• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.4
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• pp.29-35
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• 2023

Purpose: The 2015 Middle East Respiratory Syndrome (MERS) outbreak and the recent COVID-19 pandemic have highlighted the lack of negative pressure isolation rooms and the fragility of the healthcare system. The need for healthcare facility transformation for respiratory infectious diseases has become more prominent due to COVID-19, and the purpose of this study is to provide a foundation for the rapid, economical, and safe construction of negative pressure isolation wards. Methods: This study analyzes the current status of hospitals that have been converted to negative pressure isolation rooms, and provides architectural plans and examples to provide a reference for bedroom change. Research data of this study have been obtained by analyzing the drawings of negative pressure isolation wards of nationally designated inpatient treatment beds and urgent isolation beds. In addition, the relevant literature of urgent isolation beds has been analyzed to derive bedroom change type. Result: In this study, a total of 21 isolation bed conversion methods have been presented. Implications: In order to change efficiently from a general ward to an isolation ward, it is necessary to consider the actual hospital's infectious disease transmission patterns and facility conditions.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.2
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• pp.37-44
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• 2018

Purpose: This study investigates the influences of coughing direction and healthcare worker's location on the transport characteristics of coughed particles in airborne infection isolation room (AIIR), which is commonly called negative pressure isolation room, with a downward ventilation system. Methods: Computational Fluid Dynamics (CFD) was used to simulate the airflow and for tracing the behavior of particles. Results: The results show that the airflow pattern and coughing direction have a significant influence on the characteristics of particle dispersion and deposition. When healthcare workers are in the isolation room with the patient who is lying on the bed, it is recommended to be located far from the anteroom to reduce the exposures from infectious particles. And when the patient is lying, it is more effective in removing particles than when the patient is in Fowler's position. Although it is an isolation room that produces unidirectional flow, coughing particles can spread to the whole room and a large number of particles can be deposited onto patient, bed, side rails, healthcare worker, ceiling, floor, and sidewall. Implications: Following the patients' discharge or transfer, terminal cleaning of the vacated room, furniture, and all clinical equipment is essential. Also, it is necessary to establish detailed standard operating procedure (SOP) in order to reduce the risk of cross-contamination.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.2
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• pp.94-98
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• 2006

The mattresses and dust in the bed rooms of nine dermatophytes infected patients and nine domestic animals were examined by the KOH method. Microsporum canis species and Trichophyton mentagrophytes were isolated from cats and rabbits, respectively. The sources of infection of three patients were the M. canis infected cats raised by them and the four other patient's sources of infection were not confirmed. The sites of infection of the nine patients were their heads and those of the domestic animals were their heads and bodies. M. canis species were isolated from the infection sites of three cats and specimens collected by hair brush from the nine domestic animals. T. mentagrophytes species were also isolated from the infection sites of two rabbits. The seven patients had mattresses and bed room dust contaminated with M. canis.

• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.2
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• pp.73-82
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• 2017

Purpose: Since the facility guidelines for National Designated Isolation Unit wards(NDIUs) had been edited since 2016, all hospital who want to expand or install NDIU should adapt the new guidelines. Instead of providing area requirement, by the way, only essential or optional facility requirements are suggested except patient bedroom in the guidelines. So, as analyze area and area composition of the NDIUs, it could be expected that this study has a role as an area planing reference for not only NDIU but also another airborne infection isolation room. Methods: For the area analysis, 18 sample hospitals are selected among 2016 year applicants. All rooms in NDIUs are grouped as zones whether those are negative air pressurized or not and programed room or not. At the end, area of the zones are summarized and analysed a relationship between area increase and bed number by both correlation analysis and regression analysis. In addition, department usable and gross area per bed, N/G ratio, G/N ratio, and average area ratio of each zone is calculated. Results: First of all, rooms in none negative air pressurized zone of the NDIUs haven't shown a regular installation so that only those in negative air pressurized zone are targeted for the area analysis. Second of all, patient room unit(0.92) and support area(0.79), by correlation analysis, are correlated with total net area. Patient room unit(0.94) and total net area(0.79) are also shown a correlation with bed number. Department usable area($R^2=0.63$, y=36.278x + 102) and patient room unit area($R^2=0.89$, y= 27.993x - 0.8924) has a relationship with bed number by regression analysis. Average N/G is shown as 0.85 and G/N 1.36. Average area ratio of circulation, doffing area, patient room unit, and support area are 25.4%, 9.1%, 50.9%, and 14.6% in order. Implications: This study is a basic research for exploring the NDIUs guidelines to find resonable evidence to develop it for its practical use. Still, it is possibly expected that the guideline is to be developed by post occupancy evaluation in the area of where minimum requirement or facility grade needs to be defined, and by further studies with various perspectives.

• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.57-62
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• 2007

Non-vascularized free composite graft is one of the simple and effective reconstructive options, but its clinical use has been limited due to questionable survival rate. Early vascularization is essential for graft survival and is mainly carried out via recipient bed or repaired sites. This study was designed to investigate the effect of the lateral marginal approximations on the survival of the free composite flap using a model of skin-subcutaneous composite graft in rats. Thirty 1.5 ${\times}$ 1.5 $cm^2$ sized square shape composite flaps were elevated freely and reposed in place immediately on the dorsum of five Sprague-Dawley rats, and divided into five groups of six flaps. In all groups, graft bed was isolated with silastic sheet. In the group I, all sides of flap were repaired with blockage of silastic sheet insertion. Three, two, and one sides of flap were treated with same method in the group II, III, and IV respectively. Other sides of flaps were repaired without blockage, so all sides of flap were repaired in the group V. At 14 days later, the survived rate of each flap was evaluated according to the numbers of the repair sites. Histological examination was done for the evaluation of new vessel development quantitatively. Overall survived rates were increased with the number of repaired sites, but the group V only showed increased survival rate up to more than fifty percentile of the flap size with a significant difference statistically. New vessels were also increased in proportion with the number of repaired sites, and the repair site more than two had significant effect on the increased number of new vessels. In conclusion, at least more than three-fourth of flap circumference should be repaired in order to increase flap survival effectively under the condition of bed isolation.

• Transactions of the Korean hydrogen and new energy society
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• v.24 no.2
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• pp.128-135
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• 2013

The nuclear fuel cycle plant is composed of various subsystems such as a fuel storage and delivery system (SDS), a tokamak exhaust processing system, a hydrogen isotope separation system, and a tritium plant analytical system. Korea is sharing in the construction of the International Thermonuclear Experimental Reactor (ITER) fuel cycle plant with the EU, Japan, and the US, and is responsible for the development and supply of the SDS. Hydrogen isotopes are the main fuel for nuclear fusion reactors. Metal hydrides offer a safe and convenient method for hydrogen isotope storage. The storage of hydrogen isotopes is carried out by absorption and desorption in a metal hydride bed. These reactions require heat removal and supply respectively. Accordingly, the rapid storage and delivery of hydrogen isotopes are enabled by a rapid cooling and heating of the metal hydride bed. In this study, we designed and manufactured a vertical-type hydrogen isotope storage bed, which is used to enhance the cooling performance. We present the experimental details of the cooling performances of the bed using various cooling parameters. We also present the modeling results to estimate the heat transport phenomena. We compared the cooling performance of the bed by testing different cooling modes, such as an isolation mode, a natural convection mode, and an outer jacket helium circulation mode. We found that helium circulation mode is the most effective which was confirmed in our model calculations. Thus we can expect a more efficient bed design by employing a forced helium circulation method for new beds.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.163-173
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• 2014

This study was performed to investigate the current status of isolation precautions of multidrug resistant organisms(MDROs) in general hospitals with more than 200bed. The questionnaires were mailed from 3rd, April 2013 to 30th, April 2013. Methicillin resistant Staphylococcus aureus:(MRSA), vancomycin resistant Staphylococcus aureus:(VRSA), vancomycin resistant Enterococcus(VRE), multidrug-resistant Acinetobacter baumannii, carbapenem-resistant Enterobacteriaceae multidrug-resistant Pseudomonas aeruginosa were enrolled. MRSA(100.0%) and VRE(98.7%) were isolated respectively. VRE(97.3%) and MRSA(64.0%) were regulated strictly respectively. VRE(91.5%) and VRSA(50.7%) were isolated in a single room respectively. Hospital being located in Seoul(p<0.001), and beds(${\geq}600$)(p=0.008) were different significantly. The isolation space limitation(71.1%) was the highest difficulty. The development of refunding the costs of the extra supplies and other hygienic materials for infection control was discovered as the most urgent strategy.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.61-69
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• 2022

