• 제목/요약/키워드: Over discharge

검색결과 939건 처리시간 0.028초

A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • 제12권1호
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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Investigation of causes of FUO (fever of unknown origin) in children (소아 불명열 원인에 대한 고찰)

  • Park, Hyun Seok;Im, Sun Ju;Park, Su Eun
    • Clinical and Experimental Pediatrics
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    • 제49권12호
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    • pp.1282-1286
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    • 2006
  • Purpose : The causes of prolonged fever have changed during the years and are influenced by age, geographic location and availability of diagnostic facilities/techniques. The aim of the present study was to determine the causes of prolonged fever, to know the proportion and outcomes of undiagnosed children. Methods : We reviewed patients with fever persisting for more than 2 weeks in duration, with documented temperatures of $38^{\circ}C$ on several occasions, or uncertain diagnosis after intensive study of 1 week duration in other hospitals who were admitted to Pusan National University Hospital during the period from July 1999 to June 2004. Results : Fifty-four (59.0 percent) were boys and thirty-seven (41 percent) were girls. Forty-six cases were less than 6 years and 45 cases were more than 6 years; the mean age was $6.48{\pm}6.56years$. In 62 cases (68.1 percent), the fever had persisted for 2 to 3 weeks before admission and in 26 cases (28.6 percent), had lasted longer than a month. Final diagnosis had been reached in 66 of 91 children (72.5 percent). The most common cause was infection (38/91), followed by collagen vascular disease (12/91), immune deficiency (3/91), neoplasia (2/91), and miscellaneous disease. Tuberculosis was the most common infectious cause. The causes of fever were not revealed in 25 cases. Outcome on discharge were as follows; 77 cases (84.6 percent) were improved, 10 cases (11.0 percent) discharged without improvement and 4 cases (4.4 percent) expired. Conclusion : The most common cause of prolonged fever in Korean children remains infection, but the incidence of infection was decreased as compared with previous studies. Tuberculosis is the most common among infectious causes. As Kikuchi disease (subacute necrotizing lymphadenitis) represented a significant cause of prolonged fever, it should be considered if a patient has neutropenia with lymphadenopathy. Undiagnosed patients with prolonged fever (27.5 percent) have increased over previous studies.

Evaluation of the Water Quality Changes in Agricultural Reservoir Covered with Floating Photovoltaic Solar-Tracking Systems (수상 회전식 태양광 발전시설 설치에 따른 농업용 저수지의 수질변화 평가)

  • Lee, Inju;Joo, Jin Chul;Lee, Chang Sin;Kim, Ga Yeong;Woo, Do Young;Kim, Jae Hak
    • Journal of Korean Society of Environmental Engineers
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    • 제39권5호
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    • pp.255-264
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    • 2017
  • To evaluate the water quality changes in agricultural reservoir covered with floating photovoltaic solar-tracking systems, the water quality variations with time and depth were monitored on both six sites for light blocking zones and four sites for light penetration zones after the installation of floating photovoltaic solar-tracking systems in Geumgwang reservoir at Anseong-si, Kyeonggi province. For one year with 16 monitoring events, water quality parameters [i.e., water temperature, pH, dissolved oxygen (DO), chlorophyll-a (Chl-a), and blue-green algae (BGA)] were monitored at depths of 0.3 m, 1 m, 3 m, and 5 m, while chemical oxygen demand (COD), total nitrogen (TN), and total phosphorus (TP) were monitored at depths of 0.3 m. Statistically, the difference in all water quality parameters was not significantly different (p > 0.05) at the level of significance of 0.05. Based on these results, the water quality data from light blocking zones (site 1~6) and light penetration zones (site 7~10) were clustered, and were compared with time and depth. As a result, the difference in water temperature, pH, DO, COD, TN, TP, Chl-a, and BGA between light blocking zones and light penetration zones was not significant (p > 0.05) with different time and depth. For Chl-a and BGA, some data from light blocking zones greater than light penetration zones were temporary observed due to the severe drought, low water storage rate, and over growth of periphyton. However, this temporal phenomenon did not impact the water quality. Considering the small water surface area (${\leq}0.5%$) covered by floating photovoltaic solar-tracking systems, the mixing effect of whole Geumgwang reservoir caused by Ekman current and continuous discharge were more dominant than the effect of reduced solar irradiance. Further study is warranted to monitor the changes in water quality and aquatic ecosystems with greater water surface area covered by floating photovoltaic solar-tracking systems for a long time.

