• 한국물환경학회지
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• 제35권1호
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• pp.43-54
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• 2019

The objective of this study was to assess the effect of policies on water quality management based on the changes in pollutants and water quality in Special Water Preservation Area (SWPA) of Lake Paldang watershed from 1990 to 2016. The population, total sewage and flow rate of wastewater in SWPA continuously increased from 1990 to 2016, while the location of new facilities for industrial and livestock facilities has been restricted. However, unlike the buffer zone in which industrial and livestock facilities were continuously reduced after implementing of TMDL, it was found that the effect of land-use regulations on industrial and livestock facilities in SWPA were mitigated by the increase in the size of large facilities. Since 1999 when the emission standard of public sewage treatment plants (STP) was changed, the water quality of Lake Paldang has increased despite the increase of pollutant source. Since emission standard of STP changed in 2012 (BOD 5 mg/L, TP 0.2 mg/L), BOD concentration in Lake Paldang has also improved to the level of water quality in the early 1990s where as TP concentration has remained at its lowest since 1990. BOD and TP average discharge concentration of 43 STP (${\geq}500m^3/day$) in 2016 have been maintained $1.7{\pm}0.7mg/L$ and $0.06{\pm}0.02mg/L$ respectively. While the discharged load of STP in SWPA was decreased by the concentration management, the contribution rate to the total discharged load of non-point pollutants increased to 70 % in 2015, and the contribution rate to the point discharged load of individual treatment facilities increased to 80 %.

• 환경영향평가
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• 제28권5호
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• pp.483-491
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• 2019

파리 협약에 따른 post-2020에 대비하기 위한 환경영향평가(EIA : Environmental Impact Assessment) 측면에서의 온실가스 감축방안을 모색하였다. 2010~2019년 금강유역환경청의 EIA대상사업 중 26건의 환경영향평가서(EIS : Environmental Impact Statement)를 사례분석한 결과로, '온실가스 항목'은 대부분 형식적으로 작성된 것으로 분석되었다. 본 연구에서는 EIA시 '온실가스 항목'의 형식적 평가를 개선하기 위한 방안으로서, 1) EIA대상사업별 온실가스 배출량에 따른 배출부과금 할당, 2) "환경오염시설의 통합관리에 관한 법률"에 근거한 '허가배출기준 설정'에 '온실가스 항목'의 추가, 3)이해당사자들이 EIA대상 개발사업의 초기단계에 참여하는 거버넌스 확립으로 온실가스 감축 등을 제안하였고, 구체적인 내용을 논의하였다.

• 보건행정학회지
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• 제31권2호
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• 대한한의학원전학회지
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• 제35권2호
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• pp.99-120
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• 2022

Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.

• 상하수도학회지
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• 제36권4호
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• pp.229-237
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• 2022

The sewer capacity design have been based on the Huff model or the rational equation in South Korea and often failed to determine optimal capacity, resulting in frequent urban flooding or over-sizing. A time distribution of rainfall (i.e., Huff or ABM method) could be used instead of a rainfall hyetograph obtained from statistical analysis of previous rainfalls. In this study, the Huff method and the ABM method, which predict the time distribution of rain intensity, which are widely used to calculate sewage pipe drainage capacity using the SWMM, were compared with the standard rainfall intensity hyetograph of Seoul. If the rainfall duration was 30 minutes to 180 minutes, the rainfall intensity value calculated by the Huff model tended to be less than the rainfall intensity value of the standard rainfall intensity in the initial 5-10 minutes. As a result, more than 10% to 30% of under-design would be made. In addition, the rainfall intensity value calculated by the Huff model from the section excluding the initial 5-10 minutes of rainfall to the rainfall duration was calculated larger than the value using the standard rainfall intensity equation, which would result in an over-design of 10% to 30%. In the case of a relatively long rainfall duration of 360 minutes (6 hours) to 1,440 minutes (24 hours), it showed an lower rainfall intensity of 60 to 90% in the early stages of rainfall, but the problem of under-design had been solved as the rainfall duration time had elapsed. On the other hand, in the alternating block method (ABM) method, it was found that the rainfall intensity at the entire period at each assumed rainfall duration accurately matched the standard rainfall intensity hyetograph of Seoul.

