• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.277-292
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• 2015

Purpose: The purpose of this study was to develop a Clinical Ladder System (CLS) model for staff nurses working in inpatient units of tertiary care hospitals in Korea. Methods: The study was carried out in 2 steps. First, a nursing competence evaluation scale was developed. Second, evaluation of the nursing competences, qualifications, and professional activities of 230 nurses from five tertiary care hospitals was done by 49 head nurses between Feb. and Dec., 2014. Nurses were selected by head nurses according to their clinical experience and expected behavioral characteristics at each level of the ladder. Results: A nursing competence scale was developed consisting of 5 subcategories (clinical practice, ethical practice, education, leadership, and professional development) and 11 elements, and 5 levels of behavioral indicators for each element. Cronbach's alphas for the entire tool and subcategories were over .853 and stability of the scale was confirmed. There were significant differences in nursing competence according to the 5 levels of the ladder. Conclusion: The findings indicate that the proposed CLS model with a standard score for nursing competence, recommended or obligatory criteria for qualifications and professional activities provides a good tool for developing nurses' competences and retaining excellent nurses in clinical practice.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.83-91
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• 2017

Background: Piperacillin/tazobactam (TZP) is an antibiotic against a broad spectrum of gram-positive, gram-negative, and aerobic and anaerobic strains of bacteria. Due to changes in its pharmacokinetic and pharmacodynamic parameters by TZP-treated patients' renal functions and obesity, it is important to administrate and monitor TZP based on their renal functions and Body Mass Index (BMI) levels. The purpose of this study was to determine the appropriateness of administration doses of TZP based on renal functions of obese cancer patients in a tertiary hospital. Methods: This study was retrospectively conducted with obese cancer patients with $BMI{\geq}30kg/m^2$ in a tertiary hospital, Korea from September 2004 to August 2014. Data were collected through Electronic Medical Record (EMR) which contained laboratory data and TZP dosing of each patient. Results: Among 7,058 patients during the study period, 102 prescriptions were selected based on inclusion and exclusion criteria and classified by their renal functions. Although TZP should be used based on patients' renal functions to adjust its dose, its initial dose and dosing interval were consistently used without considering patients' renal functions on a regular basis. Especially, in the comparison with FDA dosing standard of TZP, approximately twice patients with $20mL/min{\leq}CrCl{\leq}40mL/min$ received domestically 4.5 g instead of 2.25 g as the TZP starting dose. Conclusion: The appropriate doses of TZP were administered to almost all of obese cancer patients; however, the recommended TZP dose was different between Korea and other countries by twice the amount. Further related studies are necessary to clearly determine the results, to optimize TZP treatment for obese patients with cancer in clinical practice, and to design and develop new TZP formulations for them in pharmaceutical industry.

• Korea Journal of Hospital Management
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• v.19 no.2
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• pp.66-72
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• 2014

Although stress has been implicated to be a risk factor that can threaten physical and mental health, there have been no sufficient studies that analyze the different levels of stress among employees working in the different levels of the hospitals. We aim to identify the general characteristics of hospitals at different levels, to compare the stress levels among customer service representatives working in the tertiary care hospitals as well as acute general hospitals. In addition, we also wanted to analyze the relationship between the types of hospitals and the stress level. The work stress was measured using the Korean Occupational Stress scale. Study subjects' demographic characteristics and lifestyle factors were analyzed using analysis of frequency and multiple regression analysis. Our study revealed that the levels of medical facility were significantly associated with the levels of job stress(P=0.043), and the stress levels of employees working in the acute general hospital's medical facilities were higher than those who were working in tertiary care facilities. We also found that those with higher depression level tended to have higher job stress (P<0.001). Therefore, it is urgent to implement some kind of job stress interventions, especially in the acute general hospital's medical facilities. Moreover, further studies including social and policy research are necessary in order to analyze the overall impact of stress on physical and mental health and to reduce health inequalities among healthcare workers.

• Journal of the Mineralogical Society of Korea
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• v.17 no.2
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• pp.123-133
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• 2004

Carbonate minerals are examined by cathodoluminescence microscopy and chemical analysis to characterize the carbonate materials occurring in the Tertiary marine basin. The microscopic technique with cathodoluminescence gives new informations that are not obtainable by conventional microscopic techniques. The carbonate cements in sandstones appear to be uniform with transmitted light or with crossed prisms. but the inspection with cathololuminescence reveals foraminiferal tests and rhomb crystals in the carbonate cements. The chemical analysis indicates that the intense luminescence depends mainly on the presence of$ Mn^{ 2+}$ and $Fe^{2+}$ as activator ions, but the $Fe^{2+}$ also acts as an important quencher ion when Fe concentration in dolomite is over 10,000 ppm. The dolomites, which are rich in calcium, are formed at the early stage of diagenesis at a temperature of about 60 ～ $70^{\circ}C$.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.145-151
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• 2012

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.

