• Title/Summary/Keyword: operating room

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Off-Pump Coronary Artery Bypass Grafting (심폐바이패스없이 시행하는 관상동맥우회술)

  • Kim, Ki-Bong;Lim, Hong-Gook;Huh, Jae-Hak;Ahn, Hyuk;Ham, Byung-Moon
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.38-44
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    • 2000
  • Background: We analyzed the result of the "Off-Pump" Coronary Artery Bypass grafting (OPCAB) performed to minimize inflammatory responses to cardiopulmonary bypass and myocardial ischemia during the aortic cross-clamp period. Material and Method : The preoperative diagnosis operative procedure mortality complication and postoperative course of the 50 patients who underwent OPCAB between January 1998 and September 1998 were analyzed. There were 34 males and 16 females with mean age of 60$\pm$9 years. Preoperative clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and postinfarction angina in 3(6%) patients. Preoperative angiographic diagnoses were three-vessel disease in 25(50%) two-vessel disease in 5(10%) one-vessel disease in 7(14%) and left main disease in 13(26%) patients. There were elective operation in 37 cases and urgent operation in 13 cases. Result: The mean number of grafts was 3.2$\pm$1.2 per patient. Grafts used were unilateral internal thoracic artery in 43 greater saphenous vein in 37 radial artery in 7 bilateral internal thoracic arteries in 4 and right gastroepiploic artery in 2 cases Forty sequential anastomoses were performed in 18 cases. Vessels accessed were left anterior descending artery in 48 diagonal branch in 41 obtuse marginal branch in 30 right coronary artery in 24 posterior descending artery in 9 ramus intermedius in 5 and posterolateral branch in 5 anastomoses. Predischarge coronary angiography performed in 44 patients demonstrated the patency rate of 89.5%(128/143) Operative mortality was 2%(1/150) Postoperative complications were arrhythmia in 5 graft occlusion that needed reoperation in 4. perioperative myocardial infarction in 2 femoral artery thromboembolism developed after the application of IABP in 1 postoperative transient delirium in 1 peripheral compression neuropathy in 1 case. Sixteen patients(32%) were extubated at the operating room and the other patients were extubated at the mean 13$\pm$20 hours after the operation. Mean duration of stay in intensive care unit was 49$\pm$46 hours. Thirteen patients(26%) required blood transfusions perioperatively and the amount of perioperative blood transfusion was mean 0.70$\pm$1.36 pack/patient. Conclusion: OPCAB is suggested to be the ideal technique with less postoperative complication less hospitalization time and less cost.less cost.

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Studies on Improvement of the psychiatric Nursing (정신적 병동 간호업무 개선에 관한 연구)

  • 신영란
    • Journal of Korean Academy of Nursing
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    • v.5 no.1
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    • pp.59-69
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    • 1975
  • Author studied on various psychiatric nursing problems applying with the test of questionnaire to the 376 nurses who are attending at 13 general hospitals and one mental hospital in Korea from Apr. 1, 1974 to July 30. 1974. The results obtained were ai follows: 1. 13.095 of nonpsychiatric registered nurses wanted the psychiatric service for their most attractive assignment and this was the 3rd in order next to the general surgical and operating room. Among the psychiatric nurses, the popularity toward psychiatric ward was 31. 0% and they were 26.0%at the private general hospitals and 6, 0% in national public hospitals. 2, The feelings or attitudes of disgust and apprehension on nursing care of the patients at-flirted with infectious diseases were the highest responses (38.5%) and these 1.ends were also appeared in 6.9% of psychiatric nurses. 3. 85.5% of nonpsychiatric registered nurses have had received course lectures on psychiatric nursing and nursing care training on the psychiatric ward at their school of nursing. 38.0% of psychiatric nurses had received post graduate psychiatric nursing and they were higher in national public hospitals (27.0% ) than in private general hospitals (11.0%). 4. The responses of satisfaction and security on their employment were almost similar patterns between nonpsychiatric registered nurses and psychiatric nurses. But among the psychiatric nurses. they were more satisfied at private general hospitals (33.0%) than that of national public hospitals (10.0%). 5. Almost the half of the nurses (50.8%) were employed by the hospitals without considering their past educational or clinical experience or career. Among the psychiatric nurses, who were employed by hospitals without considering their past experience or career were 35.0% in national public hospitals and 12.0% in private hospitals. On the contrary, the nurses who were employed by their wishes fore more higher (26.0%) in private general hospitals than national public hospitals (2.0%). 6. The nurses who thought their employment was fit for their aptitude were 48.6% in nonpsychiatric registered nurses and 51.0% in psychiatric nurses. Among the psychiatric nurses, this response was higher in private general hospitals (34.0%) than the national public hospitals (17.0%). 7. Responses on wort loadings of nurses showed almost same patterns between nonpsychiatric registered nurses and psychiatric nurses. But. among the psychiatric nurses who felt much heavier than the nurses of other part were 24.0% in national public hospitals and 8.0% in private general hospitals. 8. 92.6% of nurses felt that the psychiatric nurses should have post graduate training in psychiatric nursing prior to their assignment. 9. 96.0% of nurses agreed to the risk coverage on the payment for the nurses assigned to the psychiatric ward and the ward for infection diseases.

