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Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

A Study on the Planting and Cultivate of Hong Man-Seon(1643~1715)'s 'Salimkyungjae (山林經濟, The Economy of Forest)' (홍만선의 '산림경제(山林經濟)'에서 본 조경식물 재배(종수법(種樹法))와 가꾸기(양화법(養花法)))

  • Shin, Sang Sup
    • Korean Journal of Heritage: History & Science
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    • v.44 no.3
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    • pp.18-43
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    • 2011
  • The results of study on planting and cultivate of Hong Man-Seon(1643~1715)'s 'Salimkyungjae(The Economy of Forest)' the first summative textbook of agricultural skill of South Korea, are as follows. First, 'Salimkyungjae' suggests that one can enrich oneself, eat fruits in fall, enjoy the shade of trees in summer, and enjoy flowers in spring if one plants tree with 10 year plan with knowledge of ecology. Second, the number of plants had increased continuously from the early Chosun Dynasty to the mid Chosun Dynasty. The 52 plants in the book are classified into 31 trees, 8 shrubs, 3 others, and 10 herbs, and 28 of them are fruit trees. Hence, we can see that the book is for the promotion of welfare. Third, planting(transplantation) is the best on January of the lunar calendar, and the second on February, and fertile soil should be added much. Trees must be planted as deep as once it was planted, and buttressed. It will sprout well if it is planted at the depth of one inch, and planting a cutting should be carried out at the early March with 5 inch and finger-thick branches. Grafting is the best when it begins to sprout. Fruit trees will bear many fruits if they are grafted at the direction of South, and fruits will be greater if the trees' branches are cutting off on January. Especially, January was selected for the best season of planting traditionally. Fourth, flower trees are planted or sowed with manure around January and February of the lunar calendar, and it is recommended to replant them into flowerpots with manure when having flower buds around March and April of the lunar calendar. It would bloom earlier when using water mixed with stable manure, and sulfur smoke can be used in order to change the flower color from red to white. Flowerpots would be placed at half shaded lot with being supported by bricks. Pomegranate, gardenia, camellia and four-season flower should be planted after flowers fallen. When flower trees are beside walls, they need to be rotated frequently since their branches all point toward house. Seeds need to be preserved in a sunny hut, where its entrance and ventilating openings would be at south because it is convenient to manage pots. Fifth, insects hidden at fruit trees would be destroyed by torch smoke when roosters cry on New year's day of the lunar calendar. Insects would be decoyed into straw hanged at dawn of Cheongmyeongday(淸明日). Insects on fruit trees would be controlled using sulfur powder to close up holes or sulfur smoke to fumigate. Particularly, it suggests that utilization of fertile soil would be the best solution for growing health plants and preventing pest.

Species Diversity of Planktonic Copepods and Distribution Characteristics of Its Major Species in Coastal Waters of Korea (한국 연안에 출현하는 부유성 요각류의 종다양성과 주요 종의 분포특성)

  • Seo, Min Ho;Choi, Seo Yeol;Park, Eun-Ok;Jeong, Dalsang;Soh, Ho Young
    • Korean Journal of Environmental Biology
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    • v.36 no.4
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    • pp.525-537
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    • 2018
  • The Korean coast is divided into the West Korea Coastal zone (WKC), the South Coastal zone of Korea (SCK), the East Korea Coastal zone (EKC), and Jeju Coastal zone of Korea (JCK). Each coastal zone has different marine environment characteristics. This study analyzed zooplankton data of KOEM (Korea Environment Management Corporation) collected in the Korean coastal waters the spring and summer of 2015 and 2016. In spring, water temperature was lowest in the JCK, and gradually increased in the order of EKC, SCK, and WKC, while in summer lowest in WKC and increased in the order of EKC, SCK, and JCK. Salinity was lowest in WKC which had many rivers flowing inland, and increased in the order of SCK, EKC and JCK in spring. In summer it was lowest in JCK and increased toward WKC, SCK, and EKC. In summer, Chlorophyll-a concentrations were generally low, but was lowest in JCK in spring. In the study area, a total of 77 species occurred, of which 50 species did in spring and 65 species in summer. The number of species was lowest in JCK and highest in SCK in spring and summer, respectively. Paracalanus parvus s. l. was the most dominant species or the second dominant species in Korean coastal areas in spring, but it was predominant in summer. In addition, in spring Acartia hongi, Calanus sinicus, Oithona similis were predominant in WKC, Oithona similis and Corycaeus affinis in SCK, O. similis and Corycaeus sp. in EKC, C. affinis and O. setigera in JCK. In summer Corycaeus spp., O. similis, A. hongi, Tortanus forcipatus were predominant in WKC, C. affinis, Pseudodiaptomus marinus in SCK, O. similis, A. omorii, Corycaeus sp. in EKC, and A. steueri, A. pacifica, Oithona sp., C. sinicus in JCK. The copepod community in the Korean coastal areas were classified into four areas, WKC-western SCK, eastern SCK, EKC and JCK according to differences in environmental factors such as water temperature, salinity, Chl-a concentration, and suspended matter concentration of each coastal area.

