• Title/Summary/Keyword: Case Management

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A Feasibility Study on the Deep Soil Mixing Barrier to Control Contaminated Groundwater (오염지하수의 확산방지를 위한 대체 혼합차수재의 적용에 관한 연구)

  • 김윤희;임동희;이재영
    • Journal of Soil and Groundwater Environment
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    • v.6 no.3
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    • pp.53-59
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    • 2001
  • There is a lot of method to manage the insanitary landfill but vertical cutoff walls have been widespreadly used and were installed into the subsurface to act as a barrier to horizontal groundwater flow, The stabilized material such as specialized cement or mixed soil with additives has been generally applied for the materials of the deep soil mixing barrier in korea. The amount of the stabilized material is dependent on the field conditions, because the mixing ratio of the material and the field soil should achieve a requirement in the coefficient of permeability, lower than 1.0$\times$$10^{7}$cm/sec. This study determined the quantity and optimized function ratio of the stabilized material in the formation process of the mixed barrier that was added with stabilized material on the field soil classified into SW-SC under USCS (Unified Soil Classification System). After that the fly ash and lime were selected as an additives an that could improve the function of the stabilized material and then the method to improve the functional progress in the usage of putting into the stabilized material as an appropriate ratio was studied and reviewed. The author used the flexible-wall permeameter for measuring the permeability and unconfined compressive strength tester for compressive strength, and in the view of environmental engineering the absorption test of heavy metals and leaching test regulated by Korean Waste Management Act were performed. As the results, the suitable mixing ratio of the stabilized material in the deep soil mixing barrier was determined as 13 percent. To make workability easy, the ratio of stabilized material and water was proven to be 1 : 1.5. With the results, the range of the portion of the additives(fly ash : lime= 70 : 30) was proven to be 20-40% for improving the function of the stabilized material, lowering of permeability. In heavy metal absorption assessment of the mixing barrier system with the additives, the result of heavy metal absorption was proved to be almost same with the case of the original stabilized material; high removal efficiency of heavy metals. In addition, the leaching concentration of heavy metals from the leaching test for the environmental hazard assessment showed lower than the regulated criteria.

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Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

Management of Patients with Traumatic Rupture of the Diaphragm

  • Hwang, Sang-Won;Kim, Han-Yong;Byun, Jung-Hun
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.348-354
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    • 2011
  • Background: Traumatic rupture of the diaphragm is an unusual type of trauma. In addition, it is difficult to diagnose because it can be accompanied by injuries to other organs. If it is not detected early, the mortality rate can increase due to serious complications. Diaphragmatic rupture is an important indicator of the severity of the trauma. The aim of this study was to investigate the factors affecting the incidence of complications and mortality in patients who had surgery to treat traumatic rupture of the diaphragm. Materials and Methods: The subjects were patients who had undergone a diaphragmatic rupture by blunt trauma or stab wounds except patients who were transferred to other hospitals within 3 days of hospitalization, from January 2000 to December 2007. This study was a retrospective study. 43 patients were hospitalized, and 40 patients were included during the study period. Among them, 28 were male, 12 were female, and the average age was 42 (from 18 to 80). Outcome predictive factors including hypoxia, ventilator application days, revised trauma score (RTS), injury severity score (ISS), age, herniated organs, complications, and the mortality rate were investigated. Results: Causes of trauma included motor vehicle crashes for 20 patients (50%), falls for 10 (25%), stab wounds for 8 (20%), and agricultural machinery accidents for 2 (5%). Most of the patients (36 patients; 90%) had wound sites on the left. Diagnosis was performed within 12 hours for most patients. The diaphragmatic rupture was diagnosed preoperatively in 27 patients (70%) and in 12 patients (30%) during other surgeries. For surgical treatment, thoracotomy was performed in 14 patients (35%), laparotomy in 11 (27.5%), and a surgery combining thoracotomy and laparotomy in 15 patients (37.5%). Herniated organs in the thoracic cavity included the stomach for 23 patients (57.5%), the omentum for 15 patients (37.5%), the colon for 10 patients (25%), and the spleen for 6 patients (15%). Accompanying surgeries included splenectomy for 13 patients (32.5%), lung suture for 6 patients (15%), and liver suture for 5 patients (12.5%). The average hospital stay was $47.80{\pm}56.72$ days, and the period of ventilation was $3.90{\pm}5.8$ days. The average ISS was $35.90{\pm}16.81$ (11~75), and the average RTS was $6.46{\pm}1.88$ (1.02~7.84). The mortality rate was 17.5% (7 patients). Factors affecting complications were stomach hernia and age. Factors affecting the mortality rate were ISS and RTS. Conclusion: There are no typical symptoms of the traumatic rupture of the diaphragm by blunt trauma. Nor are there any special methods of diagnosis; in fact, it is difficult to diagnose because it accompanies injuries to other organs. Stab wounds are also not easy to diagnose, though they are relatively easy to diagnose compared to blunt trauma because the accompanying injuries are more limited. Suture of the diaphragm can be performed through the chest, the abdomen, or the thoracoabdomen. These surgical methods are chosen based on accompanying organ injuries. When there are many organ injuries, there are a great number of complications. Significant factors affecting the complication rate were stomach hernia and age. ISS and RTS were significant as factors affecting the mortality rate. In the case of severe trauma such as pelvic fractures, frequent physical examinations and chest X-rays are necessary to confirm traumatic rupture of the diaphragm because it does not have specific symptoms, and there are no clear diagnosis methods. Complications and the mortality rate should be reduced with early diagnosis and with treatment by confirming diaphragmatic rupture in the thoracic cavity and the abdomen during surgery.

