• Quality Improvement in Health Care
• /
• v.14 no.1
• /
• pp.55-59
• /
• 2008

Background : The purpose of inner cannula is to protect the upper air way and permit air to pass freely, in addition, to provide endotracheal suction, artificial respiration and to maintain adequate oxygen saturation. The tube needs to be sterilized for maintenance and cleanness of air way and for prevention of bronchospasm. However, it has been reported that there is no guideline for sterilization and many hospitals conduct their own sterilization methods, for example, once a day(13's general hospital), three times a day(The Catholic University of Korea ST Mary's hospital) or even no cleansing. Consequently, the QI team of our hospital suggested the SOP(standard operating procedure) of sterilization and evaluate cost and time effect in nursing. Method : 1) Benchmarking of 13's neurosurgery department of general hospital in Seoul 2) Investigation of test records of sputum culture from patients with intubation for tracheotomy 3) Check of results of O2 Sat. monitoring to confirm of maintaining opened air way Result : 1) Improvement of process: decrease of excess sterilization of inner cannula (from 3 times a day to once a day) 2) Cost effects: saving over 10 million won per one year 3) Providing better nursing: time effects (30 min a day) permit to conduct more nursing activities Conclusion : It can get Cost and time effects in nursing with improved sterilization method of inner cannula. It needs to do research on improvement of the monthly exchange protocol of outer cannula and provide supporting data for the proper exchange schedule. The result of additional microorganism detection from patients with new process needs to be evaluated further more.

• Journal of Information Technology Services
• /
• v.19 no.3
• /
• pp.57-73
• /
• 2020

The proportion of digital evidence in criminal cases has increased, while at the same time, the spread of the Internet has made it easy to delete information that is stored in another place and thus, the Internet is being used to delete online criminal evidence. To respond quickly and effectively to cybercrime, 29 countries signed the Convention on Cybercrime in 2001 through the Council of Europe. Article 16 of the Convention relates to the expedited preservation of stored computer data and requires signatories to adopt legislative measures to enable its competent authorities to order expeditious preservation of specified computer data where there are grounds to believe that the data is particularly vulnerable to loss or modification. More than 60 countries have joined the Convention since 2001 and have made efforts to improve their legal system in line with it. The United States legislated 18 U.S.C. § 2703(f) to preserve electronic evidence pending the issuance of a court order. The German Code of Criminal Procedure §§ 94~95 allows prosecution authorities to seize evidence or issue production orders without court control in urgent circumstances. A custodian shall be obliged to surrender evidence upon a request that evidence be preserved, and non-compliance results in punishment. Japan legislated the Criminal Procedure Act § 197(3) and (4) to establish a legal base for requesting that electronic records that are stored by an ISP not be deleted. The Korean Criminal Procedure Act § 184 outlines procedures for the preservation of evidence but does not adequately address the expeditious preservation of digital evidence that may be vulnerable to deletion. This paper analyzes nine considerations, including request subjects, requirements, and cost reimbursement to establish directions to improve the legal system for the expedited preservation of digital evidence. A new method to preserve online digital evidence in urgent cases is necessary.

• Animal Systematics, Evolution and Diversity
• /
• v.28 no.3
• /
• pp.168-177
• /
• 2012

Two stichotrichid ciliates, collected from marine waters in Jeju Island, were identified as Afroamphisiella multinucleata Foissner et al., 2002 and Pseudokahliella marina (Foissner et al., 1982) Berger et al., 1985. They are recorded for the first time in Korea. The descriptions are based on examinations of living as well as protargol-impregnated specimens. These species are characterized as follows. Afroamphisiella multinucleata has a body size in vivo of $70-95{\times}20-35{\mu}m$; elongate rectangular in shape; contractile vacuole located slightly above mid-body. The adoral zone is bipartited into 3 distal and 13-17 proximal membranelles and occupies 28-35% of the body length. The frontal row comprises 1-4 cirri and one buccal cirrus. The amphisiellid median cirral row is composed of 14-21 cirri, 10-19 left marginal cirri, and 21-30 right marginal cirri. Cortical granules are yellowish. 11-20 globular/ellipsoidal macronuclear nodules arrange proximally along the cell margins. Pseudokahliella marina has a body size in vivo of $110-195{\times}40-110{\mu}m$ and broadly elliptical in shape. The adoral zone of the membranelles occupies 50-60% of the body length, and is composed of 41-70 membranelles. A prominent frontal scutum is present. The contractile vacuole is located below the mid-body. There are 11-13 frontoventral rows, including marginal rows. Caudal cirri and transverse cirri are absent. Three invariable non-fragmented bipolar dorsal kineties are present. The left and right marginal rows are composed of 22-35 and 28-40 cirri, respectively. Colourless cortical granules are present. 8-11 spherical/ellipsoidal macronuclear nodules are connected with each other by thread-like tructures, forming an inverted C-shape.

• Radiation Oncology Journal
• /
• v.33 no.1
• /
• pp.36-41
• /
• 2015

Purpose: To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Materials and Methods: Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Results: Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. Conclusion: WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

• Survey Research
• /
• v.7 no.1
• /
• pp.109-129
• /
• 2006

This paper describes how the National Statistics Office Prepared Population and Housing Census in 2005. We focus on the methods of identifying living quarters and determining the enumeration districts. In the absence of the supports of the regional administrative offices, caused by the regulation change in 1999, the NSO devised several new techniques, such as using previous census DB, administrative records, GIS, and etc.. However, not-well-organized administrative system of the regional offices, particularly in terms of the use of IT technology, becomes one of the major bottleneck for identifying living quarters. In order for better preparation of Census, we seem to concern about not only the NSO's efforts to improve survey methods, but also the administrative system of the regional offices. This may indicates that we are at the stake of moving towards a more networked administrative system beyond the present organizational boundaries.

