• 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 the Korea Institute of Building Construction
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• v.15 no.6
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• pp.597-605
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• 2015

The method of concrete mix design used in this study aims to achieve the identical specified design strength, applying different types and replacement ratio of mineral admixtures and afterwards, fire tests were conducted using the standard time-temperature curve specified in the ASTM E119 to identify the influences of the types of mineral admixtures on the fire resistance performance of high strength concrete(HSC). The least spalling was observed in the test specimen containing blast furnace slag as a partial replacement of cement, while the most significant spalling phenomena were observed in the blast furnace slag test specimen that silica-fume was added in. In particular, the reasonable volume of spalling was observed when solely replaced by silica fume. However, the influence of the cement replacement by silica fume and blast furnace slag on the increases of spalling can be explained through blocked pores by the fine particles of silica fume, leading to decreases in permeability.

• Journal of the Korea Concrete Institute
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• v.13 no.1
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• pp.54-61
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• 2001

As a part of the movement of natural resources conservation, there have been doing many recycling research works for obsolete aged tire, wasted plastic materials, etc. The purpose of this experimental study is to develop glass concrete by recycling wasted glasses as a cementitious constituent in concrete. First of all, the optimum replacement ratio of powdered waste glasses(PWG) can be determined through pilot compressive strength test on normal and high strength concrete cylinders, which have been made in various mix proportions by changing the replacement ratio of PWG. Then, further tests have been done to figure out mechanical properties of most desirable glass concrete with optimum replacement ratio of PWG, such as static modulus of elasticity, compressive and tensile strengths, flexural strength. On the other hand, the alkali-silica reactions by the mortar-bar method(KS F 2546) have been experimentally doing in various grain sizes of PWG, since the alkali in the cement has a tendency to react with the silica in the PWG. In can be confirmed from the test that glass concrete can have better workability than concrete with silica fume, and they are alike in compressive strength. It is concluded that wasted glasses can be used as pratical additives for economic and environmentally friendly concrete.

• Journal of the Korean GEO-environmental Society
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• v.2 no.3
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• pp.57-69
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• 2001

Sand pile is widely used as a ground improvement method. Although the primary purpose of constructing sand pile is accelerating consolidation, composite ground effect also can be gained by constructing sand pile. This study was accomplished to understand composite ground effect on the ground improved by sand piles which were applied as vertical drainage material when area replacement ratio was small relatively. For determining bearing capacities of origin ground and sand piles and analysing interaction between embankment and origin ground, bearing tests and earth pressure monitoring are performed. From the results, it turned out that the contribution of sand pile as a load bearing mechanism is not substantial. However, the bearing capacity of sand pile was increased to sixty percentages when compared with origin ground. The increasement of bearing capacity could be caused the change of consolidation characteristics during the process of consolidation by overburden load. Therefore, the composite ground effects depending on stiffness increasement of sand pile would be estimated as a factor decreasing consolidation settlement.

• Journal of the Korean Recycled Construction Resources Institute
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• v.6 no.3
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• pp.69-78
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• 2011

As recent concrete products changed to pursue high class, high quality, and high strength, as translucent concrete was developed to meet esthetic effects and exhibition purpose of structures. This study aims at introducing fabrication methods of various shapes of translucent concrete and evaluating feasibility of using mineral admixture such as fly ash, ground granulated blast furnace slag and granulated glass throughout experimental tests. As the result, it was found that compressive strength of translucent concrete block at 28 days is 32.2MPa and higher elastic modulus and Poisson's ratio than ordinary concrete block, which means that translucent concrete is widely applicable to structural purpose. Application of fly ash as a replacement of cement showed lower strength of 85 to 96% than Portland cement. In the meanwhile, ground granulated blast furnace slag showed 82 to 96% depending on the amount of replacement. The use of granulated glass as replacement of optical fiber was not applicable due to invisibility of light in concrete.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.39 no.1
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• pp.71-78
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• 2015

This paper presents a method for analyzing the size and economic sensitivity of a new renewable hybrid generation system according to changes in the component replacement costs based on HOMER (Hybrid Optimization Model for Electric Renewables). The design of a hybrid system can be optimized by reducing the size of a sensitive component based on sensitivity analysis using the change in cost of a component. Sensitivity analysis can also provide information on what combinations are necessary for the optimal hybrid system. As an example, sensitivity analysis was performed on the residential load provided by HOMER, and the effects of component replacement costs on the system size and cost were quantitatively analyzed.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.173-180
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• 2005

Purpose:We investigated the effect of menopausal duration on cognitive function using adjunctive hormone replacement therapy(HRT) in postmenopausal women with depression. Method:Twelve postmenopausal women with depressive disorder were enrolled. Six patients having menopausal duration of less than 3 years was assigned to the short duration group and six patients of more than 3 years to the long duration group. Each patient was treated with conjugated equine estrogen(1.25mg) plus medroxyprogesterone(5mg) for 8 weeks. Cognitive performance was measured by the Verbal Memory Test, Visual Memory Test, Trail Making Test, Digit Symbol Test, and Attention Shift Test. The Beck Depression Inventory was used for evaluation of depressed mood. The reproductive hormone levels were also measured. Results:The long duration group showed the lower performance only in Trail Making Test B compared with the short duration group at baseline. After 8 weeks, the long duration group performed significantly better in the Trail Making Test B compared with the short duration group. The differences in change of depressive mood and gonadal hormone level between two groups were not significant. Conclusion:Menopausal duration before HRT may influence the effect of estrogen on cognition in some cognitive domains. This might be related with estrogen receptor hypersensitivity which induced by the longer estrogen deficiency.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.479-487
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• 1988

