The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.
Journal of Korean Society of Environmental Engineers
/
v.27
no.4
/
pp.394-401
/
2005
A nonthermal plasma-assisted fuel reformer was developed and the effects of operating variables on the performance of this reformer were studied. The $H_2$-rich reformed gas from the reformer was injected into a diesel engine under an idle condition and the effects of the amount of injected gas on the NO and soot reduction were investigated. It was found that with increasing electric power consumption, the degree of facility of ignition of the reforming reaction in the reformer could be enhanced. The performance of the reformer including $H_2$ concentration, $H_2$ recovery, and energy conversion was affected only by the O/C mole ratio. This was because the equilibrium reaction temperature was governed by the O/C mole ratio. With increasing O/C mole ratio, the $H_2$ recovery and energy conversion passed through the maximum values of 33.4% and 66%, respectively, at an O/C mole ratio between 1.2 and 1.5. The reason why the $H_2$ recovery and energy conversion increased with increasing O/C mole ratio when the O/C mole ratio was lower than $1.2{\sim}1.5$ appeared to be that the complete oxidation reaction occurred more enough with increasing O/C mole ratio in this low O/C mole ratio range and accordingly the reaction temperature increased. Whereas the reason why the $H_2$ recovery and energy conversion decreased with increasing O/C mole ratio when the O/C mole ratio was higher than $1.2{\sim}1.5$ appeared to be that the complete oxidation reaction was further advanced and the $H_2$ recovery and energy conversion decreased. As the weight ratio of reformed diesel to total diesel which entered the diesel engine was increased to $18.2{\sim}23.5%$, NO and soot reduction efficiencies increased and reached as values high as 68.5% and 23.5%, respectively.
Objectives: To compare the efficacy of GnRH antagonist multiple dose protocol (MDP) with that of GnRH agonist long protocol (LP) in controlled ovarian hyperstimulation for in vitro fertilization in patients with high basal FSH (follicle stimulating hormone) level or old age, a retrospective analysis was done. Methods: Two hundred ninety four infertile women (328 cycles) who were older than 41 years of age or had elevated basal FSH level (> 8.5 mIU/mL) were enrolled in this study. The patients had undergone IVF-ET after controlled ovarian hyperstimulation using GnRH antagonist multiple dose protocol (n=108, 118 cycles) or GnRH agonist long protocol (n=186, 210 cycles). The main outcome measurements were cycle cancellation rate, consumption of gonadotropins, the number of follicles recruited and total oocytes retrieved. The number of fertilized oocytes and transferred embryos, the clinical pregnancy rates, and the implantation rates were also reviewed. And enrolled patients were divided into three groups according to their age and basal FSH levels; Group A - those who were older than 41 years of age, Group B - those with elevated basal FSH level (> 8.5 mIU/mL) and Group C - those who were older than 41 years of age and with elevated basal FSH level (> 8.5 mIU/mL). Poor responders were classified as patients who had less than 4 retrieved oocytes, or those with $E_2$ level <500 pg/mL on the day of hCG injection or those who required more than 45 ampules of exogenous gonadotropin for stimulation. Results: The cancellation rate was lower in the GnRH antagonist group than in GnRH agonist group, but not statistically significant (6.8% vs. 9.5%, p=NS). The amount of used gonadotropins was significantly lower in GnRH antagonist group than in agonist group ($34.8{\pm}11.3$ ampules vs. $44.1{\pm}13.4$ ampules, p<0.001). The number of follicles > 14 mm in diameter was significantly higher in agonist group than in antagonist group ($6.7{\pm}4.6$ vs. $5.0{\pm}3.4$, p<0.01). But, there were no significant differences in clinical pregnancy rate (24.5% in antagonist group vs. 27.4% in agonist group, p=NS) and implantation rate (11.4% in antagonist group vs. 12.0% in agonist group, p=NS) between two groups. Mean number of retrieved oocytes was significantly higher in GnRH agonist LP group than in GnRH antagonist MDP group ($5.4{\pm}3.5$ vs. $6.6{\pm}5.0$, p<0.0001). But, the number of mature and fertilized oocytes, and the number of good quality (grade I and II) and transferred embryos were not different between two groups. In each group A, B, and C, the rate of poor response did not differ according to stimulation protocols. Conclusions: In conclusion, for infertile women expected poor ovarian response such as who are old age or has elevated basal FSH level, a protocol including a controlled ovarian hyperstimulation using GnRH antagonist appears at least as effective as that using a GnRH agonist, and may offer the advantage of reducing gonadotropin consumption and treatment period. However, much work remains to be done in optimizing the GnRH antagonist protocols and individualizing these to different cycle characteristics.
