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The purpose of this research is to find the reasons of overcrowding in the emergency department of an hospital, then to shorten the total stay time of patients The fact that main causes of the overcrowding exist in the process of the emergency department was discovered by analysis of the data In order to Improve these process, simulation model was developed by ARENA 70 Staffs time, staffs organization, process ratio, and patient's waiting time were estimated in the simulation model in consideration of the decision of the patient's course of action Several scenarios such as the simplification of the process, the setup of dedicated pathology lab, and mixed method were suggested and evaluated Total stay time of the patients would be reduced up to 28.45%
The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.
We report a case of 15 year-old Jehovah's Witness patient with mild anemia who underwent a successful orthognathic two-jaw surgery. Jehovah's Witness patients refuse transfusion of blood or blood products even in life threatening situations. The use of recombinant human erythropoietin and iron supplement increased hemoglobin during preoperative period. Intraoperatively, meticulous surgical hemostasis, acute normovolemic hemodilution and induced hypotension enabled the completion of the operation without the use of blood products.
As the need to have shared space has increased, the objective of this study is to overcome the problems shown by the current community facilities, use the space structure of connection and separation as a way to increase the level of utilization and the cultural values, plan the combined cultural facilities equipped with the open-type space structure equipped with the character of public interest, establish the community facilities on the border with the residential facilities, and suggest the combined cultural residential facilities with continuous programs and flows of space. Based on the space application of connection and separation, it is possible to regard the connecting points of the programs built in the combined cultural residential facilities and provide the space continuity in order to induce organic connections. Also, by dividing the functions of the current programs, each program can be reproduced. In order to plan such space, such composing methods as SPLIT, WRAP, TOOTH, AROUND, STEP, SPIRAL, VOID and FOLD are suggested. Such methods can have different compositions according to directions, locations, approaching methods and functions in order to have differentiated space.
The purpose of this study was to examine the relationships among lifestyle, leisure flow, and leisure satisfaction of skin scuba participants. Toward this end, a total of 253 skin scuba participants was selected using a convenient sampling method. 242 usable questionnaires were returned to the researchers. Data analyses were conducted for frequency analysis, exploratory factor analysis, reliability test, correlation analysis, descriptive analysis, and multiple regression analyses with PASW 18.0. The results of this study indicated that (1) health and achievement sub-dimensions of the life style had a significant effect on leisure flow, (2) leisure flow had a significant effect on team identification within on-line baseball game had a significant impact on leisure satisfaction, and (3) lifestyle had a significant effect on leisure satisfaction. Additional implications and directions for future research were discussed.
Five different size of orifice were applied in a constant volume combustion chamber for evaluating the effects of torch-ignition on combustion. The initial flame development and flame propagation were analyzed by the mass burned fraction and combustion enhancement rate. The combustion pressures were measured to calculate the mass burned fractions and the combustion enhancement rates. In addition, the flame propagations were visualized by the shadowgraph method for the qualitative comparison. The result showed that the combustion pressure and mass burned fraction were increased when using the torch-ignition device. The combustion enhancement rates of torch-ignition cases were improved in comparison with conventional spark ignition. Finally, the visualization results showed that the torch-ignition induced faster burn than conventional spark ignition due to the earlier transition to turbulent flame and larger flame surface, during the initial stage.
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Recently, management based on statistical data has become a big issue and the importance of the statistics has been emphasized for the management innovation in the defense area. However, the Military Management based on the statistics is hard to expect because of the shortage of the statistics in the military. There are many military information systems having great many data created in real time. Since the infrastructure for gathering data form the many systems and making statistics by using gathered data is not equipped, the usage of the statistics is poor in the military. The Analytical Defense Statistics System is designed to improve effectively the defense management in this study. The new system having the sub-systems of Data Management, Analysis and Service can gather the operational data from interlocked other Defense Operational Systems and produce Defense Statistics by using the gathered data beside providing statistics services. Additionally, the special function for the user oriented statistics production is added to make new statistics by handling many statistics and data. The Data Warehouse is considered to manage the data and Online Analytical Processing tool is used to enhance the efficiency of the data handling. The main functions of the R, which is a well-known analysis program, are considered for the statistical analysis. The Quality Management Technique is applied to find the fault from the data of the regular and irregular type. The new Statistics System will be the essence of the new technology like as Data Warehouse, Business Intelligence, Data Standardization and Statistics Analysis and will be helpful to improve the efficiency of the Military Management.