• Journal of Preventive Medicine and Public Health
• /
• v.28 no.3 s.51
• /
• pp.623-639
• /
• 1995

We have never seen any method to cope basically with complicated situation and problems around medical reimbursement rates here in Korea since 1977 witnessed by the beginning of medical insurance. By the way researchers concerned are beginning to propose some kinds of innovative and detailed ideas to government these days. They are Diagnosis-related group(DRG) and Resource-based .elative value scale(RBRVS). In the light of this situation it is so encouraging that our government can come up with that and move. In case of RBRVS research we have already been reaching even to the level of reviewing and revising methodology for its further development after naive pilot study on internal medicine and general surgery last year. However there might be something different conditions between USA and Korea to apply the same Dr. Hsiao's method and it must be vital to check so called' total work approach' compared with 'intra-service work approach' before expanding to the whole medical fields. According to the' Intra-service approach', the physician's work is supposed to be divided into three sub-works by the name of intraservice work, pre, and post service work. These sub-works, again should be merged together to be the pre-postwork subset through some statistical methods of the estimation process applied by Dr. Hsiao's methodology in RBRVS development later on. But in this paper that estimation process was not taken because we could have real values for all of those surveyed items related to just one specialty, OB & GY. Instead, We used some statistical comparison procedures relevant to demographic characteristics, reliability & validity and correlation analysis with American RVU(Relative value unit) between the total work and merged total work from intraservice work approach. The unit of analysis was individual physicians of OB & GY and 300 physicians were selected for each approach through statistical sampling method based on national population of OB & GY physicians in Korea. And also with the thankful help of Advisory Committee under Korean Association of OB & GY, questionnaires were made and mailed to the subjects, two times. As a result there were not any statistically significant differences in demographic characteristics between the two approaches except for the variable 'Response time for the questionnaires', but in other sections of comparisons, response rate, representative values, reliability & validity test, correlation analysis with American RVU, all showed 'Total approach' was not only more rational and statistically meaningful than 'Intra-service approach' but also had considerable merits. But we are not absolutely sure about this paper's robustness. Because of some limitations, we'd rather like to suggest further researches should be followed. In that sense the first thing would be a research for the influence of doctor's characteristics, especially 'frequency' on the rating of work and the way to define total work more clearly.

• Journal of the Korean Society of Environmental Restoration Technology
• /
• v.19 no.6
• /
• pp.87-100
• /
• 2016

This research was performed for the purpose of providing useful and base data and preservation strategy of growth characteristics of Rhododendron micranthum. From the result of research, wild growth area of Rhododendron micranthum was discovered near steep forest road on 695~901m in altitude above sea level of Baekdu-daegan National Arboretum. Vegetation colony structure of Site I was resulted in Pinus densiflora(tree stratum M.I.P.=45.3%) is dominants, Betula schmidtii(arborescent M.I.P.=9.8%) is second dominant, and Site III resulted in Pinus densiflora(tree stratum M.I.P.=30.5%) is dominants, Betula schmidtii(arborescent M.I.P.=10.3%) is second dominant. Site II resulted in Betula schmidtii(arborescent M.I.P.=30.4%) is dominants and Pinus densiflora tree(tree stratum M.I.P.=8.3%) is second dominants. For herbs, it was researched that the rate of one year herb of chrysanthemum family(10), rice family(3), sedge(2) was higher than near forest area. Among Species diversity index, that of Shannon was in range of 0.7348~1.1090. After comparing this with similar area, this value was relatively low. Dominance analysis result was analyzed that various groups are evenly distributed. Monthly highest average temperature is $23.9^{\circ}$ in Site A and Site B, and monthly lowest average temperature is $-4.5^{\circ}C$ in Site I and $-4.7^{\circ}C$ in Site II. Monthly maximum average humidity is 85.6% in Site I and 83.2% in Site II. Monthly minimum average humidity is 60.9% in Site I and 60.8% in Site II and it showed that these 2 area are located far away but have similar temperature and humidity characteristic and climate environment is similar. It was analyzed that humidity is high with the result of annual average humidity is over 60%. In growth characteristic, it showed that doubt damage of Stephanitis pyrioides, exposure of roots, peeled bark was discovered and supplement on this is urgent.

