• Journal of Chest Surgery
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• v.36 no.6
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• pp.404-410
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• 2003

Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.

• Journal of the Korean Geographical Society
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• v.30 no.1
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• pp.35-56
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• 1995

During the last two decades, Korea has achieved remarkable economic growth. In this process the nation has become urbanized and industrialized. But we have also encountered widening regional disparity, housing shortage of larger cities, transportation congestion, environmental pollution and many other problems. Rapid increasing urbanization and continuous migration toward Seoul since the late 1960s have been one of the major concerns of government. Government has sought ways to moderate the population increase in Seoul. The regulation which include new town development near Seoul and dispersion strategies of higher education and other administration and living facilities outside of Seoul havemade a great expansion of the spatial influence of Seoul city. Seoul metropolitan reaion has evolved as the most powerful center of political and economical spaces. Generally within a metropolitan region, there exists a growing mutual interdependence economically, as well as socially between a central city and its surrounding area. Seoul metropolitan region manifests itself not only as a coherent system of urbanized regions, but also as an integral part of the daily urban system. The surrounding Gyunggi province and Seoul city become closely linked both economically and functionally, constituting true functlonai urban system. This study is primarily undertaken with the purpose of delineation of the sphere of influence of Seoul city in 1990. At the time of 1985, Seoul metropolitan region was delineated according to the result of the study which was performed by Korea Research Institute for Human Settlements. Afterward, the rapid speed of metropolitanization process with dramatic increase in mobility through the provision of wider transportation system across the Capital region have evolved, resulting in the great expansion of the spatial influence of Seoul city. So this study examines the expanded area of Seoul metropolitan regin during the period of 1985-90. In order to delineate Seoul metropolitan region, the indices of urbanization and functional linkage are selected. Variables included in the measurement of the urbanization level are agricultural structure, population characteristics, manufacturing and service industries, and cultural aspects such as newspaper circulation, the ratio of car ownership and piped water supply. Variables included in the measurement of functional linkage are commuting, shopping pattern, centralized service such as medical facilities and trade of agricultural products. The standardization method and factor analysis are employed in making the delineation of Seoul metropolitan region. According to the result of this study, 2 cities, 8 Eups and 46 Myuns are included Seoul metropolitan region in 1990. If we compare this delineated area in 1990 to that of 1985, we can find the distinctive pattern of expanded axes according to the main transportation routes such as Seoul-Suweon, Seoul-Gwangju, Seoul-Incheon. In 199O, all the Gyunggi province, except a few Myuns located at the north and northwest part of Gyunggi province, are included in Seoul metropolitan region. Furthermore, this study attempts to the analysis of regional structure of Seoul metropolitan region according to the functional characteristics of each city and Gun. Variables included in this analysis are the new residential function, manufacturing function, service function, education and infermation function, public facility function and agricultural function. Factor analysis and cluster analysis are employed in making regionalization. Seoul metropolitan reaion is subdivided into four subregions which reflect different functional specialization. The first group is the specialized region of newly formed residential function. The second group is the specialized reaion of manufacturing function. The third group is the specialized region of service function. And the fourth group has little specialized in terms of manufacturing, service, and residential function. But this region has some potentiality of development when Seoul metropolitan region grow continuously. Seoul metropolitan region accounted for 43% of national population, despite 11.8% of national land size in 1990. Although Seoul metropolitan region enjoys important agglomeration economies, it also has huge social cost in the form of transportation congestion, housing shortage, rapid increase of land value, environment pollution, and etc. Efficient metropolitan plan making is a vital element in promoting Seoul's economic development and providing high quality living environment at low cost. In the light of the result of this study, the outer ring of Seoul metropolitan region, especially northeastern part, are underdeveloped compared to overdeveloped southwestern area. It is needed to develop the guidelines for the implement of the growth control and management plan, inducing more balanced development for whole Seoul metropolitan reaion.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.218-226
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• 1998

