• Quality Improvement in Health Care
• /
• v.4 no.1
• /
• pp.50-63
• /
• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• Journal of Korean Academy of Nursing
• /
• v.26 no.1
• /
• pp.223-247
• /
• 1996

This study was done to provide information which would lead to nursing care of the elderly being more holistically through an understanding of the phenomena of powerlessness based on the lived experience of powerlessness by the elderly, the meaning the elderly give to such phenomena, and what essence of powerlessness is. The methodology used in this study was Max Van Manen's phenomenological method based on the philosophy of Merleu-Ponty and a concerted approach was realized through the 11 steps suggested in the Van Manen's method. Data collection was done from March 2, 1995 to December 30, 1995. The subjects for this study were four elderly persons who lived with their families and who were over 60 years of age. Data were collected about the lived experience of the elderly, this researcher's experience of powerlessness, the linguistic meaning of powerlessness, idioms of the word or a feeling of powerlessness, and descriptions of powerlessness in the elderly as they appeared in the literature, are works, and phenomenological literature. All data were used to provide insights into the phenomena of powerlessness. Data about the experience of powerlessness by the elderly were collected through open interviews, participation, and observation. In the analysis of the theme of this study, the aspects of the theme, powerlessness in the elderly were clarified, thereby abstracting and finding meaningful statements by the elderly about their feeling of powerlessness, and then those significant statements were expressed as linguistic transformations. The summarized findings from the study are as follows : 1. Five meanings of powerlessness in the elderly were defined. 〈weakness〉, 〈dependence〉, 〈frustration〉, 〈worthlessness〉 and 〈giving up〉. 2. 〈Weakness〉 means that the elderly experience, not only their aging but also, their becoming weak and the loss of physical function frequently caused by diseases. 〈Dependence〉 means that the elderly experience dependence without any influence from the surroundings and that elderly patients who are hospitalized lose their autonomy, follow entirely their doctor's prescriptions, use aid equipment and directions, and depend only on those things. 〈Frustration〉 means that the elderly experience the loss of their roles from the past, there by feeling that there is no work for them to do anymore and therefore feel unable to do anything. 〈Worthlessness〉 means that the elderly experience the feeling of losing their social roles from the past, having no financial ability, thereby being a burden to their children or the people around them, and therefore regarding themselves useless. 〈Giving up〉 means that the elderly experience the feeling of closeness to death in the final stage of their lifetime, lose hope to be healed from their disease, and recognize the incontrollability of their own body. 3. From a general view of the meaning of the theme the powerlessness in the elderly-the most essential meaning of the theme is the 〈sense of loss〉. For the elderly are experiencing a sense of loss in the situation of being elderly and therefore being often hospitalized. Brief definitions of the five phenomena could be 〈weakness〉 meaning the loss of physical strength, 〈dependence〉 the loss of mentality caused by disease and hospitalization, 〈frustration〉 and 〈worthlessness〉 the loss of social performance caused by the loss of social functions from the past, and lastly 〈giving up〉 the loss of the controllability of such situations of aging and suffering disease. In light of the discussion above, it is understandable that the hospitalized elderly experience powerlessness not only as it related to their diseases but also to their normal aging, and this related to other characteristics of being elderly means that the 〈sense of loss〉 is the very essence of their powerlessness. 4. While most cases are of the normal elderly experiencing powerlessness in relation to their social network, cases of elderly who are hospitalized are of those experiencing powerlessness in relation to the loss of their physical desire. 5. The findings discussed above can serve as guidelines for nurses who take care of the ill elderly who are hospitalized and that can provide cues to appropriate nursing service, recognizing that the subjective experience of the objective age of the elderly is so important. Nurses can provide highly qualitative nursing service, based on their deep understanding of the suffering of the elderly due to feelings of powerlessness.