The extrafetal transfer of $Li^{+}$ in amniotic fluid was studied in 45 pregnant rabbits. LiCl solution was administered either intravenously to mother or directly into the amniotic sac and monitored the appearance and disappearance of $Li^{+}$ in the amniotic fluid, then calculated the transfer rate of $Li^{+}$ of extrafetal origin. To study the transplacental $Li^{+}$ transfer, a solution of 150 mM LiCl was infused continuously via maternal vein (initial dose: 0.7 mmol/kg, maintaining dose: 0.03 mmol/kg/min) and the $Li^{+}$ concentration was measured in maternal blood and amniotic fluid after 60 and 120 minutes of infusion. Change in the volume of aminotic fluid was determined by Congo red dilution method at the same time. Effects of duration of gestation was not considered in this study. Extrafetal transport of $Li^{+}$ into the amniotic fluid was estimated by comparing the $Li^{+}$ concentration and volume of amniotic fluid determined before and after ligating the placental vessels. Extrafetal $Li^{+}$ transport from the amniotic fluid was determined by observing the time dependent disappearance of $Li^{+}$ and Congo red in amniotic fluid after injecting 0.5 ml solution of 15 mM or 90 mM LiCl and 50 mg/ml Congo red. Following are the results obtained: 1) During infusion of LiCl through maternal vein the ratio of the aminotic $Li^{+}$/maternal plasma $Li^{+}$ increased significantly along with the increment of fetal weight. 2) The volume of amniotic fluid of larger fetuses than 20.5 gm increased significantly during administration of LiCl while that of smaller fetuses did not change. 3) After umbilical cord ligation the $Li^{+}$ concentration of amniotic fluid of larger fetuses than 20.5 gm was decreased to $59.9{\pm}10.3%$ and $56.9{\pm}42.9%$$(mean{\pm}S.D.)$ of those of control group after 60 and 120 minutes of LiCl infusion respectively. In amniotic fluid of smaller fetuses than 20.5 gm, there was no significant difference between control and ligation groups. 4) The disappearance rate of Congo red in the amniotic fluid was $45.2{\pm}8.2%/hr$. 5) The disappearance rate of $Li^{+}$ after intraamniotic injection of LiCl depended on the amount injected. On injecting $7.5\;{\mu}mol$ LiCl, $Li^{+}$ disappeared rapidly from the amniotic fluid and the rates after 60 min and 90 min were $97.0{\pm}2.8,\;98.5{\pm}2.0%$ respectively. On injecting $45\;{\mu}mol$ LiCl, the rates were $56.0{\pm}15.4,\;78.9{\pm}14.5%$ at 60 and 90 min. 6) From the above results it was concluded: a) $Li^{+}$ transfer into the amniotic fluid increased along with the fetal growth and one half of $Li^{+}$ influx is through the extrafetal route even after the maturation of fetal kidney. b) One half of the $Li^{+}$ transfer from the amniotic fluid was through swallowing of fetus, while the remaining half was transfered rapidly through amniotic membrane, which was concentration limited.
