• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.94-100
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• 2002

Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.17-35
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• 1995

Clinical observation was made on 161 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1994. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, hypertensive encephalopathy, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through western medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission, the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 11.4 days and with cerebral hemorrhage 22.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. The next was pneumonia. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.5-24
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• 1997

Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.359-365
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• 2006

Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.583-590
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• 2001

The aim of this study was to compare one-year graft patency after coronary artery bypass grafting without cardiopulmonary bypass(OPCAB) with that of conventional CABG and that of on-pump beating CABG, and to demonstrate any differences in patency of various conduits among the three groups. Material and Method: We analyzed the results of OPCAB cases(group I; n=122) compared with those of conventional CABG cases(group II; n=65) and those of on-pump beating CABG cases(group III; n=19). In group I, coronary angiography(CAG) was performed immediately postoperatively and 1 year after surgery. In group II and III, CAG was performed 1 year after surgery. Graft patency was graded as grade A(excellent), grade B(fair), or grade O(occluded). Result: The average number of distal anastomoses in groups I, II, and II were 3.1$\pm$1.1, 3.7$\pm$0.9, and 3.6$\pm$0.9, respectively. In group I, postoperative CAG was performed in 92%(112/122) of patients before discharge. The patency rate(grade A+B) was 96.4$(162/168) for arterial grafts, and 85.6%(160/187) for saphenous vein grafts(SVG). One-year follow-up CAG was performed in 74%(90/122) of patients. The patency rate was 97.8%(132/135) for arterial grafts, and 67.9%(106/156) for SVG. In group II, one-year follow-up CAG was performed in 65%(42/65) of patients. The patency rate(grade A+B) was 93.5%(43/46) for arterial grafts, and 86.8%(33/38) for SVG. Conclusion: Our results demonstrated that the patency rate of SVG after OPCAB was significantly lower than that of arterial grafts in the early postoperative CAG(p<0.001), and was also significantly lower than those of SVG of group II(p<0.001) and group III(p<0.01) in the postoperative one-year CAG, although there was no significant difference is one-year patency of arterial grafts among the three groups. Our data suggest that a specific perioperative anticoagulant therapy may be advisable in patients undergoing OPCAB with SVG.

• Applied Chemistry for Engineering
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• v.32 no.1
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• pp.117-123
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• 2021

In this study, the composite was prepared by mixing SiOx, soft carbon, and carbon black and the electrochemical properties of lithium ion battery were investigated. The content of SiOx added to improve the capacity of the soft carbon anode material was varied to 0, 6, 8, 10, 20 wt%, and carbon black was added as a structural stabilizer for reducing the volume expansion of SiOx. The physical properties of prepared CB/SiOx/C composite were investigated through XRD, SEM, EDS and powder resistance analysis. In addition, the electrochemical properties of prepared composite were observed through the charge/discharge capacity, rate and impedance analysis of the lithium ion battery. The prepared CB/SiOx/C composite had an inner cavity capable of mitigating the volume expansion of SiOx by adding carbon black. The formed internal cavity showed a low initial efficiency when the SiOx content was less than 8 wt%, and low cycle stability when the content of SiOx was less than 20 wt%. The CB/SiOx/C composite containing 10 wt% of SiOx showed an initial discharge capacity of 537 mAh/g, a capacity retention rate of 88%, and a rate of 79 at 2C/0.1C. SiOx was added to improve the capacity of the soft carbon anode material, and carbon black was added as a structural stabilizer to buffer the volume change of SiOx. In order to use the CB/SiOx/C composite as a high-efficiency anode material, the mechanism of the optimal SiOx and the use of carbon black as a structural stabilizer was discussed.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.338-348
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• 1995

We need to continuously evaluate for nursing quality and the outcome to reflect nursing, to repair and improve of nursing. The first problem for nursing quality improvement is development of evaluation tool for the quality of nursing care. We need a system for quality assurance evaluation that is, development and framework of evaluation tool for nursing care quality. The purpose of this study was attempted to develop an evaluation tool for the quality of nursing care in musculoskeletal disorder patients. The approach method of nursing quality for the development of the tool in this study was process evaluation framework. The study were devided dvelopment process and reliability, validity verification process. The subjects of development process of this tool are three nursing export groups, and the subject of reliability, validity verification process are 20 samples of two university hospital in seoul, who were within discharge 3 months after admission treatment in musculo-skeletal disorder. Data for this study was collected from March 10 to April 13, 1995. The development process of the tool were as follows : 1. Make preliminary list of the tool by focal group were constituted 12 clinical nurses. 2. Modify and add preliminary list by 4 nursing expert panel. 3. Calculate content validity of the tool by 25 nursing expert panel of judge. 4. Verify reliability and validity of the tool. 5. Finalize an evaluation tool for the quality of the nursing care in musculo-skeletal disorder. The results of this study were as follows : 1) Development an evaluation tool for the quality of nursing care in musculo-skeletal disorder. (1) The evalution tool of this study was developed 5 standards, 33 criterias and 133 indicators. (2) 5 standards were divided according to Nursing Process. from standard 1 to standard 5, involved criterias were each 6(18%), 3(9%), 3(9%), 15(46%), 6(18%). 2) Verify reliability and validity of the tool. (1) Score of adequate degree for content validity of 33 criterias and 133 indicators were every average 2.82. (2) Inter-rater reliabilities(consentaneity score) of the tool by pearson correlation coefficient between three raters were : r=.7506, r=.8934, r=.6695. and Inter-rater reliabilities by single-facet crossed design were : r=.7464. (3) The alpha coefficient relating to internal consistency was .8524 over all 30 items of 33 criterias of developed tool. (4) Score of the quality of nursing care following to generaal characteristics of this study subjects were stastically significant differences according to educational level (F=2.93, p=.029)and diagnosing classification (F=2.50, p=.042). Through this study, I'm sure that the developed tool for the quality of patient care in musculo-skeletal disorder will show the way of more improvement of the quality of nursing care and effective nursing interventions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.1
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• pp.55-74
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• 2012

