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Cavitation signal detection based on time-series signal statistics (시계열 신호 통계량 기반 캐비테이션 신호 탐지)

  • Haesang Yang;Ha-Min Choi;Sock-Kyu Lee;Woojae Seong
    • The Journal of the Acoustical Society of Korea
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    • v.43 no.4
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    • pp.400-405
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    • 2024
  • When cavitation noise occurs in ship propellers, the level of underwater radiated noise abruptly increases, which can be a critical threat factor as it increases the probability of detection, particularly in the case of naval vessels. Therefore, accurately and promptly assessing cavitation signals is crucial for improving the survivability of submarines. Traditionally, techniques for determining cavitation occurrence have mainly relied on assessing acoustic/vibration levels measured by sensors above a certain threshold, or using the Detection of Envelop Modulation On Noise (DEMON) method. However, technologies related to this rely on a physical understanding of cavitation phenomena and subjective criteria based on user experience, involving multiple procedures, thus necessitating the development of techniques for early automatic recognition of cavitation signals. In this paper, we propose an algorithm that automatically detects cavitation occurrence based on simple statistical features reflecting cavitation characteristics extracted from acoustic signals measured by sensors attached to the hull. The performance of the proposed technique is evaluated depending on the number of sensors and model test conditions. It was confirmed that by sufficiently training the characteristics of cavitation reflected in signals measured by a single sensor, the occurrence of cavitation signals can be determined.

Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

Changes and Improvements of the Standardized Eddy Covariance Data Processing in KoFlux (표준화된 KoFlux 에디 공분산 자료 처리 방법의 변화와 개선)

  • Kang, Minseok;Kim, Joon;Lee, Seung-Hoon;Kim, Jongho;Chun, Jung-Hwa;Cho, Sungsik
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.20 no.1
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    • pp.5-17
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    • 2018
  • The standardized eddy covariance flux data processing in KoFlux has been updated, and its database has been amended accordingly. KoFlux data users have not been informed properly regarding these changes and the likely impacts on their analyses. In this paper, we have documented how the current structure of data processing in KoFlux has been established through the changes and improvements to ensure transparency, reliability and usability of the KoFlux database. Due to increasing diversity and complexity of flux site instrumentation and organization, we have re-implemented the previously ignored or simplified procedures in data processing (e.g., frequency response correction, stationarity test), and added new methods for $CH_4$ flux gap-filling and $CO_2$ flux correction and partitioning. To evaluate the effects of the changes, we processed the data measured at a flat and homogeneous paddy field (i.e., HPK) and a deciduous forest in complex and heterogeneous topography (i.e., GDK), and quantified the differences. Based on the results from our overall assessment, it is confirmed that (1) the frequency response correction (HPK: 11~18% of biases for annually integrated values, GDK: 6~10%) and the stationarity test (HPK: 4~19% of biases for annually integrated values, GDK: 9~23%) are important for quality control and (2) the minimization of the missing data and the choice of the appropriate driver (rather than the choice of the gap-filling method) are important to reduce the uncertainty in gap-filled fluxes. These results suggest the future directions for the data processing technology development to ensure the continuity of the long-term KoFlux database.

Identification and Measurement of Hospital-Related Fears in Hospitalized School-Aged Children (학령기 입원아동의 병원관련 공포에 관한 탐색연구)

