• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Korean Journal of Environment and Ecology
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• v.27 no.6
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• pp.676-689
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• 2013

This study is to understand the current situation of Wonju Stream, which flows through Wonju, Kangwon-do, and Seom River, the national river located outside of Wonju, by investigating all river areas using biotope type. Also, this research looked into the relationship between biotope and appearance of wild birds by investigating the location of their appearance. Biotope groups are 'scale', 'shape', and 'landscape'. And, biotope types are 'moisture', 'physical environment', and 'existence of vegetation'. Biotope subtypes are 'river area', 'physical environment', 'vegetation type', and 'usage of land'. Seom River is classified as 21 different sections, and Wonju Stream is classified as 19 different sections. Wild birds are investigated on breeding season, which was January and May of 2008. By marking each bird's location of appearance, it figured out properties of biotope according to the location of bird's appearance. 31 species, 795 birds in spring were founded, and 49 species, 4,348 birds are founded in winter at Seom River area. Also, 34 species, 427 birds in spring, and 33 species, 3,442 birds are founded in winter at Wonju Stream area. In winter, 26 species, 547 birds, and in spring, 12 species, 72 birds at natural river with estuaries in confluence of Seom River area are founded. Also, 34 species, 1412 birds in winter, and 24 species, 341 birds in spring are founded at natural river with estuaries and wetland plants. This means that because agricultural rivers have wide river width, slow flow speed, and many different types of biotope, these rivers can be good habitats for wild birds. The precise investigations and classifications of biotope, which especially are hard for linear rivers, were done to understand the whole and current situation of rivers. Furthermore, the data that shows the locations of wild birds can basically be used for a recovery of biological habitats, a constructing of ecological streams, a river-maintenance, and an enhancement of biodiversity of Wonju. Also, because the types of biotope are altered by rain, a continuous monitoring for maintaining ecosystem of rivers are highly needed.

• Korean Journal of Ecology and Environment
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• v.53 no.3
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• pp.241-254
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• 2020

Three introduced fish species, Japanese white crucian carp (Carassius cuvieri Temminck and Schlegel, 1846), bass (Micropterus salmoides Lacepède, 1802) and bluegill (Lepomis macrochirus Rafinesque, 1819), are dominant fishes in Korean freshwater ecosystem. In this study, we analyzed habitat environment conditions of these three species and their impacts to fish communities in streams across South Korea. Fish community data were obtained from the database of the Stream/River Ecosystem Survey and Health Assessment program maintained by the Ministry of Environment and the National Institute of Environmental Research, Korea. Our results showed that species richness and Shannon diversity of fish were higher at the presence sites of introduced fish than at the absence sites. However, when the abundance of these introduced fish species was increased, the species richness and abundance of fish were decreased. An association analysis showed that the introduced fish species had a low similarity in their appearance with some indigenous fishes such as Siniperca scherzeri and Channa argus and some endemic fishes of Korea such as Zacco koreanus, Sarcocheilichthys variegatus wakiyae, and Acheilognathus yamatsutae. In addition, the introduced fish species had a low appearance similarity with a large number of fishes in their association networks. Finally, our results presented that these introduced fish species influenced the negative impacts to the stream fish communities, and they were potential risk factors for fish community in Korean freshwater ecosystem. Therefore, it is necessary that continuous monitoring and establishment of management strategy for introduced fish species to preserve fish resource and biodiversity in the Korean streams.

• Korean Journal of Environmental Biology
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• v.34 no.4
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• pp.320-328
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• 2016

