• Title/Summary/Keyword: Management methods

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An analysis of one-year experience of pediatric observation unit: The first report in Korea (소아 관찰병실 운영에 대한 분석)

  • Lee, Jee Young;Choi, Ui-Yoon;Lee, Soo Young;Lee, Ji-Young;Lee, Byong Chan;Hwang, Hui Sung;Mok, Hye Rin;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.622-628
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    • 2007
  • Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

The Improvement Plan on Unifying from Law and Regulations Related to Radiation (방사선관계법 개정 시 용어 적용에 관한 개선 방안)

  • Jeong, Dong-Kyong;Lee, Jong-Back;Park, Myeong-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.7-12
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    • 2006
  • Purpose: This is for the purpose to help the bill related to technologists be systematic and unitary by carefully analyzing a legislation, an enforcement ordinance, and enforcement regulations in the connection with the radiological worker and the radiation workers from the law and regulations related to technologists. Materials and Methods: Concerning technologists, a legislation, an enforcement ordinance, and enforcement regulations for a sort of medical technician, regarding the radiological worker, the rules of diagnosis radiation equipment safety management, and concerning the radiation workers, atomic energy law, an enforcement ordinance and enforcement regulations were gathered, compared with one another, and analyzed. Results: Among technologists, in the case of working in the department of diagnosis radiation, the title 'Radiological Worker' is used by the Medical Service Law, and in the case of working in the department of radiation tumors or the one of nucleus medicine, the title 'Radiation Workers' is used by the Atomic Energy Law. Conclusion: Besides the technical term that is used by characteristic tasks, unification of the terms that can be used in common is necessary for sure. And when a legislation, an enforcement ordinance, enforcement regulations, and notification, things like that in the radiation field are amended, certainly they should be done by mutual agreement through negotiation between the organization related to radiation and the governmental organization.

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Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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Review of Remote Sensing Studies on Groundwater Resources (원격탐사의 지하수 수자원 적용 사례 고찰)

  • Lee, Jeongho
    • Korean Journal of Remote Sensing
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    • v.33 no.5_3
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    • pp.855-866
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    • 2017
  • Several research cases using remote sensing methods to analyze changes of storage and dynamics of groundwater aquifer were reviewed in this paper. The status of groundwater storage, in an area with regional scale, could be qualitatively inferred from geological feature, surface water altimetry and topography, distribution of vegetation, and difference between precipitation and evapotranspiration. These qualitative indicators could be measured by geological lineament analysis, airborne magnetic survey, DEM analysis, LAI and NDVI calculation, and surface energy balance modeling. It is certain that GRACE and InSAR have received remarkable attentions as direct utilization from satellite data for quantification of groundwater storage and dynamics. GRACE, composed of twin satellites having acceleration sensors, could detect global or regional microgravity changes and transform them into mass changes of water on surface and inside of the Earth. Numerous studies in terms of groundwater storage using GRACE sensor data were performed with several merits such that (1) there is no requirement of sensor data, (2) auxiliary data for quantification of groundwater can be entirely obtained from another satellite sensors, and (3) algorithms for processing measured data have continuously progressed from designated data management center. The limitations of GRACE for groundwater storage measurement could be defined as follows: (1) In an area with small scale, mass change quantification of groundwater might be inaccurate due to detection limit of the acceleration sensor, and (2) the results would be overestimated in case of combination between sensor and field survey data. InSAR can quantify the dynamic characteristics of aquifer by measuring vertical micro displacement, using linear proportional relation between groundwater head and vertical surface movement. However, InSAR data might now constrain their application to arid or semi-arid area whose land cover appear to be simple, and are hard to apply to the area with the anticipation of loss of coherence with surface. Development of GRACE and InSAR sensor data preprocessing algorithms optimized to topography, geology, and natural conditions of Korea should be prioritized to regionally quantify the mass change and dynamics of the groundwater resources of Korea.

Management of Regional Lymph Nodes in Localized Vulvar Carcinoma (국소 외음부 암에서 영역 림프절의 치료)

  • Jang, Won-Il;Wu, Hong-Gyun;Park, Charn-Il;Ha, Sung-Whan;Lee, Hyo-Pyo;Kang, Soon-Beom;Song, Yong-Sang
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.1-9
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    • 2008
  • Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

Clinical Features of Acute Pancreatitis in Children (소아 급성 췌장염의 임상적 고찰)

  • Seo, Jung-Ho;Kim, Seong-Heon;Jeong, Sang-Geon;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.58-65
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    • 2010
  • Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7${\pm}$4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3${\pm}$553.2 and 766.2${\pm}$723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.

