• Journal of Chest Surgery
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• v.48 no.2
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• pp.105-111
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• 2015

Background: The aim of this study was to establish whether pulmonary lobectomy using video-assisted thoracic surgery (VATS) can be safely performed by trainees with limited experience with open lobectomy. Methods: Data were retrospectively collected from 251 patients who underwent VATS lobectomy at a single institution between October 2007 and April 2011. The surgical outcomes of the procedures that were performed by three trainee surgeons were compared to the outcomes of procedures performed by a surgeon who had performed more than 150 VATS lobectomies. The cumulative failure graph of each trainee was used for quality assessment and learning curve analysis. Results: The surgery time, estimated blood loss, final pathologic stage, thoracotomy conversion rate, chest tube duration, duration of hospital stay, complication rate, and mortality rate were comparable between the expert surgeon and each trainee. Cumulative failure graphs showed that the performance of each trainee was acceptable and that all trainees reached proficiency in performing VATS lobectomy after 40 cases. Conclusion: This study shows that trainees with limited experience with open lobectomy can safely learn to perform VATS lobectomy for the treatment of lung cancer under expert supervision without compromising outcomes.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.263-269
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• 2020

Background: The benefits of epicardial ultrasound scanning (EUS) in coronary artery bypass grafting (CABG) have not yet been established. The aim of this study was to evaluate the usefulness of EUS in CABG, including in the assessment of the quality of distal anastomoses, the identification of epicardial target vessels, and the evaluation of any graft issues other than the distal anastomoses. Methods: Fifty-three patients undergoing CABG were enrolled between March 2018 and February 2019. Intraoperative EUS was performed along with transit-time flow measurement (TTFM). Graft evaluations were performed early (shortly after surgery) and 1 year after surgery for 53 (100%) and 47 (88.7%) patients, respectively. Results: EUS was applied to assess the quality of all distal anastomoses, 32 target vessels, and 2 conduit trunks. Insufficient TTFM findings were obtained for 18 grafts. However, graft revision was performed for only 3 distal anastomoses; based on the EUS findings, the remaining 15 sites were not revised. The early and 1-year overall graft patency rates were 100% (141 anastomoses) and 96.1% (122 of 127 anastomoses), respectively. All 15 of the distal anastomoses that were not revised despite insufficient TTFM results were patent at the 1-year mark. Conclusion: The routine application of EUS in CABG could be beneficial by confirming the quality of surgery and reducing unnecessary procedures.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.32-45
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• 1996

Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

• Korean journal of food and cookery science
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• v.8 no.2
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• pp.137-145
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• 1992

A computer-assisted microbiological quality assurance program was developed based on HACCP data obtained from a 500 bed general hospital by assessing time and temperature conditions and microbiological qualities of six categories of menu items according to the process of food product flow. The purpose of the study was to develop a computer-assisted microbiological quality assurance program in order to simplify the assessment procedures and to provide a maximum assurance to foodservice personnel and the public. A 16-Bit personnel computer compatible with IBM-PC/AT was used. The data base files and processing programs were created using dBASE III plus packages. The contents of the computerized system are summarized as knows: 1. When the input program for hazard analysis runs, a series of questions are asked to determine hazards and assess their severity and risks. Critical control points and monitoring methods for CCPs are identified and saved in Master file. 2. Output and search programs for hazard analysis are composed of 6 categories of recipe data file list, code identification list, and HACCP identification of the specific menu item. 3. When the user selects a specific category of recipe from 6 categories presented on the screen and runs data file list, a series of menu item list, CCP list, monitoring methods list are generated. When the code search program runs, menu names, ingredients, amounts and a series of codes are generated. 4. When the user types in a menu item and an identification code, critical control points and monitoring methods are generated for each menu item.

• Journal of Gastric Cancer
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• v.23 no.2
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• pp.275-288
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• 2023

Purpose: This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Materials and Methods: We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. Results: Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (-1 point). Conclusions: The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.

• Journal of the Korean Society of Marine Environment & Safety
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• v.15 no.2
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• pp.79-89
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• 2009

For preliminary diagnosis on current fishing ground environment and basic information for establishment of effective and rational management policy in fisheries resources protection area, water and sediment quality and changes of total area in the 10 marine protection areas designated for fisheries resources management in Korea were assessed. Results showed that environmental quality in these areas has been degraded by pollution sources, coastal utilization and development stress, etc. The pattern and degree of contamination differed by protection areas, suggesting that it is necessary for optimum environmental management plan considering the regional characteristics. The total designated area of protection areas in 2003 changed by $-22.9{\sim}2.4%$, on average -6.4%, compared with the first year of designation; Wando-Doam Bay showd the highest increase rate (2.4%), and Hansan Bay has the highest decrease rate (-22.9%) Decrease rate of land and sea in total area showd 6.1% and 6.6%. An integrated management of environmental data in protection areas is required for systematic assessment. Therefore, the suitable environmental and information management is needed specifically considering the environment characteristics such as development and utilization conditions of land and sea area Furthermore, bemuse urbanization and industrialization threats the junctions of the protection areas, authorized ministry (MIFAFF) should develope and establish monitoring and management procedures based on the related laws.

