• Journal of Korean Public Health Nursing
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• v.1 no.1
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• pp.45-61
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• 1987

This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.281-301
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• 1993

It was revealed that the morphology and projection pattern of terminal arbors from single primary afferent are different among distinct fiber types, functional types and the different subdivision of trigeminal sensory nucleus complex(TSNC). But it was not identified the ultrastructural morphology and synaptic connections of terminal arbors from each primary afferent within TSNC. So we employed the intra-axonal horseradish peroxidase(HRP) injection technique to define the terminal arbors of primary afferent fiber from slowly adapting mechanoreceptors in the periodontal ligament of the cat, and examined 66 labeled terminal arbors within the rostrodorsomedial part(Vo.r) of the trigeminal nucleus oralis, electromicroscopically with 90nm serial sections. All the boutons labelled with HRP contained clear, spherical and uniform sized synaptic vesicles(diameter : $47.66{\pm}3.58nm$ ). Most of the labelled boutons were boutons en passant type and they were connected by unmyelinated axonal strand. In which neurofilament and microtubule was not developed but occasionally contained synaptic vesicle in contrast to the myelinated axon. The size of the labelled bouton was relatively small(long diameter : $1.46{\pm}0.24{\mu}m$, short diameter $0.85{\pm}0.26{\mu}m$, average diameter $1.15{\pm}0.24{\mu}m$) and the shape of which varied from dome to elongated shape, but scalloped glomerulus shape was not developed. Each primary ending in Vo.r made synapse with one or two neuronal propiles(average : $1.11{\pm}0.31$), of which, 89.4% of labelled boutons made synapse with only one neuronal pro pile, the remainder, 10.6% of labelled boutons, made synapse with two neuronal propile. So characteristically they made very simple synapse. Most of labelled boutons(80.03%) made asymmetrical synapse only with dendritic shaft or spine, and 6.1% of labelled boutons received symmetrical synapse from pleomorphic vesicle containing axonal ending(p-ending). So presynaptic inhibiton was relatively scarce. Synaptic triad, in which a p-ending is presynaptic both pre-and post-synaptic element of the axo-dendritic contact from the labelled primary ending was not observed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.3
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• pp.321-347
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• 1994

Muscle spindle afferents from masseter muscle were labelled by the intra-axonal HRP injection and were processed for light microscopic reconstruction. Regions containing terminal arbors scattered in the central portion of the masseteric motor neuron pool (type I a) and those restricted to 2-3 small portion of it (type II) were selected and processed for electronmicroscopic analysis with serial sections. The shape of the labelled boutons was dome or elongated shape. Scalloped or glomerulus shape with peripherial indentation containing pre or postsynaptic neuronal propiles, which is occasionally found in the trigeminal main sensory nucleus and spinal dorsal horn, was not observed. Both type Ia and type II boutons had pale axoplasm and contained clear, spherical vesicles of uniform size(dia : 49-52nm) and occasionally large dense cored vesicles(dia : 87-118nm). The synaptic vesicles were evenly distributed throughout the boutons although there was a slight tendency of vesicles to accumulate at the presynaptic site. The average of short and long diameter(short D. + long D./2) of type I a bouton was smaller than that of type II bouton. All the labelled boutons, which showed prominent postsynaptic density, large synaptic area and multiple synaptic contact, made asymmetrical synaptic contact with postsynaptic neuronal propiles. Most of the type Ia and type II boutons made synaptic contact with only one neuronal propile and boutons which shows synaptic contact or more neuronal propiles was not observed. Most of the type Ia boutons(87.2%) were presynaptic to the soma or proximal dendrite and a few remainder(12.8%) made synaptic contact with dendritic shaft or distal dendrite. In contrast, majority of type II boutons showed synaptic contact with dendritic shaft and remainder with soma or proximal dendrite. In conclusion, terminal boutons which participate in the excitatory monosynaptic jaw jerk reflex made synaptic contact with more proximal region of the neuron, and showed very simple synaptic connection, compared with those from the primary afferenst in the other region of the central nervous system such as spinal dorsal horn and trigeminal main sensory nucleus which assumed to be responsible for the mediating pain, tactile sensation, sensory processing or sensory discrimination.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.305-315
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• 1998

