• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.669-689
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• 2002

Purpose : The purpose of the present study is to develop a clinical pathway applied with activity-based management methodology for efficient clinical management to cope with rapid changing medical environments. Method : After making a preliminary pathway based on which a conceptual frame of reference was established to develop a clinical pathway, the final one was confirmed by verifying experts validity and clinical validity. The ultimate activity-based clinical pathway was restructured after clarifying, schematizing and analyzing the whole activities of clinical pathway in accordance with the conducting process of activity-based management. Result : A clinical pathway for total hip replacement was developed, in which the vertical axis consisted of assessment, examination, consultation, medication, treatment, diet, activity, and education, and the horizontal axis was composed of six days of hospitalization. Then, on the basis of the development, the clinical pathway including the improved contents and information was restructured after making the reform measure by analyzing each of activities in the pathway. And the list of contents related to the clinical management activity was made, which was described its main contents and the pre-activities that ought to be completed before conducting each of activities in the pathway. Conclusion : The clinical pathway applied with activity-based management may be used as a standard guidance for providing continuous and consistent patient care. It will provide the information for nursing activities to nurses and the management information about hospital and nursing activities to the hospital administrators. It will also be used as a tool for communication between medical staff. Besides, it will contribute to creating profits for the hospital by shortening the length of stay in patients.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.481-489
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• 1998

Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life-injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow : (1) the consultation .ate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.

• Asian Oncology Nursing
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• v.4 no.2
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.2
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• pp.107-114
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• 2011

Dental extraction is potentially stress-inducing in many disabled patient. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress, the stress reduction method was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk, (2) Complete medical consultation before dental therapy, (3) Schedule the patient's appointment in the morning, (4) Monitor and record preoperative and postoperative vital signs, (5) Use psychosedation during therapy, (6) Use adequate pain control during therapy, (7) Short length of appointment : do not exceed the patient's limits of tolerance, (8) Follow up with postoperative pain/anxiety control, (9) Telephone the risk patient later on the same day that treatment was given. Though the stress reduction method above was applied to the dental extraction in disabled patients with the advanced infected teeth, the complications(syncope, shock, bleeding & infection, etc.) may be occurred. For prevention of complications associated with the extraction, the authors treated the advanced infected teeth with endodontic drainage and incision & drainage before extraction. The final extraction and wound closure were then done after about 3 weeks.

• Journal of The Korean Dental Society of Anesthesiology
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• v.8 no.1
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• pp.1-9
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• 2008

Common dental procedures (local anesthesia and dental treatment) are potentially stress-inducing in many patients, especially medically compromised patients. The body response to dental stress involves the cardiovascular system (an increase in cardiovascular workload), the respiratory organ and the endocrine system (change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given. This protocol is predicated on the belief that the prevention of or reduction of stress ought to begin before the start of an appointment, continue throughout treatment, and, if indicated, into the postoperative period. The authors used the stress reduction protocol in the care of local anesthesia infected teeth in medically compromised patients. The final prognosis was comfortable without any complications.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.28-32
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• 2011

Purpose: A cranioremodeling helmet for correcting plagiocephaly was recently developed. However, no discrete objective methods to evaluate how the deformity is being corrected have been developed. We have established an easy and cost-effective method that can be used not only to show the correction process, but can also be used by physicians to assess the degree of plagiocephaly two-dimensionally. Methods: For two-dimensional evaluation, a length of malleable memory wire (2 mm in diameter) resembling "Sun-Wukong's headband" was placed on the patient's head. The wire around the patient's head was positioned on a plane including points 1 cm above the eyebrow and 1 cm above the auricle. The wire was placed on a sheet of paper and the outline was marked using pens of various colors during each visit. The degree of plagiocephaly correction could then be shown to the patient's parents at every consultation. Results: The method established by the present study easily shows the horizontal cross-section transformation of the head, illustrates plagiocephaly correction by the helmet, and shows the degree of correction in a two-dimensional manner. Conclusion: A soft-shell helmet is widely used for correcting plagiocephaly. However, evaluating the effectiveness of the helmet has been determined in a subjective manner, and a more objective method is now in demanded. Our study found that a "Sun-Wukong's headband" wire can accurately measure two-dimensional changes. Future studies will be required to identify landmarks needed for assessing plagiocephaly correction.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.155-160
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• 2005

