• Journal of the Korean Institute of Landscape Architecture
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• v.31 no.5
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• pp.58-72
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• 2003

Rooftop greenery has been used as a way to solve urban environmental problems by creating green space in densely populated cities. This study was carried out to suggest more effective designs for roof-garden at hospitals through a post-occupancy evaluation. The roofgarden of Asan Medical Center was evaluated with regards to setting, proximate environmental context, users, and design activity by a multi-method including plan investigations, observations, in-depth interviews and questionnaires. The results are summarized as follows; the users' main activities included resting, walking, and talking. A number of users were observed at shaded spaces sitting on such things as benches, pergolas, and shelters. The satisfaction of the users showed high satisfaction level except in the amount of shade, facilities, and shelter. The variables affecting a overall satisfaction were ‘accessibility’, ‘safety’, ‘quality of surroundings’, and ‘suitability for speculation’. By comparing the design concept with using pattern, designer's intention was not reflected sufficiently in several aspects such as ‘event deck for therapy programs’, ‘grove and path’, and ‘low planters’. This study suggests some design implications; it is necessary to furnish shaded sitting places for passive behaviors and pathways for walking or a light exercise. A wind-break wall with glass windows could widen the users' views in a limited space. Natural shade like tree shade or pergola are more desirable than artificial shades. As for the vertical location of the roofgarden, the middle floor could be better than top area for accessibility. Characteristics of building and users should be considered in detail to provide distinct spaces. Proper technical standards for the greening of artificial ground should be established.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.133-138
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• 2016

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.24 no.4
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• pp.248-254
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• 1991

The demersal fishes of Asan Bay were collected by an otter trawl in August 1990 to determine optimum sample size for the analysis of community structure. A total of 17 species comprising 957 individuals and 21,840 grams in biomass was collected. Predominant species were Cynoglossus joyneri, Thrissa koreana, Hexagrammos otakii and Johnius belengerii. Coefficients of variation for fish numbers in ten replicate tows ranged from 2.2 to $385.1\%$ for four abundant species and from 52.2 to $162.0\%$ when all species were considered. The cumulative number of species increased rapidly until 4 hauls, and less than 1 species per haul in average was added thereafter. The cumulative diversity index reached nearly an asymptote value when three of samples were combined. Variance in the number of individuals diminished as the sample size increased. The ratio of variance to mean numbers (dispersion index) was not significantly different from the unity when first 4-haul samples were combined. Four of 20-minute trawl haul are proposed to be a proper sampling size for the unbiased estimation of abundance in the study area.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.1
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• pp.21-32
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• 2009

Generally, an adult cleft lip or/and palate patient shows some amount of maxillary deficiency due to limitation of bony growth caused by heavy scars resulted from previous operations such as a cheiloplasty and/or a palatoplasty at an early child age. To solve the problem, advancement of the maxilla is usually required during orthognathic surgery. However, severe tensional force resulted from heavy scars on the palate and/or the lip, as well as the bony defect at the cleft area limited sufficient advancement of the maxillary segment and finally caused relapse of the reposed maxilla. Therefore, distraction osteogenesis of the maxilla was introduced for the successful maxillary advancement inthose kinds of patients. As both hard and soft tissues can be simultaneously and gradually extended with this technique, tensional force caused by heavy scars opposed to forward movement of the maxilla can be reduced to an extent not to develop severe relapse of the advanced maxilla. Since distraction osteogenesis of the maxilla was applied as one of standard protocols for the treatment of the patients with severe maxillary hypoplasia dueto cleft lip and/or palate, the devices for the distraction was improved to control the vectors of distraction with better and more stable. We have treated a 23-year-old male cleft patient with a severe maxillary hypoplasia using a newly developed a maxillary distraction device and a RP model for a pre-operative simulation surgery. As a result, we could successfully move the maxilla as we designed pre-operatively and also reduce much of operation time. Therefore, we report of the case to share our experience with colleagues.

• Perspectives in Nursing Science
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• v.6 no.1
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• pp.67-76
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• 2009

Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.37-43
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• 2012

Background: A lung bulla may rarely shrink as a result of an inflammation within the bulla or a closing of a bronchus involved in the inflammation process, which is termed 'autobullectomy'. The purpose of this study was to describe clinical features of patients with regressions of bullae during follow-up. Methods: We retrospectively reviewed the cases and individuals who showed unequivocal evidence of interval regressions in a pre-existing bulla. A total of 477 cases with a bulla >5 cm in diameter were screened manually. Thirty cases with bullae that showed regression during follow-up were selected. Results: Regressions of large bullae occurred in 30 of 477 cases (6.3%). The median age of those patients was 61 (range, 53~66) years and 87% of those patients were men. The main cause of a bulla was emphysema (80%). Among 30 cases, 16 cases had pneumonia in the lung parenchyma of the peribullous area. Another 7 cases had a regressed bulla accompanied by an air-fluid level within the bulla. The remaining 7 cases showed a spontaneous regression of the bulla without such events. Complete regression of a bulla occurred in 25 cases. A follow-up chest-X ray showed that in all cases except one, the bulla remained in a collapsed state after 24 months. Forced expiratory volume in one second ($FEV_1$) improved in 3 cases and the other 2 cases had increased forced vital capacity (FVC). In addition, total lung capacity (TLC) and residual volume (RV) decreased in another 2 cases. Conclusion: Regression of a lung bulla occurred not only after pneumonia or the presence of air-fluid level within the bulla, but also without such episodes. The clinical course of regression of a lung bulla varied. After regression of a bulla, lung function could be improved in some cases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.7 no.1
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• pp.70-79
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• 2006

In a recognition of regional innovation system approach for a co-development effort of the Cheonan-Asan area, Chungnam, this research conducted a survey from the local leaders of these two cities. The results of the survey show that most local leaders strongly agree with the necessity of co-development efforts, that some suggest a merge of two cities, and that some suggest industrial development programs in the city border. The local leaders expect that public officials should play a major role in co-development of the two cities while local leaders are disappointed with the public officials activities. They also highly expect that civilian leaders (NGOs) and professors should play important roles in this matter. Upon these results, the research suggests to formulate a cooperative regional innovation system for the co-development of the two neighboring cities by three steps.

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.771-778
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• 2006

Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of Intervention group significantly improved except for ferritin and TIBC regardless or ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.

• Korean Journal of Community Nutrition
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• v.14 no.6
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• pp.846-860
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• 2009

We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.

• Quality Improvement in Health Care
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• v.26 no.2
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• pp.56-65
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• 2020

Purpose:This study aims to understand and explore the subjective experiences of patient safety education among health care professionals in developing a patient safety curriculum in South Korea. Methods: A qualitative descriptive study was conducted through two focus group interviews in the period October-December 2018. Eleven participants who underwent patient safety education participated in each session. All interviews were recorded and transcribed as spoken, and qualitative content analysis was used to identify categories of discussion depicting participants' subjective experience with patient safety education. Results: A total of three categories and seven themes were identified out of 77 units of analysis. Topics were identified in the dimensions of a patient safety curriculum, as follows: (1) activities for patient safety; (2) principle of patient safety (five rights, ethics, patient participation) and patient participation; (3) leadership, teamwork, and communication; and (4) reporting and learning system for patient safety events. In the dimension of methods, (5) case and evidence-based education and (6) multidisciplinary and small group teaching were identified. Finally, in the dimension of the system, (7) policies for patient safety education were identified. Conclusion: Our findings indicate that patient safety education is a significant area for health care professionals. Health care professionals suggested that a systematic patient safety curriculum would improve their knowledge and attitude toward patient safety. Moreover, it enables them to better construct a safety environment in a hospital.