• Korean Journal of Head & Neck Oncology
• /
• v.17 no.2
• /
• pp.190-193
• /
• 2001

Background and Objectives: Reliable and versatile free flap has become a mainstay in reconstruction of the head and neck. But until now pectoralis major myocutaneous flap (PMMCF) as workhorse is useful and has some advantages such as good viability, one-stage reconstruction and carotid protection. The objective of this study was to review the role and indication of PMMCF in this era of potent free flaps for head and neck reconstruction. Patients and Methods: Sixty one PMMCF and one hundred forty six free flaps used for head and neck reconstruction between 1991 and 2001 were reviewed retrospectively. We compared the applied sites of flap, the flap failure rate and complications. Results: Contrary to the free flap, use of PMMCF has gradually decreased after the middle of 1990s. PMMCF were mainly used for mucosal defect(33cases, 54.1%) and cervical skin defect(22cases, 36.1%) and free flap were mainly used for mucosal defect(129cases, 88.4%). In point of use of PMMCF according to years, from 1991 to 1997, 30cases(70%) are used to reconstruct mucosal defect and 12cases(29%) are used to reconstruct skin defect. But from 1998 to 2001, only 2cases(10.5%) are used to reconstruct mucosal defect and 13cases(68.4%) are used to reconstruct neck skin defect. In case of free flap, from 1991 to 1997, 41cases (87%) are used to reconstruct mucosal defect and from 1998 to 2001 88cases(89%) are used as same purpose. Three major necrosis (more than 50%) deveolped in 61 PMMCF (4.9%) and three major necrosis developed in 146 free flaps(2.1%). Conclusion: PMMCF is no longer flap of choice for primary reconstruction but it is a still one of a good tool in some head and neck reconstruction such as covering single wide defect of face or neck skin, back-up procedure of free flap, postoperative status, treatment of pharyngocutaneous fistula and covering vital structure.

• Journal of Korean Traditional Oncology
• /
• v.11 no.1
• /
• pp.119-134
• /
• 2006

Shiquandabutang is very famous prescription for tonifying vital energy. We examined the anti-metatstastic effect of Shiquandabutang with in vitro invasion assay model. We performed the following experiments and the results are listed below:Cell viability assay was carried to determine the dose of Shiquandabutang. At lower dose under 200 ${\mu}g/m{\ell}$ (89.6%) viability was very high. But, viability downed as dose grows. At the dose of 600 ${\mu}g/m{\ell}$ (54.2%) viability was almost half of that of control. And at high dose of 1000 ${\mu}g/m{\ell}$ (15.8%) viability was very pure. In BrdU incorporation assay, Shiquandabutang treated groups showed the decreased DNA synthesis rate compared with control group.(200 ${\mu}g/m{\ell}$ (64.4%), 400 ${\mu}g/m{\ell}$ (7.3%)) The results of gelatinase assay showed that Shiquandabutang decreases the gelatinolytic activity of MMP-9. We examined tube formation assay and the result was that Shiquandabutang ihhibits the tube formation at the dose of 200 ${\mu}g/m{\ell}$ and 400 ${\mu}g/m{\ell}$. We examined rat aortic ring assay and the result was that Shiquandabutang ihhibits the angiogenesis of the rat aortic ring at the dose of 400 ${\mu}g/m{\ell}$. From our research, part of the mechanism underlying anti-metastastic effect of Shiquandabutang was proven in vitro. Moreover, we knew that Shiquandabutang is more effectively inhibits the angiogenesis at high dose.