Successful Management and Operating System of a UNESCO World Heritage Site - A Case Study on the Wadi Al-Hitan of Egypt - (유네스코 세계자연유산의 성공적인 관리와 운영체계 - 『이집트 Wadi Al-Hitan』의 사례 -)

  • Lim, Jong Deock
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.106-121
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    • 2011
  • The number of World Natural Heritage Sites is smaller than that of World Cultural Heritage Sites. As of 2010, the total number of natural sites was 180, which is less than 1/3 of all cultural sites. The reason why the number of natural sites is smaller can be attributed to the evaluating criteria of OUV(outstanding universal value). Only 9 fossil related sites were designated as World Heritage Sites among 180 Natural Sites. This study compares their OUVs including the academic value and characteristics of the 9 World Heritage Sites to provide data and reference for KCDC(Korean Cretaceous Dinosaur Coast) to apply as a World Natural Heritage Site. This study was carried out to obtain information and data on the Wadi Al-Hitan of Egypt which was designated as a World Natural Heritage Site. The study includes field investigation for whale fossils, interviews of site paleontologists and staff, and inspections of facilities. Three factors can likely be attributed to its successful management and operating system. First, there is a system for comprehensive research and a monitoring plan. Secondly, experts have been recruited and hired and professional training for staff members has been done properly. Finally, the Wadi Al-Hitan has developed local resources with specialized techniques for conservation and construction design, which matched well with whale fossils and the environment at the site. The Wadi Al-Hitan put a master plan into practice and achieved goals for action plans. To designate a future World Natural Heritage Site in Korea, it is important to be recognized by international experts including IUCN specialists as the best in one's field with OUV. Full-time regular-status employees for a research position are necessary from the preparation stage for the UNESCO World Heritage Site. Local government and related organizations must do their best to control monitoring plans and to improve academic value after the UNESCO World Heritage Site designation. As we experienced during the designation process of Jeju Volcanic Island and Lava Tubes as the first Korean World Natural Heritage Site, participation by various scholars and specialists need to be in harmony with active endeavors from local governments and NGOs.

A Study on the 18th Joseon Dynasty Sculturers Choi Cheon-Yak (조선 18세기 조각가 최천약(崔天若) 연구)

  • Kim, Min Kyu
    • Korean Journal of Heritage: History & Science
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    • v.46 no.1
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    • pp.124-139
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    • 2013
  • Choi Cheon-yak(about 1684~1755) is an artist who left the various artistic works such as sculptures of royal tombs, architectures. In addition, he was not only a skilled caster but also an able artisan carving jade in the early Joseon Dynasty period. Starting from making royal seals of King Suk-jong, he had made more than about 40 Royal seals until 1755. Choi Cheon-yak was well known as a skilled jade craftsman. Another of his great abilities was to carve subjects into ideal figures. In virtue of his greater abilities, he could take part in the process of constructing Royal tombs and sculpting the stone statues of military officials' which were erected at aristocrats' tombs. With these accumulated skills, when he was in charge of designing the folding screen stones for King In-jo's Jang Neong, he could even replace 12 animals system and clouds with peonies and lotus. Among his various abilities, his skill in carving a sculpture can stand comparison with any other contemporaries. His sculpture skill was at its zenith in 1752, the stone statues of military officials' at the Ui soseson's tomb count his showpiece that describes a model at the age of his late teens and is a realistic and portrayal sculpture, which met the royal family's dignity. In the same year, the stone statues of military officials' constructed by Choi Cheon-yak was elected in front of the Jo Hyen-myeong's tomb(1690~1752). This masterpiece referred to the armor of those of King Gong-min Neong and newly added a helmet and the patterns of a tortoise shell. These patterns of a tortoise shell were passed down to Park Moon-su's tomb in 1756 and Queen Jeong-sung's Hong Neung by his colleagues : Kim Ha-jeong and Byeon Yi-jin etc. He was one of the greatest sculptors in the $18^{th}$ century. People in Joseon praised him highly for his imaginative work from an amorphous object. Especially, these stone statues of military at Jo Hyeonmyeong's tomb shows the proofs of his supreme artwork.

