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김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2
Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.
Kang, Kyeong Hwan,Kim, Joong Kyun The Korean Society of Fisheries and Aquatic Scienc 2015 Fisheries and Aquatic Sciences Vol.18 No.4
To reutilize fisheries waste, we isolated a bacterial strain from a coastal area located in Busan. It was identified as Bacillus licheniformis TK3-Y. Using plate assay and 500-mL flask experiments, we found that the isolate simultaneously possessed cellulolytic, proteolytic, and lipolytic activities with salt tolerance. 10% (v/v) inoculums, were used to examine the biodegradation characteristics of the TK3-Y strain on carboxymethylcellulose, skim milk, and olive oil media. The optimum conditions for pH, temperature, agitation speed, and NaCl concentration on each 1% substrate were 6, $50^{\circ}C$, 180 rpm, and 17.5%, respectively. Under optimal conditions, the TK3-Y strain showed 1.07 U/mL cellulolytic, 1,426 U/mL proteolytic, and 6.45 U/mL lipolytic activities. Each enzyme was stable within a range of 17.5-35% NaCl. Therefore, the salt tolerance ability of strain TK3-Y was superior to other related strains. In degradation of a mixed medium containing all three substrates, both the cellulolytic and proteolytic activities were somewhat lower than those on each single substrate, while the lipolytic activity was somewhat higher. From the above results, the TK3-Y strain appears to be a good candidate for use in the efficient treatment of fisheries waste in which components are not collected separately.
( Kyeong Hwan Kang ),( Joong Kyun Kim ) 한국수산과학회(구 한국수산학회) 2015 Fisheries and Aquatic Sciences Vol.18 No.4
To reutilize fisheries waste, a bacterial strain was isolated from a coastal area located in Busan. It was identified as Bacillus licheniformis TK3-Y. Using plate assay and 500-mL flask experiments, we found that the isolate simultaneously possessed cellulolytic, proteolytic, and lipolytic activities with salt tolerance. 10% (v/v) inoculums, were used to examine the biodegradation characteristics of the TK3-Y strain on carboxymethylcellulose, skim milk, and olive oil media. The optimum conditions for pH, temperature, agitation speed, and NaCl concentration on each 1% substrate were 6, 50°C, 180 rpm, and 17.5%, respectively. Under optimal conditions, the TK3-Y strain showed 1.07 U/mL cellulolytic, 1,426 U/mL proteolytic, and 6.45 U/mL lipolytic activities. Each enzyme was stable within a range of 17.5.35% NaCl. Therefore, the salt tolerance ability of strain TK3-Y was superior to other related strains. In degradation of a mixed medium containing all three substrates, both the cellulolytic and proteolytic activities were somewhat lower than those on each single substrate, while the lipolytic activity was somewhat higher. From the above results, the TK3-Y strain appears to be a good candidate for use in the efficient treatment of fisheries waste in which components are not collected separately.
Assessment of Nakdong River Basin Management: Target Water Quality Achievement and Future Challenges
Kang, Kyeong Hwan,Kim, Junghyeon,Jeon, Hyeonjin,Kim, Kyoungwoo,Byun, Imgyu 한국방재학회 2020 한국방재학회논문집 Vol.20 No.2
2006년, 환경부에서는 <제1차 물환경관리 기본계획>을 수립하였다. 이 계획은 “Clean Water, Eco River 2015”를 목표로 수질을 보호하고 수자원의 관리를 강화하기 위하여 수립되었다. 본 연구는 낙동강 대권역 내 33개 중권역의 목표수질 달성 여부 및 미달성 중권역의 원인을 분석, 평가 하였다. 2015년 수질 데이터에 따르면, 낙동강 대권역 내 33개 중권역 중 16개 중권역이 계획수립 시 목표수질을 달성하였다. 이러한 낮은 목표수질 달성율은 계획 수립 당시 오염물질 부하 예측, 지류관리 문제, 4대강 사업 및 수질측정 대표지점에 대한 타당성 등의 문제점으로 인해 발생된 것으로 분석되었다. 또한 각 중권역 내 수질측정 대표지점에 대한 타당성을 조사한 결과, 일부 중권역에는 수질측정 대표지점 개선 및 변경이 필요한 것으로 분석되었다. 본 연구는 현재 진행중인 <제2차 물환경관리 기본계획>의 높은 달성율을 위한 오염 물질 부하 관리와 본류 및 지류 관리, 수질 측정 지표에 대한 연구와 같은 수질 개선을 위한 추가 연구도 제안하였다. In 2006, the Korean Ministry of Environment established <The 1st Water Environment Management Master Plan>. The plan aimed at “Clean Water, Eco River 2015” and guided water quality protection and strengthened water management. This study evaluated the achievement of the target water quality among the 33 mid-level basins in the Nakdong River basin and assessments of the causes of non-achievement of the target water quality by mid-level basins. According to the 2015 water quality data, only 16 of the 33 mid-level basins achieved the target water quality. The low achievement of the target water quality was attributed to the failure to predict the pollutant load at the time of planning, problems with the management of tributaries, implementation of the <Four major river restoration project>, and problems with the representativeness of the water quality representative points. In addition, feasibility studies on the water quality monitoring representative point used in each mid-level basin were also performed; some mid-level basins required improvement or change of the representative points. This study also suggested further research to improve water quality, such as detailed studies of the management of pollutant load, mainstream tributaries, and water quality indicators, for the revision of the current ongoing <The 2nd Water Environment Management Master Plan>.