• Quality Improvement in Health Care
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• v.10 no.1
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• pp.42-56
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• 2003

Background : The purpose of this study is to investigate the influencing factors on the length of emergency department stay of patients with acute myocardial infraction. Methods : we reviewed medical records of all patients who were Hospitalized with acute myocardial infraction from March 1, 2002 to February 28, 2003. Results : The average length of stay in the emergency room of the subjects was 182.74 minutes. After the emergency room treatment, 48.1% of the subjects were transferred to intensive care unit. The hospitalization through emergency room mostly took place in the office hours. There were more patients on Monday. The influencing factors on the length of stay in the emergency room of patients with acute myocardial infraction were emergency room arrival time which was classified in seasons, treatment hours of specialized doctors, medical care insurance and required time of radiologic examination. Conclusion : In order to reduce the length of emergency room stay, it might be an available solution secure enough spaces, facility, and staff of the radiologic test only for the patients of the emergency room. And the effective use of emergency facility and space, establishment of standardized treatment guideline, and provision of emergency treatment support system are also needed.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.232-237
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• 2013

Background Polydactyly of the foot is one of the most frequent anomalies of the limbs. However, most classification systems are based solely on morphology and tend to be inaccurate and less relevant to surgical methods and results. The purpose of this study is to present our new classification of polydactyly of the foot, which can serve as a predictor of treatment and prognosis. Methods To find a correlation between the various morphologic traits of polydactyly of the foot and the treatment plan and outcomes, we reviewed 532 cases of polydactyly of the foot in 431 patients treated in our hospital, expanding on our previous study that described polydactyly based on the importance of metatarsal bone status and varus deformity. The records of patients were evaluated and compared with previous studies at other centers. Results Unsatisfactory results were seen in 36 cases, which included 5 cases of incomplete separation due to syndactylism, 23 cases of axis deviation, and 8 cases of remnants of extradigit metatarsal bones. The locus of the polydactyly, or the digit which was involved, did not seem to affect the final postoperative outcomes in our study. Three factors-syndactylism, axis deviation, and metatarsal extension-are the major factors related to treatment strategy and prognosis. Therefore, we developed a new classification system using three characters (S, A, M) followed by three groups (0, 1, 2), to describe the complexity of polydactyly of the foot, such as $S_1A_2M_2$. Conclusions Our new classification could provide a communicable description to help determine the surgical plan and predict outcomes.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.2
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• pp.25-32
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• 2018

Objectives : This study was conducted to investigate the frequent diseases among the people who had been treated by collaborative treatment of Korean medicine and Western medicine, and to compare their medical use behaviors before and after the collaborative first-stage pilot project between Korean medicine and Western medicine. Methods : 4,467 patients were identified as the patients who are participated in the collaborative first-stage pilot project between Korean medicine and Western medicine during the period between July 15, 2016 and March 31 2017. We used 28,480 records of Korean national health insurance claim data from January 1 2016 to March 31 2017 to analyzed present condition of cooperative medical usage. Also we conducted a paired t test to compare the percentage of collaborative treatment days before and after the pilot project period. Results : We found that the most frequent diseases treated in the pilot project were the diseases of musculoskeletal and nervous system and then 10 major diseases such as H, K, J, C (D), N, L, E, A, H and F disease codes in order. Also it was confirmed that 14 major and 53 medium diseases are included from more than 90% of total patients. As a result of high frequency of medical treatment in Western medicine or Korean medicine is "administration of Korean medicine", which is same as before and within the pilot project. The ratio of utilizing both Western and Korean medical care for the same disease on the same day by both general patients and patients in KCD-7 disease code group C, G, I, M and S had been increased significantly. Conclusions : The pilot project might change the behavior of utilizing the medical care service by increasing the ratio of collaborative treatment of Western medicine and Korean medicine for the same disease on the same day.

• Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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• v.24 no.2
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• pp.175-182
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• 2006

The efficient management for minimum losses and demage precautions of fragile region against coastal disasters such as seismic waves and seawater overflows is proceeding continually. This study is to analyze inundation trace and extract expected damage areas with historic records of tsunami using Geographic Information System. Creating a digital elevation model of the Mangsang and the Nobong region in the east coast, we marked inundation record of tsunami and forecasted the flood area with a seismic wave height between 3 m and 5 m. The inundation trace layers and the expected damage areas on the cadastral map layer were superimposed individually. Consequently, the range and lot numbers of inundation expected area were calculated and inundation areas of 5 m tsunami were increased by 2.8 times than 3 m tsunami in case of subject regions. Analyzed results are expected to use evacuation work in case of seismic waves and to predict the compensation of the damaged area. And this study is expected to use suitable countermeasure for prevention from natural disasters.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.163-167
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• 1996

Aseptic meningitis, the most common infection of the central nervous system, is an acute illness mostly caused by enteroviruses. Cerebrospinal fluid(CSF) has been used for the detection of enteroviral RNA but the detection has been mostly performed in a single CSF specimen obtained during the illness. A major objective was to evaluate the relation of sampling time to the recovery of enteroviral RNA in CSF. Thirty seven CSF specimens were obtained from 24 patients between May and August 1993, when an outbreak of asceptic meningitis by echovirus type 9 occurred. Enteroviral RNA in CSF was detected by polymerase chain reaction(PCR). Data about onset of symptom development were obtained by review of medical records. Enteroviral RNA was detected by PCR in 29 of 37 CSF specimens. PCR yielded positive results in 4 of 5 CSF specimens obtained on day 1 to 3, 10 of 11 on day 4 to 6, 8 of 10 on day 7 to 9, 6 of 8 on day 10 to 12, 1 of 3 on day 13 to 15 postonset. Of 11 patients from each of whom more than one CSF were obtained on different day postonset, PCR yielded positive resutls in 2 of 3 cases in whom enteroviral RNA detection was negative in the first CSF. These results indicate that two or more CSF specimens obtained within 12 days postonset are required for improving the accuracy of the diagnosis of enteroviral meningitis.

• Journal of Preventive Medicine and Public Health
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• v.35 no.1
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• pp.33-40
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• 2002

Objective : From an analysis of a community outbreak of measles in Youngju, Gyeongbuk, in March 2000, the authors evaluated the effectiveness of the measles vaccination and its determinants to Provide an epidemiologic basis for the establishment of a vaccination policy. Methods : Information was collected regarding the vaccinations from the health records of four primary schools and through a questionnaire surrey of the parents of students in two middle and two high schools (N=4638). Measles cases were surveyed from the patient list of each school and from case reports in the public health center. The attack rate and vaccine effectiveness of measles was evaluated by school; grade; frequency, region, and institution of vaccination. Results : The attack rate cf measles, 6.3% among the total subjects, was higher in middle school students (15.8%) than in primary (2.0%, p<0.05) and high school students (8.9%, p<0.05). The attack rate of the unvaccinated group was 4.6-fold higher than the vaccinated group in primary schools (p<0.05). Vaccine effectiveness was 83.2% among lower graders of primary schools, 34.0% among higher graders of primary schools,26.1% in middle schools, and -7.0% in high schools. In multiple logistic regression analysis, grade in school (odds ratio, 0.77; 95% CI=0.67-0.87) and frequency of vaccination (odds ratio, 0.57: 95% CI=0.37-0.58) were significant predictors of the outcome. Conclusions : We concluded that the explosive outbreak of measles in this area resulted from both inadequate vaccination coverage and secondary failure of vaccination. There was no evidence of any effect of the cold chain system on the vaccine failure.

• Journal of Biosystems Engineering
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• v.42 no.2
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• pp.75-79
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• 2017

The use of tractors to carry out agricultural work has played an important role in mechanizing the agricultural sector. A repairable mechanical system (such as an agricultural tractor) is subject to deterioration or failure. In this study, a regression model was used to predict the failure rate of a John Deere 3140 tractor. The machine failure pattern was carefully studied, and key factors affecting the failure rate were identified in five regions of the Khouzestan province. Through a questionnaire, data was obtained from farm records. This data was grouped into six sub-groups, according to the annual use hours (AUH) and the manner in which the tractors were stored. Results showed that AUH and storage policies affected failure rate slightly. With an increase in the age of the tractors, the failure rate in the tractors used for 1050-2000 hours annually and stored outdoors was higher than those used for 200-1000 hours annually and stored in sheds. When the tractors were of the same age, the slope of the curve in the 200-1000 annual use hours increased gradually and then rapidly, but failure rate in the 1050-2000 annual use hours was high from the beginning, and subsequent increase in this value was almost uniform. As a result, it can be said that with an increase in the annual use hours, the failure and breakdown rate in John Deere 3140 tractors rapidly increases, but maintenance conditions only slightly affect the failure and breakdown rate.

