• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Journal of the Korean Institute of Landscape Architecture
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• v.36 no.3
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• pp.85-95
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• 2008

The City of Seoul enforces the 'Median reserved bus lane', a revised public transportation system, in order to achieve both a faster and more convenient transit system. This study examines the visual image and preference of the median bus stops in accordance with the operation of the median reserved bus lanes. In order to evaluate and clarify the distinct landscape of each bus stop in a different environment, our team selected 3 representative bus stops with different environments on main roads and conducted landscape simulations so as to evaluate visual preference. The sites were on a narrow range road, wide width road in the downtown area and wide width road on the outskirts of the city. The preference degree for each selected bus-stop environment was compared. The comparison conditions were a median bus stop with preexisting landscape, a median bus stop with planted trees, and a landscape without a median bus stop. The results of the study can be Summarized as follows: First, the visual influence on median bus stops depends on the visual complexity of the environment where they are located. People had an affinity for the median bus stop in which the visual complexity was low, while the preference degree of median bus stop was low in a highly complex area. Secondly, regardless of regional environment where median bus stops are located, research showed that it is more "impressive" to have a median bus-stop with planted trees than landscape without a median bus stop. Thirdly, the median bus stop with plants highly preferred over one without moreover, the landscape with planted trees would provide a comfortable mind for people. This study reveals that planting-oriented design concepts in median bus stops exhibit significant differences in the preference assessment factors. Thus, for further median bus stop construction, planting is desirable to create an impressive streetscape and better scenic quality.

• Journal of Bio-Environment Control
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• v.20 no.2
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• pp.93-100
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• 2011

Maintenance of adequate soil water potential during the period of crop growth is necessary to support optimum plant growth and yields. A better understanding of soil water movement within and below the rooting zone can facilitate optimal irrigation scheduling aimed at minimizing the adverse effects of water stress on crop growth and development and the leaching of water below the root zone which can have adverse environmental effects. The objective of this study was to evaluate the feasibility of using a portable irrigation controller with an Watermark sensor for the cultivation of drip-irrigated vegetable crops in a greenhouse. The control capability of the irrigation controller for a soil water potential of -20 kPa was evaluated under summer conditions by cultivating 45-day-old tomato plants grown in three differently textured soils (sandy loam, loam, and loamy sands). Water contents through each soil profile were continuously monitored using three Sentek probes, each consisting of three capacitance sensors at 10, 20, and 30 cm depths. Even though a repeatable cycling of soil water potential occurred for the potential treatment, the lower limit of the Watermark (about 0 kPa) obtained in this study presented a limitation of using the Watermark sensor for optimal irrigation of tomato plants where -20 kPa was used as a point for triggering irrigations. This problem might be related to the slow response time and inadequate soil-sensor interface of the Watermark sensor as compared to a porous and ceramic cup-based tensiometer with a sensitive pressure transducer. In addition, the irrigation time of 50 to 60 min at each of the irrigation operation gave a rapid drop of the potential to zero, resulting in over irrigation of tomatoes. There were differences in water content among the three different soil types under the variable rate irrigation, showing a range of water contents of 16 to 24%, 17 to 28%, and 24 to 32% for loamy sand, sandy loam, and loam soils, respectively. The greatest rate increase in water content was observed in the top of 10 cm depth of sandy loam soil within almost 60 min from the start of irrigation.

• Journal of Soil and Groundwater Environment
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• v.10 no.1
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• pp.35-42
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• 2005

This research was investigated the applicability of the biofiltration technology for the removal of volatile organic carbons (VOCs) produced from the bioremediation of oil contaminated soil. Diesel was used as surrogate for oil and, two types of biofilter systems made of ceramic and polymer media were compared for the removal efficiencies of diesel VOCs at different inlet concentrations and space velocity (SV) conditions. During the first 30-d operation, the removal efficiencies of the biofilter packed with polymer and the biofilter packed with ceramic were investigated at constant SV of $153\;h^{-1}$ When inlet concentrations of diesel VOCs were below 10 ppmv, the average removal efficiencies of the polymer biofilter and the ceramic biofilter were average $67\%\;and\;75\%$, respectively. When the inlet concentration increased to 30 ppmv, the VOC removal efficiency in the polymer biofilter was $80\%$, while the average removal efficiency in the ceramic biofilter was $60\%. Effect of the inlet concentration and SV on the removal efficiency of total diesel VOCs was investigated. As SV increased from $153\;h^{-1}$ to $204\;h^{-1}$ and $306\;h^{-1}$, the removal efficiency of total diesel VOCs was decreased gradually. The average removal efficiency of the biofilter packed with polymer carrier was decreased from $82\%\;to\;80\%\;and\;77\%$. The biofilter packed with polymer carrier showed that the removal efficiency of benzene and toluene were maintained within the range of $81\%\~86\%$. In contrast, for the biofilter packed with ceramic carrier, when SV increased from $153\;h^{-1}$ to $204\;h^{-1}$ and $306\;h^{-1}$, the removal efficiency of benzene decreased from $87\%\;to79\%\;and\;74\% . respectively. The removal efficiency of toluene decreased from $80\%\;to\;77\%\;and\;76\%$ at SV of $153\;h^{-1},\;204\;h^{-1}\;and\;306\;h^{-1}$, and $306\;h^{-1}$, respectively.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.705-711
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• 2002