  • 문영임
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.61-79
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    • 1995
  • When children are admitted to hospital, they have to adapt to new and unfamiliar stimuli. Children may respond with fear to stimuli such as pain or unfamiliar experiences. One goal of nursing is to help hospitalized children to adapt effectively to their hospital experience. Accordingly, nurses need to assess childrens' fears of their hospital experience to contribute to the planning of care to alleviate these fears. The problem addressed by this study was to identify and measure hospital-related fears(hereafter called HRF) in hospitalized school-aged children. The study was conceptualized with Roy's model. A descriptive qualitative approach was used first, followed by a quantitative approach. This study was conducted from November 30, 1989 to January 12, 1991. The sample consisted of 395 hospitalized school-aged children selected through an allocated sampling technique in nine general hospitals. The HRF questionnaire (three point likert scale ) was developed by a delphi technique. The data were analyzed by an SAS program. Factor analysis was used for the examination of component factors. Differences in the HRF related to demographic variables were examined by t-test, analysis of variance and the Scheffe test. The crude scores of the HRF scale were transformed into T- scores to calculate the standard scores. The results included the following : 1. Forty-four items were derived from 188 statements identifying the childrens' hospital-re-lated fears. These items clustered into 14 factors, fear of injections, operations, bodily harm others' pain, medical rounds, physical examinations, medical staff, disease process, blood and X-rays, drugs and cockroaches, tests, harsh discipline from parents or staff, being absent from school, and separation from family. The 14 factors was classified into four categories,'pain','the unfamiliar','the un-known' and 'separation'. 2. The reliability of the HRF instruments was .92(Cronbach's alpha). In the factor analysis, Cronbach's alpha coefficients for the 14 factors ranged from .84 to .86 and Cronbach's alpha coefficients for the four categories ranged from .70 to .84. Pearson correlation coefficient scores for relationships among the 14 factors ranged from ,11 to .50, and among the four categories, from ,44 to ,63, indicating their relative independence. 3. The total group HRF score ranged from 45 to 130 in a possible range of H to 132, with a mean of 74.51. The fears identified by the children were, in order, injections, harsh discipline by parents or staff, bodily harm, operations, medical staff, disease process, and medical rounds ; the least feared was others' pain. The fear item with the highest mean score was surgery and the lowest was examination by a doctor. HRF scores were higher for girls than for boys, and for grade 1 students than for grade 6 students. HRF scores were lower for children whose fathers were over 40 than for those whose fathers were in the 30 to 39 age group, and whose mothers were over 35 than for those whose mothers were in the 20 to 34 age group. HRF scores were lower when the mother rather than any other person stayed with the child. The expressed fear of pain, the unfamiliar, the un-known and of separation directs nurses' concern to the threat felt by hospitalized children to their concept of self. This study contributes to the assessment of fears of hospitalized children and of stimuli impinging on those fears. Accordingly, nursing practice will be directed to the alleviation of pain, pre-admission orientation to the hospital setting and routines, initiation of information about procedures and experiences and arrangments for mothers to stay with their children. Recommendations were made for further research in different settings and for development and testing of the instrument.

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Endocrinological Results of the Transsphenoidal Microsurgery for Cushing's Disease (쿠싱병에 대한 경접형동접근법의 내분비학적 결과)

  • Kim, Joon Soo;Kim, Chang Jin;Ha, Sang Soo;Kim, Jung Hoon;Lee, Jung Gyo;Kwun, Byung Duk;Hong, Sung Kwan;Lee, Ki Up;Lee, Bong Jae;Kim, Yong Jae;Choi, Choong Kon;Lee, Ho Gyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.611-621
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    • 2001
  • Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{\mu}g/dL$(mean $93.88{\mu}g/dL$) ; serum cortisol 11.9 to $47.5{\mu}g/dL$(mean $27.49{\mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{\mu}g/day$(mean $571.0{\mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.

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A Study on the Characteristics of Condensable Fine Particles in Flue Gas (배출가스 중 응축성미세먼지 특성 연구)

  • Gong, Buju;Kim, Jonghyeon;Kim, Hyeri;Lee, Sangbo;Kim, Hyungchun;Jo, Jeonghwa;Kim, Jeonghun;Gang, Daeil;Park, Jeong Min;Hong, Jihyung
    • Journal of Korean Society for Atmospheric Environment
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    • v.32 no.5
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    • pp.501-512
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    • 2016
  • The study evaluated methods to measure condensable fine particles in flue gases and measured particulate matter by fuel and material to get precise concentrations and quantities. As a result of the method evaluation, it is required to improve test methods for measuring Condensable Particulate Matter (CPM) emitted after the conventional Filterable Particulate Matter (FPM) measurement process. Relative Standard Deviation (RSD) based on the evaluated analysis process showed that RSD percentages of FPM and CPM were around 27.0~139.5%. As errors in the process of CPM measurement and analysis can be caused while separating and dehydrating organic and inorganic materials from condensed liquid samples, transporting samples, and titrating ammonium hydroxide in the sample, it is required to comply with the exact test procedures. As for characteristics of FPM and CPM concentrations, CPM had about 1.6~63 times higher concentrations than FPM, and CPM caused huge increase in PM mass concentrations. Also, emission concentrations and quantities varied according to the characteristics of each fuel, the size of emitting facilities, operational conditions of emitters, etc. PM in the flue gases mostly consisted of CPM (61~99%), and the result of organic/inorganic component analysis revealed that organic dusts accounted for 30~88%. High-efficiency prevention facilities also had high concentrations of CPM due to large amounts of $NO_x$, and the more fuels, the more inorganic dusts. As a result of comparison between emission coefficients by fuel and the EPA AP-42, FPM had lower result values compared to that in the US materials, and CPM had higher values than FPM. For the emission coefficients of the total PM (FPM+CPM) by industry, that of thermal power stations (bituminous coal) was 71.64 g/ton, and cement manufacturing facility (blended fuels) 18.90 g/ton. In order to estimate emission quantities and coefficients proper to the circumstances of air pollutant-emitting facilities in Korea, measurement data need to be calculated in stages by facility condition according to the CPM measurement method in the study. About 80% of PM in flue gases are CPM, and a half of which are organic dusts that are mostly unknown yet. For effective management and control of PM in flue gases, it is necessary to identify the current conditions through quantitative and qualitative analysis of harmful organic substances, and have more interest in and conduct studies on unknown materials' measurements and behaviors.

