• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• Korean Security Journal
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• no.21
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• pp.75-94
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• 2009

Since mechanical security systems are mostly composed of electronic, information and communication devices, they have effects in the aspects of overall social environment and crime-oriented environment. Also, the importance is increasing for wireless recognition of RFID and tracing function, which will be usefully utilized in controlling the incomings and outgoings of people/vehicles or allowance, surveillance and control. This is resulting from the increase in the care for the elderly according to the overall social environment, namely, the aging society, and the number of women entering, as well as the increase in the number of heinous crimes. The purpose of this study is to examine the theoretical considerations on ubiquitous sensor network and present a direction for securities companies for their development by focusing on the technological and application areas. To present strategies of response to a new environment for security companies, First, a diversification strategy is needed for security companies. The survival of only high level of security companies in accordance with the principle of liberal market competition will bring forth qualitative growth and competitiveness of security market. Second, active promotion by security companies is needed. It is no exaggeration to say that we are living in the modern society in the sea of advertisements and propaganda. The promotional activities that emphasize the areas of activity or importance of security need to be actively carried out using the mass media to change the aware of people regarding security companies, and they need to come up with a plan to simultaneously carry out the promotional activities that emphasize the public aspect of security by well utilizing the recent trend that the activities of security agents are being used as a topic in movies or TV dramas. Third, technically complementary establishment of ubiquitous sensor network and electronic tag is needed. Since they are used in mobile electronic tag services such as U-Home and U-Health Care, they are used throughout our lives by forming electronic tag environment within safe ubiquitous sensor network based on the existing privacy guideline for the support of mobile electronic tag terminal commercialization, reduction in communication and information usage costs, continuous technical development and strengthening of privacy protection, and the system of cooperation of academic-industrial-research needs to be established among the academic world and private research institutes for these parts.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.752-759
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• 1997

Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.75-84
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• 1994

The need for assessment of ureteric function in the patient with an obviousely dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydrone-phrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during $^{99m}Tc$-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Kt1/2) and ureteral (Ut1/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Kt1/2 (>20 min), no patient with an abnormal ureter underwent therapy at the ureteropelvic junction because the hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.19 no.1
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• pp.8-34
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• 2014

We reviewed foreign evaluation systems based on the macrobenthic and macroalgal communities and developed a system, composed of a set of ecological indices able to evaluate the functionality (FI, Functional Index; estimation of stability and productivity) and maturity (MI, Maturity Index; comparisons with biological parameters of natural reefs) of artificial reefs by comparing the status in the adjacent natural reefs in Korean coastal waters. The evaluation system was applied to natural and artificial reefs/reef-planned areas (natural reefs), established in the 5 marine ranching areas (Bangnyeong-Daechung, Yeonpyung, Taean, Seocheon and Buan) in the west coast of Korea. The FI ranged between 31.6 (Bangnyeong-Daechung) and 72.5% (Buan) and MI did between 53.1 (Seocheon) and 76.9% (Taean) in average. The evaluation of artificial reefs by the two indices, showed the most appropriate status in Taean. The FI between the adjacent artificial and natural reefs were in significant linear relationship ($r^2=0.83$, p=0.01). This indicated the local status of biological community may be critical in determining the functionality of the artificial reefs. We have suggested an integrative but preliminary evaluation system of artificial reefs in this study. The output from the evaluation system may be utilized as a tool for environment/resource managers or policy makers, responsible for effective use of funds and decision making. Given the importance, we need to use the options to enhance and improve the accuracy as follows: (1) continuous validation of the evaluation system and rescaling the criteria of indicators, (2) vigorous utilization of observation and experience through the application and data accumulation and (3) development and testing of brand-new indicators.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.121-130
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• 2014

Purpose: To assess the surface profile of dentinal wall, dentin chips and smear layer during the canal shaping with rotary (ProTaper) and ProFile and reciprocating (WaveOne) nickel-titanium file. Materials and Methods: Sixty human extracted mandibular premolars and incisors with single canals were randomly selected. Three experimental groups (n = 20) were instrumented with ProTaper (F2), ProFile (25/.06), WaveOne (25/.08) with irrigation of 2.5% NaOCl. The dentin chips were collected from flute of file during each canal preparation. After canal preparation, roots were grinded and each group was divided into two subgroups (n = 10) for surface profile and smear layer of dentinal wall of shaped root canal. Each specimen was observed under scanning electron microscope for evaluating size of dentin chips, root canal surface recessions and smear layer. Scores of Smear layer were statistically analyzed using Kruskal Wallis test and Mann Whitney test at P = 0.05 level. Results: The size of dentin chips from ProFile, ProTaper and WaveOne was up to $7{\mu}m$, $6.5{\mu}m$, and$4{\mu}m$, respectively. In the surface profile, the width of surface irregularity was measured and Profile, ProTaper and WaveOne was up to $150{\mu}m$, $70{\mu}m$, and $80{\mu}m$, respectively. Completely cleaned root canals were not found. In the middle and apical third of the canals, WaveOne group showed higher smear layer score than ProFile and ProTaper groups (P < 0.05). Conclusion: Within limits of this study, reciprocating motion WaveOne group was not significant difference of shaping ability with the full-sequence ProFile and ProTaper systems except canal clearness of middle and apical third of root canal. When using WaveOne to shaping root canal, thorough root canal irrigation is recommended.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.15-21
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• 2003

Background : There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. Methods : A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. Results : The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). Conclusion : The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.