This study was conducted to provide important basic information about effective management of the marine environment at major inflow streams in Lake Andong and Lake Imha. The investigation was conducted 8 times from May, 2015 (AD1, AD2, IH1, IH2) to September, 2016 (AD3, AD4, IH3, IH4), and 8 surveyed sites were selected at Lake Andong (4 sites) and Lake Imha (4 sites). The inquiry identified 114 species, $59,913.7inds.\;m^{-2}$ in Lake Andong and 112 species, $39,038.4inds.\;m^{-2}$ in Lake Imha. The results indicate that the number of species and individuals in Lake Andong is more than that in Lake Imha, because Lake Andong has a variety of riparian vegetation and a richness of organic materials. Community analysis at Lake Imha revealed a dominant index of 0.57 (${\pm}0.18$), a diversity index of 2.87 (${\pm}0.31$), an evenness index of 0.73 (${\pm}0.04$), and a richness index of 4.17 (${\pm}0.71$). The results of functional feeding group analysis showed that a high proportion of species and individuals are gathering collectors. The results of functional habitat group analysis showed that a high proportion of species and individuals are clingers. The result of a physico-chemical water assay and dissolved oxygen and electric conductivity tests revealed that these measures increased when the water temperature decreased. The result of Pearson's correlation analysis by biological factors and physico-chemical factors showed that species and electric conductivity are highly correlated with one another. Major inflow streams of Lake Andong and Lake Imha were exposed to various point pollution sources and non-point pollution sources. This implies a necessity for continuous monitoring of the aquatic ecosystems in order to effect systematic water quality management of Lake Andong and Lake Imha.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.126-130
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• 2012

Purpose : Methode an effective block was investigated to deal with volatile radioactive gas, short lived radioactive waste generated as a result of the routinely produced radiopharmaceuticals FDG (2-deoxy-2-[$^{18}F$]fluoro-D-glucose) and compound with $^{11}C$. Materials and Methods : All components of the radiation stack monitoring and data management system for continuous radioactive gas detection in the air extract system purchase from fixed noble gas monitor of Berthold company. TEDLAR gas sampling bags purchase from the Dongbanghitech company. TEDLAR gas sampling bags (volume: 10 L) connected via paraflex or PTFE tubing and Teflon 3 way stopcock. When installing TEDLAR gas sampling bags in Hot cell on the inside and not radioactive gas concentrations were compared. According to whether the Hot cell inside a activated carbon filter installed, compare the difference in concentration of the radioactive gas $^{18}F$. Comparison of radiation emission concentration difference of module a FASTlab and TRACElab. Results : Activated carbon filter are installed in the Hot cell, a measure of the concentration of radioactive gas was 8 $Bq/m^3$. Without activated carbone filter in the hot cell was 300 $Bq/m^3$. Tedlar bag prior to installation of the radioactive gases a measure of the concentration was 3,500 $Bq/m^3$, $^{11}C$ synthesis of the measured concentration was 27,000 $Bq/m^3$. After installed a Tedlar bag and a measure concentration of the radioactive gases was 300 $Bq/m^3$ and $^{11}C$ synthesis was 1,000$Bq/m^3$. Conclusion : $^{11}C$ radioactive gas that was ejected out of the Hot cell, with the use of a Tedlar gas sampling bag stored inside. A compound of 11C is not absorbed onto activated carbon filter. But can block the release out by storing in a Tedlar gas sampling bag. We was able to reduce the radiation exposure of the worker by efficient radiation protection.

• Ecology and Resilient Infrastructure
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• v.3 no.4
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• pp.221-230
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• 2016

Multi-functional floating wetland island (mFWI) was developed in order to prevent algal bloom and to improve water quality through several unit purification processes. A test bed was applied in the stagnant watershed in an urban area, from the summer to the winter season. For the advanced treatment, an artificial phosphorus adsorption/filtration medium was applied with micro-bubble generation, as well as water plants for nutrient removal. It appeared that the efficiency of chemical oxygen demand (COD) and total phosphorus (T-P) removal was higher in the warmer season (40.9%, 45.7%) than in the winter (15.9%, 20.0%), and the removal performance (suspended solid, chlorophyll a) in each process differs according to seasonal variation; micro-bubble performed better (33.1%, 39.2%) in the summer, and the P adsorption/filtration and water plants performed better (76.5%, 59.5%) in the winter season. From the results, it was understood that the mFWI performance was dependent upon the pollutant loads in different seasons and unit processes, and thus it requires continuous monitoring under various conditions to evaluate the functions. In addition, micro-bubbles helped prevent the formation of anaerobic zones in the lower part of the floating wetland. This resulted in the water circulation to form a new healthy aquatic ecosystem in the surrounding environment, which confirmed the positive influence of mFWI.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.199-206
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• 2009

Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.225-232
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• 2000

