• Women's Health Nursing
• /
• v.6 no.2
• /
• pp.234-257
• /
• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.2
• /
• pp.139-149
• /
• 2003

Objectives：To review the history of the development and current status of Korean Child and Adolescent Psychiatry and to propose the future tasks at this 20th anniversary of Korean Academy of Child and Adolescent Psychiatry. Methods：Records and publications of Korean Academy, personal communications with senior members of the Academy, the author's recollections and memoirs. Results：Korean Child Psychiatry started with opening Child Psychiatry Clinic at Seoul National University Hospital in 1979 and establishing Division of Child and Adolescent Psychiatry at the same hospital in 1980. A Child Psychiatry Study Group was formed in 1983 and it transformed into Korean Academy of Child and Adolescent Psychiatry in 1986. In the past 20 years, Korean child and adolescent psychiatry made an impressive progress and contributed significantly to the development of Korean medicine as well as to the establishment of child mental health service. There are 77 board-certified and 48 board-eligible child psychiatrists, and 18 child psychiatry fellows are in training as of 2003. Main forces of this successful introduction of child psychiatry are 1) 7 child psychiatry training centers at major university hospitals, 2) publication of Korean Journal of Child and Adolescent Psychiatry in 1990, 3) the establishment child psychiatry board certification system in 1996. Korean child psychiatry has extended its role in the international child psychiatry and took leadership in establishing Asian Society of Child and Adolescent Psychiatry and Allied Professions(ASCAPAP). Conclusion：Korean child psychiatry has achieved a remarkable progress for the past 20 years and is currently producing 15 or more child psychiatry each year. However, there are needs of more active involvements in adolescent problems, more active consultation-liaison services at general hospitals as well as community mental health institutions. More school consultation and preventive educational services are desired. There is a urgent need of carrying out more empirical studies with strong scientific rigor. Korean Academy should pay attention and provide assistance to the development of child psychiatry service in other countries in Asia.

• KOREAN JOURNAL OF CROP SCIENCE
• /
• v.31 no.3
• /
• pp.375-382
• /
• 1986

This study was carried out to obtain the basic information for the clarification of spring growth habits mechanism of naked barleys. The isozyme patterns and activities of peroxidase in the young spike and leaf blade were analyzed during the differentiation and development of young spike. The characteristic differences between the normal and rosetted type were in c and g isozymes in young spike, and in i isozyme in the leaf blade. In the normal type, c and i isozymes disappeared at the stage of spi-kelet differentiation, g isozyme at the stage of flolet differentiation. But, in the rosetted type, those three isozymes remained in dark stained condition until the time of final sampling. Especially, those three isozymes were higher in the rosetted type than those in the normal type even at the stage of bract differentiation(BDS), just prior to the reproductive stage. The activities of peroxidase decreased slowly after BDS in the young spike and leaf blade in the normal type, While, in the rosetted type, increased linearly, and the degree of increasing was remarkable in the young spike. It was interesting that the degree of activities in young spike was higher in the rosetted type than that in the normal type even at BDS. From the above results, the remarkable differences of the isozyme patterns and activities at BDS between the normal and rosetted type were considered to be the physiological expression of the varieties concerned with the degree of spring growth habits.

• Proceedings of the Korean Society of Crop Science Conference
• /
• 2017.06a
• /
• pp.51-52
• /
• 2017