The Acceptance and Transition of Confucian Gamsil in Joseon period (조선시대 유교식 감실(龕室)의 수용과 변용)

  • Park, Jong Min
    • Korean Journal of Heritage: History & Science
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    • v.44 no.4
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    • pp.56-69
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    • 2011
  • A Gamsil is an ritual instrument which enshrine the ancestral tablets of four lines from late great-great-grandfather and grandmother to late father and mother. This has their soul. Juja's "Garye" informs its structure pattern. It is placed in Sadang and takes the form of a perfectly square box. It partitions four rooms and enshrine an ancestral tablet room by room. They get the ancestral tablets line up from west to east. And they also enshrine the ancestral tablets without his descendant together in Gamsil. A Gamsil is a space to enshrine the ancestral tablets and to place an order within a family. A social status and A family economic power become a standard in making and managing Sadang. Kingdom in Joseon period limited the ancestral tablets considering of his degree of official rank which descendant enshrined. A official servant can be stable economically in getting a stipend and build sadang in the house. While household a little in economic enshrine the ancestral tablets at a Gamsil placed at the a space of private home. His personal circumstances make size and pattern, place change in relation to Gamsil. A Gamsil looks like house in structure and pattern. It has the immortality of the soul. And it changed from a table size to a ancestral tablet size. This Gamsil is comfortable to move and is made considering of the width and height of household. The transition of Gamsil means institutions is in close to a family economic power in social change. Kingdom in Joseon early period makes a policy of a Gamyo's build and an ancestral enshrine in basement of Juja's "Garye". The transition of Gamsil gave a common people limitted socially and institutionally the service of late four lines. Most of people enshrine the ancestral tablets of their four lines in approaching of in the late of Joseon Dinasty. They compromise on their reality and cause. The transition of Gamsil implied many different things in social ; the authenticity search and a dignity expression of his family, the foundation for the diffusion of an ancestral service, a space sharing with ancestor and descendent, the increment of a family economic power etc.

Semantic Interpretation of the Nu-Jeong Cultural Landscape During the 16~18th Century at Youngnam and Honam Area -Focusing on the Designated Cultural Properties- (16~18세기 영·호남 누정에 깃든 문화경관의 의미론적 해석 - 지정 문화재를 중심으로 -)