This study aims at investigating the effects of psychostimulant on functional cerebral localization during the attentional tasks in ADHD. Inclusional subjects were 13 boy between 6-12 years old who met the DSM-IV criteria for ADHD. In each patient, there was a drugfree period(without methyphenidate) and a drug-loaded period(with oral methylphenidate administration), and within each period there was a resting state and a stimulated state with TOVA. Comparisons were made by measuring the amplitudes of four bands(${\alpha}$, ${\beta}$, ${\delta}$, ${\theta}$) of quantitative EEG to see if there were any differences between the drug-free period(resting and stimulated) and the drug-loaded period(resting and stimulated). In the resting state, there was no difference between the drug-free and drug-loaded periods. In the stimulated state with TOVA, the presence of methylphenidate induced significant changes in the theta to beta ratio(${\theta}/{\beta}$) in the right frontal, right parieto-occipital, and left temporal-parietal areas in contrast to the drugf-ree period. These data suggest that methylphenidate shows electrophysiological influences on cerebral topographical activities during the attentional tasks in ADHD.

• Journal of Intelligence and Information Systems
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• v.23 no.1
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• pp.127-141
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• 2017

Advances in Internet technologies and the proliferation of mobile devices enabled consumers to approach a wide range of goods and services, while causing an adverse effect that they have hard time reaching their congenial items even if they devote much time to searching for them. Accordingly, businesses are using the recommender systems to provide tools for consumers to find the desired items more easily. Association Rule Mining (ARM) technology is advantageous to recommender systems in that ARM provides intuitive form of a rule with interestingness measures (support, confidence, and lift) describing the relationship between items. Given an item, its relevant items can be distinguished with the help of the measures that show the strength of relationship between items. Based on the strength, the most pertinent items can be chosen among other items and exposed to a given item's web page. However, the diversity of the measures may confuse which items are more recommendable. Given two rules, for example, one rule's support and confidence may not be concurrently superior to the other rule's. Such discrepancy of the measures in distinguishing one rule's superiority from other rules may cause difficulty in selecting proper items for recommendation. In addition, in an online environment where a web page or mobile screen can provide a limited number of recommendations that attract consumer interest, the prudent selection of items to be included in the list of recommendations is very important. The exposure of items of little interest may lead consumers to ignore the recommendations. Then, such consumers will possibly not pay attention to other forms of marketing activities. Therefore, the measures should be aligned with the probability of consumer's acceptance of recommendations. For this reason, this study proposes a model-based approach to combine those measures into one unified measure that can consistently determine the ranking of recommended items. A regression model was designed to describe how well the measures (independent variables; i.e., support, confidence, and lift) explain consumer's acceptance of recommendations (dependent variables, hit rate of recommended items). The model is intuitive to understand and easy to use in that the equation consists of the commonly used measures for ARM and can be used in the estimation of hit rates. The experiment using transaction data from one of the Korea's largest online shopping malls was conducted to show that the proposed model can improve the hit rates of recommendations. From the top of the list to 13th place, recommended items in the higher rakings from the proposed model show the higher hit rates than those from the competitive model's. The result shows that the proposed model's performance is superior to the competitive model's in online recommendation environment. In a web page, consumers are provided around ten recommendations with which the proposed model outperforms. Moreover, a mobile device cannot expose many items simultaneously due to its limited screen size. Therefore, the result shows that the newly devised recommendation technique is suitable for the mobile recommender systems. While this study has been conducted to cover the cross-selling in online shopping malls that handle merchandise, the proposed method can be expected to be applied in various situations under which association rules apply. For example, this model can be applied to medical diagnostic systems that predict candidate diseases from a patient's symptoms. To increase the efficiency of the model, additional variables will need to be considered for the elaboration of the model in future studies. For example, price can be a good candidate for an explanatory variable because it has a major impact on consumer purchase decisions. If the prices of recommended items are much higher than the items in which a consumer is interested, the consumer may hesitate to accept the recommendations.

• Tuberculosis and Respiratory Diseases
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• v.64 no.1
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• pp.8-14
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• 2008

Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.