"Plant genetic resources for food and agriculture" means any genetic material of plant origin of actual or potential value for food and agriculture. "Genetic material" means any material of plant origin, including reproductive and vegetative propagating material, containing functional units of heredity. (Internal Treaty on Plant Genetic Resources for Food and Agriculture, ITPGRFA). The "Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization (ABS) to the Convention on Biological Diversity (shortly Nagoya Protocol)" is a supplementary agreement to the Convention on Biological Diversity. It provides a transparent legal framework for the effective implementation of one of the three objectives of the CBD: the fair and equitable sharing of benefits arising out of the utilization of genetic resources. The Nagoya Protocol on ABS was adopted on 29 October 2010 in Nagoya, Japan and entered into force on 12 October 2014, 90 days after the deposit of the fiftieth instrument of ratification. Its objective is the fair and equitable sharing of benefits arising from the utilization of genetic resources, thereby contributing to the conservation and sustainable use of biodiversity. The Nagoya Protocol will create greater legal certainty and transparency for both providers and users of genetic resources by; (a) Establishing more predictable conditions for access to genetic resources and (b) Helping to ensure benefit-sharing when genetic resources leave the country providing the genetic resources. By helping to ensure benefit-sharing, the Nagoya Protocol creates incentives to conserve and sustainably use genetic resources, and therefore enhances the contribution of biodiversity to development and human well-being. The Nagoya Protocol's success will require effective implementation at the domestic level. A range of tools and mechanisms provided by the Nagoya Protocol will assist contracting Parties including; (a) Establishing national focal points (NFPs) and competent national authorities (CNAs) to serve as contact points for information, grant access or cooperate on issues of compliance, (b) An Access and Benefit-sharing Clearing-House to share information, such as domestic regulatory ABS requirements or information on NFPs and CNAs, (c) Capacity-building to support key aspects of implementation. Based on a country's self-assessment of national needs and priorities, this can include capacity to develop domestic ABS legislation to implement the Nagoya Protocol, to negotiate MAT and to develop in-country research capability and institutions, (d) Awareness-raising, (e) Technology Transfer, (f) Targeted financial support for capacity-building and development initiatives through the Nagoya Protocol's financial mechanism, the Global Environment Facility (GEF) (Nagoya Protocol). The Rural Development Administration (RDA) leading to conduct management agricultural genetic resources following the 'ACT ON THE PRESERVATION, MANAGEMENT AND USE OF AGRO-FISHERY BIO-RESOURCES' established on 2007. According to $2^{nd}$ clause of Article 14 (Designation, Operation, etc. of Agencies Responsible for Agro-Fishery Bioresources) of the act, the duties endowed are, (a) Matters concerning securing, preservation, management, and use of agro-fishery bioresources; (b) Establishment of an integrated information system for agro-fishery bioresources; (c) Matters concerning medium and long-term preservation of, and research on, agro-fishery bioresources; (d) Matters concerning international cooperation for agro-fishery bioresources and other relevant matters. As the result the RDA manage about 246,000 accessions of plant genetic resources under the national management system at the end of 2016.

• Radiation Oncology Journal
• /
• v.25 no.2
• /
• pp.109-117
• /
• 2007

[ $\underline{Purpose}$ ]: To evaluate the incidences and potential predictive factors for symptomatic radiation pneumonitis (SRP) and radiographic pulmonary toxicity (RPT) following adjuvant radiotherapy (RT) for patients with breast cancer. A particular focus was made to correlate RPT with the dose volume histogram (DVH) parameters based on three-dimensional RT planning (3D-RTP) data. $\underline{Materials\;and\;Methods}$: From September 2003 through February 2006, 171 patients with breast cancer were treated with adjuvant RT following breast surgery. A radiation dose of 50.4 Gy was delivered with tangential photon fields on the whole breast or chest wall. A single anterior oblique photon field for supraclavicular (SCL) nodes was added if indicated. Serial follow-up chest radiographs were reviewed by a chest radiologist. Radiation Therapy Oncology Group (RTOG) toxicity criteria were used for grading SRP and a modified World Health Organization (WHO) grading system was used to evaluate RPT. The overall percentage of the ipsilateral lung volume that received ${\geq}15\;Gy\;(V_{15}),\;20\;Gy\;(V_{20})$, and $30\;Gy\;(V_{30})$ and the mean lung dose (MLD) were calculated. We divided the ipsilateral lung into two territories, and defined separate DVH parameters, i.e., $V_{15\;TNGT},\;V_{20\;TNGT},\;V_{30\;TNGT},\;MLD_{TNGT}$, and $V_{15\;SCL},\;V_{20\;SCL},\;V_{30SCL},\;MLD_{SCL}$ to assess the relationship between these parameters and RPT. $\underline{Results}$: Four patients (2.1%) developed SRP (three with grade 3 and one with grade 2, respectively). There was no significant association of SRP with clinical parameters such as, age, pre-existing lung disease, smoking, chemotherapy, hormonal therapy and regional RT. When 137 patients treated with 3D-RTP were evaluated, 13.9% developed RPT in the tangent (TNGT) territory and 49.2% of 59 patients with regional RT developed RPT in the SCL territory. Regional RT (p<0.001) and age (p=0.039) was significantly correlated with RPT. All DVH parameters except for $V_{15\;TNGT}$ showed a significant correlation with RPT (p<0.05). $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory than $V_{15\;SCL}$ for the SCL territory. $\underline{Conclusion}$: The incidence of SRP was acceptable with the RT technique that was used. Age and regional RT were significant factors to predict RPT. The DVH parameter was good predictor for RPT for the SCL territory while $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory.