  • Lee, Hyun Woo
    • Korean Journal of Heritage: History & Science
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    • v.45 no.1
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    • pp.190-217
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    • 2012
  • This research has studied the building awareness of Nu-Jeong that a view of nature and aesthetic consciousness to unite the nature are inherent by considering Nu-Jeong of scholars who left fame and wealth behind and retired to hermitage in the backwoods in the 16~18 Century. This is to clarify correlation with leaving nature as it is, namely, an ideal state that scholars at the time would enjoy, through landscape awareness accepted into Nu-Jeong literature. In addition, this research has tracked the ideologic flow that acts on space formation by clarifying Korean unique meanings inherent to Nu-Jeong's cultural landscape. As a suggestion for this, the interpretation through 'Pungsu location Nu-Jeong name's analysis Nu-Jeong literature analysis', etc. was tried, so its integrated conclusion is as follows. It is not a chance that scholars of Joseon have left numerous literature works singing the nature. They already had huge interest and knowledge on the nature, and achieved active poetic exchange by sublimating the praise of nature as literature. Nu-Jeong, which was a place of exchange like this, had cleanliness of the nature and ideological purity as an oppositional space on turbid political realities. The Nu-Jeong literature drew the nature into a literature space as it is, without doing abstraction or ideation on the nature. The owner of Nu-Jeong exclusively possessed such natural landscape in grim and independent postures, so it provided a clue of Nu-Jeong cultural landscape that this research aimed to discuss. Scholars who aimed to raise wide and large vigor filled in between the sky and earth got to convince that people are born from the nature, grow in the nature and finally return to the nature. What people are born from the nature and finally return to the nature is just consistent with Taoistic and Zhua-ngzi thoughts denying human work, and leaving nature as it is or nature itself remained intact which is an ideal state. The construction at the time is a vessel containing the spirit of the times of the era. This thesis has proved that the Nu-Jeong culture of scholars located on the central line of Korean landscape was the flower of Joseon's scholar culture by interpreting it semantically.

A Study on the Space Planning and Landscape of 'Unjoru(雲鳥樓)' as Illustrated in the Family Hereditary Drawing, "Jeolla Gurye Ohmidong Gado(全羅求禮五美洞家圖)" ('전라구례오미동가도(全羅求禮五美洞家圖)'를 통해 본 운조루(雲鳥樓)의 공간배치계획과 경관 고찰)

  • Shin, Sang-sup
    • Korean Journal of Heritage: History & Science
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    • v.46 no.4
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    • pp.48-63
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    • 2013
  • The results of the study on the space planning and landscape design of Unjoru(雲鳥樓) through the 'Jeolla Gurye Omidong Gado(全羅求禮五美洞家圖)' drawn using GyeHwa(界畵) technique are as follows. First, 'Omidong Gado' is believed to date back to the period when Unjoru(1776~1783) was established for the following reasons: (1) The founder, Yoo-IJu(柳爾?), sent the drawing for the house while he was serving as the governor of YongCheon county(龍川府史). (2) It shows the typical dwelling houses' space division and its location is in a good spot with mountain in the back and water in front(背山臨水) and there is every indication of scheme drawing. (3) Front gate was changed and remodeled to a lofty gate in 1804. Second, Nogodan & Hyeongjebong of Jiri Mountain sit at the back of Unjoru, and faces Obong mountain and Gyejok mountain. In addition, the Dongbang stream flowing to the east well illustrates the Pungsu theory of mountain in the back and water in the front. Third, the house is structured in the shape resembling the character 品, divided into 5 areas by hierarchical order in the cross line from all directions. The site, which includes the outdoor yard and the back garden, consists of 5 blocks, 6 yards and 2 gardens. Fourth, the outdoor yard with aesthetical value and anti-fire function, is an ecological garden influenced by Confucianism and Taoism with a pond (BangJiWonDo Type, 方池圓島形) at the center. Fifth, the Sarang yard(舍廊庭) is decorated with terrace garden and flower garden, and the landscaping components such as oddly shaped stone, crane, plum, pine tree, tamarisk tree and flowering plants were used to depict the ideal fairy land and centrally placed tree for metaphysical symbolism. The upper floor of Sarangchae commands distant and medium range view, as well as upwards and downwards. The natural landscape intrudes inside, and at the same time, connects with the outside. Sixth, pine forest over the northern wall and the intentionally developed low hill are one of the traditional landscaping techniques that promotes pleasant residential environment as well as the aesthetics of balanced fullness.

