• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.321-330
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• 1999

Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.50-59
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• 1981

간호학생들이 당연하고 있는 문제점 미래의 간호학생들이 교육문제를 논하기 위하여는 간호학생들이 가지고 있는 문제점을 파악하고 또 이해하는 것이 우선순위가 될 것이다. 간호학생들이 문제점에 대한 연구는 한국에서 뿐아니라 미국에서도 꽤 많이 시행되어져 왔으며 특히 간호학과정에서 중간 탈락되는 중퇴자들에 대한 연구들 중에 이러한 문제점에 대해서 언급한 것이 많다. 고등학교를 졸업하고 곧 대학과정에 진학한 학생들을 대상으로 조사 보고될 Munro의 자료에 의하면 전문대학과정에서 27$\%$, 대학과정에서는 41$\%$의 간호학생들이 간호학과정에서 중간 탈락하고 있음이 보고되고 있다. 이들이 중간탈락하는 데에는 여러 가지 이유가 있으나 그 중 ''간호학에 흥미를 잃어서''가 가장 큰 이유로 보고되고 있다. 이곳 한국사회에서도 역시 비슷한 현상을 보이고 있다. 그러나 대학입시경쟁과 대학내에서의 전과가 거의 허용되지 않는 특수여건이기 때문에 학교를 중간 탈락하는 율은 미국이 보고만큼 높지는 않으나 역시 ''간호학에 흥미를 잃는다''는 것이 간호학생들의 가장 큰 문제점으로 대두되고 있다. 최근 한국에서 시행된 간호학생들에 관한 연구(표 1 참조)에 의하면 간호학생들의 학문에 대한 만족도는 조사자의 35$\~$50$\%$정도에 불과하였고 더우기 이 비율은 고학년에 올라갈수록 더욱 감소되고 있는 경향을 보이고 있다. 한국에서 시행된 어느 연구보고에 의하면 간호학에 실망했다고 생각하는 학생이 전체의 67$\%$였으며, 다른 학교로 전과를 희망한 경험이 있다는 학생이 71$\%$나 되는 것으로 보고되고 있다. 그러나 왜 흥미를 잃게 되는지 그 이유에 대하여 설명해 주는 연구는 많지 않았다. 미국의 한 저자는 간호학생들이 간호학에 흥미를 잃게 되는 원인을 간호원의 역할에 대한 이해가 정확하지 못한 것과 졸업 후 진로기회에 대한 인식부족 때문이라고 추측하고 있다. 간호학에 흥미를 잃게 되는 이유는 크게 다음의 세 가지로 분류 요약될 수 있다. 첫째, 간호학을 전공으로 택한 동기이다. 간호학의 특수성으로 인하여 학생들이 간호학을 전공으로 택한 동기도 다른 전공분야보다는 훨씬 다른 여러 종류를 보이고 있다. 즉, 종교적 이유, 다른 사람들에게 봉사할 수 있는 직업이기 때문에, 쉽게 취업을 할 수 있어서, 결혼 후에도 직업을 가질 수 있기 때문에, 외국으로 쉽게 취업할 수 있어서 등이 간호학을 선택한 이유로 보고되고 있다. 흥미나 적성에 맞다고 생각하기 때문에 간호학을 택한 학생의 수는 다른 과에 비하여 훨씬 적다. 이러한 흥미나 적성 때문이 아닌 여러 가지 다른 이유들로 인하여 간호학을 택한 경우에 특히 간호학에 쉽게 흥미를 잃어버리는 것을 볼 수 있다. 