Psychology and Quality of Life in Cancer Patients on Radiation Therapy (방사선치료 중인 암 환자의 심리와 삶의 질)

  • Yang Jong-Chul;Chung Woong-Ki
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.271-279
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    • 2004
  • Purpose: The object of this study Is to investigate sociodemographic and clinical characteristics, psychology, self-esteem and quality of life in cancer patients on radiation therapy and to provide useful information for therapeutic approach to cancer patients on radiation therapy. Materials and Methods: The subjects were 36 patents who had been treated with radiation therapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients on radiation therapy were investigated, and symptom checklist-90-revised, Rosenberg Self-esteem Scale for self esteem, World Health Organization Quality of Life Assessment Instrument for quality of life were administered to subjects. And Spearman's correlation analysis was used among these. Result : The tendency of somatization, depression, anxiety and hostility in cancer group were significantly higher than normal group. Self esteem and quality of life in cancer group were significantly lower than normal group. No significant difference was found in comparison of psychology, self esteem and qualify on life according to sociodemographic variables. Among clinical characteristics, in the presence of metastasis in cancer patients, the scores of anxiety, phobia and paranoid ideation were higher In patients with pain, the score of somatization was higher And in case of weight loss, the score of somatization was higher. The higher score of depression, anxiety and hostility were significantly associated with lower self-esteem. And higher score of somatization, depression, anxiety and hostility were significantly associated with lower quality of life. Conclusion: Understanding and management of psychological symptoms, such as somatization, depression, anxiety, and hostility, and pain control are necessary to improve quality of life in cancer patients on radiation therapy.

Investigation and Risk Assessment of Asbestos-Containing Materials used in Buildings (건축물에 사용된 석면함유물질(ACMs)의 조사 및 위해성 평가)

  • Kim, Hong-Kwan;Chon, Young Woo;Roh, Young Man;Hong, Seung-Han;Kim, Chi-Nyon;Lee, Ik-Mo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.28 no.1
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    • pp.35-42
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    • 2018
  • Objectives: The objectives of this study are to research the usage characteristics of asbestos-containing building materials and to conduct exposure risk assessment by applying no. 2016-230 "Methods of Risk Assessment of Asbestos-Containing Buildings" from the Ministry of Environment. Methods: One hundred buildings located in the Seoul and Gyeonggi-Incheon area were chosen, with 29 in Seoul, 20 in Incheon, and 51 in Gyeonggi-do Province. The year of construction was divided between three buildings in the 1970s, 11 buildings in the 1980s, 42 buildings in the 1990s, and 44 buildings in the 2000s. The bulk samples were analyzed by using a polarizing microscope after a pre-process using a stereomicroscope in a hood with an HEPA filter. This study defined ACMs(asbestos-containing materials) as asbestos when the content percentage was over 1% in the analysis result. Methods and standards of risk assessment of asbestos-containing building materials were conducted by refering to no. 2016-230 "Method of Risk Assessment of Asbestos-Containing Buildings" from the Ministry of Environment. The risk of exposure to ACMs was rated by a score based on three categories(high, middle, low risk of asbestos exposure). Results: In this study, 30 of the 100 buildings and 36 of the 416 bulk samples(8.6%) were found to have had asbestos. Asbestos was detected at a high rate, in 18 out of 42, in buildings constructed in the 1990s and at the lowest rate(7 out of 44) for buildings constructed in the 2000s. As a result of the evaluation according to no. 2016-230 "Method of Risk Assessment of Asbestos-Containing Buildings" of the Ministry of Environment, the risk assessment level of two asbestos-containing building materials was found to be "Medium", and 28 buildings materials were found to be at the "Low" level. Conclusion: As asbestos is regulated by the government, it is required to conduct active management and implemention by introducing methods of risk assessment of asbestos exposure that are supported by data from various situations. In the case of buildings owned by individuals, building owners should be aware of the risk of exposure to asbestos.

Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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Dynamics of Technology Adoption in Markets Exhibiting Network Effects

  • Hur, Won-Chang
    • Asia pacific journal of information systems
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    • v.20 no.1
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    • pp.127-140
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    • 2010
  • The benefit that a consumer derives from the use of a good often depends on the number of other consumers purchasing the same goods or other compatible items. This property, which is known as network externality, is significant in many IT related industries. Over the past few decades, network externalities have been recognized in the context of physical networks such as the telephone and railroad industries. Today, as many products are provided as a form of system that consists of compatible components, the appreciation of network externality is becoming increasingly important. Network externalities have been extensively studied among economists who have been seeking to explain new phenomena resulting from rapid advancements in ICT (Information and Communication Technology). As a result of these efforts, a new body of theories for 'New Economy' has been proposed. The theoretical bottom-line argument of such theories is that technologies subject to network effects exhibit multiple equilibriums and will finally lock into a monopoly with one standard cornering the entire market. They emphasize that such "tippiness" is a typical characteristic in such networked markets, describing that multiple incompatible technologies rarely coexist and that the switch to a single, leading standard occurs suddenly. Moreover, it is argued that this standardization process is path dependent, and the ultimate outcome is unpredictable. With incomplete information about other actors' preferences, there can be excess inertia, as consumers only moderately favor the change, and hence are themselves insufficiently motivated to start the bandwagon rolling, but would get on it once it did start to roll. This startup problem can prevent the adoption of any standard at all, even if it is preferred by everyone. Conversely, excess momentum is another possible outcome, for example, if a sponsoring firm uses low prices during early periods of diffusion. The aim of this paper is to analyze the dynamics of the adoption process in markets exhibiting network effects by focusing on two factors; switching and agent heterogeneity. Switching is an important factor that should be considered in analyzing the adoption process. An agent's switching invokes switching by other adopters, which brings about a positive feedback process that can significantly complicate the adoption process. Agent heterogeneity also plays a important role in shaping the early development of the adoption process, which has a significant impact on the later development of the process. The effects of these two factors are analyzed by developing an agent-based simulation model. ABM is a computer-based simulation methodology that can offer many advantages over traditional analytical approaches. The model is designed such that agents have diverse preferences regarding technology and are allowed to switch their previous choice. The simulation results showed that the adoption processes in a market exhibiting networks effects are significantly affected by the distribution of agents and the occurrence of switching. In particular, it is found that both weak heterogeneity and strong network effects cause agents to start to switch early and this plays a role of expediting the emergence of 'lock-in.' When network effects are strong, agents are easily affected by changes in early market shares. This causes agents to switch earlier and in turn speeds up the market's tipping. The same effect is found in the case of highly homogeneous agents. When agents are highly homogeneous, the market starts to tip toward one technology rapidly, and its choice is not always consistent with the populations' initial inclination. Increased volatility and faster lock-in increase the possibility that the market will reach an unexpected outcome. The primary contribution of this study is the elucidation of the role of parameters characterizing the market in the development of the lock-in process, and identification of conditions where such unexpected outcomes happen.

Classification of submitted KSNMT dissertation (대한핵의학기술학회 투고 논문 분류)

  • Han, Dong-Chan;Lee, Hyuk;Hong, Gun-Chul;Ahn, Byeong-Ho;Choi, Seong-Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.65-69
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    • 2017
  • Purpose KSNMT(Korea Society of Nuclear Medicine Technology) stepping first step in 1997, has published first journal related with nuclear medicine technology in 1985. With classifying In Vivo Session Dissertation reported in the entire journal, trend of the Dissertation will be studied. Materials and Methods Dissertations which published from 1985 to first half of 2016 in the journal are classified with presentation form and with scanner, And all the data is organized with Excel program. Through the data, the number of dissertations published in each year, the number of dissertation published in details, and keyword distributions in each period are analyzed. Results The number of In-vivo section dissertations was 1151 and the number of In-vivo section dissertations that have common subject with In-vitro section was 28. The number of In-vivo section dissertation in 1980s was 46, in 1990s was 149, in 2000 was 467 and from 2010 to the first half of 2016 was 517. The number of dissertation with original articles was 571, with abstract was 529, with symposium was 31, with special lecture was 25, with review was 11, with interesting image was 7, with poster was 3 and with case report was 2. With symposium and special lecture excluded, which count 56, the number of dissertation with PET was 319, with Planar was 302, with SPECT was 172, with radiopharmaceutical was 113, with guard and safety management 103, with BMD was 28, etc. was 86. The number of dissertation about oncology was 201, about scanner was 179, about cardiovascular and circulatory system was 102, about safe environment was 82, about musculoskeletal system was 76, about nervous nuclear medicine was 66, about quality assurance was 61, about genitourinary system was 56, about endocrine system was 49, about digestive system was 44, about Therapy, about industrial safety was 24, about molecular imaging was 15, infection and inflammation was 9, about respiratory system was 8 and etc. was 108. The mostly used keyword through 1999 to 2005 was PET and through 2006 to 2016 was PET/CT. Conclusion To encourage various dissertations to be submitted, Korea Society of Nuclear Medicine should analyze date about not only about dissertations that are already published, but also about various research materials. Moreover, Korea Society of Nuclear Medicine also have to provide technical support such as sharing big data from homepage and systematical support to its member to publish dissertation that has high impact factor. It is important each individual researcher to have continuing effort as well as each organization cooperation.