An Examination on the Origin of Stone Pagodas of the Silla Kingdom (신라석탑(新羅石塔)의 시원(始源) 고찰(考察))

  • Nam, Si Jin
    • Korean Journal of Heritage: History & Science
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    • v.42 no.2
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    • pp.154-169
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    • 2009
  • Korea is famous for a number of stone pagodas. In particular, it is noticeable that the stone pagodas came after wooden pagodas in all the Kingdoms of Goguryeo, Baekje, and Silla. Since the advent of wooden pagodas, it was during the latter half period of Three Kingdoms(especially, in the early Seventh century) that the first stone pagoda appeared at Mireuksa Temple site in imitation of the wooden ones. Now that no one can deny that Korean stone pagodas have developed, imitating the wooden pagodas. It is also obvious that the Stone Pagoda at Mireuksa site is the prototype of Korean stone pagodas. However, this study casts doubt on the theory that the stone pagodas in the Silla Kingdom originated not from the wooden pagodas, but from the brick pagodas, whereas the stone pagodas in Baekje Kingdom which has been said to come from the wooden ones. The fact that the temples and pagodas in both Baekje and Silla were erected by the same builders and technicians is one of the evidences supporting the assertion of the study. This study, accordingly, examines on the origin of the Silla pagodas by supposing the two genealogies. The first one can be summarized in chronological order as follows: starting from wooden pagodas, Stone Pagoda at Mireuksa site, Stone Pagoda at Jungrimsa site, Stone Pagoda at Gameunsa site, and Stone Pagoda at Goseonsa site. The second one, on the other hand, runs as follows: starting from bick pagodas, Stone Pagoda at Bunhwangsa, Uiseong Tapri five-storied Stone Pagoda, Seonsan Jukjang-ri five-storied Stone Pagoda, and Seonsan Naksan-ri three-storied Stone Pagoda in order. As the above genealogies show, the origin of the stone pagodas has been an controversy, especially because of the two different points of view: the one is that the roof-supporting strata(Okgaesuk-Bachim) originated from the brick structure and the ancient tomb ceiling of Goguryeo Kingdom, and the other is that the strata is a sort of the simplified design of the wooden roof structure. This study, however, takes note of the difference in length of the strata between the brick pagodas and the stone pagodas; the former stretches out its strata longer than the latter. Consequently, the study points out that the roof-supporting strata of the stone pagodas is originally a sort of modification of the wooden roof structure.

Investigation of Microbial Contamination in Semisulcospira libertine and Evaluation of Its Reduction Effects by Sediment Removal Treatment (다슬기(Semisulcospira libertine)의 미생물 오염도 평가 및 해감 제거공정에 따른 저감화 효과)

  • Choi, Man-Seok;Jun, Eun Bi;Choi, Seungho;Bang, Hyeon-Jo;Park, Shin Young
    • Journal of Food Hygiene and Safety
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    • v.34 no.4
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    • pp.361-366
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    • 2019
  • In this study, microbial contamivation semisulcospira libertine and effect of sedimentation treatment of major bacterial and fungal pathogens were investigated. The total aerobic bacteria, coliforms, Escherichia coli, Staphylococcus aureus, and yeast and mold present in raw and water-dipped Semisulcospira libertine were enumerated using the standard plate count methods on using the standard plate method on potato dextrose agar (PDA), 3M Petrifilm for coliforms / E. coli, 3M Petrifilm for S. aureus, and plate count agar (PCA), respectively. In analysis of microbial contamination of raw Semisulcospira libertine, the total aerobic bacteria, coliforms, and yeast and mold were monitored as 6.40, 2.70, and $6.79{\log}_{10}CFU/g$, respectively. Both E. coli and S. aureus were not detected (detection limit: 10 CFU/g). However, Semisulcospira libertine dipped in ground water for 3 hours had higher contamination levels of all natural indigenous microorganisms than raw Semisulcospira libertine. Especially, E. coli was detected as $2.46{\log}_{10}CFU/g$ in the ground water-dipped Semisulcospira libertine. The total aerobic bacteria in the ground water-dipped Semisulcospira libertine was not significantly reduced (p>0.05) compared to that in the raw Semisulcospira libertine. Moreover, coliforms were significantly increased (p>0.05) in all water-dipped Semisulcospira libertine. Only fungi were slightly reduced (less than 0.2 log) (p>0.05) in the tap water-dipped Semisulcospira libertine by comparison with the raw Semisulcospira libertine. The results of this study suggest that the use of chemical sterilizing agents and other physical methods in the washing stage will be necessary for the microbial reduction in raw Semisulcospira libertine because the use of sediment removal treatment by ground or tap water did not affect the microbiological safety of the raw Semisulcospira libertine.