• Title/Summary/Keyword: Procedures

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An Institutional Approach for Application of the Contracting-out in City Parks - Focused on the Case Study of City Park Management of Seongnam City - (도시공원의 민간위탁 적용을 위한 제도적 방안 - 성남시 도시공원 운영사례를 중심으로 -)

  • Byeon, Jae-Sang;Kim, In-Ho;Shin, Sang-Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.5
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    • pp.33-47
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    • 2011
  • One of the most fundamental jobs of contemporary government is to look into various ways of providing its citizens with the best service work. This study aims to establish a procedure through which to consign the management of city parks to private companies, thus inviting participation and satisfaction on the part of citizens. In particular, this procedure includes creating a system of selecting private managing companies, for instance, specifying standards of selection and assembling selection committees. The results of this study can be summarized as follows. First, city parks can be managed better by private companies than by local governments in terms of cost cuts, personnel training, business efficiency, and know-how accumulation. The legal background for this is found in central and local legal articles. Second, it is recommended that the selection committee be composed of 6 to 9 members, both insiders and outsiders. In addition to selecting private managing companies for contracting-out, the committee should under take the role of consulting on how to perform and revise selecting standards, so that they can continue to improve these procedures. Third, the decision on private management should be noticed in advance and be made based on standards considering each local government's condition. These standards should consider the aspects of the public good, cost saving, quality of service, managing supervision, and citizen participation. The committee's assessment takes into account both the quality and the quantity of the standards. Fourth, the contracting-out for city park management should follow the order of: announcing consignment and receiving applicants, organizing selection committees and assessing applications, selecting and contracting, midterm evaluation, and re-announcement and re-consignment. To run city parks through the contracting-out is expected to increase the number of park visitors. Additionally, private consignment will involve a participation of diverse citizenship, thus playing an important role in city parks' building of a green-culture community.

Analysis of causative microorganisms and choice of antibiotics according to the onset of neonatal sepsis (신생아 패혈증에서 발현시기에 따른 원인균 분석과 항생제 선택)

  • Sung, June Seung;Kim, Dong Yeon;Kim, Sun Hee;Byun, Hyung Suk;Hwang, Tai Ju;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.623-629
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    • 2006
  • Purpose : The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. Methods : One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. Results : The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. Conclusion : Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.

Delayed closure effect in preterm infants with patent ductus arteriosus (미숙아 동맥관개존증의 지연된 폐쇄가 예후에 미치는 영향)

  • Lee, Hyun Ju;Sim, Gyu Hong;Jung, Kyung Eun;Lee, Jin A;Choi, Chang Won;Kim, Ee Kyung;Kim, Han Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1065-1070
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    • 2008
  • Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. Results : The mean gestational age (GA) was $26{\pm}2weeks$ (range, 23-32 wk), and the birth weight was $782{\pm}146g$ (range, 430-990 g). The delayed closure group was associated with early GA ($25.7{\pm}1.7wk$ vs $27.1{\pm}2.0wk$, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010). Conclusion : Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.

Study of sedation according to neurologic and non-neurologic pediatric patients (소아연령에서 질환별 진정에 관한 연구)

  • Kim, Jeong Hwa;Kim, Min Seon;Lee, Dae-Yeol;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1047-1051
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    • 2008
  • Purpose : This study aims to evaluate the efficacy and safety of sedatives for pediatric patients using noninvasive procedures. Methods : We performed a prospective study in 446 (aged 1 month-21 y) consecutive pediatric patients undergoing sedation to study noninvasive sedation techniques from February to August 2007. We reviewed demographic data, sedative drugs, dosage, complications, and successful rates of sedation according to the underlying diseases. Results : The overall successful rate of sedation was 435/446 (97.5%). The overall rate of successful sedation using chloral hydrate was 99.1% (420/424), and was 70.6% (12/17) and 60.0% (3/5) with ketamine and midazolam, respectively. Of the neurologic patients (n=172, aged 1 month to 21 years), 136 patients were sedated for EEGs, 5 patients for renal scans, and 31 patients for neuroimaging studies such as brain CT or MRI. All non-neurological patients (n=274, aged 1 month to 5 years) were diagnosed with urinary tract infection and sedated for renal scan. The overall success rate of sedation for this group was 99.6% (273/274). A total of 14 adverse events were observed (3.1%). Most adverse reactions were mild in severity and clinically insignificant. Conclusion : Using chloral hydrate alone has enough effect to sedate non-neurologic patients. However, neurologic patients in the severe course group, especially those suffering from intractable epilepsy, autism, or severe cerebral palsy, must be medicated with chloral hydrate 2 times at most; instead, injections of ketamine or midazolam in the early stage may result in a more promising outcome.