• The Korean Nurse
• /
• v.30 no.1
• /
• pp.51-62
• /
• 1991

The Study was carried out for the purpose of investigating the degree of perception in nursing activities. This study reports perceptions of nurses on the choices they make among competing activities, contrasts this perception with their opinion of what tasks they would like to spend time on. A sample of 231 clinical nurses was selected to participate in this study at two genernal hospitals in Seoul. The data was collected from July 10th to 25th, 1990. Subjects were instructed to rate one of five points likert type scale on the 43 items of nursing activities. Analysis of data was done by means of the SPSS-X Program using frequency, t-test and ANOVA. The results of this study were as follows; 1. The characteristics of the subjects were as follows: The age group of 25-29 yeares was 45.9%. For religion, Christians had the highest score, 68.4 % and singles in subjects were 81.4%. For academic background, 64.5% were graduated from nursing junior colleges. In the subjects, staff nurses were 86.6%. 22.5% of them had worked for less than 1 year and 20.8% had 37 months to 5 years experience at the time of the survey. 62.8% were satisfied with the job. 2. The perception level of nursing activities: 1) The mean score for perception of professional nursing functions was 4.157 point, with a maximum score set. at 5 points. The mean score for perception of priorities was 3.781. Perception of spending time was 3.932. 2) In perception of professional nursing functions, more important items were Aseptic technique (4.866), Shift and exchange of information concerning patients(4.654), Observing patients (4.799). Less important items were Transporting patients(3.411), Changing linens(3.442), Giving a bed shampoo (3.506). In priorities, more important ones. were Aseptic technique(4, 706), Shift and exchange of information concerning patients (4.524.), Observing patients(4.390), Taking vital signs (4.355). And less important ones were Changing linens (3.100), Giving bed baths(3.113), Giving back rubs(3.121). In spending time, more important ones were Aseptic technique(1.706), Observing patients (4.532), Shift and exchange of information concerning patients(4.532). And less important ones were Changing lines(3.368), Transporting patients(3.394), Giving bed baths(3.450). 3) In the role perception level, the mean distribution of perception was 3.511- 4.335; the role was perceived to be in order of frequency as a facilitator, coordinator, change agent and advocator role. The most important scale of factors by nursing activities was indirect nursing activities.

• Asian-Australasian Journal of Animal Sciences
• /
• v.16 no.1
• /
• pp.57-62
• /
• 2003

An effort was made to assess comparative production performance in broiler chickens fed diets containing solvent extracted cottonseed meal (CSM) processed from BT and Parental Non-BT lines. Processed meal of national check and commercial produce cottonseeds were also used for comparison. The free gossypol contents were 0.02, 0.02, 0.44 and 0.03% in meals of BT, Parental Non-BT, national check and commercial produce cottonseeds, respectively. Day-old broiler chicks (n=243) were divided to 27 groups of 9 each. Nine dietary treatments (iso-nitrogenous, 23% CP and iso-caloric, 2,800 kcal ME/kg) were formulated viz., D1 (control, soybean meal-SBM based), D2 and D3 (BT CSM at 10% of diet with and without additional iron), D4 and D5 (non-BT CSM with and without additional iron), D6 and D7 (national check CSM with or without additional iron), and D8 and D9 (commercial produce CSM with or without additional iron at 2 ppm for every 1 ppm of free gossypol, respectively). Each dietary treatment was offered to three replicated groups up to 6 weeks of age. At the end of 6 weeks of age, 10 birds were taken out randomly from each treatment and were sacrificed to study carcass traits, organs' yield and histo-pathological changes in vital organs. The broiler chickens received CSM processed from BT (D2, 1,753 g and D3, 1,638 g) and Parental Non-BT (D4, 1,653 g and D5, 1,687 g) with or without additional Fe grew at same rate as observed in soybean meal (solvent ext.) based diet (D1, 1,676 g). The feed intake and feed conversion efficiency (feed: gain) in these dietary treatments (BT, non-BT line based diets) also did not differ significantly (p>0.05) from control diet. Similar observation was also observed in dietary treatments (D8 and D9) containing solvent extracted cottonseed meal of commercial produce origin. However, a decrease (p<0.05) in body weight gain and feed intake was observed in D6 containing national check CSM with high gossypol content. Addition of Fe in the diet (D7) improved (p<0.05) feed intake and weight gain but not to the extent as observed in diets containing BT, parental non-BT, and commercial produce CSM or control. However, any type of CSM did not affect feed conversion efficiency when fed with or without additional iron. The carcass characteristics in terms of dressing percentage, liver weight and heart weight was not significantly (p>0.05) different between the treatments. The eviscerated yields emanated from diets containing either BT, non-BT or commercial produce were statistically similar to control. However, eviscerated yield of broilers fed national check CSM with or without iron supplementation was lower (p<0.05) than BT cotton with Fe supplementation and commercial produce CSM. The study envisaged that BT, parental non-BT and commercial produce solvent extracted cottonseed meal can be included at 10% in soybean meal based broiler diet replacing soybean meal and rice bran without additional iron.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.11
• /
• pp.746-754
• /
• 2016