Three experiments were conducted to determine utilization of Song-Gang(equation omitted) stone as the dietary additive for growth and immune stimulant in juvenile olive flounder. In the feeding trial, four diets were formulated to contain 0, 0.5, 1.0 and 2.0% Song-Gang(equation omitted) stone per kg diet (SGS$_{0}$ , SGS$_{0.5}$, SGS$_{1.0}$ , SGS$_{2.0}$ ). Fish averaging 5.0$\pm$0.04 g (mean$\pm$SD) were fed one of four experimental diets in triplicate groups for 8 weeks. There were no significant differences in weight gain, feed efficiency, protein efficiency ratio, hematosomatic index, condition factor and survival among fish fed all the diets. In chanlenge test, fish were infected by intraperitoneal injection of 0.1 $m\ell$ bacterial suspension with Edwardsielia tarda per fish after the feeding trial. Fish fed SGS$_{0.5}$ diet have a significantly higher cumulative survival rate than did fish fed the other diets (P<0.05). In the anti-mold test, Asprrgiilus niger, Penicillium pinophiltfm, Chaeromium globosum were inoculated with Song-Gang(equation omitted) stone using ASTM G-21 method. The amount of Α. niger, Ρ. pinuphiium. C. globosum didn't increase in Song-Gang(equation omitted) stone for 4 weeks for the test period. Therefore, these results indicate that 0.5% Song-Gang(equation omitted) stone per kg diet could increase immune resistance in juvenile olive flounder and Song-Gang(equation omitted) stone could be used as the anti-mold additive in fish feed.
Kang, Chun Goo;Park, Hoon-Hee;Oh, Shin Hyun;Lee, Han Wool;Kim, Jung Yul;Oh, Joo Yung;Lee, Ju Young;Kim, Jae Sam;Lee, Chang Ho
The Korean Journal of Nuclear Medicine Technology
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v.17
no.2
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pp.3-9
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2013
Purpose: Currently commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desire to evaluate the usefulness of nuclear medicine imaging. Materials and Methods: The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using $^{99m}Tc-pertechnate$. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn ten times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Results: Under the same conditions infusion rate 40 mL/min fixed to adjust the pressure of the pump when the radiopharmaceuticals between 2-3 minutes in the most integrated in the kidney phantom was excreted inthe bladder. Glomerular filtration rate (GFR), respectively, by each device SYMBIA 1,091 mL/min, FORTE 1,232 mL/min, ARGUS 1,264 mL/min, INFINIA 1,302 mL/min in that there isno statistically significant difference was found, Tmax values and T1/2 values stars from all equipment with no statistically significant difference was found. CV values of the coefficient of variation less than 5% was found to be repeatable, and to 2.67% of the lowest SYMBIA appeared, INFINIA was the highest in the 4.86%. Conclusion: Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.
Geological CO2 sequestration is a global warming response technology to limit atmospheric emissions by injecting CO2 captured on a large scale into deep geological formations. The presented results concern mineralogical and hydrogeological investigations (FE-SEM, XRD, XRF, and MICP) of mudstone samples from drilling cores of the Pohang basin, which is the research area for the first demonstration-scale CO2 storage project in Korea. They aim to identify the mineral properties of the mudstone constituting the caprock and to quantitatively evaluate the hydrogeologic sealing capacity that directly affects the stability and reliability of geological CO2 storage. Mineralogical analysis showed that the mudstone samples are mainly composed of quartz, K-feldspar, plagioclase and a small amount of pyrite, calcite, clay minerals, etc. Mercury intrusion capillary pressure analysis also showed that the samples generally had uniform particle configurations and pore distribution and there was no distinct correlation between the estimated porosity and air permeability. The allowable CO2 column heights based on the estimated pore-entry pressures and breakthrough pressures were found to be significantly higher than the thickness of the targeting CO2 injection layer. These results showed that the mudstone layers in the Yeongil group, Pohang basin, Korea have sufficient sealing capacity to suppress the leakage of CO2 injected during the demonstration-scale CO2 storage project. It should be noticed, however, that the applicability of results and analyses in this study is limited by the lack of available samples. For rigorous assessment of the sealing efficiency for geological CO2 storage operations, significant efforts on collection and multi-aspect evaluation for core samples over entire caprock formations should be accompanied.