The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.504-510
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• 2004

Background: Vasodilatory shock after cardiac surgery may result from the vasopressin deficiency following cardio-pulmonary bypass and sepsis, which did not respond to usual intravenous inotropes. In contrast to the adult patients, the effectiveness of vasopressin for vasodilatory shock in children has not been known well and so we reviewed our experience of vasopressin therapy in the small babies with a cardiac disease. Material and Method: Between February and August 2003, intravenous vasopressin was administrated in 6 patients for vasodilatory shock despite being supported on intravenous inotropes after cardiac surgery. Median age at operation was 25 days old (ranges; 2∼41 days) and median body weight was 2,870 grams (ranges; 900∼3,530 grams). Preoperative diag-noses were complete transposition of the great arteries in 2 patients, hypoplastic left heart syndrome in 1, Fallot type double-outlet right ventricle in 1, aortic coarctation with severe atrioventricular valve regurgitation in 1, and total anomalous pulmonary venous return in 1. Total repair and palliative repair were undertaken in each 3 patient. Result: Most patients showed vasodilatory shock not responding to the inotropes and required the vasopressin therapy within 24 hours after cardiac surgery and its readministration for septic shock. The dosing range for vasopressin was 0.0002∼0.008 unit/kg/minute with a median total time of its administration of 59 hours (ranges; 26∼140 hours). Systolic blood pressure before, 1 hour, and 6 hours after its administration were 42.7$\pm$7.4 mmHg, 53.7$\pm$11.4 mmHg, and 56.3$\pm$13.4 mmHg, respectively, which shows a significant increase in systolic blood pressure (systolic pressure 1hour and 6 hours after the administration compared to before the administration; p=0.042 in all). Inotropic indexes before, 6 hour, and 12 hours after its administration were 32.3$\pm$7.2, 21.0$\pm$8.4, and 21.2$\pm$8.9, respectively, which reveals a significant decrease in inotropic index (inotropic indexes 6 hour and 12 hours after the administration compared to before the administration; p=0.027 in all). Significant metabolic acidosis and decreased urine output related to systemic hypoperfusion were not found after vasopressin admin- istration. Conclusion: In young children suffering from vasodilatory shock not responding to common inotropes despite normal ventricular contractility, intravenous vasopressin reveals to be an effective vasoconstrictor to increase systolic blood pressure and to mitigate the complications related to higher doses of inotropes.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.175-183
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• 2009

Background: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement or pediatric mitral lesions can cause problems such as a lack of growth potential. There re only limited experiences with mitral valve repair at any institution, so the purpose of his study is to evaluate the outcomes of mitral valve repair n pediatric patients. Material and Method: Sixty-four consecutive children (28 males and 36 females) with a mean age of $5.5{\pm}4.7$ years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without trial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). Result: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there as no significant difference among the groups. The median follow-up was 4.6 years range: $0.5{\sim}12.2$ years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of $2.1{\pm}1.1$ procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there ere significant differences according to the repair strategies. Conclusion: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.45-53
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• 2008

Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.229-235
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• 2011

Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.

• 대한공업교육학회지
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• v.39 no.2
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• pp.101-121
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• 2014

The study aims to develop the NCS based vocational curriculum model for the practical and creative human resources. For effectiveness of the study, the study consists of literature studies of both domestic and international, contents analysis, case study, expert(9samples) consultation and review, and in-depth-interview of the three advisory members. The validity of the developed model is analyzed through mean, standard deviation and contents validity ratio(CVR). The main results of the model development in our study are as follow. First, our NCS based vocational curriculum model for the practical and creative human resources is developed with the analyses of NCS development manuals, training standard utilization and training curriculum organization manuals, NCS learning module development manual and case studies, NCS research report, NCS based curriculum pilot development resources directed toward the high schools and vocational school as well as the domestic and international literature study on career training model like NCS. Second, based on the findings of our analysis in combination with the findings from the consultations with the expert and advisory committee, total 19 sub-factors of each step and domain are extracted. The sub-factors of domain in step 1 are the competency unit, definition of competency unit, competency unit element, performance criteria, range of variable, guide of assessment, key competency; in step 2, they are subject title, subject objectives, chapter title, chapter objectives, pedagogical methods, assessment methods and basic job competence; and in step 2, they are NCS based subject matrix table, NCS based subject profile, NCS based job training curriculum table, NCS based subjects organization flowchart, NCS based job training operation plan. Third, the final model including step 3 NCS based subject profile are developed in association with the linked organizational sub-factors of step 1 and step 2. Forth, the validity tests for the final model by the step and domain yield the mean 4.67, CVR value 1.00, indicating the superior validity. Also, the means of each sub-factors are all over 4.33 with the CVR value 1.00, indicating the high validity as well. The means of the associated organizations within the model are also over 4.33 with the CVR value of 1.00. Standard deviations are all .50 or lower which are small. Fifth, based on the validity test results and the in-depth-interview of the expert and advisory committee, the model is adjusted complemented to establish final model of the NCS based vocational curriculum for the practical and creative human resources.