Smart healthcare systems, a convergent industry based on information and communications technologies (ICT), has emerged from personal health management to remote medical treatment as a distinguished industry. The smart healthcare environment provides technology to deliver vital information, such as pulse rate, body temperature, health status, and so on, from wearable devices to the hospital network where the physician is located. However, since it deals with the patient's personal medical information, there is a security issue for personal information management, and the system may be vulnerable to cyber-attacks in wireless networks. Therefore, this study focuses on a key-development and device-management system to generate keys in the smart environment to safely manage devices. The protocol is designed to provide safe communications with the generated key and to manage the devices, as well as the generated key. The security level is analyzed against attack methods that may occur in a healthcare environment, and it was compared with existing key methods and coding capabilities. In the performance evaluation, we analyze the security against attacks occurring in a smart healthcare environment, and the security and efficiency of the existing key encryption method, and we confirmed an improvement of about 15%, compared to the existing cipher systems.

• Journal of the Korean Society for Railway
• /
• v.15 no.1
• /
• pp.42-47
• /
• 2012

There are ATC (Automatic Train Control), ATP (Automatic Train Protection), ATS (Automatic Train Stop) and ATO (Automatic Train Operation) etc. in train control systems. As various train control systems are installed according to sections, on-board signaling systems are installed to apply to the section. Hence, operation flexibility of trains is decreased. In other words, when trains are operated in the section where other train control systems are used, the on-board signaling systems are changed. Recently, a study on the combined on-board signaling system has been researched to solve this problem. The combined on-board signaling system consists of ATC, ATP and ATS device. Because the train control systems are vital, it needs to design the combined on-board signaling system by using k out of n system. In this paper, when k out of n system is applied in the combined on-board signaling system, the reliability and loss cost are analyzed by using failure rate in each device. Hence, the ideal number of systems is presented according to the number of outputs.

• Journal of Trauma and Injury
• /
• v.23 no.1
• /
• pp.21-28
• /
• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• The Korean Journal of Emergency Medical Services
• /
• v.15 no.2
• /
• pp.101-108
• /
• 2011

Purpose: Cardiopulmonary resuscitation (CPR) prevents tissue necrosis of the brain and cardiac muscle in the cardiac arrest patient and requires exact skills in order to increase survival rate. Through comparison of the training effects of feedback manikin and non-feedback manikin, this study present the effective CPR device to CPR instructors. Method: This CPR course for 80 students by using Resusci Anne $SkillReporter^{TM}$ (RASR; Laerdal Medical, Stavanger, Norway) and Actar 911 $Squadron^{TM}$ (A911; Vital Signs, New Jersey, USA) held on December 22, 2009. Thirty seven students and two assistants were placed in one laboratory, there were five RASR manikins which provide the LED performance indicator, not the metronome. Forty two students and two assistants were placed in the other laboratory, there were 20 A911 manikins which don't provide any feedback indicator. Chest compression scores and ventilation compression scores obtaining from two groups were analysed statistically by using independent t-test. Results: Chest compression scores, average depth (mm) was 37.5 in RASR and 41.80 A911 (p=.004), too depth (#) was 2.8 in RASR and 19.4 A911 (p=.005), average number per min (#/min) was 64.4 in RASR and 68.2 A911 (p=.038), wrong hand position (#/min) was 10.9 in RASR and 30.8 A911 (p=.040). Four items that showed better scores in group RASR had statistically significant difference. Ventilation compression scores, percent correct (%) was 40.6 in RASR and 20.6 A911 (p<.001), number correct (#) was 4.7 in RASR and 2.1 A911 (p=.002), too fast (#) was 0.9 in RASR and 2.9 A911 (p=.003), average volume (ml) was 536.5 in RASR and 707.1 A911 (p=.011). Also, three items that showed better scores in group RASR had statistically significant difference. Conclusions: Regarding the positive effect of CPR training feedback, comparison between the real-time visual feedback manikin (RASR) and the non-feedback manikin (A911) showed that RASR had better results than A911 in chest compression except average number per min (it means that we need harder chest manikin) and ventilation. Verification of the training effect in the real world such as CPR outcomes is also necessary. A proper application of manikin in training circumstances and research on retention of CPR skills will be needed.