Efficacy of Frozen-Thawed ET in Patients with Old Age or Non-Pregnant in Fresh ET Cycles (고령 환자와 신선주기 배아이식에서 임신에 실패한 환자에서 동결-융해 배아이식의 효용성)

  • Choi, Su Jin;Lee, Sun Hee;Song, In Ok;Koong, Mi Kyoung;Kang, Inn Soo;Jun, Jin Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.4
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    • pp.237-243
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    • 2006
  • Objective: The aim of this study was to evaluate the efficacy of frozen-thawed ET in poor prognosis patients such as the old age (38~44 years; OA group) and the patients who did not achieve clinical pregnancy with the first fresh ET cycle (non-pregnant patients; NP group). Methods: Laboratory and clinical data were collected from fresh and frozen-thawed ET cycles of OA and NP group. Controlled ovarian hyperstimulation (COH) and conventional insemination or ICSI, in vitro culture and ET were performed by routine procedures. Supernumerary embryos were frozen by the slow freezing method, and frozen embryos were thawed by the rapid thawing method. Embryo development, pregnancy and implantation rates were statistically analyzed by Student t-test and chi square test Results: Mean ages were similar between fresh ET ($40.0{\pm}1.8$ years, n=206) and frozen-thawed ET ($39.9{\pm}1.9$ years, n=69) cycles in OA group. However, the clinical pregnancy and implantation rate of subsequent frozen-thawed ET significantly higher than those of fresh ET cycles (29.0% and 11.2% vs. 16.5% and 7.0%, p<0.05). In NP group, there was no difference in the mean age between fresh ET ($31.2{\pm}2.3$ years, n=40) and frozen-thawed ET ($31.9{\pm}3.1$ years, n=119) in subsequent cycles. The clinical pregnancy and implantation rates were similar between the subsequent fresh ET (42.5% and 22.6%) and the frozen-thawed ET (40.3% and 18.8%). Conclusion: In old age patients, higher pregnancy rate of frozen-thawed ET compared to fresh ET cycles in this study. It may be related that better uterine environments for implantation in frozen-thawed ET cycles than that of non-physiological hormonal condition in uterus of fresh COH cycles.

Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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The Effects of ALP Model-Applied Science Class on Elementary Students' Scientific Communication Skills (ALP 모형을 적용한 과학 수업이 초등학생의 과학적 의사소통능력에 미치는 영향)

  • Ha, Ji-hoon;Shin, Young-joon
    • Journal of The Korean Association For Science Education
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    • v.37 no.6
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    • pp.1025-1035
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    • 2017
  • The purposes of this study are to analyze the merits and limits of flipped learning by suggesting the ALP model for efficient application and to test the effects of the new ALP model. The process of new model and program development is based on ADDIE in this study. This study consists of two steps. First through literature research on the difficulties of the flipped learning, the elements are extracted to develop new model. Second, these elements were placed according to the teaching and learning flow, which resulted in the procedures. As a result, the ALP model was developed. The ALP model is a new model for applying teaching and learning methods for efficient application of the flipped learning. This model was applied to elementary science classes to test its effects in scientific communication skill. Interviews and cognitive survey were also conducted to collect additional information. The results of this study are as follows: There were various difficulties in flipped learning. Based on literature research results, the ALP model and the science programs for elementary students have been developed. The experimental group showed statistically meaningful improvement in scientific communication skill. The scientific communication skill has two subcategories: the forms and the types. According to the form analysis results, the experimental group showed a statistically meaningful improvement in the form of Table and Picture, but not in the form of Writing and Number. With the same reason given previously, this study confirmed that the application of ALP model improves the students' visual form communication skills such as Table and Picture better than reading form communication skills such as Writing and Number. According to the type analysis results, the experimental group showed a statistically meaningful improvement in "the scientific insistence" type, and "the justification" which is the sub element of "the scientific insistence" type. With this reason, this study suggests that the class applied ALP model gives students more time and opportunities to learn. Though the survey and interviews about the student's awareness of the class with applied the ALP model, this study showed that students actively exchanged their opinions in the class with applied ALP model.