Epidemiologic Investigation of an Outbreak of Shigellosis in Kyongju, Korea (1998년 경주시 한 초등학교 학생과 인근 주민에서 발생한 세균성이질)

  • Jung, Cheol;Bae, Geun-Ryang;Hur, Yeong-Joo;Lee, Sang-Won;Jeong, Eun-Kyeong;Lim, Hyun-Sul
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.1-9
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    • 2000
  • Objectives : This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of 'M' primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. Methods : The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of 'M' primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. Results : The attack rate of diarrhea was 28.7% in the subjects from Sept.24 to Oct. 24, 1958. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of 'M' primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of 'M' primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that 'M' primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, $1\sim3$ days (72.5%) in duration, $2\sim3$ times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). Conclusions : The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess fools should be done thoroughly.

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Risk Factors for the Progression of Pediatric Chronic Kidney Disease-A Single Center Study (소아 만성 신질환 진행의 위험인자 분석-단일기관 연구)

  • Han, Kyoung-Hee;Lee, Sung-Ha;Lee, Hyun-Kyung;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.239-246
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    • 2007
  • Purpose : The progressive deterioration of renal function in children can impose a serious and lifelong impact on their lives. The ultimate goal in the management of children with chronic kidney disease(CKD) is to prolong survival, to prevent complications, and to promote growth and neurodevelopment. The aim of this study is to investigate the risk factors for the decline of renal function in pediatric CKD patients. Methods : Data from patients who met the criteria for the Kidney Disease Outcomes Quality Initiative(K/DOQI) CKD stage 2 to 4 between August 1999 and March 2007 were retrospectively analyzed. The estimated glomerular filtration rate(eGFR) was calculated by the Schwartz formula, using serum creatinine levels and height. We calculated the annual eGFR change from the difference between the baseline eGFR and the last eGFR divided by the duration(years) of the follow-up period. We analyzed the association between the annual eGFR change and factors such as age, gender, K/DOQI stage, underlying renal disease, serum calcium, and inorganic phosphorous during the follow-up period. Results : Sixty one children(44 boys & 17 girls) were enrolled. The age at entry was $7.1{\pm}4.7$ years. The annual eGFR change was $-1.2{\pm}11.9 mL/min/1.73m^2/year$. Our study showed that older age(P=0.005). hypocalcemia(P=0.012), and hypenhosphatemia(P=0.002) were significantly related to more rapid decline in renal function. Conclusion : In pediatric CKD, older age, hypocalcemia and hyperphosphatemia are related to more rapid deterioration of renal function.

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Semantic Process Retrieval with Similarity Algorithms (유사도 알고리즘을 활용한 시맨틱 프로세스 검색방안)

  • Lee, Hong-Joo;Klein, Mark
    • Asia pacific journal of information systems
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    • v.18 no.1
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    • pp.79-96
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    • 2008
  • One of the roles of the Semantic Web services is to execute dynamic intra-organizational services including the integration and interoperation of business processes. Since different organizations design their processes differently, the retrieval of similar semantic business processes is necessary in order to support inter-organizational collaborations. Most approaches for finding services that have certain features and support certain business processes have relied on some type of logical reasoning and exact matching. This paper presents our approach of using imprecise matching for expanding results from an exact matching engine to query the OWL(Web Ontology Language) MIT Process Handbook. MIT Process Handbook is an electronic repository of best-practice business processes. The Handbook is intended to help people: (1) redesigning organizational processes, (2) inventing new processes, and (3) sharing ideas about organizational practices. In order to use the MIT Process Handbook for process retrieval experiments, we had to export it into an OWL-based format. We model the Process Handbook meta-model in OWL and export the processes in the Handbook as instances of the meta-model. Next, we need to find a sizable number of queries and their corresponding correct answers in the Process Handbook. Many previous studies devised artificial dataset composed of randomly generated numbers without real meaning and used subjective ratings for correct answers and similarity values between processes. To generate a semantic-preserving test data set, we create 20 variants for each target process that are syntactically different but semantically equivalent using mutation operators. These variants represent the correct answers of the target process. We devise diverse similarity algorithms based on values of process attributes and structures of business processes. We use simple similarity algorithms for text retrieval such as TF-IDF and Levenshtein edit distance to devise our approaches, and utilize tree edit distance measure because semantic processes are appeared to have a graph structure. Also, we design similarity algorithms considering similarity of process structure such as part process, goal, and exception. Since we can identify relationships between semantic process and its subcomponents, this information can be utilized for calculating similarities between processes. Dice's coefficient and Jaccard similarity measures are utilized to calculate portion of overlaps between processes in diverse ways. We perform retrieval experiments to compare the performance of the devised similarity algorithms. We measure the retrieval performance in terms of precision, recall and F measure? the harmonic mean of precision and recall. The tree edit distance shows the poorest performance in terms of all measures. TF-IDF and the method incorporating TF-IDF measure and Levenshtein edit distance show better performances than other devised methods. These two measures are focused on similarity between name and descriptions of process. In addition, we calculate rank correlation coefficient, Kendall's tau b, between the number of process mutations and ranking of similarity values among the mutation sets. In this experiment, similarity measures based on process structure, such as Dice's, Jaccard, and derivatives of these measures, show greater coefficient than measures based on values of process attributes. However, the Lev-TFIDF-JaccardAll measure considering process structure and attributes' values together shows reasonably better performances in these two experiments. For retrieving semantic process, we can think that it's better to consider diverse aspects of process similarity such as process structure and values of process attributes. We generate semantic process data and its dataset for retrieval experiment from MIT Process Handbook repository. We suggest imprecise query algorithms that expand retrieval results from exact matching engine such as SPARQL, and compare the retrieval performances of the similarity algorithms. For the limitations and future work, we need to perform experiments with other dataset from other domain. And, since there are many similarity values from diverse measures, we may find better ways to identify relevant processes by applying these values simultaneously.