E-Commerce in the Historical Approach to Usage and Practice of International Trade ("무역상무(貿易商務)에의 역사적(歷史的) 어프로치와 무역취인(貿易取引)의 전자화(電子化)")

  • Tsubaki, Koji
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • 제19권
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    • pp.224-242
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    • 2003
  • The author believes that the main task of study in international trade usage and practice is the management of transactional risks involved in international sale of goods. They are foreign exchange risks, transportation risks, credit risk, risk of miscommunication, etc. In most cases, these risks are more serious and enormous than those involved in domestic sales. Historically, the merchant adventurers organized the voyage abroad, secured trade finance, and went around the ocean with their own or consigned cargo until around the $mid-19^{th}$ century. They did business faceto-face at the trade fair or the open port where they maintained the local offices, so-called "Trading House"(商館). Thererfore, the transactional risks might have been one-sided either with the seller or the buyer. The bottomry seemed a typical arrangement for risk sharing among the interested parties to the adventure. In this way, such organizational arrangements coped with or bore the transactional risks. With the advent of ocean liner services and wireless communication across the national border in the $19^{th}$ century, the business of merchant adventurers developed toward the clear division of labor; sales by mercantile agents, and ocean transportation by the steam ship companies. The international banking helped the process to be accelerated. Then, bills of lading backed up by the statute made it possible to conduct documentary sales with a foreign partner in different country. Thus, FOB terms including ocean freight and CIF terms emerged gradually as standard trade terms in which transactional risks were allocated through negotiation between the seller and the buyer located in different countries. Both of them did not have to go abroad with their cargo. Instead, documentation in compliance with the terms of the contract(plus an L/C in some cases) must by 'strictly' fulfilled. In other words, the set of contractual documents must be tendered in advance of the arrival of the goods at port of discharge. Trust or reliance is placed on such contractual paper documents. However, the container transport services introduced as international intermodal transport since the late 1960s frequently caused the earlier arrival of the goods at the destination before the presentation of the set of paper documents, which may take 5 to 10% of the amount of transaction. In addition, the size of the container vessel required the speedy transport documentation before sailing from the port of loading. In these circumstances, computerized processing of transport related documents became essential for inexpensive transaction cost and uninterrupted distribution of the goods. Such computerization does not stop at the phase of transportation but extends to cover the whole process of international trade, transforming the documentary sales into less-paper trade and further into paperless trade, i.e., EDI or E-Commerce. Now we face the other side of the coin, which is data security and paperless transfer of legal rights and obligations. Unfortunately, these issues are not effectively covered by a set of contracts only. Obviously, EDI or E-Commerce is based on the common business process and harmonized system of various data codes as well as the standard message formats. This essential feature of E-Commerce needs effective coordination of different divisions of business and tight control over credit arrangements in addition to the standard contract of sales. In a few word, information does not alway invite "trust". Credit flows from people, or close organizational tie-ups. It is our common understanding that, without well-orchestrated organizational arrangements made by leading companies, E-Commerce does not work well for paperless trade. With such arrangements well in place, participating E-business members do not need to seriously care for credit risk. Finally, it is also clear that E-International Commerce must be linked up with a set of government EDIs such as NACCS, Port EDI, JETRAS, etc, in Japan. Therefore, there is still a long way before us to go for E-Commerce in practice, not on the top of information manager's desk.