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A Study of Rockbursts Within a Deep Mountain TBM Tunnel (산악 TBM 터널에서 발생한 암반파열 현상에 대한 연구)

  • Lee, Seong-Min;Park, Boo-Seong
    • Journal of the Korean Geotechnical Society
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    • v.19 no.6
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    • pp.39-47
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    • 2003
  • Rockbursts are mainly caused by a sudden release or the stored strain energy in the rock mass. They have been the major hazard in deep hard rock mines but rarely occur in tunnels. Due to the short history and limited information on rockbursts, the topic has rarely been studied in Korea. Some cases of rockbursts, however, have been reported during construction of a mountain tunnel for waterway. This study focuses on analyzing data on rockbursts obtained from a TBM (Tunnel Boring Machine) tunnel and suggests methods for a comprehensive understanding on rockbursts. From the analysis of the field data of rockbursts, it was found that most rockbursts mainly occurred at the section between the tunnel face and the TBM operating room, and the rock bursting phenomena lasted up to 20 days after excavation in certain areas. The data also show that the bursting spots are located all around the tunnel surface including the face, the wall, and the roof, The maximum size of bursting spots is usually less than 100cm. This study also suggests new scale systems of brittleness and uniaxial compressive strength to evaluate the possible tendency for a rockburst. These systems are scaled based on the scale system of strain energy density. In addition, with these scale systems, this research shows that there are potentially higher tendencies for rockbursts in this specific tunnel. Moreover this research suggests that properties of rock and rock mass, RMR (Rock Mass Rating) value, tunneling method, excavating speed, and depth of tunnel have a strong correlation with rockbursts.

Korean Nurses Knowledge Concerning Vaginal Birth After Cesarean(VBAC) and its Educational Material (제왕절개 기왕력이 있는 질 분만(VBAC)에 관한 간호사의 인식정도와 교육안)

  • Park Sang-Ju;Choi Kyung-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.267-284
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    • 1999
  • The purpose of this study are 1. Evaluate the degree of knowledge of Vaginal Birth After Cesarean(VBAC) of Korean nurses. 2. To gather and develop educational material for VBAC. The sample was surveyed Korean Nurses knowledge about VBAC, from November 1998 through March 1999. For the data analysis, the SPSS computer program percentage and frequency were used for descriptive statistics. The x2 and the t-test were used to compare the results of the two sample groups. Open questions asked in the survey were sorted out by content, then displayed in chart form. For the education material, the Internet was the main source of information. Information on the Internet was provided by professional doctors and prenatal educational nurses. The results of the survey are as follows: 1. Out of 97 Nurses 15.3% answered that cesarean deliveries do not need to be performed after previous cesarean sections : however. 46.4% answered that cesarean sections must be performed after previous cesarean sections. 2. Of the nurses surveyed 14% had no knowledge or had never heard of VBAC. 3 Nurses did not have questions from patients concerning VBAC was 34.7%. This led to the conclusion that patients either do not have knowledge about VBAC or patients have no interest in the trial of labor. 4, Nurses indicated that their information about VBAC originated from other people's experiences (31%), Nursing School (25%), Media information (9%), and through literature review (6%). This data led to the conclusion that the knowledge about VBAC may not be extensive enough to counsel and guide patients who are willing to endure the trial of labor. 5. Nurses preferred hospital education programs to develop their knowledge concerning VBAC. Based upon survey, the conclusion was made that General Nurses and Maternity Nurses did not have knowledge about VBAC success rates and the possibility of a trial of labor. In order for nurses to help patients make decisions concerning VBAC, nurses have to gam more knowledge through hospital educational programs. Further more, the study suggests that through hospital educational programs, the possibility and importance of VBAC must be emphasized to nurses who work in maternity areas. Second, through prenatal educational programs, the possibility and importance of VBAC must be explained and emphasized to patients who had previous cesarean sections. Third, the clinical pathways of VBAC need to be developed. Fourth, each hospital needs to develop multi-disciplinary teams, consis-ting of obstetricians, risk management/quality management, staff registered nurses, and the director for perinatal services. This team can review cesarean section rates and help to increase the practice of VBAC.