간호학에 현실적인 개념을 가지고 있는 학생들일수록 추상적이고 현실적인 개념을 가지고 있는 학생들보다 더 간호학에 지속적인 흥미를 가지며 중간에 탈락하는 율이 훨씬 적다는 것이 많은 연구에서 보고되었다. 또한 흥미나 적성 때문에 간호학을 택하였다는 학생들이 다른 과로 전과를 희망하는 율이 낮다는 것도 보고되었다. 둘째, 교과내용자체나 실습에 대한 불만족이다. 간호학에 대한 체계적인 교과내용의 결여, 과중한 과제물, 임상실습에서의 욕구불만, 실습으로 인한 부담, 지식과 실습의 차이점에 대한 갈등 등이 주요 이유로 보고되고 있다. 대부분의 연구들이 이 교과목이나 실습에 대한 불만족, 특히 실습경험에서의 갈등을 학생들이 흥미를 잃는 가장 중요한 요인이 되는 것으로 보고하고 있다. 어느 한 연구에서는 응답자의 90$\%$가 임상실습에 만족하지 못한다고 응답하였으며 그들 중의 88$\%$가 실습감독에 문제가 있다고 생각한다고 보고하였다. 셋째, 교수들에 대한 불만족이다. 대부분의 연구들이 학년이 올라가면 갈수록 교수에 대한 신뢰도가 낮아지며 또한 그에 비례하여 간호학에 대한 만족도가 낮아진다고 보고하고 있다. 교육내용에 대한 전문지식의 결여, 학생들과의 인간적인 관계의 결여, 교수법에 대한 불만족 등이 교수에 대한 불만의 주요내용으로 보고되었다. 미래의 간호에 부응할 학생교육 계속적인 사회적 변동과 더불어 급격하게 변화하고 있는 일반인들의 건강에 대한 요구도와 앞에서 기술한 문제점 등을 감안할 때 학생들에게 동기를 부여하고 간호학에 확신감을 가질 수 있도록 준비시키므로써 간호환경에서 실망하기보다는 오히려 그것을 받아들여 변화하는 사회요구에 책임감을 느낄 수 있도록 교육시키는 것이 미래의 간호학생을 준비시키는데 가장 중요한 요인이라고 할 수 있겠다. 이러한 교육을 위하여 다음의 두가지 안을 제시한다. 1. 교수와 학생간의 관계-서로의 좋은 동반자 : 교수들이 학생에게 미치는 영향, 특히 학생들의 성취도에 대한 영향에 대하여는 이미 많은 연구가 시행되었다. Tetreault(1976)가 간호학생들의 전문의식에 영향을 미치는 요인에 대하여 연구한 바에 의하면 다른 어느 것보다도 교수의 전문의식여부가 학생들의 전문의식 조성에 가장 큰 영향을 미친다고 하였다. 또한 학생들이 교수에게 신뢰감을 가지고 있을때, 교수들이 전문가로서의 행동을 하는 것을 보았을때 비로서 배움이 증가된다고 하였다. Banduras는 엄격하고 무서운 교수보다는 따뜻하고 인간적인 교수에게 학생들이 더 Role Model로서 모방하려는 경향을 나타낸다고 보고 하였다. 그러면 어떻게 학생에게 신뢰받는 교수가 될 수 있겠는가? apos;학생들의 요구에 부응할 때apos;라고 한마디로 표현할 수 있을 것이다. Lussier(1972)가 언급한 것처럼 학생들의 요구에 부응하지 못하는 교육은 Piaget이 언급한 교육의 기본 목표, 즉 개인에게 선배들이 한 것을 그대로 반복하여 시행하도록 하는 것이 아니라 새로운 것을 시도할 수 있는 능력을 가지게 하는 목표에는 도달할 수 없으며 이러한 목표는 간호학에도 가장 기본이 되어야 할 기본목표이기 때문이다. 