• Korean Journal of Environmental Agriculture
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• v.16 no.3
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• pp.233-238
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• 1997

WASP5 was applied to evaluate water quality of Bokha stream with 17km of its main stem located in Ichon-city, Kyunggi province in Korea. Boundaries of the stream for the WASP5 were the Jumi bridge, 10 major tributaries and one wastewater treatment system. The stream was divided into 37 segments with about 350m length. The flowrate of the 10 day's average of the stream was obtained from the hydrograph data and the discharge-stage rating curve. Simulated quality constituents included nitrogen, phosphorus, BOD and DO. Monthly records of water quality and loads in 1996 were used for the calibration of parameters of WASP5. Simulation showed high correlations between calculated and observed concentration with monthly runoff ratio in Bokha stream. At downstream boundary, Jumi bridge [Seg.36], similar correlations were appeared. However, simulated concentrations by using annual runoff ratio were somewhat differentiated from those of the observed.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.99-106
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• 2005

Neuroblastoma treatment remains challenging, but treatment has become more effective due to the establishment of clinical and biological variables that determine prognostic risks. Initially, stage and age were the prime determinants of survival used in clinical practice. Risk-based therapy currently is the hallmark of neuroblastoma treatment. This study reviews one center's experience with the management of neuroblastoma. Sixty-three patients with neuroblastoma were treated from 1989 to 2003. All patients were graded according to the International Neuroblastoma Staging System (INSS) at diagnosis. There were 37 boys and 26 girls. The median age was 2.14 years (range, 33 days-10.2years). The primary site was the adrenal gland in 47, dumbbell shape extending into spinal canal in 6, retroperitoneum in 5, mediastinum in 3, and other sites in 2. The probability of 5-year overall survival (OS) and event free survival (EFS) were 46.7 % and 44.2 % by Kaplan-Meier method. According to INSS, there were stage 1 in 2 cases, stage 2 in 5, stage 3 in 12, stage 4 in 42, and stage 4s in 2. There were statistically significant differences in the survival rates between patients with stage1, 2 and stage 3, 4(P<0.05). For the stage 3 and 4, the extents of surgical resection, determined from the operative records and pathologies, were complete resection in 17 cases, minimal residual in 15, and partial resection 11, and the 5-year OS rate was 57.8, 51.4, and 13.6 %, respectively. There is a trend toward higher OS with more complete resection (P<0.05). We conclude that age and stage at diagnosis are prognostic factors, and complete excision of the primary tumor can provide better prognosis for patients with stage 3 and 4 neuroblastoma.

• Advances in pediatric surgery
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• v.14 no.2
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• pp.164-172
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• 2008

The survival rate for rhabdomyosarcoma (RMS) has significantly improved after the introduction of combined multimodality treatment. We report the 20-year treatment outcome of pediatric rhabdomyosarcoma in a single institution. The medical records of 16 patients treated for rhabdomyosarcoma between December 1986 and August 2007 at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were retrospectively reviewed. Mean age at diagnosis was 7.1 years (range: 1.3 -14.2 years). Retroperitoneum was the most common primary site (n=7, 43.8 %), and embryonal type was predominant (n=11, 6 %). Before the treatment, most patients were in advanced TNM stage (stage III 50 %, IV; 25 %). The patient distribution according to the Intergroup Rhabdomyosarcoma Study Clinical Grouping System (IRS-CGS) was as follows; Group I 31.3 %, Group II 12.5 %, Group III 31.3 % and Group IV 25 %. Patients were classified into three groups according to the extent of resection of the primary tumor; complete resection (CR, n=5; 31.3 %), gross total resection (GTR, n=7; 43.8 %) and incomplete resection (IR, n=4; 25 %). Recurrence was observed in 9 patients (56.3 %) while there was no recurrence in CR patients. All patients with recurrence were identified as moderate or high-risk according to the IRS-V Risk Group. Pre-treatment TNM stage of RMS in our institution was advanced with aggressive clinical feature, however postsurgical conditions according to IRS-CGS were similar to the previous reports by IRS. This suggests that down-staging of IRS-CGS was achieved with multimodality treatment with CR or GTR. It also suggests that complete resection is the most important prognostic factor in the treatment of RMS in children. Patients classified as moderate or high-risk need close follow-up due to high recurrence rate. In case of localized recurrence, better outcome may be achieved with multimodality treatment including limited surgery.