The aim of this study is to establish anatomical dimension of the lip in young population in Korean, using specially designed soft ware with photographic image. We measure 13 anatomical dimensions of lips in 2,229 young people. (917 male, 1312 female, Aged from 18-33 years. Average age 19.7). Statistical analysis of these measurements of large population could offer useful information in facial plastic surgery. The mean measurements are as follows 1. Lengths (male/female) Widths of philtrum: $1.11{\pm}0.19cm/1.02{\pm}0.21cm$ Heights of philtrum: $1.6{\pm}0.24cm/1.47{\pm}0.21cm$ Heights of cupid bow: $0.88{\pm}0.16cm/0.83{\pm}0.16cm$ Height of upper vermilion: $0.74{\pm}0.16cm/0.70{\pm}0.15cm$ Height of lower vermilion: $1.08{\pm}0.17cm/1.02{\pm}0.15cm$ Height of upper lip(Rt.): $1.24{\pm}0.2cm/1.23{\pm}0.2cm$ Height of upper lip(Lt.): $1.24{\pm}0.2cm/1.17{\pm}0.19cm$ Half horizontal length of lip: $2.2{\pm}0.26cm/2.11{\pm}0.2cm$ Horizontal length of lip: $4.41{\pm}0.4cm/4.25{\pm}0.36cm$ Height of lower face: $7.1{\pm}0.58cm/6.52{\pm}0.6cm$ 2. Angles Nasolabial angle: $97.77{\pm}11.97^{\circ}/95.5{\pm}11.34^{\circ}$ Mentolabial angle: $133.88{\pm}14.65^{\circ}/129.27{\pm}13.67^{\circ}$ Angle of Cupid's bow: $111.65{\pm}13.99^{\circ}/116.75{\pm}16.2^{\circ}$ Previous reported photogrammetric measurements was difficult to implement to surgical practice. Because these were printed photographies of the same size. Therefore, in this study, we can measure a lot of objects and items more conveniently and correctly by using proportional program on computer after taking a digital photograph. Consequently, proportional measurements with photogrammetry of lip could be useful and corrective substitute for anthropometrical measuring. These data could be useful reference for preoperative consultation, surgical planning and learning anatomical measurement of lips and adjacent structures.

• Journal of Wetlands Research
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• v.9 no.1
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• pp.69-78
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• 2007

Constructed wetlands and other aquatic systems have been successfully used for waste and wastewater treatment in either temperate or tropical regions. To treat waste or wastewater in a sustainable manner, the integrated eco-engineering designs are explained in this paper with 2 case studies: (i) a combination of vertical-flow constructed wetland (CW) with plant irrigation systemfor fecal sludge management and (ii) integrated CW units with landscaping at full-scale application for domestic wastewater treatment. The pilot-scale study of fecal sludge management employed 3 vertical-flow CW units, each with a dimension of $5{\times}5{\times}0.65m$ (width ${\times}$ length ${\times}$ media depth) and planted with cattails (Typha augustifolia). At the solid loading rate of 250 kg total solids (TS)/$m^2.yr$ and a 6-day percolate impoundment, the CW system could achieve chemical oxygen demand (COD), TS and total Kjeldahl nitrogen (TKN) removal efficiencies in the range of 80 - 96%. The accumulated sludge layers of about 80 - 90 cm was found at the CW bed surface after operating the CW units for 7 years, but no clogging problem has been observed. The CW percolate was applied to 16 irrigation Sunflower plant (Helianthus annuus) plots, each with a dimension of $4.5{\times}4.5m$ ($width{\times}length$). In the study, the CW percolate were fed to the treatment plots at the application rate of 7.5 mm/day but the percolate was mixed with tap water at different ratio of 20%, 80% and 100%. Based on a 1-year data of 3-crop plantation were experimented, the contents of Zn, Mn and Cu in soil of the experimental plots were found to increase with increasing in CW percolate ratios. The highest plant biomass yield and oil content of 1,000 kg/ha and 35%, respectively, were obtained from the plots fed with 20% or 50% of the CW percolate, whereas no accumulation of heavy metals in the plant tissues (i.e. leaves, stems and flowers) of the sunflower is found. In addition to the pilot-scale and field experiments, a case study of the integrated CW systems for wastewater treatment at Phi Phi Island (a Tsunami-hit area), Krabi province, Thailand is illustrated. The $5,200-m^2$ CW systems on Phi Phi Island are not only for treatment of $400m^3/day$ wastewater from hotels, households or other domestic activities, but also incorporating public consultation in the design processes, resulting in introducing the aesthetic landscaping as well as reusing of the treated effluent for irrigating green areas on the Island.