In this study diverse dehydrogenative polymers (DHPs) were synthesized with three precursors of native lignin [p-coumaryl alcohol (PCA), coniferyl alcohol (CA), sinapyl alcohol (SA)] in the presence of horseradish peroxidase (HRP, EC. 1.11.1.7)/$H_2O_2$. To compare the structural features between DHPs and native lignin, the DHPs as well as pine/poplar milled wood lignins were simultaneously subjected to gel permeation chromatography (GPC) to determine average molecular weights and derivatization followed by reductive cleavage (DFRC) to investigate the frequency of ${\beta}$-O-4 linkage. The highest yield of DHP was measured to 71% when CA was solely injected (G-DHP) and the yield of H-DHP was 42%. However, single injection of SA could not form any polymer in this system. The average molecular weights of DHPs were ranged between 3,000~4,700, which were only 1/2 fold compared with that of pine MWL (G-type lignin: Mw 7,340) and 1/3 scale compared with that of poplar MWL (GS-type lignin: Mw 13,250). DFRC analysis revealed that the formation of ${\beta}$-O-4 linkage during dehydrogenative polymerization was the highest in the GS-DHP with ca. 502 ${\mu}mol$/g, which was, however, remained to only 50% compared to that in poplar MWL (1107 ${\mu}mol$/g). The ${\beta}$-O-4 linkage was estimated to ca. 286 ${\mu}mol$/g In the G-DHP, which was twice as much as that of H-DHP(127 ${\mu}mol$/g). Similar to GS-DHP, only half amount of ${\beta}$-O-4 linkage, compared to pine MWL, was formed during in vitro polymerization of CA by horseradish peroxidase/$H_2O_2$.
In this study we have attempted to evaluate the technical feasibility of "BB-HY", which is depleted gas reservoir as a gas storage field, using the commercial compositional simulator "ECLIPSE 300". The "BB-HY" reservoir has an initial gas in place of 143 BCF which is relatively small, and its porosity and permeability are 19.5% and 50 md, respectively. For "BB-HY" gas reservoir, we have performed a feasibility analysis by investigating the cushion gas (or working gas), converting time to gas storage field, operation cycle, number of wells and the possible application of horizontal borehole as well. From the simulation results, it was found that the amount of cushion gas in "BB-HY" reservoir is required at least 50% of IGIP in order to operate stably as gas storage field. When one produces gas for longer time and hence the remaining gas in reservoir is less than optimal cushion gas, no technical problem was occurred as long as additional cushion gas is injected up to the optimal cushion gas. In the case of changing the operation cycle into producing gas for three months during winter season from producing five months, the result shows that either the cushion gas should be greater than 60% or the more number of wells should be drilled. Meanwhile, from the results of sensitivity analysis for the number of wells, in cases of operating six or eight vertical wells, the stable reproduction of the injected gas can not be possible in "BB-HY" gas reservoir since the remaining gas in reservoir is increased. Therefore, in "BB-HY" reservoir, at least ten vertical wells should be drilled for the stable operation of gas. This time, when three horizontal wells are additionally drilled including the existing two vertical wells, it was found that the operation of injection and reproduction of gas is relatively stable in "BB-HY" gas reservoir.
The engineered barrier system of high-level radioactive waste disposal must maintain its performance in the long term, because it must play a role in slowing the rate of leakage to the surrounding rock mass even if a radionuclide leak occurs from the canister. In particular, it is very important to clarify gas dilation flow phenomenon clearly, that occurs only in a medium containing a large amount of clay material such as a bentonite buffer, which can affect the long-term performance of the bentonite buffer. Accordingly, DECOVALEX-2019 Task A was conducted to identify the hydraulic-mechanical mechanism for the dilation flow, and to develop and verify a new numerical analysis technique for quantitative evaluation of gas migration phenomena. In this study, based on the conventional two-phase flow and mechanical behavior with effective stresses in the porous medium, the hydraulic-mechanical model was developed considering the concept of damage to simulate the formation of micro-cracks and expansion of the medium and the corresponding change in the hydraulic properties. Model verification and validation were conducted through comparison with the results of 1D and 3D gas injection tests. As a result of the numerical analysis, it was possible to model the sudden increase in pore water pressure, stress, gas inflow and outflow rate due to the dilation flow induced by gas pressure, however, the influence of the hydraulic-mechanical interaction was underestimated. Nevertheless, this study can provide a preliminary model for the dilation flow and a basis for developing an advanced model. It is believed that it can be used not only for analyzing data from laboratory and field tests, but also for long-term performance evaluation of the high-level radioactive waste disposal system.
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