Purpose: In response to the rapid spread of COVID-19 in 2020, the government supported facilities and equipment through the 'Urgent Isolation Ward Expansion Project'. Design and remodeling of efficient negative pressure isolation facilities had to be done in a short period of time, and the performance gap between facilities was very large because the types of hospitals and wards of existing medical facilities were diverse. In order to secure the stability of isolation wards between medical facilities and reduce the facility gap, guidelines for planning isolation wards considering the diversity of each hospital should be appropriately presented. In consideration of these points, this study aims to provide basic data for future remodeling guidelines for each plan type of the negative pressure isolation ward first. Methods: We analyzed the plans before and after the change of 13 case hospitals that performed the urgent care bed expansion project for COVID-19 confirmed patients. Before the remodeling, the current status of the facility was analyzed according to the type of corridor, the location of the nursing station, and the location of the elevator. After remodeling, the flow of medical staff and patients, the flow of entry and exit of clean and contaminated items, and the space of negative pressure and non-negative pressure areas. Results: The ward type was divided into three types according to the corridor type and room arrangement: double loaded corridor type with two side wards, race track type with one side ward, and race track type with two side wards. Based on these three types, the standard floor plan type of the isolation ward was proposed in terms of the location of the elevator bank and Nurse station. Implications: When the existing general ward is converted into a negative pressure isolation ward, this study can be a basic data to present customized guidelines for each ward type.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.75-80
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• 2011

Purpose: Europe and U.S use multi-bed therapy rooms. Hereupon, this study aims to examine the safety when current one-bed therapy rooms in Seoul National University Hospital is changed into two-bed ones. Materials and Methods: This study evaluated external exposure by gamma radiation emitted from other patients and internal and external exposure caused by pollutions from other patients in case that Seoul National University Hospital installs a shielding wall between beds in existing therapy rooms. Results: When internal and external exposure was evaluated to evaluate safety of two-bed hospital rooms, 'isolation amount of patients' 5mSv exposure or below is received according to the Atomic Energy Act. Conclusion: With the increasing number of patients with thyoid cancer, patients using therapy rooms are on the rise. Therefore, improving one-person therapy rooms to two-person ones in line with international trend would increase cost reduction and management efficiency, and patients' alienation and isolation can be reduced to increase healing effects.

• Journal of Microbiology and Biotechnology
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• v.21 no.11
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• pp.1101-1108
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• 2011

The rise in global energy demand has prompted researches on developing strategies for transforming coal into a cleaner fuel. This requires isolation of microbes with the capability to degrade complex coal into simpler substrates to support methanogenesis in the coal beds. In this study, aerobic bacteria were isolated from an Indian coal bed that can solubilize and utilize coal as the sole source of carbon. The six bacterial isolates capable of growing on coal agar medium were identified on the basis of their 16S rRNA gene sequences, which clustered into two groups; Group I isolates belonged to the genus Rhizobium, whereas Group II isolates were identified as Chelatococcus species. Out of the 4 methods of whole genome fingerprinting (ERIC-PCR, REP-PCR, BOX-PCR, and RAPD), REP-PCR showed maximum differentiation among strains within each group. Only Chelatococcus strains showed the ability to solubilize and utilize coal as the sole source of carbon. On the basis of 16S rRNA gene sequence and the ability to utilize different carbon sources, the Chelatococcus strains showed maximum similarity to C. daeguensis. This is the first report showing occurrence of Rhizobium and Chelatococcus strains in an Indian coal bed, and the ability of Chelatococcus isolates to solubilize and utilize coal as a sole source of carbon for their growth.