Valve replacements in 82 children, aging up to 15 years[mean 11.67 years] were done at Seoul National University Hospital during 13 years period from 1974 to 1986. The patients were composed of 5] males and 31 females and 50 patients had acquired heart disease and 32 patients congenital heart disease. 75 patients received single valve replacements, 6 patients double valve replacements, 1 patient triple valve replacement, and among all of them, 11 patients redo-replacements. The bioprosthetic valves have been applied to 58 patients and prosthetic valve to 24 patients and the latter was the main artificial valve since 1984. Among the 69 patients who had definite post-operative records, the overall mortality was 27.5%[20.3% was early mortality and 7.2% late mortality] and the overall mortality was lowered to 4.3% since 1984. There were early post-operative complication rate of 26.1% and late complication rate 34.8%, and among the latter, the valve failure rate was 11.4% patient-year, and the thrombo-embolism rate 1.76%/patient-year. 55 patients among the survivals after post-operative 1 month, were received follow-up with various anticoagulating medication for total 2046 patient-months[mini-mum 1 month to maximum 90 month, mean 37.2*25.44 months] and actuarial survival rate was 82*8% at 5 years and valve failure free and thrombo-embolic free survival rate were 61*8% and 90*3% respectively. And among them, valve failure free survival `rate of tissue valve were 91*6% at post-operative 2 years, 78*3% at 3 years, 59*9% at 4 years, 54*10% at 5 years, 53*15% at 6 years, so markedly decreased at 3-5 years post-operatively. These results suggest that cardiac valve replacement in children have been effective therapeutic method though various problems are still remained, and the choice of valve should be prosthetic valve mainly due to its durability at the present.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.497-509
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• 1988

Current therapy of aortic dissections remains unstandardized because of the relative rarity of these catastrophic events and conflicting reported results of various therapeutic strategies. Hence, we reviewed our current results and planned to purify our method of interpretation of results and so, to standardize therapeutic managements. This study comprised unselected, consecutive 27 patients with aortic dissections who were operated at Seoul National University Hospital from Jan 1983 to March 1988. The results from analysis of their preoperative, operative and postoperative finding were as follows: 1] 7 patients had acute type A, 14 had chronic type A, 4 had acute type B, and 2 had chronic type B. 2] The causes of dissections were unclear, but 8 patients had Marfan`s syndromes, 2 had previous operative histories on cardiovascular systems and 2 had congenital heart diseases. 3] Multiple preoperative variables were found to correlate significantly with operative mortality and complications. The prevalences of such preoperative major complicating factors were significantly more frequent in acute than chronic [P < 0.05] and type A than type B [P < 0.01]. 4] Operations were performed according to the type of the dissections and whether it was acute or chronic. Usually dacron tube graft replacements were performed[25/26]. Intraluminal sutureless graft replacement was performed in 11 patients. Of the 14 patients with combined aortic regurgitation, concomitant aortic valve resuspension in 4, seperative aortic valve replacement in 1, and aortic valve replacement with coronary reimplantation were performed in 9 patients. 2 patients had concomitant arch vessel managements. 5] Over-all operative mortality rate was 33% and 54% for acute type A, 25% for acute type B, 29% for chronic type A, 0% for chronic type B respectively. The main causes of operative mortality were cardiovascular complications [mainly CPB-weaning failure] in acute cases and hemorrhagic complications in chronic cases.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.211-216
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• 2008

Background: Postoperative pain after bilateral total knee replacement (TKR) is expected to be more severe than unilateral TKR. Intravenous patient-controlled analgesia (IV PCA) is less effective than other methods of pain management especially immediately after an operation even though it is an easily controlled method for managing pain. This study was designed to evaluate the effect of femoral nerve blocks combined with IV PCA after bilateral TKR for postoperative pain control. Methods: The patients in group I (n = 20) were given only IV PCA with morphine and group II (n = 20) were given bilateral femoral nerve blocks with 12 ml of 0.25% bupivacaine and epinephrine 1 : 400,000 before extubation followed by an IV PCA. Main outcome measures included numerical rating pain score, cumulative opioid consumption, hourly dose during each time interval, and side effects. Results: The pain score in group II was significantly lower than that in group I immediately after recovery of awareness and at 3, 6, 12 hours postoperatively. Cumulative opioid consumption was significantly decreased in group II during the first 48 hours postoperatively. The hourly dose in group II was also significantly lower than that in group I until 12 hours postoperatively. There was no difference in side effects between the groups. Conclusions: We concluded that bilateral femoral nerve blocks improve analgesia and decrease morphine use during IV PCA after bilateral TKR.