학생들이 현재 어떤 요구를 가지고 있으며 또 어떤 생각을 하고 있는지 계속 파악하고 있는 것이 학생요구에 부응하는 교육을 할 수 있는 기본조건이 될 것이다. 의외로 많은 교수들이 학생들을 이해하고 있다고 생각하고 있으나 잘못 이해하고 있는 경우가 많다. 표 2는 현 간호학생들이 생각하고 있는 가치관과 문제점을 파악하고 또 교수가 그 가치관과 문제점을 어느 정도 파악하고 있는지 알아보기 위하여 일개 4년제 대학 200여명의 학생과 그 대학에 근무하는 18명의 교수진을 대상으로 질문한 결과를 간략하게 보고한 것이다. 또한 여기에서 학생이 보고하는 가치관, 문제점, 교수에게 바라는 점이 교수가 이해하고 있는 것과 차이가 있다는 것도 보여주고 있다. 우리가 학생들의 요구를 파악할 수 있도록 귀를 기울이고 이해하며, 그 요구에 부응하려고 노력할때 진정한 교수와 학생간의 관계가 이루어질 수 있을 것이며 이때 비로서 우리는 apos;partnershipapos;을 이룰 수 있을 것이다. 이때 간호학에 대한 실망은 줄어들 수 있을 것이며 우리도 학생들에게 전문가적인 태도를 함양시켜줄 수 있는 기회를 부여할 수 있을 것이다. 이렇게 될때 앞으로 기다리고 있는 미지의 의무에 효과적으로 또 적극적으로 대처할 수 있는 자질을 형성한 학생들을 준비해 낼 수 있을 것이다. 2. 간호모델에 의한 교과과정의 확립과 임상실습에의 적용 : 교과과정이 학생들의 모양을 만들어주는 하나의 기본틀이라고 말할 수 있다면 미래의 요구에 부응하는 학생들을 준비시키기 위하여 지금까지와는 다른 새로운 방향의 교과과정이 필요하다는 것은 재론할 필요가 없을 것이다. 이미 진취적인 간호대학에서는 guided design systems approach 또는 integrated curriculum 등의 새로운 교과과정을 시도하고 있음은 알려진 사실이다. 물론 간호모델에 준한 교과과정을 발전시키는데 대한 장점과 이에 수반되는 여러가지 새로운 문제점에 대하여 많은 논란이 있으나 모든 교과과정이 처음 시도될 때부터 완전한 것이 있을 수 없으며 시간이 지남에 따라 성숙되는 것임을 감안해 볼 때 이러한 새로운 교과과정에의 시도는 미래의 새로운 간호방향에 필수적인 사업이라고 하겠다. 이러한 교과과정을 개발하는데 몇가지 게안점을 첨부하려 한다. (1) 새로운 교과과정의 개발은 처음부터 끝까지 모든 교수진의 협력과 참여로 이루어져야 한다. (2) 비록 처음에는 어렵고 혼란이 있더라도 교과과정은 의학모델이 아닌 간호모델을 중심으로 이루어져야 한다. (3) 간호모델에서 다루어지는 개념들은 모두 직접 간호업무에 적용될 수 있는 것으로 선택되어야 한다. (4) 교과과정의 결과로 배출되는 학생들의 준비정도는 그 지역사회에 적합하여야 한다. (5) 그 지역사회의 고유한 문화적 요소가 포함되어야 한다. 아직 우리는 간호분야 내부의 갈등을 해결하지 못하고 있는 시기에 있다. 우리 내부의 문제점을 잘 해결할 수 있을때 외부와의 갈등에 잘 대처할 수 있을 것이다. 내부의 갈등을 잘 해결하기 위한 힘을 모으기 위하여는 동반자, 즉 교수와 학생, 간호교육자와 임상간호원 등이 서로 진정한 의미의 동반자 될때 가장 중요한 해결의 실마리가 될 것이다.