• Polymer(Korea)
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• v.24 no.5
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• pp.610-620
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• 2000

Vinyl acetate (VAc) was polymerized at 30, 40, and 5$0^{\circ}C$ using 2,2'-azobis (2,4-dimethylvaleronitrile) (ADMVN) and tertiary butyl alcohol (TBA) as the initiator and the solvent, respectively. High molecular weight (HMW) atactic poly(vinyl alcohol) (PVA) was prepared by saponifying the poly(vinyl acetate) (PVAc) synthesized. The effect of polymerization conditions were investigated in terms of conversion, degree of branching for acetyl group of PVAc, and molecular weight of both PVAc and PVA. The polymerization rate of VAc in TBA was proportional to the 0.49th power of ADMVN concentration in good accordance with the theoretical value of 0.5. HMW-PVA with high yield could be obtained successfully, probably due to lower polymerization temperature and decreased chain transfer reaction rate which was achieved by adopting ADMVN and TBA. PYAc having average degree of polymerization (P$_{n}$) of 10000~13000 was obtained at the conversion of 35~70%. Saponification of so prepared PVAc yielded PVA having P$_{n}$ of 2400~6100. The syndiotactic diad content increased with decreasing polymerization temperature and increasing VAc concentration due to a steric hindrance effect of TBA during polymerization.

• Geophysics and Geophysical Exploration
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• v.1 no.3
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• pp.161-169
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• 1998

The Kunsan basin is a pull-apart basin which was formed during Tertiary. The pre-Tertiary section consists of various rock types, such as meta-sediments, igneous rocks, carbonates, clastics, and volcanics. Tertiary sections are the main targets for the petroleum exploration. In order to determine the optimum processing parameters of the basin, about 12 kinds of test processings were performed. The first main steps for the quality control is to determine the noisy or bad traces by examining the near trace section and shot gathers. The true amplitude recovery was applied to account for the amplitude losses due to spherical divergence and inelastic attenuation. Source designature and predictive deconvolution test were conducted to determine the optimum wavelet parameters and to remove the multiples. Velocity analysis was performed at 1km intervals. The optimum mute function was picked by locating the range of offsets which gives the best stacking response for any particular reflections. Post-stack deconvolution was tested to see if the quality of stacked data improved. The stacked data was migrated using a finite difference algorithm. The migration velocity was obtained from the stacking velocities using the time varying percentages. The AGC sections were provided for the structural interpretation. The RAP sections were used for DHI analysis and for the detection of volcanics.

• Geophysics and Geophysical Exploration
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• v.7 no.1
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• pp.62-69
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• 2004

The objective of this study is to estimate the distribution of a zone disturbed by excavation (EDZ) around tunnels that have been excavated at about 500 m depth in pre-Tertiary hard sedimentary rock. One of the most important tasks is to evaluate changes in the dynamic stability and permeability of the rock around the tunnels, by investigating the properties of the rock after the excavation. We performed resistivity and acoustic tomography using two boreholes, 5 m in length, drilled horizontally from the wall of a tunnel in pre-Tertiary hard conglomerate. By these methods, we detected a low-resistivity and low-velocity zone 1 m in thickness around the wall of the tunnel. The resulting profiles were verified by permeability and evaporation tests performed at the same boreholes. This anomalous zone matched a high-permeability zone caused by open fractures. Next, we performed resistivity monitoring along annular survey lines in a tunnel excavated in pre-Tertiary hard shale by a tunnel-boring machine (TBM). We detected anomalous zones in 2D resistivity profiles surrounding the tunnel. A low-resistivity zone 1 m in thickness was detected around the tunnel when one year had passed after the excavation. However, two years later, the resistivity around the tunnel had increased in a portion, about 30 cm in thickness, of this zone. To investigate this change, we studied the relationship between groundwater flow from the surroundings and evaporation from the wall around the tunnel. These features were verified by the relationship between the resistivity and porosity of rocks obtained by laboratory tests on core samples. Furthermore, the profiles matched well with highly permeable zones detected by permeability and evaporation tests at a horizontal borehole drilled near the survey line. We conclude that the anomalous zones in these profiles indicate the EDZ around the tunnel.

• Journal of Ginseng Research
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• v.39 no.4
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• pp.392-397
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• 2015

Background: Red ginseng (RG) is processed from Panax ginseng via several methods including heat treatment, mild acid hydrolysis, and microbial conversion to transform the major ginsenosides into minor ginsenosides, which have greater pharmaceutical activities. During the fermentation process using microbial strains in a machine for making red ginseng, a change of composition occurs after heating. Therefore, we confirmed that fermentation had occurred using only microbial strains and evaluated the changes in the ginsenosides and their chemical composition. Methods: To confirm the fermentation by microbial strains, the fermented red ginseng was made with microbial strains (w-FRG) or without microbial strains (n-FRG), and the fermentation process was performed to tertiary fermentation. The changes in the ginsenoside composition of the self-manufactured FRG using the machine were evaluated using HPLC, and the 20 ginsenosides were analyzed. Additionally, we investigated changes of the reducing sugar and polyphenol contents during fermentation process. Results: In the fermentation process, ginsenosides Re, Rg1, and Rb1 decreased but ginsenosides Rh1, F2, Rg3, and Compound Y (C.Y) increased in primary FRG more than in the raw ginseng and RG. The content of phenolic compounds was high in FRG and the highest in the tertiary w-FRG. Moreover, the reducing sugar content was approximately three times higher in the tertiary w-FRG than in the other n-FRG. Conclusion: As the results indicate, we confirmed the changes in the ginsenoside content and the role of microbial strains in the fermentation process.