• Advances in pediatric surgery
• /
• v.4 no.1
• /
• pp.34-38
• /
• 1998

Infantile hypertrophic pyloric stenosis(IHPS) is common in full-term babies, and relatively rare in prematures. The diagnosis of IHPS in premature infants may be obscured because of the lack of classic symptoms and signs and the absence of the standard criteria for ultrasonic diagnosis. The purpose of this study is to discover the clinical differences between premature and full-term infants with pyloric stenosis, and determine the appropriate diagnostic methods for early diagnosis in premature infants. The clinical records of 52 IHPS patients who had been operated upon from October, 1994 to April, 1997 were reviewed. The incidence of IHPS in premature infants was 25 %. The onset of symptom was 4.7 weeks of age in premature, and 2.9 weeks in full-term babies. Diagnosis was established by typical symptoms. signs. and diagnostic imaging studies. In two premature infants, diagnosis was confirmed by upper gastrointestinal(GI) series, because ultrasonography did not meet the diagnostic criteria. Two premature infants initially diagnosed as gastroesophageal reflux by esophagography. were found to have IHPS by upper GI series. For the diagnosis of IHPS, a new set of criteria for premature babies has to be developed.

• Clinical and Experimental Pediatrics
• /
• v.53 no.10
• /
• pp.886-891
• /
• 2010

Purpose: This study aims to investigate the clinical characteristics of children diagnosed with the novel influenza A (H1N1) in the winter of 2009 at a single medical institution. Methods: Out of 545 confirmed cases of influenza A (H1N1) in children, using the real time RT-PCR method at Kosin University Gospel Hospital from September to December of 2009, 149 patients and their medical records were reviewed in terms of symptoms, laboratory findings, complications and transmission within a family. Results: Median age of subjects was 7 years (range: 2 months-18 years). New cases increased rapidly from September to reach a peak in November, then declined rapidly. Most frequently observed symptoms were fever (96.7%), cough (73.2%), rhinorrhea (36.9%) and sore throat (31.5%). Average body temperatures on the 1st, 2nd and 3rd hospital day were $38.75{\pm}0.65^{\circ}C$, $38.08{\pm}0.87^{\circ}C$ and $37.51{\pm}0.76^{\circ}C$, respectively. Complete blood counts and biochemical tests performed on the first admission day showed within the reference values in most cases. Of the 82 patients with simple chest radiography, 18 (22%) had pneumonic lesions; multi-focal bronchopneumonia in eleven, single or multi-segmental lobar pneumonia in five, and diffuse interstitial pneumonia in two patients. All of the 149 patients improved from their symptoms and discharged within 9 days of admission without any late complication. Conclusion: Children with 2009 pandemic influenza A (H1N1) at our single institution displayed nonspecific symptoms and laboratory findings, resembling those of common viral respiratory illnesses, and did not appear to develop more severe disease.

• Neonatal Medicine
• /
• v.17 no.2
• /
• pp.232-238
• /
• 2010

Purpose: An increase in the breastfeeding rate has been followed by an increase in the number of mothers seeking help in relactation. We investigated the factors related to successful relactation by assessing the impact of medications, supplementer, consultations, and family support. Methods: A retrospective review of the medical records and telephone survey of mothers who had visited the relactation clinic were conducted from January 2004 to April 2007. Results: Data from 84 mothers were analyzed to identify the factors associated with success in relactation. Seventy-five percent of the mothers succeeded in obtaining exclusive breastfeeding. Success in relactation was associated with informed referral from medical personnel, the use of galactogogues, and family support. Conclusion: This study provides new and noteworthy insights concerning relactation. This highlights the need to inform the mothers about the data of relactation, to use galactogogues, and to have their families involved for psychological support and endurance during visits to the relactation clinic.

• Journal of Trauma and Injury
• /
• v.30 no.4
• /
• pp.173-178
• /
• 2017

Purpose: Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER. Methods: We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups. Results: A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034). Conclusions: In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.

• Archives of Craniofacial Surgery
• /
• v.19 no.1
• /
• pp.3-12
• /
• 2018

Background: Millard's rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed surgical procedure. Methods: We retrospectively reviewed 82 patients' medical records and presented surgical technique and outcomes. The main features of the authors' strategy are emphasizing horizontal length of the lip, orbicularis oris muscle duplication for improving the definition of the philtral column, overcorrection of domal portion than the non-cleft side in order to compensate for the recurrence during growth. Two judges rated two times the appearance of the patients' nose and lip using Asher-McDade aesthetic index. Intra- and interobserver reliabilities were determined using Cohen's kappa statistics. Results: All patients recovered eventually after surgery; however, two patients have a minor complications (wound infection in one patient, wound disruption due to trauma in the other patient). The improvement of the aesthetic results can be achieved with this modified Millard technique. Total mean scores of the Asher-McDade index was 2.08, fair to good appearance. The intraobserver reliabilities were substantial to almost perfect agreement and the interobserver reliabilities were moderate to almost perfect agreement. Conclusion: We modified Millard method for repair of complete unilateral cleft lip. The surgical outcomes were favorable in long-term follow-up. We hope our technique will serve as a guide for those new to the procedure.