• Journal of Gastric Cancer
• /
• v.4 no.4
• /
• pp.213-218
• /
• 2004

Purpose: The superficial spreading type of early gastric cancer has different clinicopathologic features from other types of early gastric cancer in terms of its invasiveness and lymph-node metastases. Therefore, we attempted to elucidate the pathological features, surgical procedures and patients prognoses. Materials and Methods: Clinical information was reviewed for patients who had undergone a gastrectomy for gastric cancer during an 8-year period ($1995\~2002$) at Dankook University Hospital and Ulsan University, with an average follow-up of 48 months. Three hundred (300) superficial spreading lesions were analyzed with respect to macroscopic type, lymph-node (LN) metastasis, recurrent pattern, survival rate and method of surgical operation. In addition, the clinicopathological features of the superficial spreading type were compared with those of 739 other patients with small-sized cancer. Results: In both groups, the IIc-type macroscopic lesion, the elevated subtype to be more specific, occurred most frequently. There was no significant difference in the method of surgery between the groups. The submucosal invasion was $39.8\%$ in small-sized cancer, and $61.7\%$ in superficial spreading cancer (P=0.005). The incidence of LN metastasis was $11.3\%$ in early gastric cancer, $7.8\%$ in small-sized cancer and $20.0\%$ in superficial spreading cancer (P=0.005). The incidence of lymphatic invasion was $4.6\%$ in small-sized cancer and $13.0\%$ in superficial spreading cancer (P=0.009). The incidence of recurrence was $1.4\%$ in small-sized cancer and $3.6\%$ in superficial spreading cancer. The overall 5-year survival rate was $84.8\%$ in superficial spreading cancer and $93.0\%$ in small-sized cancer (P=0.052). The 5-year diseasefree survival rate was $94.7\%$ in superficial spreading cancer and $87.5\%$ in small-sized cancer (P=0.053). Conclusion: The superficial spreading type of early gastric cancer tends to be more invasive and to show a higher incidence of lymph-node metastasis than small-sized early gastric cancer. A wide resection with extensive lymph-node dissection seems to be an appropriate treatment for a superficial spreading type of early gastric cancer.

• Journal of Korean Academy of Nursing
• /
• v.30 no.1
• /
• pp.122-136
• /
• 2000

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.2
• /
• pp.97-107
• /
• 2001

Background : Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. Method: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both $FEV-1$ and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. Results : There was no significant difference in the demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the $PaCO_2$ was higher ($42.9{\pm}4.7$ vs $38.8{\pm}3.1\;mmHg$ at rest; $47.9{\pm}7.0$ vs $41.1{\pm}5.9\;mmHg$ after exercise; p<0.01) and the right ventricular ejection fraction was lower ($57.6{\pm}6.5$ vs $61.4{\pm}4.7%$ at rest; $51.1{\pm}10.8$ vs $59.8{\pm}6.6%$ after exercise; p<0.01) both at rest and after exercise. The $PaCO_2$ after exercise was also lower ($65.7{\pm}12.6$ vs $80.2{\pm}14.4\;mmHg$, p<0.01), while the Pa02 at rest tended to be lower($82.9{\pm}12.0$ vs $87.8{\pm}7.5$, p>0.05). In both groups, right ventricular ejection fraction correlated with the $PaCO_2$ after exercise(PTE r=0.536, PE r=0.557), and the $PaCO_2$ at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). Conclusion : Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.

• Journal of the Korean Institute of Telematics and Electronics
• /
• v.26 no.2
• /
• pp.94-101
• /
• 1989

Transport properties of 2DEG at AlGaAs/GaAs interface such as average electron energy, flight distance, each valley occupancy ratio, average electron velocity for various fields are investigated by MONTE-CARLO method. As the electric field increases, more electrons transit drastically from (000) valley to (000) upper valley. This phenomenon shows the nonstationary effect such as velocity overshoot. The duration of the transient decreases from about 1.4 psec for electric field E = 7KV/cm to about 0.7 psec for 12KV/cm. The average electron velocity during transient transport in 2DEG is about 8 times the steady-state velocity for E = 12KV/cm at room temperature. In comparison with bulk GaAs the peak velocity in the 2DEG is higher than that in even pure bulk GaAs at electric field E = 7 KV/cm. On the basis of the fact that the electrons in the 2DEG have larger peak velocity and shorter transient time of velocity than those in the bulk GaAs, it is suggested that the device with 2DEG may obtain higher mobility than that with bulk GaAs.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
• /
• v.10 no.6
• /
• pp.15-26
• /
• 2015

