• Environmental Engineering Research
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• 제18권1호
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• pp.37-43
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• 2013

Water distribution pipes installed underground have potential risks of pipe failure and burst. After years of use, pipe walls tend to be corroded due to aggressive soil environments where they are located. The present study aims to assess the degree of external corrosion of a distribution pipe network. In situ data obtained through test pit excavation and direct sampling are carefully collated and assessed. A statistical approach is useful to predict severity of pipe corrosion at present and in future. First, criteria functions defined by discriminant function analysis are formulated to judge whether the pipes are seriously corroded. Data utilized in the analyses are those related to soil property, i.e., soil resistivity, pH, water content, and chloride ion. Secondly, corrosion factors that significantly affect pipe wall pitting (vertical) and spread (horizontal) on the pipe surface are identified with a view to quantifying a degree of the pipe corrosion. Finally, a most reliable model represented in the form of a multiple regression equation is developed for this purpose. From these analyses, it can be concluded that our proposed model is effective to predict the severity and rate of pipe corrosion utilizing selected factors that reflect the fuzzy soil environment.

• Computers and Concrete
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• 제7권2호
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• pp.103-118
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• 2010

Penetration of a fragment-like projectile into Fiber Reinforced Concrete (FRC) was simulated using finite element (FE) and particle formulations. Extreme deformations and failure of the material during the penetration event were modeled with multiple approaches to evaluate how well each represented the actual physics of the penetration process and compared to experimental data. A Fragment Simulating Projectile(FSP) normally impacting a flat, square plate of FRC was modeled using two target thicknesses to examine the different levels of damage. The thinner plate was perforated by the FSP, while the thicker plate captured the FSP and only allowed penetration part way through the thickness. Full three dimensional simulations were performed, so the capability was present for non-symmetric FRC behavior and possible projectile rotation in all directions. These calculations assessed the ability of the finite element and particle formulations to calculate penetration response while assessing criteria necessary to perform the computations. The numerical code EPIC contains the element and particle formulations, as well as the explicit methodology and constitutive models, needed to perform these simulations.

• 국제초고층학회논문집
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• 제9권2호
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• pp.127-154
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• 2020

Disproportionate collapse triggered by local structural failure may cause huge casualties and economic losses, being one of the most critical civil engineering incidents. It is generally recognized that ensuring robustness of a structure, defined as its insensitivity to local failure, is the most acceptable and effective method to arrest disproportionate collapse. To date, the concept of robustness in its definition and quantification is still an issue of controversy. This paper presents a detailed review on about 50 quantitative measures of robustness for building structures, being classified into structural attribute-based and structural performance-based measures (deterministic and probabilistic). The definition of robustness is first described and distinguished from that of collapse resistance, vulnerability and redundancy. The review shows that deterministic measures predominate in quantifying structural robustness by comparing the structural responses of an intact and damaged structure. The attribute-based measures based on structural topology and stiffness are only applicable to elastic state of simple structural forms while the probabilistic measures receive growing interest by accounting for uncertainties in abnormal events, local failure, structural system and failure-induced consequences, which can be used for decision-making tools. There is still a lack of generalized quantifications of robustness, which should be derived based on the definition and design objectives and on the response of a structure to local damage as well as the associated consequences of collapse. Critical issues and recommendations for future design and research on quantification of robustness are provided from the views of column removal scenarios, types of structures, regularity of structural layouts, collapse modes, numerical methods, multiple hazards, degrees of robustness, partial damage of components, acceptable design criteria.

• Journal of Chest Surgery
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• 제20권2호
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• pp.289-299
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• 1987