• Journal of Korea Technology Innovation Society
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• v.10 no.3
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• pp.406-430
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• 2007

Most pharmaceutical licensing deals are made in the early stage of drug development. While this development process is not unique for complicated technology, a special feature of drug development is that it is highly regulated and a well-defined process. Its statistics in terms of costs and chances of technical success have been researched extensively. This enables relatively detailed calculations as benchmarks for actual deals to be made. Based on such calculations and on the analysis of licensing terms in published agreements, various companies offer quite expensive information, databases, software programs and consultation services to help establish what might be reasonable economic terms in a licensing deal. Over the years, pharmaceutical royalties have been the subject of various articles in journals. Most specific on this subject was the article on determining pharmaceutical royalties. Many other articles are about a more general nature deal with determining reasonable royalty rates, evaluating and underpinning the empirical value and usefulness of the 25% rule. The object of this article is to provide a relatively simple analytical approach based on the major economic terms underlying pharmaceutical licensing deals. The aim is to enhance the understanding of the relations between the major factors involved. Details are disregarded, as generally, where the terms of licensing deals depend on predictions over a considerable length of time, the value of detail is limited. Some specific issues addressed by the approach are the impact on profits of large investments, high risks and long development times characteristic of drug development, the consequent strong impact that the ultimate sales levels and operating margins may have on what might be considered a reasonable royalty rate, and the relationship between upfront payments and milestone payments to be paid during pharmaceutical development and the royalties due once the drug enters the market.

• Journal of the Korean Institute of Navigation
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• v.23 no.1
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• pp.75-84
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• 1999

Although many studies on modelling of port competitive situation have been conducted, both theoretical frame and methodology are still very weak. In this study, therefore, a new algorithm called ESD (Extensional System Dynamics) for the evaluation of port competition was presented, and applied to simulate port systems in northeast asia. The detailed objectives of this paper are to develop Unit fort Model by using SD(System Dynamics) method; to develop Competitive Port Model by ESD method; to perform sensitivity analysis by altering parameters, and to propose port development strategies. For these the algorithm for the evaluation of part's competition was developed in two steps. Firstly, SD method was adopted to develop the Unit Port models, and secondly HFP(Hierarchical Fuzzy Process) method was introduced to expand previous SD method. The proposed models were then developed and applied to the five ports - Pusan, Kobe, Yokohama, Kaoshiung, Keelung - with real data on each ports, and several findings were derived. Firstly, the extraction of factors for Unit Port was accomplished by consultation of experts such as research worker, professor, research fellows related to harbor, and expert group, and finally, five factor groups - location, facility, service, cargo volumes, and port charge - were obtained. Secondly, system's structure consisting of feedback loop was found easily by location of representative and detailed factors on keyword network of STGB map. Using these keyword network, feedback loop was found. Thirdly, for the target year of 2003, the simulation for Pusan port revealed that liner's number would be increased from 829 ships to 1,450 ships and container cargo volumes increased from 4.56 million TEU to 7.74 million TEU. It also revealed that because of increased liners and container cargo volumes, length of berth should be expanded from 2,162m to 4,729m. This berth expansion was resulted in the decrease of congested ship's number from 97 to 11. It was also found that port's charge had a fluctuation. Results of simulation for Kobe, Yokohama, Kaoshiung, Keelung in northeast asia were also acquired. Finally, the inter port competition models developed by ESB method were used to simulate container cargo volumes for Pusan port. The results revealed that under competitive situation container cargo volume was smaller than non-competitive situation, which means Pusan port is lack of competitive power to other ports. Developed models in this study were then applied to estimate change of container cargo volumes in competitive relation by altering several parameters. And, the results were found to be very helpful for port mangers who are in charge of planning of port development.