• The Korean Society of Law and Medicine
• /
• v.17 no.2
• /
• pp.85-124
• /
• 2016

The Human gene testing act (GenDG) in Germany starts from the characteristic features of gene testing, i.e. dualisting structure consisted of anlaysis on the one side and the interpretation on the other side. The linguistic distincion of 'testing', 'anlaysis' and 'judgment' in the act is a fine example. Another important basis of the regulation is the ideological purpose of the law, that is information autonomy. The normative texts as such and the founding principle are the basis of the classification of testing types. Especially in the case of gene testing for medical purpose is classified into testing for diagnostic purpose and predictive purpose. However, those two types are not always clearly differentiated because the predictive value of testing is common in both types. In the legal regulation of gene testing it is therefore important to manage the uncertainty and subjectivity which are inherent in the gene-analysis and the judgment. In GenDG the system ensuring the quality of analysis is set up and GEKO(Commity for gene tisting) based on the section 23 of GenDG concretes the criterium of validity through guidelines. It is also very important in the case of gene testing for medical purpose to set up the system for ensurement of procedural rationality of the interpretation. The interpretation of the results of analysis has a wide spectrum because of the consistent development of technology on the one side and different understandings of different subjects who performs gene testings. Therefore the process should include the communication process for patients in oder that he or she could understand the meaning of gene testing and make plans of life. In GenDG the process of genetic counselling and GEKO concretes the regulation very precisely. The regulation as such in GenDG seems to be very suggestive to Korean legal polic concerning the gene testing.

• Journal of Society of Preventive Korean Medicine
• /
• v.1 no.1
• /
• pp.85-104
• /
• 1997

As the concern about health is increased, the importance of preventive medicine that prevent disease in advance to overcome boundary of disease remedy gets emphasized in the whole world. The fundamental thoughts of oriental medicine are the harmony between the human body and nature, the unified idea regarding mind in the same light with body, and the symmetry of the cosmo dual forces. And oriental medicine is a kind of study that has developed on the ground of prevention thought. from old days, it has been developed the preventive medicine at is called 'Yangseng(養生; recuperation)' etc. with the clinical medicine. The preventive medicine of oriental medicine was taking a serious of the first preventive medicine of an incurable disease thought and the prevention thought that belongs to the second and third preventive medicine is described through the whole oriental medicine. Also the clinical and preventive medicine to apply to the clinics have an in- separable relation. Therefore I inspected the part of the preventive medicine described in some oriental medicine books and studied the characteristics of preventive medicine of oriental medicine as follows; First, the preventive medicine of oriental medicine has the characteristics that is emphasized generally in the first preventive medicine and wholly it is composed in the system of the first, second and third preventive medicine. It has the presentative theory such as 'Jungkijonae sabulkaghan(正氣存內 邪不可干; If good energy is in body, a disease. dosen't occur)', 'Husajukpung Phijeyushi(虛邪賊風 避之有時; When e infectious disease like plague break out, they must avoid the place occurring the disease)', 'Chuninsangeung(天人相應; The harmony of nature and human)' etc.. This is intimately related to the incurable disease thought of the inside diameter and oriental medicine has pursued that. Second, due to the most prerequisite theory of disease production, the balanced condition of environment, the cause of a disease and host is called the health. As oriental medicine has the system of aetiology like that, we can see the host and environments are importance most of all. Namely we can think of the relation of host >> environment > the cause a disease Up to date Jungkijonae Sabulkaghan(正氣存內 邪不可干) that the most oriental medicine doctors have had a knowledge is not whole theory but a pan of oriental medicine science and it is included in oriental medicine theory to avoid infectious disease such as Husajukpung Phijeyushi(虛邪賊風 避之有時). Third, according to the natural result of the first and second contents, we can know that its characteristics stress the remedy without drugs. Because Jungkijonae Sabulkaghan(正氣存內 邪不可干), Husasukpung Phijeyushi(虛邪賊風 避之有時), and Chuninsangeung(天人相應) mean that they prevent disease in condition of freedom from ailment, We can prevent the disease production through the positive preventive methods such as exercise, spirit, food and innate prevention etc.. fourth, the preventive medicine of oriental medicine has developed with therapeutics and it contains all oriental medical methods such as host, environment, exercise, acupuncture and moxibustion, innate or postnatal methods. Also it is the general preventive medicine that has fundamental philosophy of oriental medicine; for examples, the unified idea, the harmony of nature and human, and the unity of mind and body. fifth, to develope the above scientific merit and special features, the preventive medicine of Oriental medicine must be objectified and reemergent stud? gets more and more essential from now on. Especially we need to have the scientific concern of Oriental medicine about the cause of a disease, environmental hygiene, industrial sanitation, and personal hygiene etc..