The fibrous layer of mandibular condyle of the neonatal, 1-, 7-, 14-, 27-, 55-days and 1 year old rats were examined in the electron microscope with particular attention to the ultrastructure and diameter of collagen fibrils. In the 1-day rats, most of the cells of the fibrous layer were undifferentiated mesenchymal cells and fibroblasts with rough a little developed rough endoplasmic reticulum(RER) and golgi apparatus(GA). In 7-, 17 and 27-days old rats, most of the fibroblast showed well developed GA and RER with widely distended cisternae containing granular materials. In many of these cells contained intracytoplasmic filaments among the cytoplamic organelle. In 55-day and 1-year old rats, three types of cells were observed, ie, cells containing well developed cytoplasmic organelle presumed to be involved in the collagen fibril synthesis, cells showing well developed lysosomes, golgi apparatus, mitochondria and short cytoplasmic process presumed to be involved in the active resorption of the injured collagen fibrils or cellular debris, cells containing many intracytoplasmic filaments and a little organelle presumed to be cells of inactive state. The average diameters of collagen fibrils were similar in 1- and 7-day old rats as $38.48{\pm}3.81nm$, $38.06{\pm}3.86nm$. That was thickest in 14 days old rats as $50.21{\pm}3.93nm$ among experimental groups. They were gradually thinner in 27-, 55-day rats as $40.05{\pm}2.52nm$, $43.63{\pm}1.20nm$ and thinnest in 1-year old rats as $37.38{\pm}2.17nm$. The distribution pattern of diameters of collagen fibrils were unimordal with peak of 30-60nm in rats from 1-day to 17-day old. With aging from 27-day to 1 year old rats, collagen fibril diameters showed wide distribution pattern and percentage of thin collagen fibrils increased. These results may show the functional adaptation of fibrous layer of mandibular condyle to the increased mechanical forces with aging.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.87.4-88
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• 1976

The statistcal study was done on 81 cases of the foreign bodies in the food passages (73 cases) and air passages (8 cases), who had visited the Dept. of Otolaryngology of Kyung Hee Medical Center and treated endoscopically, from Nov. 1971 to Mar 1976. The results were as follows, 1) The incidence of esophageal foreign bodies (73 cases) in order of frequency was coin (61 cases; 83.6%), bone (6 cases; 8.2%), food particles (3 cases; 4.1%), discs (2 cases), and other metals (l case). The incidence of foreign bodies in the air passages (8 cases) was food particles (3 cases; 37.5%), pointed metal (2 cases; 25%), plastic pencil cap (l case), plastic ring (1 case), and wood piece (1 case) in order. 2) In sex distribution, 51 cases (62.9%) were males and 30 cases (37.1%) were females, and the ratio between males and females was about 1.7 : 1.3. In the age incidence, 69 cases (82.5%) of all foreign bodies were under 5 years of age, and especially, coin cases were 59 cases (96.7%) and the highest was 8 years of age, lowest was 11 months of age. 7 cases (87.5%) of all airway foreign bodies were under 10 years of age. 4) The ratio between the food passages(73 cases) and the air passages (8 cases) was about 9 : 1. In the location of the foreign bodies of the food passages, 66 cases (90.4%) were in the first esophageal narrowing, 5 cases (6.9%) in the second narrowing, and 2 cases (2.7%) in the third narrowing. In the air passages, the frequent sites were trachea (5 cases; 62.5%), larynx (2 cases), and bronchus (1 case) in order. 5) In duration of lodgement, 63 cases (86. 3%) of esophageal foreign bodies were removed within 24 hours, and one case was removed within 16 days. The number of cases lodged within 24 hours were 4 cases (50%). in the air passages and one case was removed within 18 days. 6) In treatment, 37 cases (50.7%) of esophageal foreign bodies were extracted by modified upper esophagoscopy, 33 cases (42.5%) by esophagoscopy under the local anesthesia, 3 cases (4.1%) by esophagoscopy under the general anesthesia. 8 cases of the coin cases were passed into the stomach during the endoscopic examination. Laryngeal foreign bodies (2 cases; 25%) were extracted by laryngoscopy under the local anesthesia. 2 cases (40%) of tracheal foreign bodies by Bronchoscopy with tracheotomy under the local anesthesia, 3 cases (60%) by Bronchoscopy under the general anesthesia, and bronchial foreign body (1 case) by open thoracotomy under the general anesthesia, at the Dept. of Chest surgery.

• Polymer(Korea)
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• v.32 no.4
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• pp.359-365
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• 2008

We have fabricated a novel thermo-responsive nanofibrous surfaces by grafting PIPAAm by electron beam irradiation onto poly(3-hydroxybutyrate-co-3-hydroxyvalerate)(PHBV) nanofibrous mats. The electrospun PHBV nanofiber structures revealed randomly aligned fibers with average diameter of 400 nm. Increased atomic percent of nitrogen was observed on the PIPAAm-grafted PHBV mats after electron beam irradiation determined by ESCA. The amounts of PIPAAm-grafted onto PHBV films were $6.49{\mu}g/cm^2$ determined by ATR-FTIR. The PIPAAm-grafted surfaces exhibited decreasing contact angles by lowering the temperature from 37 to $20^{\circ}C$, while ungrafted PHBV surfaces had negligible contact angle change. This result indicates that PIPAAm surfaces, which are hydrophobic at the higher temperature, became markedly more hydrophilic in response to a temperature reduction due to spontaneous hydration of the surface-grafted PIPAAm. Thermo-responsive nanofibers showed good tissue compatibility. Cultured cells were well detached and recovered from the surfaces by changing culture temperature from 37 to $20^{\circ}C$.

