start, he showed significant improvement in his symptoms of burning sensation of fingers and toes. On the contrary, due to deteriorating kidney function even with ERT, he is considered for kidney transplantation. Despite of diagnostic delay until late 4th decades, ERT showed a potential improvement of acroparesthesia in our patient. However, late start of ERT can lead to poor outcome in multiorgan function. Therefore, early diagnosis with high index of suspicion followed by continuous ERT with regular monitoring have an impact on quality of life in Fabry disease.

• Korean Journal of Agricultural and Forest Meteorology
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• v.12 no.2
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• pp.132-142
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• 2010

Characteristics of meteorological elements were analyzed at Hwagae and Agyang where are the representative areas of Hadong green tea cultivation in Korea. An automatic weather monitoring system (AWS) and a simple data log were employed to measure meteorological data such as temperature, relative humidity, precipitation, and wind direction and speed for 2009. The annual average air temperature of Hwagae and Agyang was 14.5 and 14.2, respectively, showing the warmest month in August ($25.4^{\circ}C$ for Hwagae and $24.9^{\circ}C$ for Agyang) and the coldest month in January ($0.3^{\circ}C$ for Hwagae and $0.2^{\circ}C$ for Agyang). Annual average of daily temperature difference (= daily maximum temperature - daily minimum temperature) was $11.3^{\circ}C$ for Hwagae and $11.1^{\circ}C$ for Agyang. Hwagae and Agyang had 62.7% and 65.3% of the annual average relative humidity, respectively. Annual precipitation was 1387 mm for Hwagae and 1793 mm for Agyang of which were higher of 605mm for Hwagae and 835 mm for Agyang compared to that in 2008. Majority of precipitation occurred between May and August, attributing 77.6% for Hwagae and 76.6% for Agyang to the annual precipitation. The annual total sunshine duration was 2054.3 hrs in Hwagae with the longest monthly sunshine duration in May (235.1 hrs) and the shortest monthly sunshine duration in July (102.5 hrs). Dominant wind direction changed seasonally from northwesterly wind in fall and winter to southeasterly wind in spring and summer. The annual average wind speed was 1.5 m $s^{-1}$ with the highest monthly wind speed of 2.0 m $s^{-1}$ in December and the lowest monthly wind speed of 1.1 m $s^{-1}$ in February. It is expected that continuous observation and assessment of meteorological data will improve our understanding of optimal environmental conditions for green tea cultivation and be used for developing models of green tea cultivation in the Hadong area.