The purpose of this study was to examine the area, theme and method of domestic articles on the successful establishment of venture companies, which were presented between 1998 and 2014, according to related basic classification criteria in an effort to shed light on the characteristics of these studies. It's basically meant to make a contribution to the development of research on the success of venture business and to be of practical use for the success of venture companies in our country. After related earlier studies were analyzed, 164 articles were collected, and 64 articles were selected from among them. The articles that were overlapped, not presented or not registered were excluded. The related studies had been conducted by different learned societies that were interested in the same research themes, and the studies were primarily led by the Korean Society of Business Venturing as of 2014, especially by Asia-Pacific Journal of Business Venturing and Entrepreneurship that was a journal published by this society. This society seemed to have taken the initiative in this field. There was a tendency that the related studies increased in number due to the shifts of modern industrial society and the changing policies of the government, as the number of the studies has been on the steady rise since 2012. In terms of method, quantitative research methods, especially descriptive studies, were prevailing. To step up the development of research into this field, a wide variety of research methods should be utilized in the future. As for the sphere of research, the characteristics of founders, strategic characteristics and environmental characteristics were mainly covered as the success factors of venture business. More diverse variables should be explored as well to make more advanced, extended research in the years to come. The findings of the study are expected to provide both theoretical and practical information on the establishment and success of venture business to make a contribution to the development of research.

• Korean Journal of Ecology and Environment
• /
• v.33 no.3 s.91
• /
• pp.187-196
• /
• 2000

This paper describes a simple method that uses differences among Carlson's (1977) trophic state index (TSI) values based on total phosphorus (TP), chlorophyll a (CHL) and Secchi depth (SD) to draw inferences regarding the factors that are limiting to phytoplankton growth and the composition of lake seston. Examples are provided regarding seasonal and spatial patterns in a large subtropical lake (Lake Okeechobee, Florida, USA) and inter- and intra-lake variations from a multilake data set developed from published studies. Once an investigator has collected routine water quality data and established TSI values based on TP, CHL, and SD, a number of inferences can be made. Additional information can be provided where it also is possible to calculate a TSI based on total nitrogen (TN). Where TSI (CHL)<>TSI (SD), light attenuating particles are large (large filaments or colonies of algae), and the phytoplankton may be limited by zooplankton grazing. Other limiting conditions are inferred by different relationships between the TSI values. Results of this study indicate that the analysis is quite robust, and that it generally gives good agreement with conclusions based on more direct methods (e.g., nutrientaddition bioassays, zooplankton size data, zooplankton removal experiments). The TSI approach, when validated periodically with these more costly and time-intensive methods, provides an effective, low cost method for tracking long-term changes in pelagic structure and function with potential value in monitoring lake ecology and responses to management.

• Journal of Mushroom
• /
• v.17 no.4
• /
• pp.211-217
• /
• 2019

Currently, cultivation of mushrooms using the Information and Communication Technology (ICT)-based smart farming technique is increasing rapidly. The main environmental factors for growth of mushrooms are temperature, humidity, carbon dioxide (CO₂), and light. Among all the mentioned factors, currently, only temperature has been maintained under automatic control. However, humidity and ventilation are controlled using a timer, based on technical experience.Therefore, in this study, a Pleurotus eryngii first-generation smart farm model was set up that can automatically control temperature, humidity, and ventilation. After installing the environmental control system and the monitoring device, the environmental condition of the mushroom cultivation room and the growth of the fruiting bodies were studied. The data thus obtained was compared to that obtained using the conventional cultivation method.In farm A, the temperature during the primordia formation stage was about 17℃, and was maintained at approximately 16℃ during the fruiting stage. The humidity was initially maintained at 95%, and the farm was not humidified after the primordia formation stage. There was no sensor for CO₂ management, and the system was ventilated as required by observing the shape of the pileus and the stipe. It was observed that, the concentration of CO₂ was between 700 and 2,500 ppm during the growth period. The average weight of the mushrooms produced in farm A was 125 g, and the quality was between that of the premium and the first grade.In farm B. The CO₂ sensor was in use for measurement purposes only; the system was ventilated as required by observing the shape of the pileus and the stipe. During the growth period, the CO₂ concentration was observed to be between 640 and 4,500 ppm. The average weight of the mushrooms produced in farm B was 102 g.These results indicate that the quality of the king oyster mushroom is determined by the environmental conditions, especially by the concentration of CO₂. Thus, the data obtained in this study can be used as an optimal smart farm model, where, by improving the environmental control method of farm A, better quality mushrooms were obtained.