• Journal of the Korean Wood Science and Technology
• /
• v.37 no.1
• /
• pp.94-104
• /
• 2009

It is urgently required to develop the production of fermentation-heat energy from the waste agricultural and forest biomass and its effective heat exchanging system for the supply of warm water to rural households and greenhouses. In this study 3 helical-type and 1 plate-type heat exchangers using 3 different waste biomasses [e.g. hardwood (HW) sawdust (100%), softwood (SW) sawdust : HW sawdust (50 : 50) and HW sawdust : grass (90 : 10)] were applied in order to find out the best heat recovery system. The heat exchanger was basically considered to improve the overall heat recovery efficiency, to minimize heat loss and to simplify manufacturing, assembling and breaking up the fermenting beds. The helical-type heat exchanger (HX-H3) installed in fermenting bed of HW sawdust : grass (90 : 10) showed relatively higher temperature profiles, in particular mid- and upper-parts than lower and surface parts during 45-day fermentation process. The maximum temperature was ranged from $40^{\circ}C$ to $65^{\circ}C$ with average $60^{\circ}C$. The water temperature of tank outlet was ranged to $33{\sim}48^{\circ}C$ during whole measuring periods. By the way plate-type one (HX-P) installed in same biomass compositional fermenting bed showed $64.5{\sim}76.5^{\circ}C$ at center part, and $43{\sim}56^{\circ}C$ and $42{\sim}58^{\circ}C$, water tank and tank outlet temperatures, respectively, during 100 day measurement. It could be concluded that the plate-type heat exchanger (HX-P) provides not only the effective heating for the rural households and greenhouses, but also having the best heat recovery performance, easy manufacturing, assembling and breaking up the systems.

• Korean Journal of Organic Agriculture
• /
• v.27 no.4
• /
• pp.479-499
• /
• 2019

This study was conducted to investigate the responses of soil properties and microbial communities to different agricultural management and soil types, including organic management in Andisols (Org-A), organic management in Non-andisols (Org-NA), conventional management in Andisols (Con-A) and conventional management in Non-andisols (Con-NA) by using a pyrosequencing approach of 16S rRNA gene amplicon in Radish farms of volcanic ash soil in Jeju island. The results showed that agricultural management systems had a little influence on the soil chemical properties but had significant influence on microbial communities. In addition, soil types had significant influences on both the soil chemical properties and microbial communities. Organic farming increased the microbial density of bacteria and biomass C compared to conventional farming, regardless of soil types. Additionally, Org-NA had the highest dehydrogenase activity among treatments, whereas no difference was found between Org-A, Con-A and Con-NA and had the highest species richness (Chao 1) and diversity (Phyrogenetic diversity). Particularly, Chao 1 and Phyrogenetic diversity were increased in organic plots by 12% and 20%, compared with conventional plots, respectively. Also, regardless of agricultural management and soil types, Proteobacteria was the most abundant bacterial phylum, accounting for 21.9-25.9% of the bacterial 16S rRNAs. The relative abundance of putative copiotroph such as Firmicutes was highest in Org-NA plot by 21.0%, as follows Con-NA (13.1%), Con-A (6.7%) and Org-A (5.1%.), respectively and those of putative oligotrophs such as Acidobacteria and Planctomycetes were higher in Con-A than those in the other plots. Furthermore, LEfSe indicated that organic system enhanced the abundance of Fumicutes, while conventional system increased the abundance of Acidobacteria, especially in Non-andisols. Correlation analysis showed that total organic carbon (TOC) and nutrient levels (e.g. available P and exchangeable K) were significantly correlated to the structure of the microbial community and microbial activity. Overall, our results showed that the continuous organic farming systems without chemical materials, as well as the soil types made by long-term environmental factors might influence on soil properties and increase microbial abundances and diversity.

• Journal of Soil and Groundwater Environment
• /
• v.12 no.1
• /
• pp.87-96
• /
• 2007

Risk assessment was carried out in order to improve the remediation and management strategy on a contaminated gunnery site, where a flood control reservoir is under construction nearby. Six chemicals, including explosive chemicals and heavy metals, which were suspected to possess risk to humans by leaching events from the site were the target pollutants for the assessment. A site-specific conceptual site model was constructed based on effective, reasonable exposure pathways to avoid any overestimation of the risk. Also, conservative default values were adapted to prevent underestimation of the risk when site-specific values were not available. The risks of the six contaminants were calculated by API's Decision Support System for Exposure and Risk Assessment with several assumptions. In the crater-formed-area(Ac), the non-carcinogenic risks(i.e., HI values) of TNT(Tri-Nitro-Toluene) and Cd were slightly larger than 1, and for RDX(Royal Demolition Explosives), over 50. The total non-carcinogenic risk of the whole gunnery range calculated to a significantly high value of 62.5. Carcinogenicity of Cd was estimated to be about $10^{-3}$, while that of Pb was about $5\;{\times}\;10^{-4}$, which greatly exceeded the generally acceptable carcinogenic risk level of $10^{-4}{\sim}10^{-6}$. The risk assessment results suggest that an immediate remediation practice for both carcinogens and non-carcinogens are required before the reservoir construction. However, for more accurate risk assessment, more specific estimations on condition shifts due to the construction of the reservoir are required, and more over, the effects of the pollutants to the ecosystem is also necessary to be evaluated.