• Korean Journal of Clinical Laboratory Science
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• v.48 no.2
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• pp.158-167
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• 2016

The requirements for medical laboratories ISO 15189 is examined in organization and a quality management system, stressing the importance of evidence, document control, and control of records and clinical material. Medical services are provided from the areas of resource management, and pre-examination, examination and post-examination processes. The main goal of ISO 15189 accreditation is to improve the quality of laboratory services provided for patients and clinical users not only through compliance with consensually developed and harmonized requirements but also by adopting the philosophy of continual improvement using the Plan-Do-Check-Act cycle. Laboratory quality should be evaluated and improved in all steps of the testing process as the state-of-the art indicates that the pre- and post-analytical phases are more vulnerable to errors than the intra-analytical phase. The Korea Laboratory Accreditation Scheme (KOLAS), a national accreditation body, provides medical laboratory accreditations for appropriate approaches to evaluating the competence of a medical laboratory in providing effective services to its customers and clinical users. Adoption of ISO 15189 in 2010s as a government policy has been delayed, and only 5 laboratories have been accredited to date in Korea. The medical laboratories should seek the adoption of ISO 15189 with a positive attitude for quality improvement and strengthening of international competitiveness.

• Economic and Environmental Geology
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• v.41 no.2
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• pp.225-242
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• 2008

The site effect for 23 broadband seismic stations in the southern Korean Peninsula was estimated by using the spectral ratio of coda waves. In principle, the site effect means the pure amplification below the station excluding effects of seismic source and attenuation in the wave transmission. However, the site effect determined in this study is equivalent with the relative site amplification factor to the mean amplification for all stations. A total of 500 three-component seismograms from 35 earthquakes, of which magnitude ranged from 2.5 to 5.1 occurred from January, 2001 to January, 2007 was used to obtain the site amplification factor. The site amplification factors were estimated for the frequency bands centered at 0.2, 0.5, 1, 2, 5, 10, 15, and 20 Hz. It was found that the factors for two horizontal components of transverse and radial records were concordant with each other in the all frequency bands. However, the factor for the vertical component was found to be systematically lower than those for two horizontal components. The factors obtained in the low frequency band below 2 Hz ranged from 0.5 to 1.5 in all seismic stations except for KMA and KIGAM stations in Bagryeongdo (BRD1 and BRD2) of which factor showed high value above 1.5. Some stations such as SEO, SNU, HKU, NPR, and GKPI showed high value above 1.5 in the high frequency band from 5 to 20 Hz. Especially, the factors of GKP1 station represented extremely high value ranging from 1.8 to 7.8. Also, the factors for stations of KWJ, SND, and ULJ showed low value below 0.5. The spatial distribution for the relative amplification factor represented a tendency of being approximately lower in north-eastern area than south-western area in the southern Korean Peninsula.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.214-220
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• 2004

Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.229-236
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• 2008

Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.358-364
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• 2010

Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.

• Journal of The Korean Association For Science Education
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• v.33 no.5
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• pp.893-910
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• 2013

The purpose of this study was to identify changes in mental models of students in the elementary school about causes of seasonal changes. During a total of eight sessions, eight sixth graders were asked to describe the causes of seasonal changes through pictures, writing and thinking aloud by using microgenetic research methods, and the changes in mental models were examined. When the research was conducted, linguistic and behavioral factors and contents of interviews of participants were recorded on video. Moreover, a variety of materials such as field observation chart were written by a researcher and mental models records were written by a student. The protocol was written by integration of collected results, and it was repeated to read and was inductively categorized. The results of this study were as follows: First, participants' mental models about causes of seasonal changes were changed in various paths within and across sessions. Participants' mental models that had been more changed in various ways were closer to the scientific model. In addition, like rotation and revolution, students who correctly established the preconceptions related to seasonal changes formed the mental models consistent with scientific concept based on new information. On the other hand, students who did not correctly establish the preconceptions did not deviate from non-scientific mental models. Second, prior knowledge, experience and information which participants held in advance, accuracy of prior knowledge, resolution of inconsistency between new knowledge and existing mental models, activation of mental models through operation of models and drawing an picture affected the changes of mental models. Teachers should provide to learners with sufficient experience which can be configured to various mental models in order to form the scientific concepts. And they need to let learners feel the doubt and resolve it through presentation of new teaching material which is inconsistent with the existing mental models.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.37-43
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• 2004

Objective: The purpose of this paper is to study the possible differences in clinical and polysomnographic findings, depending on the presence or absence of subjective complaints of abnormal sleep behavior, in patients with RWA on polysomnography. Method: We reviewed patient records and polysomnographic data of patients referred to the Sleep Laboratory at Seoul National University Hospital from June 1996 through October 2002. We defined the manifest RBD group (n=32) as patients having both complaints of abnormal sleep behavior and RWA on polysomnography. The latent RBD group (n=20) consisted of patients who exhibited RWA on polysomnography but did not complain of abnormal sleep behavior. The clinical characteristics and polysomnographic findings between the two groups were compared and analyzed. Results: Fifty-two subjects had RWA, as detected by polysomnography (42 males and 10 females, mean age of $55.1{\pm}19.1\;years$). Subjects in the manifest RBD group were significantly older than those in the latent RBD group ($61.59{\pm}13.5$ vs. $44.70{\pm}2.76\;years$, independent t-test, p<0.01). More subjects in the manifest RBD group exhibited abnormal REM behavior on polysomnography than did subjects in the latent RBD group (81.3 vs. 50.0%, Fisher's exact test, p<0.05). No significant differences between the groups were found in the prevalence of brain disorders and primary sleep disorders, gender proportion, and sleep architecture. Conclusion: No difference in sleep architecture was found between the manifest and the latent RBD groups. Only age and the presence of abnormal sleep behavior on polysomnography differentiated the two groups. We suggest that RWA on polysomnography without complaints of abnormal sleep behavior may be early manifestation of manifest RBD. Attention to RWA on polysomnography is necessary to help prevent full-blown RBD from developing.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.22-28
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• 2004