A total of 1,239 patients had cardiac valve replacement using 1,514 substitute valves at Seoul National University Hospital from 1968 to 1986. Of the total substitute vales, 84.9% were the glutaraldehyde-treated xenograft valves. Six hundred ninety-four patients who had 820 bioprosthetic tissue valves were studied for their clinical characteristics. They were a total and consecutive cases to the end of the study. Four hundred sixty-four patients had the lonescu-Shiley pericardial valves: MVR 291, AVR 66 and MVR+AVR 107; 163 had the Hancock porcine valves; 46 had the Angell-Shiley porcine valves; and 21 had the Carpentier-Edwards porcine valves. Five hundred forty patients underwent single valve replacement: MVR 460, AVR 76 and TVR 4; 154 had multiple valve replacement: MVR+AVR 141, MVR+TVR 12 and one triple valve replacement. Additional surgery was necessary in 22.3% of the cases. Operative mortality rate within 30 days of surgery was 6.77% for the total patients: 5.2% and 4.2% with MVR, 13.6% and 12.5% with AVR, and 7.5% and 7.4% with MVR+AVR using the lonescu and the Hancock valves respectively. A linealized annual late mortality rate was 2.56%/patient-year. Six hundred forty-three operative survivors were followed up for a total of 1482.7 patient-years [a mean 27.7 months], and the follow-up rate was 67.7%. The Idealized complication rates were: 2.02% emboli/patient-year, 0.94% bleeding/patient-year, 1.21% endocarditis/patient-year, and 3.84% overall valve failure/patient-year. A linealized rate of primary tissue failure was 0.87%/patient-year. Actuarial survival rates including the operative mortality were: 87.8*2.6%, 82.3*4.9% and 82.2*4.7% with MVR, AVR and MVR+AVR using the lonescu valves at 4 years after surgery respectively; and they were 88.0*4.1% with MVR at 8 years, 82.3*4.9% with AVR at 4 years and 84.9*7.0% with MVR+AVR at 6 years after surgery using the Hancock valves respectively. Probabilities of freedom from thromboembolism were 89.8*6.3% with MVR using the lonescu valves at postoperative 5 years and 89.2*3.8% with MVR using the Hancock valves at postoperative 7 years, and 93.3*3.9% with AVR using the lonescu valves at postoperative 5 years. None had embolic complication after AVR using the Hancock valves. Probabilities of freedom from valve failure [according to the Stanford criteria] were 81.0*7.1% with MVR using the lonescu valves at postoperative 4 years and 57.4*12.5% with MVR using the Hancock valves at postoperative 9 years. These clinical results prove the excellent antithrombogenicity of the glutaraldehyde-treated xenograft substitute valves and confirm the previously speculated rate of tissue failure. At the present situation, it may be concluded that there is a room for the further development of more durable bioprosthetic valves.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1316-1321
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• 2000

Objectives : The authors analyzed the surgical series of Cushing's disease to evaluate the proper treatment policy and to verify the possible prognostic factors. Material and Methods : Of 50 patients diagnosed as Cushing's disease and operated at Department of Neurosurgery of our institute between 1988 and 1999, 48 patients with available medical records were analyzed retrospectively. Mean follow-up period was 48 months(3 to 109 months). Preoperative diagnosis was made after evaluating the patients with multiple-stage endocrinological studies and 31 selective patients were evaluated with inferior petrosal sinus sampling(IPSS). Magnetic resonance imaging(MRI) and/or high resolution computerized tomography(CT) was done in all patients. A total of 51 transsphenoidal adenomectomy(TSA) were performed including 3 revision for initial surgical failure cases. Remission was decided on the basis of both endocrinological criteria and clinical status. Radiation and/or ketoconazole therapy were applied to failed cases. For the verification of prognostic factors, the authors evaluated the statistical significance of multiple variables over remission rate by chi-square test. Result : Sensitivity of IPSS for central localization was 93.5% which was better than that of MRI(87.5%). But for lateralization, it was 72.4% for IPSS versus MRI 90.5%. Success rate of TSA was 82%(42/51) and recurrence rate was 9%(4/48). When including adjuvant treatments for surgically failed cases, overall success rate was 89.6% and all of 3 reoperated cases(TSA) due to recurrence were successful. Significant complication occurred in 7.8%(4/51) after TSA including hypopituitarism, diabetes insipidus, and visual loss. Non-existence of tumor in MRI and prolonged symptom duration(>3 years) were significant prognostic factors. Conclusion : TSA can be considered as initial treatment for Cushing's disease. In surgically failed cases, multiple treatment modality may improve the overall outcome and repeated TSA for recurrent cases seem to provide similar success.

