• Journal of Trauma and Injury
• /
• v.23 no.2
• /
• pp.119-127
• /
• 2010

Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

• Journal of Trauma and Injury
• /
• v.23 no.2
• /
• pp.113-118
• /
• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.20 no.2
• /
• pp.58-65
• /
• 2022

Purpose: Alcohol is one of the most commonly co-ingested agents in deliberate self-poisoning (DSP) cases presenting at the emergency department (ED). The increased impulsivity, aggressiveness, and disinhibition caused by alcohol ingestion may have different clinical features and outcomes in cases of DSP. This study investigates whether alcohol co-ingestion affects the clinical features and outcomes of DSP patients in the ED. Methods: This was a single-center retrospective study. We investigated DSP cases who visited our ED from January 2010 to December 2016. Patients were classified into two groups: with (ALC+) or without (ALC-) alcohol co-ingestion. The clinical features of DSP were compared by considering the co-ingestion of alcohol, and the factors related to discharge against medical advice (AMA) of DSP were analyzed. Results: A total of 689 patients were included in the study, with 272 (39.5%) in the ALC+ group. Majority of the ALC+ group patients were middle-aged males (45-54 years old) and arrived at the ED at night. The rate of discharge AMA from ED was significantly higher in the ALC+ group (130; 47.8%) compared to the ALC- group (p=0.001). No significant differences were obtained in the poisoning severity scores between the two groups (p=0.223). Multivariate analysis revealed that alcohol co-ingestion (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.01-1.98), alert mental status (OR=1.65; 95% CI, 1.17-2.32), past psychiatric history (OR=0.04; 95% CI, 0.01-0.28), age >65 years (OR=0.42; 95% CI, 0.23-0.78), and time from event to ED arrival >6 hrs (OR=0.57; 95% CI, 0.37-0.88) were independent predictive factors of discharge AMA (p=0.043, p=0.004, p=0.001, p=0.006, and p=0.010, respectively). Conclusion: Our results determined a high association between alcohol co-ingestion and the outcome of discharge AMA in DSP patients. Emergency physicians should, therefore, be aware that DSP patients who have co-ingested alcohol may be uncooperative and at high risk of discharge AMA.

• IE interfaces
• /
• v.1 no.1
• /
• pp.85-99
• /
• 1988

High Touch product is characterized by shorter life cycle together with specification/integration of existing function in order to capitalize the rapidly emerging high technology. R & D strategy for a development of High Touch product generally emphasizes two aspects ; Industrial Design (ID) and Ergonomic Design (ED). However, working knowledge on ED of a systematic identification of potential High Touch products is not readily available. The purpose of this study was three-folded : (1) To emphasize the fact that greater efforts should be geared to ED in High Touch design ; (2) To develop an ergonomic approach based on analysis of implicit human needs that identifies potential area of High Touch ; (3) To bubble with new and probable High Touch products in home electronics that actually demonstrate the validity of this study.

• Journal of Korean Library and Information Science Society
• /
• v.40 no.2
• /
• pp.5-26
• /
• 2009

The purpose of this study aims to provide possible suggestions for the improvement KDC 5th ed. as a system. After analyzing and evaluating various devices of KDC 5th ed. such as schedules, common auxiliary tables, internal tables(omitted), notes, relative index, precedence order(omitted), alternatives, manual(omitted) and relocated table(omitted), suggestions for the improvement were proposed. If above suggestions are adopted, effective literature classification scheme which is suited to domestic circumstances will be certainly prepared.