A Model to Measure the Success of a Web-based Information System at a Government Agency - the Chungwadae Case (공공기관 업무관리시스템 성과평가 모형 개발에 관한 연구: 청와대 업무관리시스템(e지원시스템)을 중심으로)

  • Bae, Lee-Chul;Hong, Il-Yoo
    • Asia pacific journal of information systems
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    • v.18 no.1
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    • pp.97-115
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    • 2008
  • Introduction The e-government is concerned with using Internet and Web technologies to exchange information and services with citizens, businesses and other related organizations, and it centers on three functions, namely informational, interactive, and transactional [UN, 2001]. Many developed countries like the U.S. have been actively involved in e-government projects, since they enable both more effective public services for citizens and more efficient internal operations. Korea is among these leading countries that are planning to leverage computer and communication technologies to provide for integration of work processes and information as well as convenient access to information and services. For this reason, evaluating e-government projects is becoming a crucial issue for both researchers and policy-makers. However, most research to date has primarily focused on a model of success of an e-government system designed for citizens, overlooking internal systems specifically created for employees working in a public organization. This paper is intended to propose a model to measure the success of a Web-based information system designed for use by internal users at Chungwadae, the executive branch of Korea's central government. The paper is also aimed at applying the model to the assessment of the present system being used at Chungwadae in comparison with the preceding system. Evaluating an e-Government System The most widely cited model of information systems success today is that of DeLone and McLean[1992, 2003, 2004]. The original model states that the success of an information system can be measured using six dimensions, including system quality, information quality, use, user satisfaction, individual impact, and organizational impact. Although the ultimate success of an information system may be reflected in the impact that the system has upon individuals as well as an organization, aspects of using the system such as system use and user satisfaction can play an important role in determining the system success, because the system would be a sheer failure if users don't like and use the system. As a response to criticisms given by numerous researchers, the authors adapted their model to fit the emerging Web-based environment. The revised model[DeLone and McLean, 2003] they offered included an additional quality dimension, namely service quality, and combined individual and organizational impacts into net benefits which can also influence user satisfaction. The e-government system success model can be built around this updated model. Our model incorporates information quality, system quality, and service quality as in the DeLone and McLean model. However, the 'system use' dimension has been replaced by perceived usefulness, as suggested by Seddon[1998]. In addition, because the e-government systems that this paper focuses on are internal public systems used in government agencies, the 'net benefits' dimension has been replaced by perceived work efficiency. Based on the proposed model, a total of nine hypotheses have been formulated which we tested using an empirical analysis. Methods A questionnaire form has been created with items that are designed to examine the relationships among the variables in the model. The questionnaire has been handed over, in person, to 65 members of Chungwadae staff who are now actively using the E-Support System, the present information system created to support internal work at Chungwadae. We made arrangements to meet with each individual who agreed to participate in our survey, and helped to fill out the survey form with explanations. Of the 65 copies that were delivered, only 33 were returned, and 30 responses of these have been adopted for our analysis, since three were not valid. The extremely small sample size was due to the limited number of staff members who had adequate experience required of this study. Results We gathered data from the questionnaire survey and analyzed them using a regression analysis to test the hypotheses. As shown in the table below, the results indicated that all three dimensions of an information system’s quality are positively related to user satisfaction. However, information quality and system quality were found to be positively related to perceived usefulness, while service quality was not. In addition, perceived usefulness is not positively related to user satisfaction, implying that a user may find a system useful, but may not be satisfied with it. Finally, user satisfaction and perceived usefulness both are positively related to perceived work efficiency. This suggests that workers' positive experience with the system is important to guarantee favorable work efficiency. Conclusions We conclude that the proposed model proved useful in measuring the success of an internal information system used by a government agency. To demonstrate the applicability and usefulness of the model in the paper, we applied the model to the assessment of the present internal system used at Chungwadae in comparison with the preceding system. The results showed that the present system outperforms the preceding one in a statistically significant way. Future research will have to focus on applying the model to Korea's governmental agencies other than Chungwadae and examine whether it proves applicable in different types of governmental organizations.