Objective: The purpose of this study is to investigate the prevalence rate of OSA in subjects whose main sleep complaint is insomnia and to find differential factors of OSA in these insomniac subjects. Method: We reviewed the medical records and polysomnographic findings of patients referred to the Sleep Laboratory at Seoul National University Hospital from January 1996 to December 2002. Four-hundred and seventy subjects complained of insomnia as their main sleep problem (235 males and 235 females, mean age $53.6{\pm}12.4\;years$). First, we investigated the prevalence rate of OSA in these insomniac patients. Second, we compared the clinical and demographic characteristics of the OSA-associated group with those of the non-associated group. Third, we examined whether the degree or presence of differential factors within the OSA group correlate with severity of OSA, as determined by the respiratory disturbance index (RDI). Results: Among 470 insomniac subjects, 125 subjects (26.6%) were diagnosed as OSA by nocturnal polysomnography. OSA-associated subjects were significantly older ($58.4{\pm}12.3\;years$ vs. $51.8{\pm}11.2\;years$, p<0.01), and had significantly higher body mass index (BMI) ($23.4{\pm}3.3\;kg/m^2$ vs. $22.5{\pm}3.1\;kg/m^2$, p=0.44) than non-associated subjects. The OSA-associated group had more subjects with male gender (64.0% vs. 44.9%, p<0.01), hypertension (20.0% vs. 9.3%, p<0.01) or snoring (96.0% vs. 63.5%, p<0.01). Within the OSA-associated group, age had a significant positive correlation with RDI (p=0.01). Conclusion: We found that a considerable portion of patients complaining of insomnia as their main sleep problem were diagnosed as OSA. Snoring, old age, male gender, obesity, and comorbid hypertension were found to be differential factors of OSA in insomniac patients. We suggest that diagnostic efforts including nocturnal polysomnography are needed for insomniac patients with any of the above risk factors of OSA.

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.113-119
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• 2011

The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 months old children was carried out in Nonsan, Korea. We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data. Accuracy of the child's vaccination card by type of National Immunization Program vaccine in whole medical institutions were from 41.8% to 83.2%. Accuracy for the date of vaccination of vaccination card in National Immunization Programme vaccine were from 55.3% to 89.7%. In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.28 no.3
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• pp.85-97
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• 2010

This research studied the location and the spatial composition of Pihyang-jeong zone. Pihyang-jeong is regarded as one of the five great pavilions in Chollabuk-do. Located in Taein-myeon of Jeongeup-si, Pihyang-jeong is also called as 'the number one pavilion in Honam area'. 1. There is no record regarding the first construction of Pihyang-jeong. There is only transmitting by word of mouth that the scholar Choi Chi-won had an excursion to here and composed some poetry during the age of King Heon-gang of Shilla dynasty. However, there are records that Lee Ji-gweng had expanded the humble structure in 1618, Park Sung-go repaired it in 1664 and Yoo Geun repaired it again in 1715. 2. The location of Pihyang-jeong is 'high in north and low in south' and typical 'mountain in rear and water in front'. It has Seong-hwang Mountain(189m) in the north, Hang-ga Mountain(106m) in the south, Tae Mountain(33m) in the south and an open field in the northwest. 3. The spatial composition around Pihyang-jeong is as following. Pihyang-jeong faces 'Hayeonji'(the lower side lotus pond) in the south-south-west direction. 4. The buildings around Pihyang-jeong are; Pihyang-jeong, which was the pavilion of the government official not directly in charge of government office, Hambyeok-lu in the Hayeonji and the facility for the caretaker. Pihyang-jeong is a rectangular building with double eaves and hipped-and-gabled roof. It has five rooms in the front and four rooms in the side. Hambyeok-lu had been first built in 1918 as two-storey wooden pavilion with dancheong, traditional multicolored paintwork on wooden buildings. Then it was modified into rectangular single-storey pavilion with hipped-and-gabled roof and five rooms in 1971. In 2010, it was rebuilt as a hexagonal pavilion; therefore, the present shape is completely different one from the original shape. 5. The scenic features around Pihyang-jeong are as following. There are 21 stone monuments in Pihyang-jeong zone. The fence surrounding Pihyang-jeong is a traditional Korean style crude stone fence. There are three gates in three-gates-style, each gate made with two posts and one 'matbae'(gabled) roof. Also, a stepping stone for mounting/dismounting was found in the east of Pihyang-jeong outer perimeter. 6. The water scenic feature around Pihyang-jeong is a representative case of drawing in the water from the natural pond nearby government office and building a pavilion around the water. 7. The planting around Pihyang-jeong is as following. There are Zelkova trees in the boundary perimeter. In the southern small park, there are Zelkova trees, Crape-myrtie trees, Bushy young pine trees, Pine trees, Satuki, Purple azalea and Grass field. Around Hambyeok-lu in the Ha-yeonji, Elm trees, Zelkova trees and Pine trees are growing in good condition.