• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.905-914
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• 2006

Background and Purpose : The purpose of this study was to classify according to the TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) acute stroke patients (first-ever stroke) treated at the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital. Methods : In the time period Oct. 2005 to Oct. 2006. 101 patients with a first-ever stroke admitted to the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. They had neurological deficits for a time more than 24 hours. We classified patients according to the original TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) Results : The incidence in males was 54.4%, in females was 45.6%. Ischemic stroke (86.l%) was more common than hemorrhagic stroke (13.9%). The results of TOAST classification in this study were as follows: small-vessel occlusion, 72.4% large-artery atherosclerosis. 14.9 % cardioembolism, 4.6% stroke of other determined etiology, 4.6%: stroke of undetermined etiology, 3.5%. Patients in the small-vessel occlusion subgroup in this study were the most frequent. The result of this study is that Korean stroke registry is not in accordance with western medicine. Conclusions : The TOAST classification system is the most widely accepted tool to categorize stroke subtypes in western medicine, but in oriental medicine, it is not yet widely accepted. The authors suggest the general use of the TOAST classification to determine adequate management for stroke patients, to predict the prognosis and recurrence of stroke and to develop a Korean standard of stroke in oriental medicine.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.1
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• pp.109-121
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• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• Journal of radiological science and technology
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• v.37 no.2
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• pp.143-150
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• 2014

This study was designated to investigate the bremsstrahlung and radiation dose by beta rays. Radiation attenuation from I-131 treatment ward was analyzed using radio protective apron. Shielding materials which is included lead or water were simulated in Monte Carlo Simulation then the spectrum on interaction was analyzed. The shielding materials were categorized according to the thickness. 0.25mm and 0.5mm thick lead and 0.1mm and 0.2mm thick water shielding materials were configured in Monte Carlo Simulation for this study. Only lead shielding method and water plus lead shielding method were carried. As a results, when 0.5mm thick lead shielding method was performed, the radiation dose was similar to the results with water plus lead shielding method. In case of using 0.25mm thick lead shielding, the shielding effect was somewhat less. However, that shielding method cause dose reduction of about 60% compare with non-shielding material.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.145-153
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• 2016

Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.242-252
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• 2013

Purpose: The purpose of this study was to examine medical professionals' perception and knowledge of hospice and palliative care (HPC) and attitude toward death. Methods: The survey was performed on 84 physicians and 172 nurses in Busan, Korea. Data were collected from April 5, 2012 to April 30, 2012. Results: Regarding the purpose of HPC, the most popular perception was "To alleviate pain and accommodate comfort" among both physicians and nurses. For the need for HPC, "Terminal patients need a separate ward for emotional fluctuation" the answer chosen by both groups the most. Both groups scored low on knowledge of HPC. For pain and symptom management, physicians scored higher than nurses (physicians: $6.97{\pm}1.82$, nurses: $5.68{\pm}1.93$, P<0.001). Conclusion: Considering the survey results, we suggest development of a program to improve medical professionals' perception and knowledge of HPC and attitude toward death.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.296-302
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• 2016

Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.75-83
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• 2018

Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.

• Journal of Preventive Medicine and Public Health
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• v.6 no.1
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• pp.43-49
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• 1973

In this study noise source in a ward at four general hospitals in Seoul area has been investigated and analysed. The degree of reaction against noise by 171 randomly has also been examined. The results of the study have shown that the source of noise is the speakers of wired broadcasting or from visiting guests in two hospitals located in residential area. The patients at the two other hospitals located at commercial site have been suffered more from traffic noise. However, because of their separated living at hospital from their ordinary houselife, sixty one percent of the inpatients have wished a music sound of around 60 dB (A). After having considered the results of the investigation and wishes of the inpatients, following suggestions have been made: 1. Reduce the number of guests or their length of stay. 2. Wired broadcasting system should be substitued by wireless one, or if it's unavoidable, it should be used in office rooms only. 3. Since the stops and starts of vehicles induce much noise, Seoul City Government be requested to prepare an appropriate administrative measure for the vehicles around hospital area and it should prevent the establishment of new hospitals along high way site. 4. By using earphone, inpatients can choose a wireless channel according to each individual's taste. This through the masking effect, would cover up the noise source. 5. Rooms along the streets should be utilized as offices, otherwise double windows should be set up for inpatient's wards.

• 한국해양학회지
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• v.21 no.2
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• pp.110-117
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• 1986

In southeastern sea of Korea, ammonium excretion rates of mixed macrozooplankton population ranged from 0.90 to 2.32$\mu\textrm{g}$ atoms NH$\_$4/-Nm$\^$-3/h$\^$-1/ and zooplankton excretion contributed from 3 to 15% of total nitrogen requirement by phytoplankton. Wet weight specific ex cretion rate was averaged to be 3.45$\mu\textrm{g}$ atoms NH$\_$4/-Ng$\^$-1/wet weight h$\^$-1/. Zooplankton biomass in wet weight and protein tended to increase to ward outer outer shelf. GDH assay of macrozooplankton demonstrated a typical Michaelis-Mentenkinetics with 5.1mM of half saturation constant(Km). Protein specific GDH activity in the present study ranged from 1.5 to 3.2$\mu\textrm{g}$ atoms NH $\_$4/-N mg$\^$-1/protein h$\^$-1/. Higher protein specific GDH activity in the outer shelf implies that zooplankters in the outer shelf were more active in nitrogen metabolism grazing higher primary production in the outer shelf. In the present study, averaged GDH/excretion ratio was 18.8${\pm}$2.6(n=6)showing high correlation between zooplankton GDH activity and direct ammonium excretion rate by zooplankton. GDH assay can be extremely useful in the future study for the ammonium regeneration by different size zooplankton fraction in various marine environments.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.37 no.5
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• pp.891-903
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• 2017

In recent days, school violence has been rising as a significant social problem. The occurrence of school violence can be fueled by a wide range of social and environmental contexts, thus it is very difficult to come up with the ultimate solution. Community CPTED program is one of the more comprehensive set of efforts that has been developed to prevent crime in general, and the primary focus of the study is to investigate suitable components of CPTED to prevent school violence based on the physical conditions of communities as well as the perception of residents outside of school grounds, in the vicinity of schools. Three sets of analyses in series were employed in the research. First, Ward's minimum-variance cluster analysis was used to classify the places where school violence can occur outside of school grounds based on the physical conditions recognized by local residents. Next, Importance-Performance Analysis was performed to analyze the perception of local residents about the importance and the effectiveness of CPTED components in preventing school violence. Subsequently, Ordered Logit Model was used to analyze the local residents' awareness on safety regarding school violence in their community space. Combining the results of the analyses, the priority of the community CPTED applications to prevent school violence outside of school was derived. Reflecting the local residents' perception on safety of students in their community, the sense of security in communities against school violence can be reinforced by the communities' sensible efforts in creating safer environment for their students.