Theme-Based Integrative Education Program Development of Industrial Specialized High School (공업계열 특성화 고등학교의 주제 중심 통합형 교육 프로그램 개발)

  • Yoon, Ji A;Lee, Chang Hoon;Kim, Ki Soo
    • 대한공업교육학회지
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    • v.38 no.1
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    • pp.163-194
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    • 2013
  • This study aims at giving examples that can be applied in the real education field, and it develops theme-based integrative education program for Industrial Specialized high school students. It analyzed the models of many scholars about the development of education course, and devised developmental models and procedures of the theme-based integrative education program of engineering specialized high school from those. As a result, it used and reorganized ADDIE model which is the systematic education course development model and the theme-based integrative education development model of Frazee and Rudnitski(1995) as the basic structure, and came to devise theme-based integrative education program of engineering specialized high school while referring to creative engineering design education program development model by Lee Chang-hoon. This study that is theme-based integrative education program for engineering-specialized high school students and is the result of this study has the following characters. First, This theme-based integrative education program that is developed for engineering-specialized high school students can be applied and the initial example that approach the Theme-Based. Second, This Education Program included the Activity project that is "Making Maglev" for the third grade at the engineering-specialized high school and One of the Program's aim is to bring up their attitude that engaged to in the class having the Interest. Third, Theme-based integrative education program for engineering-specialized high school is composed the workbook for the students and the teaching guidance plan for the teachers. Workbook for the students is composed four Units;"Brief about the Maglev","Basic principles about the Maglev","Intensive principles about the Maglev", Activity project about the Maglev". And each unit is made by Learning Purpose, Introducing, Learning Contents(Deepen Learning, Reading Magazines), Assesment etc. Teaching guidance plan for the teachers include that Summary, Purpose, Time Planing & Streaming Map for the class, contents associated Maglev, prerequisite learning, constructure of the education program, flow chart, learning activity, assesment(self-appraiser and peer review).

Development of Preliminary Quality Assurance Software for $GafChromic^{(R)}$ EBT2 Film Dosimetry ($GafChromic^{(R)}$ EBT2 Film Dosimetry를 위한 품질 관리용 초기 프로그램 개발)

  • Park, Ji-Yeon;Lee, Jeong-Woo;Choi, Kyoung-Sik;Hong, Semie;Park, Byung-Moon;Bae, Yong-Ki;Jung, Won-Gyun;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.113-119
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    • 2010
  • Software for GafChromic EBT2 film dosimetry was developed in this study. The software provides film calibration functions based on color channels, which are categorized depending on the colors red, green, blue, and gray. Evaluations of the correction effects for light scattering of a flat-bed scanner and thickness differences of the active layer are available. Dosimetric results from EBT2 films can be compared with those from the treatment planning system ECLIPSE or the two-dimensional ionization chamber array MatriXX. Dose verification using EBT2 films is implemented by carrying out the following procedures: file import, noise filtering, background correction and active layer correction, dose calculation, and evaluation. The relative and absolute background corrections are selectively applied. The calibration results and fitting equation for the sensitometric curve are exported to files. After two different types of dose matrixes are aligned through the interpolation of spatial pixel spacing, interactive translation, and rotation, profiles and isodose curves are compared. In addition, the gamma index and gamma histogram are analyzed according to the determined criteria of distance-to-agreement and dose difference. The performance evaluations were achieved by dose verification in the $60^{\circ}$-enhanced dynamic wedged field and intensity-modulated (IM) beams for prostate cancer. All pass ratios for the two types of tests showed more than 99% in the evaluation, and a gamma histogram with 3 mm and 3% criteria was used. The software was developed for use in routine periodic quality assurance and complex IM beam verification. It can also be used as a dedicated radiochromic film software tool for analyzing dose distribution.