• Journal of Animal Science and Technology
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• v.45 no.2
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• pp.229-240
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• 2003

An in vitro test and a broiler feeding trial were conducted to test the effect of hydrothermal treatment of wheat bran on phytate-P degradation and it’s feeding effect on performance of broilers. Hydrothermal treatment of wheat bran was carried out at 55$^{\circ}C$ with pH 5.5 buffer solution. Phytate-P content of wheat bran decreased quadrically as the wheat bran: buffer solution ratio increased from 1:0.5 to 1:5. Phytate-P degradation was not significantly affected by incubation times above 10 min., drying temperature (55$^{\circ}C$, 65$^{\circ}C$ and 75$^{\circ}C$) or pH of the buffer solution (5.5 and 7.0). A feeding trial was conducted with 240 sex separated d-old broiler chickens (Ross$^{\circledR}$). Broilers were randomly housed to 24 cages of 10 birds each. Six cages (3 of each sex) were assigned to 4 treatments: Control-normal level of non-phytate-P (NPP); LP-low NPP treatment which had 0.1% lower NPP than Control; LPWB-LP with wheat bran which provided 475 IU of plant phytase per kg diet; LPHWB-LP with hydrothermally treated wheat bran. Results of the feeding trial showed that broilers in the LP treatment gained significantly less than other treatments in starter period (1-21d) but only male broilers for growing LP gained significantly less than Control in the grower (22-35d) and overall period. There were no significant differences in weight gain among the birds of LPWB, LPHWB and Control. Feed intake during the overall period was not significantly different between LPWB and Control but that of LP was lower than LPHWB and that of LPHWB was lower than Control. Feed/gain ratio was significantly lower in LPHWB and LP than in Control and LPWP. Mortality was highest in LPHWB. Availability of crude fat, crude ash and Ca was significantly lower in LP than other treatments. Availability of P and Zn was higher in LPWB and LPHWB than in Control and LP. Availability of P, Mg and Zn was highest in LPHWP treatment. Excretion of P was significantly lower in low NPP treatments than in Control. Serum Ca level was highest whereas serum P level was lowest in LP. Tibial crude ash content was higher in wheat bran treatments, but lower in LP than Control. However, tibial Ca content was higher in Control and LP than wheat bran treatments. Tibial P content of LP and LPWB was lower than Control. However, tibial content of Fe was highest in LP. It was concluded that wheat bran, a source of plant phytase, could be used in low NPP broiler diets to prevent the depression of performance. Reduction of P excretion can be achieved concomitantly. Hydrothermal treatment of wheat bran was effective in improving utilizability of some minerals but was not effective in improving performance of broilers.

• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.48-59
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• 1999

Objectives. This study was conducted to evaluate the association between upper extremity musculoskeletal symptoms and Rapid Upper Limb Assessment(RULA) in vehicle assembly line workers. The goal of this study is to show the feasibility of RULA as a checklist for work related musculoskeletal symptoms (WMSDs) in Korean workers. Methods. The total number of 199 people from the department of assembly and 115 people from the department of Quality Control(QC) in automotive plant were subjects for this cross sectional study. A standard symptom questionnaire survey has been used for the individual characteristics, work history, musculosketal symptoms and non-occupational covariates. The data were obtained by applying one-on-one interview for the all subjects. RULA has been applied for ergonomic work posture analysis and the primary ergonomic risk sure was computed by RULA method. Association between upper extremity musculoskeletal symptoms and RULA were assessed by multiple logistic regression analysis. Results. A total of 314 workers was examined. The prevalence of musculoskeletal symptoms by NIOSH case definition was 62.4%. The distribution of musculoskeletal symptoms by the part of the body turned out to be following; back:41.4%, neck: 32.8%, shoulder: 26.4%, arm: 10.5% and hand:29.3%. The relationship of the individual RULA scores were statistically significant for the prevalence of musculoskeletal symptoms. As the result of the multiple logistic regressioin analysis, grand final score (OR=2.250 95% CI: 1.402-3.612) was associated with musculoskeletal symptoms in any part of the body.; upper arm score(OR=1.786 95% CI: 1.036-3.079) and posture score A(OR=1.634 95% CI: 1.016-2.626) in neck; muscel use score(OR=3.076 95% CI:1.782-5.310) and posture score A(OR=1.798 95% CI: 1.072-3.017) in shoulder; upper arm score(OR=1.715 95% CI: 1.083-2.715) and muscel use score(OR=2.057 95% CI:1.303-3.248) in neck & shoulder; muscle use score(OR=10.662 95% CI: 3.180-35.742) in arm; writst/wist score(OR=2.068 95% CI: 1.130-3.786) and muscle use score(OR=2.215 95% CI: 1.284-3.819) in hand & wrist.; muscle use score of trunk (OR=2.601 95% CI: 1.147-5.901) in back. Conclusions. Musculoskeletal symptoms of the extremities were strongly associated with individual RULA body score. These results show that RULA can be used as a useful assessment tool for the evaluation of musculoskeletal loading which is known to contribute to work-related musculoskeletal disorders. RULA also can be used as a screening tool or incorporated into a wider ergonomic assessment of epidemiological, physical, mental, environmental and organizational factors. As shown in this study, complement of the analysis system for the other risk factors and characterizing between the upper limb and back part will be needed for future work.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.203-207
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• 2010