• Journal of the East Asian Society of Dietary Life
• /
• v.18 no.4
• /
• pp.592-600
• /
• 2008

The perceived performance of food management and the food utilization status of school food service managers in nine sectors of management in the Kyunggido area were evaluated[ED highlight - please ensure this is correct]. The results of this study revealed that 84.5% of the service managers used domestic food and $20{\sim}40%$ used organic food, with an average of 80% using one of these types of foods. In addition, the average use of pre-handling food varied widely when compared to other food items[ED highlight - very confusing, please ensure my changes do not alter your intended meaning] Additionally, most respondents used frozen food (72.0%), processed food (83.9%), and substitute food (53.4%), for the average of 20%,[ED highlight - I cannot infer your intended meaning here, what is an average of 20%? Please clarify]; however, 40.6% did not use any food substitutes. The most common reason given for using pre-handled[ED highlight - do you mean pre-packaged or pre-prepared? Please clarify] food was to save time (32.2%), whereas frozen foods were most often used to help with menu organization (37.5%). Additionally, the respondents most common reason for using processed food was its high acceptability (47.8%), while substitute foods were most often used due to non suitable foods beingreturned (75.3%). Among the varieties of food that were used, those that are easily obtained and cooked were used the most. Furthermore, the mean score for the perceived performance of food sanitary management was $4.51{\pm}0.425$ (based on the 5-point Likert scale). Finally, it was generally believed that the overall food management well executed, but that more active management of unsatisfactory food suppliers is required[ED highlight - please ensure my changes do not alter your intended meaning].

• Korean Journal of Microbiology
• /
• v.53 no.3
• /
• pp.193-199
• /
• 2017

This study was aimed to evaluate the antimicrobial activity of Penicillium purpurogenum ED76 on several clinically important microorganisms. The endophytic fungus P. purpurogenum ED76 was previously isolated from Swietenia macrophylla leaf. The antimicrobial efficacy of P. purpurogenum ED76 dichloromethane extract was determined via disc diffusion and broth microdilution assay. A kill curve study was conducted and the morphology of extract treated bacterial cells were viewed under scanning electron microscope. The dichloromethane extract showed significant inhibitory activity on 4 test bacteria and 2 test yeasts. The minimal inhibitory concentration of the extract ranged from 125 to $1,000{\mu}g/ml$, which indicates the different susceptibility levels of the test microorganisms to the fungal extract. The kill curve study has revealed a concentration-dependent inhibition for all test microorganisms. With the increase of the extract concentration, the microbial growth was significantly reduced. The scanning electron micrograph of dichloromethane extract-treated Staphylococcus aureus cells showed the total damage of the cells. The cell wall invagination of the bacterial cells also indicates the loss of cellular materials and metabolic activity. The gas chromatography mass spectrometry analysis of the extract also showed that the major compound was stigmasterol, which constitutes 45.30% of the total area. The dichloromethane extract of P. purpurogenum ED76 exhibited significant inhibitory activity on several clinically important bacteria and yeasts. The study proposed a possible mode of action that the extract cause significant damage to the morphology of S. aureus cells.

• Journal of Trauma and Injury
• /
• v.19 no.1
• /
• pp.41-46
• /
• 2006

Purpose: Hypovolemia is not uncommon among trauma patients in the emergency department (ED). Successful resuscitation of a hypovolemic patient often requires rapid intravenous administration of massive amounts of fluid. A rapid fluid infuser is used in the ED for this purpose, there have been no studies of their clinical uses and effectiveness. We studied clinical experience with a rapid fluid infuser at an urban university hospital in Seoul, Korea. Methods: We reviewed the medical records of 38 patients admitted to the ED with a history of application of a rapid fluid infuser from January 2004 to July 2005. Adult trauma patients older than 15 years of age were included in this study. Clinical data on the patients and the volume of fluid used to achieve a stable blood pressure were extracted from their medical records. Results: The total number of adult trauma patients with a history of application of a rapid fluid infuser from January 2004 to July 2005 in the ED was 16. The mean systolic blood pressure for deciding to apply the rapid fluid infuser was $74.9{\pm}12.7mmHg$. The mean time and volume used to achieve a stable blood pressure were 40.4 min and$2947.3{\pm}1339.2ml$, respectively. In all patients, the amount of fluid infused before using the rapid fluid infuser was between 500 ml and 10,000 ml, compared to 1,000 ml and 6,200 ml with the rapid fluid infuser. The mean amount of fluid per min. via the rapid fluid infuser was 85.5 ml. Vital signs were stabilized in 11 patients, 6 of the 11 were discharged alive. Conclusion: The mean amount of fluid delivered per min. via the rapid fluid infuser was much less than expected; thus, there should be clinical guidelines on volume resuscitation with a rapid fluid infuser in the ED. In the future, prospective, multicenter, clinical-data collection is needed for a more sophisticated study.