• Journal of Soil and Groundwater Environment
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• v.22 no.3
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• pp.1-9
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• 2017

The numerical analysis of groundwater flow is indispensable for predicting problems associated with water resource development, civil works, environmental hazards, and nuclear power plant construction. Korea lacks public regulatory procedures and guidelines for groundwater flow modeling, especially in nuclear facility sites, which makes adequate evaluation difficult. Feasible step-by-step guidelines are also unavailable. Consequently, reports on groundwater flow modeling have low-grade quality and often present controversial opinions. Additionally, without public guidelines, maintaining consistency in reviewing reports and enforcing laws is more challenging. In this study, the guidelines for groundwater flow modeling were reviewed for three countries - the United States (Documenting Groundwater Modeling at Sites Contaminated with Radioactive Substances), Canada (Guidelines for Groundwater Modelling to Assess Impacts of Proposed Natural Resource Development Activities), and Australia (Australian Groundwater Modelling Guidelines), with the aim of developing groundwater flow modeling regulatory guidelines that can be applied to nuclear facilities in Korea, in accordance with the Groundwater Act, Environmental Impact Assessment Act, and the Nuclear Safety Act.

• Safety and Health at Work
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• v.3 no.3
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• pp.155-165
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• 2012

Reflecting the current international trends toward proactive risk assessment and control at work with practical procedures, participatory action-oriented approaches are gaining importance in various sectors. The roles of these approaches in promoting the safety and health at work are discussed based on their recent experiences in preventing work-related risks and improving the quality of work life, particularly in small-scale workplaces. The emphasis placed on the primary prevention at the initiative of workers and managers is commonly notable. Participatory steps, built on local good practices, can lead to many workplace improvements when the focus is on locally feasible low-cost options in multiple aspects. The design and use of locally adjusted action toolkits play a key role in facilitating these improvements in each local situation. The effectiveness of participatory approaches relying on these toolkits is demonstrated by their spread to many sectors and by various intervention studies. In the local context, networks of trainers are essential in sustaining the improvement activities. With the adequate support of networks of trainers trained in the use of these toolkits, participatory approaches will continue to be the key factor for proactive risk management in various work settings.

• Proceedings of the KIEE Conference
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• 2000.11c
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• pp.413-415
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• 2000

Piezoelectric ceramics of PZT have been developed to apply for transformers in notebook. Use of piezoelectric ceramics in applications like piezoelectric transformers was made possible by the development of new materials with high electromechanical coupling coefficients and high mechanical quality factor. "Hard" ferroelectiric ceramics of complex composition based on lead zirconate titanate with Mn additive have been prepared. The perovskitic phase reaction of the oxides. The crucial role played by the intermediate mixing and grinding procedures in the assessment of the final properties of the material was investigated. Densification up to approximately the theoretical density value was achieved. The polarization was obtained by subjecting the samples at $30kVcm^{-1}$ poling electric field, in a silicon oil bath heated at $110^{\circ}C$. Their microstructural and morphological properties were checked by X-ray diffraction analysis and scanning electron microscopy. The optimized samples presented very high qualify and electromechanical coupling factors, together with small dielectric loss.

• Korean journal of food and cookery science
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• v.19 no.5
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• pp.647-658
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• 2003

Foodservice at elementary schools has been provided nation-wide. It is predictable that foodborne diseases would increase continuously. Formation of a counterplan is urgently needed. This study was designed to identify the stage which contains the critical control points (CCPs) for the microbiological management of HACCP (Hazard Analysis Critical Control Point) at the foodservice provided at elementary schools. Foodservice places at four elementary schools in Seoul were sampled and the overall hygiene of cooking, utensils and equipment, employees, and environment by season were examined. The results showed that the number of bacteria in overall samples was increased and that E. coli, Salmonella and Staphylococcus by biochemical test emerged in more diverse samples in summer than in spring. Particularly, the number of aerial bacteria in summer was three-fold greater than that in either spring or winter. E. coli 0157 was not detected, although Salmonella was identified by PCR analysis in the meat knives, chopping boards, waste bins and meat dish at elementary school foodservice. According to this data, cross-contamination should be managed in the stage of mixing up the ingredients with improper equipments and insanitary treatments. Thus, the establishment of SSOP (Sanitation Standard Operating Procedures) and GMP (Good Manufacturing Practice) at elementary school foodservice is stringently required, along with sanitation education for workers and employees as CCPs.