Purpose: Hepatitis B is infection caused by Hepatitis B virus (HBV). Currently, there are several methods, Kits and equipments for conducting Hepatitis B test. Due to ununiformed methods, it would cause some differences. To manage these differences, it needs process evaluating function of test system and reagent using particular standard substance. The aim of this study is to investigate tendency of RIA method's reagent used in Asan Medical Center through comparing several other test reagents using national standard substance. Materials and Methods: The standard substance in National Institute of Food and Drug Safety Evaluation's biology medicine consists of 5 things, 4 antigens and 1 antibody. We tested reagents using A, B company's Kits according to each test method. All tests are measured repeatedly to obtain accurate results. Results: Test result of "HBs Ag Mixed titer Performance panel" is obtained match rate compared S/CO unit standard with RIA method and EIA 3 reagents, CIA 2 reagents is that company A's reagent is 94.4% (17/18), 83.3% (15/18), B is 88.9% (16/18), 77.8% (14/18). Test result of "HBs Ag Low titer Performance panel" is obtain that EIA 2 reagents is shown 7 posive results, CIA 3 reagents is 11, and RIA method's company A's reagent is 3, B is 2 of 13 in low panel. "HBV surface antigen 86.76 IU/vial" tested dilution. A is obtain positive results to 600 times(0.14 IU/mL), B is 300 times (0.29 IU/mL). Case of "HBV human immunoglobulin 95.45 IU/vial", A is shown positive result to 10,000 times (9.5 mIU/mL) and B is 4,000 times (24 mIU/mL). Test result of "HBs Ag Working Standards 0.02~11.52 IU/mL" is shown that Company A's kit concentration level was 0.38IU/mL, company B was 2.23 IU/mL and higher level of concentration was positive results. Conclusion: When comparing various test reagents and RIA method according to National Standard substances for Hepatitis B test, we recognized that there were no significant trends between reagents. For hepatitis B virus antigen-antibody titers even in parts of the test up to 600 times the antigen, antibodies to 10,000 times the maximum positive results could be obtained. Therefore, we confirmed that results from Asan Medical Center are performed smoothly by reagents and system for hepatitis B virus test.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.213-221
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• 2001

Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.751-769
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• 1998

This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.

• Journal of Korean Society of Environmental Engineers
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• v.30 no.6
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• pp.642-652
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• 2008

The aim of our research was to apply experimental design methodology in the optimization condition of Photo-Fenton oxidation of the residual livestock wastewater after the coagulation process. The reactions of Photo-Fenton oxidation were mathematically described as a function of parameters amount of Fe(II)($x_1$), $H_2O_2(x_2)$ and pH($x_3$) being modeled by the use of the Box-Behnken method, which was used for fitting 2nd order response surface models and was alternative to central composite designs. The application of RSM using the Box-Behnken method yielded the following regression equation, which is an empirical relationship between the removal(%) of livestock wastewater and test variables in coded unit: Y = 79.3 + 15.61x$_1$ - 7.31x$_2$ - 4.26x$_3$ - 18x$_1{^2}$ - 10x$_2{^2}$ - 11.9x$_3{^2}$ + 2.49x$_1$x$_2$ - 4.4x$_2$x$_3$ - 1.65x$_1$x$_3$. The model predicted also agreed with the experimentally observed result(R$^2$ = 0.96) The results show that the response of treatment removal(%) in Photo-Fenton oxidation of livestock wastewater were significantly affected by the synergistic effect of linear terms(Fe(II)($x_1$), $H_2O_2(x_2)$, pH(x$_3$)), whereas Fe(II) $\times$ Fe(II)(x$_1{^2}$), $H_2O_2$ $\times$ $H_2O_2$(x$_2{^2}$) and pH $\times$ pH(x$_3{^2}$) on the quadratic terms were significantly affected by the antagonistic effect. $H_2O_2$ $\times$ pH(x$_2$x$_3$) had also a antagonistic effect in the cross-product term. The estimated ridge of the expected maximum response and optimal conditions for Y using canonical analysis were 84 $\pm$ 0.95% and (Fe(II)(X$_1$) = 0.0146 mM, $H_2O_2$(X$_2$) = 0.0867 mM and pH(X$_3$) = 4.704, respectively. The optimal ratio of Fe/H$_2O_2$ was also 0.17 at the pH 4.7.