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Introduction of Kjeldahl Digestion Method for Nitrogen Stable Isotope Analysis (δ15N-NO3 and δ15NNH4) and Case Study for Tracing Nitrogen Source (Kjeldahl 증류법을 활용한 질산성-질소 및 암모니아성-질소 안정동위원소비 분석 및 질소오염원 추적 사례 연구)

  • Kim, Min-Seob;Park, Tae-Jin;Yoon, Suk-Hee;Lim, Bo-La;Shin, Kyung-Hoon;Kwon, Oh-Sang;Lee, Won-Seok
    • Korean Journal of Ecology and Environment
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    • v.48 no.3
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    • pp.147-152
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    • 2015
  • Nitrogen (N) loading from domestic, agricultural and industrial sources can lead to excessive growth of macrophytes or phytoplankton in aquatic environment. Many studies have used nitrogen stable isotope ratios to identify anthropogenic nitrogen in aquatic systems as a useful method for studying nitrogen cycle. In this study to evaluate the precision and accuracy of Kjeldahl processes, two reference materials (IAEA-NO-3, N-1) were analyzed repeatedly. Measured the ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ values of IAEA-NO-3 and IAEA-N-1 were $4.7{\pm}0.2$‰ and $0.4{\pm}0.3$‰, respectively, which are within recommended values of analytical uncertainties. Also, we investigated spatial patterns of ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ in effluent plumes from a waste water treatment plant in Han River, Korea. ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ values are enriched at downstream areas of water treatment plant suggesting that dissolved nitrogen in effluent plumes should be one of the main N sources in those areas. The current study clarifies the reliability of Kjeldahl analytical method and the usefulness of stable isotopic techniques to trace the contamination source of dissolved nitrogen such as nitrate and ammonia.

Investigation of Microbial Contamination in Oenanthe javanica at Postharvest Environments (미나리(Oenanthe javanica) 수확 후 처리 환경에서의 위생지표세균 및 병원성 미생물 오염도 조사)

  • Kim, Yeon Rok;Lee, Kyoung Ah;Choi, In-Wook;Lee, Young-Ha;Kim, Se-Ri;Kim, Won-Il;Ryu, Song Hee;Lee, Hyo Sub;Ryu, Jae-Gee;Kim, Hwang-Yong
    • Journal of Food Hygiene and Safety
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    • v.29 no.4
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    • pp.268-277
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    • 2014
  • This study assessed microbiological hazards at postharvest stage of dropwort farms (A, B, C, D, E, F, G, H, I) located in 4 different areas in Korea. The samples were assessed for sanitary indication bacteria (total aerobic bacteria, coliform, and Escherichia coli) and pathogenic bacteria (Escherichia coli O157:H7, Listeria monocytogenes, Staphylococcus aureus and Bacillus cereus). Total aerobic bacteria and coliform in 9 dropwort farms were detected at the levels of 0~7.00 and 0~4.25 log CFU/g, mL, of $100cm^2$. In particular, microbial contamination in worker's hand showed higher than cultivation environment factors. Escherichia coli was detected in several farms of soil, irrigation water, washing water and worker's hand and also, dropwort in these farms was contaminated with E. coli (positive reaction). In case of pathogenic bacteria, B. cereus was detected at the highest levels in soil. S. aureus was detected qualitatively from only one sample of dropwort washed by water. E. coli O157:H7 and L. monocytogenes were not detected. Although dropwort pass through 2 process (trimming and washing), the microbial contamination was not differ significantly before and after which indicates that current washing system was not effect on reduction of microorganism. From these results, the postharvest environment and workers have been considered as cross-contamination factors. Thus, processing equipments and personal hygiene should be managed to reduce the microbial contamination of dropwort. Accordingly management system such as good agricultural practices (GAP) criteria is needed for the safety of dropwort