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Comparison of Parallel and Fan-Beam Monochromatic X-Ray CT Using Synchrotron Radiation

  • Toyofuku, Fukai;Tokumori, Kenji;Kanda, Shigenobu;Ohki, Masafumi;Higashida, Yoshiharu;Hyodo, Kazuyuki;Ando, Masami;Uyama, Chikao
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.407-410
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    • 2002
  • Monochromatic x-ray CT has several advantages over conventional CT, which utilizes bremsstrahlung white x-rays from an x-ray tube. There are several methods to produce such monochromatic x-rays. The most popular one is crystal diffraction monochromatization, which has been commonly used because of the fact that the energy spread is very narrow and the energy can be changed continuously. The alternative method is the use of fluorescent x-ray, which has several advantages such as large beam size and fast energy change. We have developed a parallel-beam and a fan-beam monochromatic x-ray CT, and compared some characteristics such as accuracy of CT numbers between those systems. The fan beam monochromatic x-rays were generated by irradiating target materials by incident white x-rays from a bending magnet beam line NE5 in 6.5 GeV Accumulation Ring at Tukuba. The parallel beam monochromatic x-rays were generated by using a silicon double crystal monochromator at the bending magnet beam line BL-20BM in Spring-8. A Cadmium telluride (CdTe) 256 channel array detector with 512mm sensitive width capable of operating at room temperature was used in the photon counting mode. A cylindrical phantom containing eight concentrations of gadolinium was used for the fan beam monochromatic x-ray CT system, while a phantom containing acetone, ethanol, acrylic and water was used for the parallel monochromatic x-ray CT system. The linear attenuation coefficients obtained from CT numbers of those monochromatic x-ray CT images were compared with theoretical values. They showed a good agreement within 3%. It was found that the quantitative measurement can be possible by using the fan beam monochromatic x-ray CT system as well as a parallel beam monochromatic X-ray CT system.

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Magnetic Properties of RF Diode Sputtered $Ni_{80}Fe_{20}/SiO_2$ Multilayers (모양으로 유도된 자기 이방성을 가진 $Ni_{80}Fe_{20}/SiO_2$ 다층막의 자기적 성질)

  • Yun, Eui-Jung;Jung, Myung-Hee
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.44 no.2
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    • pp.1-6
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    • 2007
  • This study investigated the magnetic properties of $Ni_{80}Fe_{20}/SiO_2$ laminates with shape-induced magnetic anisotropy. The multilayer films were deposited on Si or upilex substrates, from separate $Ni_{80}Fe_{20}$ and $SiO_2$ (at %) alloy targets using a rf diode sputtering system. $Ni_{80}Fe_{20}/SiO_2$ laminates with a various number of bilayers (N) were prepared. The laminates with ellipse array patterns were prepared using photolithographic technique. The magnetic properties were measured at room temperature using a B-H hysteresisgraph and a high frequency permeameter. The several steps during domain wall reversal were observed in multilayer films, attributing to inter-magnetic layer coupling. Intrinsic uniaxial anisotropy field increases with N. The experimental values of the total anisotropy field are found to be in good agreement with the calculated values. This study utilized the shape anisotropy of the laminated film objects with small ellipse array patterns to induce a larger uniaxial anisotropy so as to maximize their operating frequency.

Actual Disinfection and Sterilization Control in Korean Healthcare Facilities (국내 의료기관의 소독과 멸균 관리 실태)

  • Jeong, Sun Young;Choi, Jeong Hwa;Kim, Eun Kyoung;Kim, Su Mi;Son, Hee;Cho, Nan Hyoung;Choi, Ji Youn;Park, Eun Suk;Park, Jin Hee;Lee, Ji Young;Choi, Soon Im;Woo, Jin Ha;Kim, Og Son
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.4
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    • pp.392-402
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    • 2014
  • Purpose: This study was done to investigate the status of disinfection and sterilization in healthcare facilities. Method: A survey of 193 Korean healthcare facilities was conducted from February 8 to March 7, 2013. Data were analyzed using descriptive statistics, ${\chi}^2$ test, Fisher's exact test, one-way ANOVA, Scheffe with SPSS WIN 18.0. Results: Of the healthcare facilities 93.2% had specific guidelines for disinfection/sterilization, but only 47.9% had a committee on disinfection/sterilization for decision-making, less than half (42.7%) conducted regular monitoring of actual practices, while 83.9% had established procedures for recovery in case of problems with the disinfection process and 89.0% kept records and archives of disinfection practices. Cleaning process, selection of chemical disinfectants and process of disinfection and sterilization were found to be inadequate in some healthcare facilities. Perception score for adequacy of medical instruments was 8.10, environmental disinfection was 7.20, and sterilizer management was 8.45 out of a possible 10. Conclusion: Compared to larger institutions, smaller healthcare facilities had less effective disinfection and sterilization management systems, while some facilities showed inadequate practices for medical equipment and general sterilization. Better academic and state-level support is recommended for smaller facilities in order to establish a better system-wide management system.