• Bulletin of the Society of Naval Architects of Korea
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• v.25 no.4
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• pp.69-80
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• 1988

This paper proposes simple formulae for buckling and ultimate strength estimation of plates subjected to water pressure and uniaxial compression. For the construction of a formula for elastic buckling strength estimation, parametric study for actual ship plates with varying aspect ratios and the magnitude of water pressure is carried out by means of principle of minimum potential energy. Based on the results by parametric study, a new formula is approximately expressed as a continuous function of loads and aspect ratio. On the other hand, in order to get a formula for ultimate strength estimation, in-plane stress distribution of plates is investigated through large deflection analysis and total in-plane stresses are expressed as an explicit form. By applying Mises's plasticity condition, ultimate strength criterion is then derives. In the case of plates under relatively small water pressure, the results by the proposed formulae are in good agreement compared with those by other methods and experiment. But present formula overestimates the ultimate strength in the range of large water pressure. However, actual ship plates are subjected to relatively small water pressure except for the impact load due to slamming etc.. Therefore, it is considered that present formulae can be applied for the practical use.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.163-173
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• 2013

When the mandible performs opening movement, the condyle-disk complex conducts sliding movement along the articular eminence. Thus, anatomic configuration of articular eminence is very important to normal movement of TMJ. The purpose of this study was to measure the posterior slope of the articular eminence and evaluate the effect of a pathologic bone change in the condylar head on the stiffness of articular eminence, and compare the differences of the articular eminence slope by gender and age using dental cone-beam CT. As using i-CAT Cone-Beam Computed Tomography, the CT images of 204 TMJs of 102 patients(43 men and 59 women, mean age: 37.7 years) who were diagnosed at Wonkwang University Sanbon Dental Hospital were evaluated. All images were converted into a TMJ analysis mode to observe the continuous sagittal section images and coronal section images of the joints. To observe and assess bone changes in the condyle, three dentists measured the stiffness of the articular eminence on the same images, and when two of the three dentists agreed on their reading, these results were adopted and recorded. The articular eminence slope, considering the condylar anatomic configuration, was measured in three regions, namely, lateral part, central part, and medial part of the condyle. In the cases of a normal condyle(NCBC) and a condyle(CBC) with bone change, the articular eminence slopes were $57.0^{\circ}$(NCBC) and $51.8^{\circ}$(CBC) at the medial part, $57.9^{\circ}$(NCBC) and $52.4^{\circ}$(CBC) at the central part, and $55.1^{\circ}$(NCBC) and $49.5^{\circ}$(CBC) at the lateral part of the condyle. And the articular eminence slope of the condyle with bone change demonstrated less steepness than that of normal condyle (p<0.05). The articular eminence slope showed mediolaterally that it was the steepest at the central, followed by at the medial, and at the lateral (p<0.05). There were no significant differences by the gender and the age (p.0.05).

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2017.05a
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• pp.463-466
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• 2017

The purpose of this paper is to develop a module capable of all-directional driving different from conventional wheeled robots, and to solve the problems of the conventional mobile robot with side driving performance degradation, It is possible to overcome the disadvantages such as an increase in the time required for the unnecessary driving. The all - direction spherical wheel drive module for driving a ball - balancing robot is required to develop a power transfer mechanism and a driving algorithm for driving the robot in all directions using three rotor casters. 3DoF (Axis) A driver with built-in forward motion algorithm is embedded in the module and a driving motor module with 3DoF (axis) for driving direction and speed is installed. The movement mechanism depends on the sum of the rotation vectors of the respective driving wheels. It is possible to create various movement directions depending on the rotation and the vector sum of two or three drive wheels. It is possible to move in different directions according to the rotation vector field of each driving wheel. When a more innovative all-round spherical wheel drive module for forward movement is developed, it can be used in the driving part of the mobile robot to improve the performance of the robot more technically, and through the forward-direction robot platform with the drive module Conventional wheeled robots can overcome the disadvantage that the continuous straightening performance is lowered due to resistance to various environments. Therefore, it is necessary to use a full-direction driving function as well as a cleaning robot and a mobile robot applicable in the Americas and Europe It will be an essential technology for guide robots, boarding robots, mobile means, etc., and will contribute to the expansion of the intelligent service robot market and future automobile market.