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A Study on Process Optimization for CSOs Application of Horizontal Flow Filtration Technology (수평흐름식 여과기술의 CSOs 적용을 위한 공정 최적화 연구)

  • Kim, Jae-Hak;Yang, Jeong-Ha;Lee, Young-Shin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제19권2호
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    • pp.56-63
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    • 2018
  • The management of Combined Sewer Overflows(CSOs) and Separated Sewer Overflows(SSOs) discharge directly to the effluent system in an untreated state, which occurs when the facility capacity is exceeded due to heavy rain, has become an important issue in recent years as the heavy rain becomes a regular phenomenon. Despite the continuous development of filtration technology, targeting densely populated urban areas, CSOs are rarely applied. Therefore, this study was carried out to optimize the process to apply CSOs in a pilot-scale horizontal flow filtration system with a rope-type synthetic fiber. The research was carried out in two steps: a preliminary study using artificial samples and a field study using sewage. In the preliminary study using an artificial sample, head loss of the filter media itself was analyzed to be approximately 1.1cm, and the head loss was increased by approximately 0.1cm as the linear velocity was increased by 10m/hr. In addition, the SS removal efficiency was stable at 81.4%, the filtration duration was maintained for more than 6 hours, and the average recovery rate of 98% was obtained by air backwashing only. In the on-site evaluation using sewage, the filtration duration was approximately 2 hours and the average removal efficiency of 83.9% was obtained when belt screen (over 450 mesh) was applied as a pre-treatment process to prevent the premature clogging of filter media. To apply the filtration process to CSOs and SSOs, it was concluded that the combination with the pre-treatment process was important to reinforce the hydraulic dimension for the stable maintain of operation period, rather than efficiency. Compared to the dry season, the quality of incoming sewage was lower in the rainy season, which was attributed to the characteristics of the drainage area with higher sanitary sewerage. In addition, the difference in removal efficiency according to the influent quality of the wet season and dry season was small.

The Characteristic of Point Source Loads for Nitrogen and Phosphorus to Gwangyang Bay, Korea (광양만으로 유입되는 질소, 인의 점원 오염부하 특성)

  • Kim Do-Hee;Cho Hyeon-Seo;Lee Young Sik
    • Journal of the Korean Society for Marine Environment & Energy
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    • 제8권1호
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    • pp.1-8
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    • 2005
  • We estimated the loadings of nitrogen and phosphorus flowing into Gwangyang Bay front river for monthly interval from April to December of 2003. We analyzed the concentrations of nitrogen and phosphorus in water and estimated the flowing rates of fresh water in 34 rivers. The amounts of water flowing into the Gwdngyang Bay from Sum-Jin River was 51-76% in the total inflow of the river. The river water over 96% of discharge was from Sumjin River, Dong River, Ju-Kyo River, Seo River and Shinkyum River. The flowing patterns of nitrogen and phosphorus into Gwangyang Bay were similar to the flowing of river. The nitrogen and phosphorus loadings into the Bay were higher in July and August than in dry seasons. In particular, the concentrations of phosphorus were high in Namshu River, Deukyang River and Kilho River sewage during in dry seasons. The range of DIN and TN loadings from Sumjim River were 46-66% and 36-64%, respectively. The loading of DIP and TP from Sumjim River were 2-55% and 12-67%, respectively. These results show that the most efficient control of N. p flow into Gwangyang Bay is to restrain the inflows of N, p from Namshu River, Deukyang River and Kilho River and to restrain the flows of N, p from Dong River, Ju-Kyo River and industrial plant. The DIN/DIP atom ratio in river water was about 18 in July and August, while the ratio was more higher in dry seasons than July and August of rainy seasons. The TN/TP atom ratio in river water was about 7 in rainy seasons, while the ratios were higher than 100 in the other months of dry seasons.