Objective : The purpose of this study is to investigate the skin disease in Sanghanron"傷寒論" and Geumgweyoryak"金匱要略". Methods : We conducted a study on the original text paragraphs of Sanghanron and Geumgweyoryak containing the skin disease and analysis of Woo, Oh, Sung, Zhang, etc. We drew a parallel between skin disease from Sanghanron and Geumgweyoryak and matching diagnoses from western medicine. Results : The results were as follows. 1. In Sanghanron and Geumgweyoryak pruritus was related to psychogenic pruritus and similar to skin disease caused by decrease of sweating, dry skin in cholinergic urticaria, atopic dermatitis and eczema, etc. in western medicine. 2. In Geumgweyoryak ichthyosis was caused by woman's disease, after menopause, chronic disease and malnutrition and related to winter itch and xerotic eczema in western medicine. 3. In Sanghanron Goose bumps, keratosis follicularis, acute and chronic urticaria and cold urticaria were occurred because of poorly managed fever care and side effect of antibiotic. 4. In Geumgweyoryak red face was similar to face flushing and side effects, which is after drug and laser treatment on face, in western medicine. 5. In Geumgweyoryak urticaria was, in a broad sense, skin disease with pruritus and secondary infection resulted from scratch. Skin diseases with pruritus are similar to urticaria, dermatitis herpetiformis, lichen planus, atopic dermatitis, contact dermatitis, psoriasis, nummular eczema, lichen simplex chronicus, prurigo nodularis, neurodermatitis and internal disease with pruritus in western medicine. 6. In Geumgweyoryak spots in the skin were caused by fever and similar to allergic purpura and SLE symptom in western medicine. 7. In Geumgweyoryak bullous disease with yellowish discharge was similar to eczema, pustule, atopic eczema, etc. in western medicine. 8. In Geumgweyoryak repeated inflammation of oral cavity, genitals, eyes and skin was similar to Behcet's disease in western medicine. 9. In Sanghanron and Geumgweyoryak boil was similar to abscess and acute lymphadenitis in western medicine caused by oily foods and infections. 10. In Geumgweyoryak swelling and boil were occurred in a poor health. Damage from metalic material could cause a convulsion and was similar to tetanus in western medicine. Conclusion : We analyzed the original text paragraphs of Sanghanron and Geumgweyoryak and explanations about skin disease. As a results, we found out etiology, pathogenesis, treatments of the skin disease in Sanghanron and Geumgweyoryak. Further we compared with western medicine to develop better understanding of the skin disease.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• Proceedings of the Korean Vacuum Society Conference
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• 2016.02a
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• pp.93-93
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• 2016

Large scale integrated circuits (LSIs) has been improved by the shrinkage of the circuit dimensions. The smaller chip sizes and increase in circuit density require the miniaturization of the line-width and space between metal interconnections. Therefore, an extreme precise control of the critical dimension and pattern profile is necessary to fabricate next generation nano-electronics devices. The pattern profile control of plasma etching with an accuracy of sub-nanometer must be achieved. To realize the etching process which achieves the problem, understanding of the etching mechanism and precise control of the process based on the real-time monitoring of internal plasma parameters such as etching species density, surface temperature of substrate, etc. are very important. For instance, it is known that the etched profiles of organic low dielectric (low-k) films are sensitive to the substrate temperature and density ratio of H and N atoms in the H2/N2 plasma [1]. In this study, we introduced a feedback control of actual substrate temperature and radical density ratio monitored in real time. And then the dependence of etch rates and profiles of organic films have been evaluated based on the substrate temperatures. In this study, organic low-k films were etched by a dual frequency capacitively coupled plasma employing the mixture of H2/N2 gases. A 100-MHz power was supplied to an upper electrode for plasma generation. The Si substrate was electrostatically chucked to a lower electrode biased by supplying a 2-MHz power. To investigate the effects of H and N radical on the etching profile of organic low-k films, absolute H and N atom densities were measured by vacuum ultraviolet absorption spectroscopy [2]. Moreover, using the optical fiber-type low-coherence interferometer [3], substrate temperature has been measured in real time during etching process. From the measurement results, the temperature raised rapidly just after plasma ignition and was gradually saturated. The temporal change of substrate temperature is a crucial issue to control of surface reactions of reactive species. Therefore, by the intervals of on-off of the plasma discharge, the substrate temperature was maintained within ${\pm}1.5^{\circ}C$ from the set value. As a result, the temperatures were kept within $3^{\circ}C$ during the etching process. Then, we etched organic films with line-and-space pattern using this system. The cross-sections of the organic films etched for 50 s with the substrate temperatures at $20^{\circ}C$ and $100^{\circ}C$ were observed by SEM. From the results, they were different in the sidewall profile. It suggests that the reactions on the sidewalls changed according to the substrate temperature. The precise substrate temperature control method with real-time temperature monitoring and intermittent plasma generation was suggested to contribute on realization of fine pattern etching.