• Journal of Chest Surgery
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• 제56권5호
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• pp.346-352
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• 2023

Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

• 한국수자원학회:학술대회논문집
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• 한국수자원학회 2020년도 학술발표회
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• pp.231-231
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• 2020

Unlike conventional treatment technologies, the performance of nature-based facilities were susceptible to seasonal changes and climatological variabilities. This study evaluated the effects of seasonal variables on the treatment performance of constructed wetlands (CWs). Two CWs treating runoff and discharge from agricultural and livestock areas were monitored to determine the efficiency of the systems in reducing particulates, organics, and nutrients in the influent. For all four seasons, the mean effluent suspended solids concentration in the agricultural CW (ACW) increased by -2% to -39%. The occurrence of algal blooms in the system during summer and fall seasons resulted to the greatest increase in the amount of suspended materials in the overlying water. unlike ACW, the livestock CW (LCW) performed efficiently throughout the year, with mean suspended solids removal amounting to 61% to 68%. Algal blooms were still present in LCW seasonally; however, the constant inflow in the system limited the proliferation of phytoplankton through continuous flushing. The total nitrogen (TN) and total phosphorus (TP) removal efficiencies in ACW were higher during the summer (21% to 25%) and fall (8% to 21%) seasons since phytoplankton utilize nitrogen and phosphorus during the early stages of phytoplankton blooms. In the case of LCW, the most efficient reduction in TN (24%) and TP (54%) concentrations were also noted in summer, which can be attributed to the favorable environmental conditions for microbial activities. The mean removal of organics in ACW was lowest during summer season (-52% to 35%), wherein the onset of algal decay triggered a relative increase in organic matter and stimulate bacterial growth. The removal of organics in LCW was highest (54 % to 55%) during the fall and winter seasons since low water temperatures may limit the persistence of various algal species. Variations in environmental conditions due to seasonal changes can greatly affect the performance of CW systems. This study effectively established the contributory factors affecting the feasibility of utilizing CW systems for treating agricultural and livestock discharges and runoff.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.99-115
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• 2023

Purpose: Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes. Formula supplementation is common within our low-income, ethnic-minority community. We studied exclusively breastfed (EBF) neonates' early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality. Methods: Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0-24 hours), discharge (30-48 hours), and at first appointment (days 3-5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out. Results: Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples' metabolome (p=0.450). Conclusion: Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.

• Korean Circulation Journal
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• 제53권9호
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• pp.635-644
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• 2023

Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m² with the conventional threshold of 30 kg/m² in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions: When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.

• 가정간호학회지
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• 제1권
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• pp.57-70
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• 1993

본 연구는 입원환자들의 가정간호사제도에 대한 찬반여부 및 가정간호 서비스 내용과 그 요구도를 파악하기 위하여 대구시내 3개 종합병원에서 1993년 9월 6일부터 10월 9일까지 뇌질환, 척추질환 및 근골격계질환으로 입원한 환자중 퇴원예정에 있는 환자 242명을 대상으로 설문지에 응답하도록 하여 자료를 수집하였다. 가정간호제도를 찬성한 환자는 66.1%(161명)이었으며 반대는 33.5%(81명)이었다. 환자의 일반적 특성별로는 30세에서 49세 사이가 75.5%, 중소도시에 거주하는 75.9%로 높은 찬성율을 보였다. 특히 의료보호 환자군에서는 40.0% 낮은 찬성율을 보였다. 척추손상 환자의 75.6%가 찬성한 반면 복합질 환자는 54.5%의 찬성율을 보였다. 그리고 거동 가능한 환자의 69.4%, 임종을 기다리는 환자의 80.0% 및 조기퇴원을 희망하는 환자의 73.9%가 가정 간호사제도를 찬성하였다. 가정간호사제도를 찬성하는 환자(161명)의 찬성 이유는 주치의와 계속적인 연결을 갖고 싶어서가 37.3%로 가장 높았고, 그 다음 병원에 오기가 블편해서였고 기능적 상태에 따라 찬성 이유간에는 유의한 차이가 있었다(p<0.05). 가정간호사제도를 반대하는 환자(81명)의 이유를 보면 병원보다 질이 낮을 것같다가 가장 많았고, 방문이 번거롭다 및 가정에서 가족이 돌볼 수 있어서의 순이였다. 조기퇴원을 원하는 환자는 74.8%였으며 조기퇴원 이유는 병원생활이 지루하기 때문에가 57.5%로 가장 많았고, 조기퇴원을 원하지 않는 환자는 질병상태에 대한 불안감 때문에가 54.0%로 가장 높았다. 가정간호사제도를 찬성한 환자들에게 가정간호서비스 내용을 23개 항목으로 나눈 요구 빈도에서 앞으로 수혜받기를 원하는 가정간호활동 내용은 회복촉진, 합병증예방, 상담 및 건강관리지도로 76.4%로 가장 많았으며, 그 다음의 투약관리 및 지도 (62.1%), 활력증상의 정기적인 측정(555.9%)의 순이었고 임종간호(3.7%) 및 호흡유지를 위한 간호(9.9%) 등은 요구빈도가 가장 낮았다. 가정간호서비스 항목에 있어서 진단내용, 환자의 기능적 상태, 합병증 유무 등에 따라서는 큰 차이 없이 회복촉진, 합병증예방상담 및 건강관리지도 항목에서 가장 높은 요구도를 나타냈고 나머지 간호요구는 큰 차이가 없었다.