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Stabilization of Heavy Metal Contaminated Paddy Soils near Abandoned Mine with Steel Slag and CaO (제강슬래그와 CaO를 이용한 폐광산 주변 중금속 오염 농경지 토양의 안정화 처리 연구)

  • Son, Jung-Ho;Roh, Hoon;Lee, Sun-Young;Kim, Sung-Kyu;Kim, Gil-Hong;Park, Joong-Kyu;Yang, Jae-Kyu;Chang, Yoon-Young
    • Journal of Soil and Groundwater Environment
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    • 제14권6호
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    • pp.78-86
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    • 2009
  • Applicability of CaO and steel slag as stabilizers in the treatment of field and paddy soils near Pungjeong mine contaminated with arsenic and cationic heavy metals was investigated from batch and column experiments. Immobilization of heavy metals was evaluated by TCLP dissolution test. Immobility of heavy metal ions was less than 15% when steel slag alone was used. This result suggests that $Fe_2O_3$ and $SiO_2$, known as the major component of steel slag, have little effect for the immobilization of heavy metal ions due to acidity of TCLP solution. Immobilization of cationic heavy metals was little affected by the ratio of CaO and steel slag while arsenic removal was increased as the ratio of steel slag to CaO increased. In the column test, concentrations of both arsenic and cationic heavy metals in effluents were below the water discharge guideline over the entire reaction period. This result can be explained by the immobilization of cationic heavy metals from the increased pH in soil solution as well as by the formation of insoluble $Ca_3(AsO_4)_2$. From this work, it is possible to suggest that arsenic and cationic heavy metals can be concurrently stabilized by application of both CaO and steel slag.

Effects of Early Parenteral Nutrition for Extremely Low Birth Weight Infants (초극소 저출생 체중아(${\leq}$1,000 g)에서 조기에 시작하는 정맥 영양공급의 효과)

  • Ahn, So-Yoon;Shin, Ji-Hun;Shin, Jung-Hee;Sung, Se-In;Jung, Ji-Mi;Kim, Jin-Kyu;Chang, Yun-Sil;Jang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • 제18권1호
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    • pp.76-81
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    • 2011
  • Purpose: The object of this study was to evaluate the efficacy of early total parenteral nutrition with early amino acid in extremely low birth weight infant (ELBWI). Methods: We retrospectively analyzed the medical records of all ELBWIs who were born and admitted to Samsung Medical Center from January 2003 to December 2003 and January 2009 to December 2009 and alive at the time of discharge. Data for nutritional status and morbidities were compared between period 1 (2003, n=22), in which parenteral nutritional support was started gradually over several days and period 2 (2009, n=38), in which parenteral nutrition with amino acid was started as soon as possible after birth. Results: Compared to period 1, birth weight and Apgar score were lower in period 2. The intake amount of glucose, amino acid and total calorie was higher and the level of blood urea nitrogen was increased more from 7th day to 14th day after birth in period 2 when compared than period 1. The weight gain velocity was faster at 7th and 14th postnatal day in period 2. There were no differences in the incidence of necrotizing enterocolitis, moderate to severe bronchopulmonary dysplasia, and severe intraventricular hemorrhage (${\geq}$ Gr III) between two periods but, the incidence of periventricular leukomalacia(PVL) was significantly lower in period 2. Conclusion: Early initiation of total parenteral nutrition with early amino acid in ELBWIs was beneficial at weight gain with lowering catabolism and increasing anabolism. And it could be related with reducing the incidence of PVL.

Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • 제13권1호
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results (경피적 동맥관 폐쇄술에 사용된 Duct-Occlud Coil의 종류에 따른 중-단기 결과의 비교)

  • Kim, Myung Kwan;Han, Dong Ki;Choi, Jae Young;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Sul, Jun Hee;Lee, Sung Kue
    • Clinical and Experimental Pediatrics
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    • 제48권2호
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    • pp.158-164
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    • 2005
  • Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.