Comparison of Sea Level Data from TOPEX/POSEIDON Altimeter and in-situ Tide Gauges in the East Asian Marginal Seas (동아시아 주변해역에서의 TOPEX/POSEIDON 고도 자료와 현장 해수면 자료의 비교)

  • Youn, Yong-Hoon;Kim, Ki-Hyun;Park, Young-Hyang;Oh, Im-Sang
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.5 no.4
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    • pp.267-275
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    • 2000
  • In an effort to assess the reliability of satellite altimeter system, we conducted a comparative analysis of sea level data that were collected using the TOPEX/POSEIDON (T/P) altimeter and the 10 tide gauge (TG) stations in the satellite passing track. The analysis was made using data sets collected from marginal sea regions surrounding the Korean Peninsula at T/P cycles of 2 to 230, which correspond to October 1992 to December 1998. Because of strong tidal activity in the study area, treatment of tidal errors is a very critical step in data processing. Hence in the computation of dynamic heights from the Tn data, we adapted the procedures of Park and Gamberoni (1995) to reduce errors associated with it. When these T/P data were treated, the alias periods of M$_2$, S$_2$, and K$_1$ constitutions were found at 62.1, 58.7, and 173 days. The compatibility of the T/P and TG data sets were examined at various filtering periods. The results indicate that the low-frequency signal of Tn data can be interpreted more safely with longer filtering periods (such as up to the maximum selected values of 200 days). When RMS errors for 200-day low-pass filter period was compared among the whole 10 tidal stations, the values spanned in the range of 2.8 to 6.7 cm. The results of correlation analysis at this filtering period also showed a strong agreement between the Tn and TG data sets over the whole stations investigated (e.g., P values consistently less than 0.0001). According to our analysis, we conclude that the analysis of surface sea level using satellite altimeter data can be made safely and reasonably long filtering periods such as 200 days.

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The Optimum of Respiratory Phase Using the Motion Range of the Diaphragm: Focus on Respiratory Gated Radiotherapy of Lung Cancer (횡격막의 움직임을 이용한 최적화된 호흡 위상의 선택: 폐암의 호흡 동기 방사선치료 중심)

  • Kim, Myoungju;Im, Inchul;Lee, Jaeseung;Kang, Suman
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.157-163
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    • 2013
  • This study was to analyze quantitatively movement of planning target volume (PTV) and change of PTV volume through movement of diaphragm according to breathing phase. The purpose of present study was to investigate optimized respiration phase for radiation therapy of lung cancer. Simulated breathing training was performed in order to minimize systematic errors which is caused non-specific or irregular breathing. We performed 4-dimensional computed tomography (4DCTi) in accordance with each respiratory phase in the normalized respiratory gated radiation therapy procedures, then not only defined PTVi in 0 ~ 90%, 30 ~ 70% and 40 ~ 60% in the reconstructed 4DCTi images but analyzed quantitatively movement and changes of volume in PTVi. As a results, average respiratory cycle was $3.4{\pm}0.5$ seconds by simulated breathing training. R2-value which is expressed as concordance between clinically induced expected value and actual measured value, was almost 1. There was a statistically significant. And also movement of PTVi according to each respiration phase 0 ~ 90%, 30 ~ 70% and 40 ~ 60% were $13.4{\pm}6.4mm$, $6.1{\pm}2.9mm$ and $4.0{\pm}2.1mm$ respectively. Change of volume in PTVi of respiration phase 30 ~ 70% was decreased by $32.6{\pm}8.7%$ and 40 ~ 60% was decreased by $41.6{\pm}6.2%$. In conclusion, PTVi movement and volume change was reduced, when we apply a short breathing phase (40 ~ 60%: 30% duty cycle) range. Furthermore, PTVi margin considered respiration was not only within 4mm but able to get uniformity of dose.