• The Korean Journal of Pesticide Science
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• v.18 no.3
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• pp.130-140
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• 2014

Recently, some of the previous studies reported that tolclofos-methyl is still exist in ginseng cultivated soil, even though it is has been banned for ginseng. Therefore, the current study was aimed to examine the levels of absorption and translocation of tolclofos-methyl from ginseng cultivated soil to ginseng root and leaf stem for the period of 1 year. For this study, ginseng plants were transplanted in pots and treated with $5.0mg\;kg^{-1}$ of tolclofos-methyl (50% WP). At the end of each interval periods (every three months) the samples (soil, roots and leaf stems) were collected and analyzed the absorption and translocation levels of tolclofos-methyl using gas chromatography and mass spectrometry (GC-MS). The limit of quantitation of tolclofos-methyl was found to be $0.02mg\;kg^{-1}$ and 70.0~120.0% recovery was obtained with coefficient of variation of less than 10% regardless of sample types. In this study, a considerable amount of translocation of tolclofos-methyl residues were found in soil (4.28 to $0.06mg\;kg^{-1}$), root (7.09 to $1.54mg\;kg^{-1}$) and leaf stem (0.79 to $0.69mg\;kg^{-1}$). The results show that the tolclofos-methyl was absorbted and translocated from ginseng cultivated soil to ginseng root and ginseng leaf stem and found to be decreased time-coursely. Secondly, we were also analyzed soil, root and leaf stems samples from Hongcheon, Cheorwon, Punggi and Geumsan by GC-MS/MS (172 pesticides), LC-MS/MS (74 pesticides). In this study, 43 different pesticides were detected ($0.01{\sim}7.56mg\;kg^{-1}$) in soil, root and leaf stem. Further, tolclofos-methyl was detected 4 times separately in root sample alone which is less ($0.01{\sim}0.05mg\;kg^{-1}$) than their maximum residual limit (MRL) in ginseng. Consequently, the results from both studies indicate the residues of tolclofos-methyl found in ginseng cultivated soil and ginseng ensuring their safety level. Moreover, long-term evaluations are needed in order to protect the soil as well as ginseng free from tolclofos-methyl residues.

• Information Systems Review
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• v.12 no.1
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• pp.165-188
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• 2010

Recently public and finance SI (system integration) industry is called as 4D (difficult, dangerous, dirty, dreamless) industry because of low profit, overtime works and poor motivation of employees. Even some people think at SI industry to be a labor intensive industry instead of a high technology industry. The current study considers outside environmental change of SI industry as well as inside capability enhancement of SI companies. The study adopted action research method with the author's expertise and experiences as a head of a major SI company in Korea. The current research framework suggests 5 areas of profitability enhancement that offers propositions and implications. 5 areas of profitability enhancement are (1) policy improvement, (2) business portfolio innovation (3) sales capability reinforcement, (4) delivery capability reinforcement, and (5) cost management innovation. The five areas include 11 propositional factors and 21 implementation plans which were chosen from the profitability perspectives of SI companies.In order to successfully execute propositions and implementation plans of the framework, 3 years is needed and after 3 years profitability are expected to increase 10% higher than the current level. The framework, propositions and suggestions in this study are expected to offer a real contribution for SI companies that want to enhance competitiveness and profitability. Future extension of the current study to benchmarking the competitiveness and profitability between local companies and global companieswill bring a solid attention from industry and academics.