A Study on the Management and Living Environment of the Group-homes for the Elderly -Focusing on Jeonju and Kwangju- (노인그룹홈의 운영과 생활환경에 관한 연구 -전주시와 광주시를 중심으로-)

  • Ahn, Kyung-Ohn
    • Korean Journal of Human Ecology
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    • v.18 no.4
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    • pp.841-855
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    • 2009
  • The main objective of this study is to examine the situations of group-homes for the elderly and clarify the problems of them. This study investigates the present conditions of welfare facilities and supply conditions. 4 group-homes were surveyed in Jeonju and Kwangju cities. Data was collected through various ways including the survey conducted by facility operators, the measurement of living space, and photo-takings. The major results of this study are as follows: 1) With the introduction of nursing care insurance in 2008, the increase of the demand and supply to group-home will be expected, due to less cost for recuperation. The care of elderly in homelike atmosphere is effective to the elderly suffering from dementia. Therefore, it is proper that the supply of group-homes for dementia will be needed. 2) Group-homes for the elderly are being supplied under the standards of welfare facilities in the present. Separate supply standards, however, are needed because they are not suitable for small scale group-homes. 3) To supply Group-homes for the elderly on a one-unit basis would cause various problems such as economical unreality, personnel distribution and so on. It is necessary to supply more than two units for more efficient management. 4) The management of group-homes for the elderly is financially unstable because the operating funds heavily depend on the users or people who are connected with the facilities through private networks. Therefore, additional support is needed to settle the financial problem. It would be helpful to build the public networking that provides information about the group-home for the elderly for the public. 5) In case of the increase in the supply of the group-home in a residential area, it could be helpful to promote the group-home to the public. 6) The operators state that the main problems of group homes for the elderly lie in financial difficulties and the shortage of professionals and volunteers. The financial, personnel, and material support for personnel and the supervision of management are required for the transparency and effectiveness of the facility management. In addition, the closer network and cooperation system with the community is required. 7) The present living environments for group-homes for the elderly leave much room for improvement, considering the physical condition of the elderly. The more careful selections in the color, shape, material, and equipment of the facilities should be made for the convenience of the elderly users.

NCS-based Education & Training and Qualification Proposal for Work-Learning Parallel Companies Introducing Smart Manufacturing Technology (스마트 제조기술을 도입하는 일학습병행 학습기업을 위한 NCS 기반 교육훈련 및 자격 제안)

  • Choi, Hwan Young
    • Journal of Practical Engineering Education
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    • v.12 no.1
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    • pp.117-125
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    • 2020
  • According to the government's smart factory promotion project for small and medium-sized enterprises, more than 10,000 intelligent factories are scheduled or already built in the country and the government-led goal is to nurture 100,000 skilled workers by 2022. Smart Factory introduces numerous types of education and training courses from the supplier's point of view, such as training institutions belonging to local governments, some universities, and public organizations, in the form of an efficient resource management system and ICT technology convergence in the automated manufacturing equipment. The lack of linkage with the NCS, the standard for training, seems to have room for rethinking and direction. Results of survey is provided for the family companies of K-University in the metropolitan area and Chungnam area, and analyzes job demands by identifying whether or not they want to introduce smart factories. Defining the practitioners who will serve as a window for the introduction of smart factory technology within the company, setting up a training goal in consideration of the career path, and including the level of training required competency units, optional competency units, and training time suitable for introducing and operating smart factories. Author would like to present an NCS-based qualification design plan.

A Study on Improving the Organizational Structure for University Libraries with Service Paradigm Shifts (서비스 패러다임의 변화에 따른 대학도서관의 조직개편에 관한 연구)

  • 신은자;이해영
    • Journal of the Korean Society for information Management
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    • v.18 no.2
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    • pp.273-294
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    • 2001
  • In recent years, changes in the university libraries environment have led to increased emphases on improving or restructuring the organizational structures of university libraries. Technology, trends toward access over ownership, user focus, and restructuring in higher education are some of the major factors contributing to these changes. The users' new information retrieving behavior are emerged from the developments in information technology with new media and from the competitive research environments, and thus this trend has led to the gradual increase of collection arrangement by subjects rather than by forms, particularly from 1995 in Korean universities' libraries. Users especially in university libraries who are frequently seeking information on the specific subject, are going to find a room accoinmodating all forms of information on the subject, that is, one-stop information service. As a result, subject division structure have adopted as a new organizational structure in Korea. Our survey shows 34 out of 73 university libraries in Korea is taking this structure of which collections are arranged by subjects, while the rest of them are operating with a traditional organizational structure by forms focusing on keeping of collection management. In the future, university libraries with traditional organizational structure will be moving towards the subject division structure which is a recommended one by this study.

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