• Journal of Electrochemical Science and Technology
• /
• v.10 no.1
• /
• pp.14-21
• /
• 2019

Supported liquid membrane process usually is used for recovering or enrichment of valuable metals in the industrial wastewater. But, even if the metals in the wastewater was separated with high chemical selectivity, it cannot be enough concentrated since separation performance of supported liquid membrane (SLM) process is limited by concentration gradient between feed solution and stripping solution. If metal concentration in the stripping solution to be enough low, transport of metal through membrane can be accomplishment constantly. Therefore, Electrodialysis (ED) has been placed after SLM process and the stripping solution of SLM was used as the feed solution for the ED process. Transport of ions in the solutions is successfully performed by ED process. Thus, the metal concentration in the stripping solution does not rise as to stop ion transport. Besides, valuable metals easily are concentrated by ED process for re-use. In this study, effects of operation parameters like initial Cd(II) concentration, HCl concentration in the feed solution of SLM and applied voltage are investigated on separation efficiency, flux and permeability of the both processes. As the feed solution concentration increased, all performance values has increased. When initial concentration of 100 mg/L is used, separation performances (SP) are 55% and 70%, for SLM and consecutive process, respectively. The best HCl concentration in the feed solution of SLM has determined as 2 M, in this conditions SP are 64% and 72%, for SLM and consecutive process, respectively. With increased of applied voltage on ED process, SP of the consecutive process has been raised from 72% to 83%. According to the obtained experimental data, consecutive process has better separation performance than SLM. When the separation performances of both processes were compared for the same operating conditions, it was determined higher the separation efficiency, permeability and flux values of the consecutive process, 8%, 9% and %10.6, respectively. Consequently, the use of the consecutive process increases the performance efficiency of both processes. The consecutive process studied has quite a good chemical separation efficiency, and enrichment capability. Moreover, this process requires few water and energy.

• Herbal Formula Science
• /
• v.7 no.1
• /
• pp.167-181
• /
• 1999

Rhizoma Arisaematis, Lignum Akebiae, Rhizoma Zedoariae, Cortex Eucommiae, Folium Perillae, Radix Sophorae Subprostratae, Radixi, Radix Ledeboutriellae, Rhizoma Atractylodis, Herba Ephedrae, Radix Puerariae and Radi Aconitx Bupleuri have been used in Korea for many centuries as a treatment for various disease. The purpose of the present study is to determine the effect of several herbs on norepinephrine(NE) induced blood vessel contraction in rabbits and pigs. Rabbit(2 kg, male) were killed by $CO_2$ exposure and a segment (8-10mm) of each rabbit was cut into equal segments and mounted in a tissue bath. Contractile force was measured with force displacement transducers under 2-3 g loading tension. The dose of norepinephrine(NE) which evoked 50% of maximal response $(ED_{50})$ was obtained from cumulative dose response curves for NE $(10^{-6}{\sim}10^{-3}M)$. Contractions evoked by NE $(ED_{50})$ were inhibited significantly by Rhizoma Arisaematis, Lignum Akebiae, Rhizoma Zedoariae, Cortex Eucommiae, Folium Perillae, Radix Sophorae Subprostratae and Herba Ephedrae in abdominal aorta. Contractions evoked by NE $(ED_{50})$ were inhibited significantly be Lignum Akebiae, Rhizoma Zedoariae, Cortex Eucommiae, Herba Ephedrae, Radix Puerariae and Radix Bupleuri in femoral artery. Contractions evoked by NE $(ED_{50})$ were inhibited significantly by Radix Sophorae Subprostratae, Radix Aconiti and Herba Ephedrae in renal artery. These results indicate that each herb can relax NE induced contraction of rabbit and pig blood vessel selectively, and that this relaxation relates to Gui-Gyung(歸經).