Impact of Pulmonary Vascular Compliance on the Duration of Pleural Effusion Duration after Extracardiac Fontan Procedure (수술 전 폐혈관 유순도가 심장 외 도판을 이용한 Fontan 수술 후 늑막 삼출 기간에 미치는 영향)

  • Yun Tae-Jin;Im Yu-Mi;Song Kwang-Jae;Jung Sung-Ho;Park Jeong-Jun;Seo Dong-Man;Lee Moo-Song
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.579-587
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    • 2006
  • Background: Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have poor surgical outcome; prolonged pleural drainage, protein losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for prolonged pleural effusion drainage after the Fontan operation. Material and Method: A retrospective review of 96 consecutive patients who underwent the Extracardiac Fontan procedures (median age: 3.9 years) was performed. Fontan risk score (FRS) was calculated from 12 categorized preoperative anatomic and physiologic variables. PVC $(mm^2/m^2{\cdot}mmHg)$ was defined as pulmonary artery index $(mm^2/m^2)$ divided by total pulmonary resistance $(W.U{\cdot}/m^2)$ and pulmonary blood flow $(L/min/m^2)$ based on the electrical circuit analogue of the pulmonary circulation. Chest tube indwelling time was log-transformed (log indwelling time, LIT) to fit normal distribution, and the relationship between preoperative predictors and LIT was analyzed by multiple linear regression. Result: Preoperative PVC, chest tube indwelling time and LIT ranged from 6 to 94.8 $mm^2/mmHg/m^2$ (median: 24.8), 3 to 268 days (median: 20 days), and 1.1 to 5.6 (mean: 2.9, standard deviation: 0.8), respectively. FRS, PVC, cardiopulmonary bypass time (CPB) and central venous pressure at postoperative 12 hours were correlated with LIT by univariable analyses. By multiple linear regression, PVC (p=0.0018) and CPB (p=0.0024) independently predicted LIT, explaining 21.7% of the variation. The regression equation was LIT=2.74-0.0158 PVC+0.00658 CPB. Conclusion: Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.

Mid-term Results of Mitral Valve Repair in Mitral Regurgitation (승모판 폐쇄부전중에서 승모판막 재건술 및 중기성적)

  • Yun, Yang-Gu;Jang, Byeong-Cheol;Yu, Gyeong-Jong;Kim, Si-Ho
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.24-31
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    • 1996
  • Between January 1992 and February 1995, 36 patients with mitral regurgitation were treated by a mitral repair There wert nineteen men and seventeen women whose mean age was 41.8 years, ranged from 10 to 71. Seventeenth patients had dystrophic change of mitral valve, twelve patients had rheumatic change of mitral valve, second patients had infective change of mitral valve and another fifth patients had functional change of mitral valve. Operation proced res were suture annuloplasty (35 cases), resection of leaflet (25 cases), chordal shortening(9 cases) and commisurotomy(1 cases). These procedures were combined in most patients. Two third of the patients were in New York Heart Association class III or IV and four fifth of the patients were in mitral regurgitation grade III or IV by doppler echocardiogram. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data and functional class. Intraoperative TEE had been used in all most patients after weaning of bypass. If there remained MR more than grade 2, the valve was re-repaired or replacement. There were no operative death. The late mortality was 5.5% and cause of death was congestive heart failure. Patients have been followed up from 3 to 40 months, mean 15. Second patients underwant reoperation due to recurred mitral regurgitation, 4 and 19 days after the operation. During reoperation, we found that the repair suture was disrupted in both patients. Th s expierence demonstrated that intraoperative TEE is accurate and predictable and excellent immediate and mid-term results have been achieved by mitral valve repair.

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