• Korean Journal of Animal Reproduction
• /
• v.9 no.1
• /
• pp.9-30
• /
• 1985

The study was carried out to find out the changes of the sex hormone levels in the milk of Holstein cows during the reproductive stages such as the estrous cycle, pregnancy and periparturient period. The FSH, LH, estradiol-17$\beta$ and progesterone from the milk samples were assayed by radioimmunoassay methods. The results of this study were summarized as follows: 1. The levels of progesterone and estradiol-17$\beta$ were similar among inter-quarters, but they were higher in after milking than before milking times, with no statistical significance. 2. The milk progesterone levels during the estrous cycles reached a peak mean level of 3.55$\pm$0.26ng/$m\ell$ at 15 days after estrus and they did not show any differences among the length of estrous cycles. The estradiol-17$\beta$ levels during the estrous cycles showed a peak level of 36.40$\pm$2.38pg/$m\ell$ at estrus, and decreased(17.20$\pm$0.46 pg/$m\ell$ to 18.65$\pm$1.26pg/$m\ell$) at luteal phase. 3. The FSH levels during the estrous cycles ranged from 2.25$\pm$0.23mIU/$m\ell$ to 4.35$\pm$0.24mIU/$m\ell$ showing significant changes. The LH levels during the estrous cycles gradually increased and remained a peak level of 10.90$\pm$0.36mIU/$m\ell$ from 20 to 25 days after estrus. 4. The progesterone levels during the pregnancy were decreased from 30 to 60 days after artificial insemination, and therafter continuously increased until 240 days. The estradiol-17$\beta$ levels during the pregnancy were 24.56$\pm$1.19pg/$m\ell$ at day 30 after artificial inseminaton, and increased rapidly until 180 days. The levles were agagin decreased by 26.17$\pm$3.03pg/$m\ell$ until 210 days and markedly increased by 68.00$\pm$8.70pg/$m\ell$ until 240 days. 5. The prolactin levels during the pregnancy were 31.27$\pm$2.31ng/$m\ell$ and 42.60$\pm$2.37ng/$m\ell$ at day 150 and 240 after artificial insemination respectively. The LH levels during the pregnancy reached a peak of 27.47$\pm$7.90mIU/$m\ell$ at day 30 after artificial insemination, and thereafter gradually decreased. 6. The progesterone levels during the periparturient period reached a peak of 4.61$\pm$0.34ng/$m\ell$ at day 3 prepartum, and thereafter gradually decreased, and showed 2.05$\pm$0.60ng/$m\ell$ at day 7 postpartum. The estradiol-17$\beta$ levels during the periparturient period showed high level from 207.23$\pm$6.04pg/$m\ell$ at day 1 prepartum to 239.90$\pm$13.90pg/$m\ell$ at day 2 prepartum, and thereafter began to decline and reached 51.87$\pm$1.72pg/$m\ell$ at by 7 postpartum. 7. The prolactin levels during the periparturient period showed relatively higher level at the time of parturition. The LH levels during the periparturient period rnage from 6.32$\pm$0.32mIU/$m\ell$ to 13.90$\pm$1.37mIU/$m\ell$ showing significant changes. 8. The progesterone levels(4.6$\pm$0.8ng/$m\ell$) of the pregnant cows were significantly higher than those (1.84$\pm$1.4ng/$m\ell$) of nonpregnant cows. The cows of artificial insemination from 61 to 90 days after parturition showed higher progesterone levels. 9. During 20 to 25 days after artificial insemination, the accuracy of pregnancy diagnosis from milk progesterone levels were 94.4% for nonpregnant cows(<2.3ng/$m\ell$), and 75.0% for pregnant cows( 3.2ng/$m\ell$). The average overall accuracy of pregnancy prediction for nonpregnant and pregnant cows 83.3% 10. The results obtained this study suggest that the understanding of the endocrinological mechanisms by means of milk hormone analysis during the estrous cycle, pregnancy and parturition would give the basic information needed for increasing efficiency of reproduction. This study would not only provide an accurate method of the early pregnancy diagnosis by milk progesterone levels but also contribute to the research of providing the method of detecting of FSH levels in milk, which was difficult in blood serum.