• Journal of Hospice and Palliative Care
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• v.13 no.1
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• pp.13-23
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• 2010

Purpose: This study was to identify the role of general hospice palliative nurse through job analysis (duties, task, and task elements). Methods: The sample consisted of 136 nurses or professors who were performing duties related to hospice care areas in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Descriptive statistics were performed by using SPSS WIN 17.0. Results: The job description of general hospice palliative nurse was identified 8 duties, 36 tasks, and 137 task elements. As for the 8 duties, the average scores of frequency, criticality, and difficulty were 2.94, 3.66, and 2.80, respectively. The role of ‘pain assessment’ was the most important task element among frequency and criticality. The lowest score at the frequency and criticality were ‘manage public finance’ and ‘collect datum through diagnostic test & lab', respectively. Furthermore, the role of 'identify spiritual needs of patients and family' was the most difficult task, whereas the role of 'manage documents and information' was the least. Conclusion: In this study, we could recognize the reality of general hospice palliative nurse's performances. For general hospice palliative nurse, therefore, concrete practice guide lines of psychosocial and spiritual care, communication skills, and bereavement care with qualifying system are critically needed.

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.63-79
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• 1974

1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.7
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• pp.839-845
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• 2009

Colorectal cancer is the third most common malignant neoplasm in the world. Much attention has been focused on reducing colon cancer risk through medical properties of natural compound that could act as anticarcinogens. In this study, we evaluated the antioxidant and antigenotoxic effects of Styela plicata (S. plicata) from in vitro experiments. S. plicata extracts showed antioxidant activity measured by TRAP assay and antigenotoxic effect in $200{\mu}M$ $H_2O_2$ induced DNA damage in human leukocytes. Especially, freeze-dried S. plicata extracted with methanol showed the highest level of TRAP (0.225 mM) and inhibition of DNA damage (66.8%). Additionally we observed the effect of S. plicata on the formation of aberrant crypt foci (ACF) induced by dimethylhydrazine (DMH) and DMH induced DNA damage (by comet assay) in male SD rats. The animals were divided into three groups and fed high-fat and low fiber diet (100 g lard+20 g cellulose/kg diet) without (normal control and DMH control) or with a 3% (w/w) of lyophilized S. plicata powder (DMH+S. plicata). One week after beginning the diets, rats were treated with DMH (30 mg/kg, s.c.) for 6 weeks except for normal control group, which was treated saline instead; dietary treatments were continued for the entire experiment. Nine weeks after DMH injection, administration of S. plicata resulted in reduction of ACF numbers, to 82.7% of the carcinogen control value ($7.67{\pm}2.04$ vs. $1.33{\pm}0.53$: p<0.01). S. plicata supplementation induced antigenotoxic effect on DMH-induced DNA damage in the blood cell (% tail intensity: $6.79{\pm}0.26$ vs. $6.13{\pm}0.22$). These data indicate that S. plicata extract has antigenotoxic and anticarcinogenic effects from in vitro experiments and S. plicata exerts a protective effect on the process of colon carcinogenesis, possibly by suppressing the DMH-induced DNA damage in blood cell and the development of preneoplastic lesions in colon.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.10-17
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• 2016

Purpose: The diagnosis of Kawasaki disease depends on clinical symptoms, which makes it difficult to diagnose early in patients with only cervical lymphadenopathy. The purpose of this study is to understand the clinical characteristics of cervical-lymph-node-first presentation of Kawasaki disease and compare them with those of typical Kawasaki disease. Methods: We surveyed 283 patients who were admitted to Hallym Sacred Heart Hospital and were diagnosed with Kawasaki disease from January 2012 to December 2014. The patients were divided into two groups: cervical-lymph-node-first presentation of Kawasaki disease (LKD, N=24) and typical Kawasaki disease (KD, N=259). The medical records were retrospectively reviewed. Results: The mean age of the LKD group was higher than that of the KD group (P=0.04). At admission, the LKD patients had on average 1.62 out of 5 symptoms, whereas the KD patients had 3.47. The time from fever to diagnosis and administration of IV immunoglobulin was longer in the LKD group than in the KD group (P<0.001). The mean C-reactive protein of the LKD group was higher than that of the KD group (P=0.01). There were no statistical differences in the presence of coronary artery complications between the two groups at two weeks or at two months after diagnosis (P=0.52, P=0.08). Conclusions: The Kawasaki disease patients with fever and cervical lymphadenopathy usually do not present obvious clinical symptoms, which makes it hard to diagnose in the early phase of disease. Clinician must pay attention when examining these patients.