A Study on Curriculum Improvement of the Korea Army Nursing Academy (국군간호사관학교 교육과정 개선을 위한 기초 연구)

  • 고자경
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.22-43
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    • 1983
  • 1. Need for and Purpose of the Study. There is an increasing demand for curriculum improvement of the Korean Army Nursing Academy (KANA), since it was upgraded into 4-year institution of higher learning from 3-year one. In particular, it is strongly advocated that the KANA needs the outside expertise for its curriculum improvement-namely not only from the internal military view of points but also from the viewpoints of professional educational society, In line with such a necessity for the study, this study was aimed at 1) analyzing the current actual practices of KANA'S curriculum, 2) investigating the desired practices of KANA'S curriculum, and 3) identifying the discrepancy between the actual and desired practices of curriculum. 2. Problems for the Study This study had 4 problems to be answeared as follows: 1) What are the actual curriculum practices of KANA? 2) What are the desired curriculum practices of KANA? 3) How are the extents of perception of actual and desired curriculum different in four groups (student, faculty & administrator, nurse, and medical doctor in militay hospital) ? 4) What are the restraining forces that impede the change from actual to desired curriculum practices? 5) What are the relationships of curriculum component,』 in actual and desired curriculum practices? 3. Methods and Procedures This study was conducted by means of document analysis in addition to literature review and by means of needs assessment questionnaire which was developed by the researcher. The questionnaire included 62 statments with 7 questions for demographic data collection. The needs assessment questionnaire was managed to a total of 243 subjects (100 students, 46 faculty & administrators, 55 nurses, and 42 medical doctors), The collected data were treated using SPSS computer system so as to calculate mean scores, standard deviations, and correlation coefficients. The significance test was made through t-test and one-way ANOVA. The statistical significance level was set at both .05 and .01 level. 4. Major findings The major findings in this study are as follows: 1) The score of desired practices was significantly greater than that of actual practices, representing a strong need for curriculum betterment. 2) There were significant differences in the perceptions of actual practices as well as desired practices among four groups (student, faculty & administrater, nurse, and medical doctor). 3) The most frequently selected restraining forces were army's inherent character, economical limitation, and educational expertise limitations. 4) Such variables as sex, position attachment to the KANA and grade made a statistically significant effect on the perception of desired curriculum practice, while the variables like marrige, position, and military class made it on the perception of actual curriculum practice. 5) The coefficients among the curriculum components were lower in perception of the actual curriculum practices than those in the desired practices. 5. Conclusions The conclusions based on the major findings of this study are as follows: 1) The current curriculum development procedure of the KANA is not consistent with the theoretical frame of systematic development sarategy of curriculum. 2) There are wide conflicts among the groups who are supposed to participate in curriculnm development, concerning the actual and desired practices of KANN'S curriculum. 3) A great deal of need for curriculum improvement for the KANA is clearly felt, and in particular, in the process of teaching and learning. 4) Each component of curriculum is not intergrated into a whole development procedure, being segregated each other. 5) For better curriculum improvement, such restraining forces as financial and professional limitations should be eliminated. 6. Recommendations 1) For Further Research a. There is a need to replicate this study after in-depth statistical analysis of each item of need assessment questionnaire, and with more representative subjects. b. A study should be conducted which. has its focus on the analysis of restraining forces for the change from actual to desired curriculum practices of the KANA. 2) For KANA'S Curriculum Improvement a. There is a need to promote the professional expertise of the participants in curriculum development and the communication among them. b. It is desirable to establish an institution or section of administration, which is soley in charge of curriculum development. c. To better develop KANA's curriculum not only faculty and administrators but also students should be encouraged to participate in development process, while the military medical doctors' participation should be carefully considered.

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