• Journal of Medicine and Life Science
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• 제17권2호
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• pp.47-52
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• 2020

Glucagon regulates glucose and fat metabolism as well as being involved in the production of ketone bodies. The new antidiabetic drug, a sodium-glucose co-transporter-2 inhibitor, increases glucagon, and reduces the risk of cardiovascular death and hospitalization due to heart failure. The presence of metabolic syndrome is an important risk factor for cardiovascular diseases(CVD) in type 2 diabetes(T2DM) patients. We, thus, investigated the association between glucagon levels and metabolic syndrome in T2DM patients. This cross-sectional study involved 317 T2DM patients. Fasting and postprandial (30 min after ingestion of a standard mixed meal) glucagon levels were measured. Metabolic syndrome was defined according to the criteria of the International Diabetes Federation. A multiple regression logistic analysis was employed for statistical evaluation. A total of 219 (69%) subjects had metabolic syndrome. The fasting and postprandial glucagon levels did not differ between the group with metabolic syndrome and the group without. Postprandial glucagon levels increased significantly with the increase in the number of metabolic syndrome components, but the fasting levels did not. However, a hierarchical logistic regression analysis revealed that the postprandial glucagon levels did not contribute significantly to metabolic syndrome even after adjusting for other covariates. Fasting and postprandial glucagon levels are not associated with metabolic syndrome in T2DM patients. However, further studies are needed to investigate the relationship between glucagon and cardiovascular risk in patients with T2DM.

• 콘크리트학회논문집
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• 제22권4호
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• pp.585-593
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• 2010

선행연구에서 제안된 변형률기반 전단강도모델에 근거하여, 슬래브-기둥 내부 및 외부접합부의 직접뚫림전단강도와 불균형휨모멘트강도를 정확하게 평가할 수 있는 강도모델을 개발하였다. 슬래브-기둥 접합부는 뚫림전단파괴에 앞서서 휨균열에 의해서 손상을 받으므로, 이 연구에서는 위험단면의 압축대에서 대부분의 전단저항이 발휘된다고 가정하였다. 슬래브 휨모멘트에 의해서 유발되는 압축수직응력이 콘크리트 압축대의 전단강도에 미치는 영향을 고려하기 위하여, 다축응력 상태에 대한 콘크리트 재료파괴기준을 이용하였다. 그 결과 위험단면의 전단성능이 휨손상의 정도에 따라서 정의되었다. 외부접합부는 비대칭적인 위험단면을 가지고 있으므로 하중재하방향을 고려하여 휨모멘트강도를 정의하였다. 실험 결과와 비교 결과, 제안된 강도모델은 현행 설계기준 보다 실험체의 강도를 더 정확하게 추정하는 것으로 밝혀졌다.

• 보건행정학회지
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• 제19권3호
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• Journal of Trauma and Injury
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• 제25권3호
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• pp.79-86
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• 2012

Purpose: The most common cuase of transfusion for trauma victims in an emergency department is hypovolemic shock due to injury. After an injury to an internal organ of the chest or the abdomen, transfusion is needed to supply blood products and to compensate tissue oxygen transport and bleeding. From the 1990's, there have been some reports that transfusion is one of the major factors causing multiple-organ failure. Thus, as much as possible, tranfusion has been minimized in the clinical setting. This study aims to analyze the prognostic factors for mortality among trauma victims transfused with blood products in an emergency department. Methods: We conducted this study for the year of 2010 retrospectively. The study group included adult trauma victims tranfused with blood products in our ED. The exclusion criteria were discharge against medical advice, and missing follow-up due to transfer to another facility. During the study period, 34 adult trauma victims were enrolled. We compared the clinical variables between survivors and non-survivors. Results: the mean age of the 34 victims was 58.06 years, and males account for 58.5% of the study group. The most-frequently used form transportation was ambulance(119, 55.9%), and the most common injury mechanism was mobile vehicle accidents(67.6%). The mean revised trauma score (RTS) was 5.9, and the mean injury severity score (ISS) was 47.76. The mortality rate in the ED was 58.5%, Comparison of survivors with non-survivors showed statistical differences in injury mechanism, initial SBP, DBP, RTS, ISS, and some laboratory data such as AST, ALT, pH, PO2, HCO3, glucose (p<0.05). Regression analyses showed that mortality among adult trauma victims transfused in the ED correlated with RTS. Conclusion: When an adult trauma victim is transported to the ED and needs a tranfusion, the emergency physician carefully assess the victim by using physiologic data.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.166-173
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• 2018

Purpose: Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients. Methods: This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient's blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week. Results: A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ${\geq}15$). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (p<0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p<0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups. Conclusions: MIF may be considered as a predictive factor for sepsis in trauma patients.