• Asia pacific journal of information systems
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• v.23 no.1
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• pp.45-63
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• 2013

The purpose of this research is on the identification of the effects of perceived interactivity formed by the electronic collaborative referral system on the organizational loyalty. Two channels through which the effects proceeded were investigated. One is the "system channel" which consists of "interactivity of the inter-organizational system ${\rightarrow}$ intention of using the system ${\rightarrow}$ organization loyalty" (hypothesis 1, 2), that is the channel which anticipates that a better understanding on the interactivity of the inter-organizational system makes the intention of the using the system strong, and this strong intention results the higher organization loyalty. The other is "organization channel" which consists of "interactivity of the inter-organizational system ${\rightarrow}$ perceived interactivity on the counterpart ${\rightarrow}$ perceived relation benefits with the counterpart ${\rightarrow}$ organization loyalty" (hypothesis 3, 4, 5). The channel means that as the perceived interactivity of users on the inter-organizational system becomes greater, the perceived interactivity with the counterpart is increasing. And this makes the users feel that more benefits can be obtained by the relationship with system providing organization, and finally makes the organization loyalty that is the intention to maintain the relationship greater. The corroborative evidence data confirm the two channels are obtained by questing on the electronic referral system of Samsung Medical Center to the doctors of the first and second collaborated hospitals or clinics, and by analyzing statistically. The verification result for the "system channel" showed that as the perception on the interactivity of inter-organizational system was increasing, the intention for consistent using increased(support hypothesis 1), and then the organization loyalty that is the relationship maintaining indication by using the referral system also increased(support hypothesis 2). And the confirmation result for the "organization channel" indicated that the perceptive interactivity on the counterpart increased as the understanding on the interactivity of inter-organizational system increased(support hypothesis 3), consecutively, with the intuitive relation benefits increase with the counterpart(support hypothesis 4) the organization loyalty means the intention to maintain the relationship was confirmed to increase(support hypothesis 5). These results demonstrate that when the perceived interactivity in using many systems at the collaboration between organizations is increasing, the positive image on the systems creates the consistent system using intention, and the positive image increases the wants for preserving the relationship with counter organization. In addition, the perceived interactivity of inter-organizational system users affects directly on the perceived interactivity of the counter organization, so the important role of inter-organizational system in promoting the interactivity between cooperative counterparts was recognized. And the perceived interactivity on the counter organization become greater, the influence on the perceived benefits from cooperation is positive. Therefore, the perceived interactivity by using inter-organizational system was confirmed as a prerequisite for the continuous relationship.

• Journal of Digital Convergence
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• v.11 no.8
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• pp.219-225
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• 2013

The purpose of this study was to retrospectively investigate the contributing factors in facial soft tissue injuries among children. A record-based analysis was carried out on 126 patients with facial lacerations who visited I hospital in the dept of plastic surgery from April 2010 to May 2011. Through all age group showed a significant difference in incidence rate for male and female.(p<.05). Overall, 49% of injuries occurred outdoors and the most frequent cause of injury was slip-down (42%), followed by being struck (40%). In general, the frequency of injuries peaked summer(30.2%) and increased between 12pm and 4pm. 105 patients (83.3%) arrived at the emergency room within an hour. The forehead(26%) was the most commonly injured area. The depth of soft tissue injuries was mostly subcutaneous(54%), and 1~2cm was the length of injury with the highest incidence(46%). Most children (40%) needed local anesthesia and only 4 children (1.53%) suffered associated fractures. Facial injuries require special attention because of their potential threat in inducing permanent scar or disfigurement. For the safety of children, the preventive measures to reduce facial soft tissue injuries must be improved.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.46-60
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• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• The korean journal of orthodontics
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• v.36 no.4
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• pp.308-320
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• 2006

Rapid canine retraction, first introduced by Liou, is a distraction osteogenesis applied to the periodontal ligament tissue. Rapid tooth movement was facilitated by establishing minimal bony resistance on the distal surface of the canine by socket preparation and by osteogenesis on the mesial side in response to the periodontal distraction. Since undesired buccal tipping or extrusion of the canine during retraction tends to occur, it is crucial to maintain the firm path of movement and the axis of the canine during retraction. In order to improve the predictability of the canine movement, lingually extended distraction screws with heavy labial guiding wires were designed. Prefabricated plastic canine models for the estimation of socket depth and miniscrew implants for anchorage reinforcement were also devised. Applying these devices to a female patient with Class II anterior protrusion, the whole treatment was effectively finished in 13 months. Loss of vitality or periodontal problems did not occur throughout treatment, and stable occlusion was maintained during 10 months of retention. This case report demonstrates that a predictable rapid canine retraction can be achieved through the use of this modified technique.