Purpose : The use antimicrobial agents is one of the important strategies for the treatment and prophylaxis of microbial infections. But injudicious abuse and misuse of antimicrobial agents is problem to add an extra weight on medical fee, increase of resistant bacteria and side effects according to the antibiotic use. This study was performed to establish the pertinent use of antimicrobial agent in Chonbuk National University Hospital(CNUH). Characteristics of antibiotics use was analysis by reviewing the medical records of patients admitted to CNUH during the period of May 1998. Methods : One thousand eight hundred and thirty three patients were enrolled in this study(medical division 1,014 cases, surgical division 819 cases). Medical records were retrospectively reviewed to classify the rate of antibiotics use, name of antibiotics used, appropriateness of antibiotics use. Results : The overall rate of antibiotic usage in CNUH was 67.2%(1,231/1,833), showing higher rate in surgical division(89.6%) compare to that of medical division(49.0%). Among 1,231 patients to whom antimicrobial agents were given, only 125(10.2%) were treated with single antimicrobial agents. 311(25.3%) were treated with two antimicrobial agents, and 795(64.5%) patients received 3 or more antibiotics. ${\beta}$-lactams(56.4%) were most frequently used followed by aminoglycosides(35.3%), the others(4.9%) and quinolons(3.4%). Amoxicillin-clavulanate was the mostly commonly used antibiotics followed by amoxicillin and unasyn. Prophylactic use of antibiotics was carried in seven hundred six patients(57.4%), mostly in surgical division, which can be considered somewhat inappropriate in the initiation time and duration of antibiotic use. Conclusion : Importance of monotherapy and appropriate prophylactic antibiotic use should be emphasized. Strategies of antibiotics use, such as restriction of drug use, continuous monitoring system, flow sheet system should be considered to reduce antibiotics use and establish the appropriate use of antibiotics as well as inhibiting the occurrence of resistant strains.

• Korean Journal of Food Science and Technology
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• v.45 no.3
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• pp.376-381
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• 2013

In this study, we monitored total mercury and methylmercury concentrations in tuna, billfish, and deep-sea fish distributed in Seoul city. With the acquired data, we carried out statistical analysis and an exposure assessment for intake. The mean concentrations (mg/kg) of total mercury and methylmercury were $0.32{\pm}0.31/0.20{\pm}0.20$ for tuna, $0.43{\pm}0.48/0.20{\pm}0.17$ for patagonian toothfish, $0.99{\pm}0.72/0.51{\pm}0.40$ for billfish and $1.20{\pm}0.70/0.95{\pm}0.51$ for sharks, respectively. We found that sharks, billfish, patagonian toothfish, and tuna were more contaminated with total mercury and methylmercury, in sequence, and that 66% of the total mercury concentration consisted of methylmercury, on average. Although the estimated weekly intakes of methylmercury from commercial deep-sea fish were lower than the weekly intakes recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), we identified that the total mercury and methylmercury concentrations in tuna, billfish, and deep-sea fish continued to increase with the passage of time. Therefore, we confirmed the necessity of continuous monitoring and comprehensive analysis for general safety.

• Korean Journal of Ecology and Environment
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• v.50 no.4
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• pp.381-402
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• 2017

In order to investigate distribution of vascular plants along elevational gradient in the Nodong valley of Gyebangsan, vascular plants of eight sections with 100-meter-high were surveyed from the Auto-camping site (800 m) to the top of a mountain (1,577 m). There were a total of 382 taxa: 89 families, 234 genera, 339 species, 7 subspecies, 34 varieties, and 2 forms. As a result of analyzing the pattern of species richness, it showed a reversed hump-shaped with minimum richness at mid-high elevation. As a result of analyzing habitat affinity types, the proportion of forest species increased with increasing elevation. But, the ruderal species decreased with increasing elevation, and then increased at the top of a mountain. As for the proportion of life forms, the annual herbs gradually decreased with increasing elevation, but it did not appear between 1,300 m and 1,500 m and then increased at the top of a mountain. The trees gradually increased with elevation and decreased from 1,300~1,400 m. The vascular plants divided into four groups by using DCA. The arrangement of each stands was arranged in order from right to left on the I axis according to the elevation. The distribution of vascular plants is determined by their own optimal ranges of vegetation. Also, rise in temperature due to climate change affects the distribution of vascular plants, composition, and diversity. Therefore, continuous monitoring is necessary to confirm ecological and environmental characteristics of vegetation, distribution ranges, changes of habitat. Furthermore, plans for conservation and management based on these data should be prepared according to climate change.