• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.27-31
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• 1994

There are a number of reports suggesting that there may be a correlation between the clinical response to radiotherapy in various tumors and the clonogenic survival of cell lines derived from these tumors following exposure to 2 Gy(SF2). Authors conducted this study to determine SF2 for cells in primary culture from surgical specimens. The tumor tissues with squamous cell carcinoma of uterine cervix and head and neck were obtained. The tumor tissues were disaggregated to single cells by incubating with collagenase type w for 2 hours with constant stirring. Single cell suspensions were inoculated in four 24-well plates precoated with cell adhesive matrix. After 24 hours of incubation at 37$ ^{\circ}C $, rows of four wells were then irradiated, consisting of control set and five other sets each receiving doses of 1,2,3,4, and 6 Gy. After incubation for a total of 13 days, the cultures were stained with crystal violet and survival at each dose was determined by quantitative image analysis system, To determine whether cell growth was of epithelial origin, immunocytochemical staining with a mixture of cytokeratin and epithelial monoclonal antibodies were performed on cell cultures. During the period of this study, we received 5 squamous cell carcinoma specimens of head and neck and 20 of uterine cervical carcinoma. Of these, 15 yielded enough cells for radiosensitivity testing. This resulted an overall success rate of 60$ \% $. The mean SF2 value for 15 tumours was 0.55$\pm$0.17 ranging from 0.20 to 0.79. These results indicate that there is a broad range of sensitivities to radiation in same histologic type. So with a large patient population, we plan to determine whether a different SF2 value is associated with tumours that are controlled with radiotherapy than those that are not.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.121-143
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• 2010

To investigate the effect of implant types and bone resorption on the fracture characteristics. 4 types of Osstem$^{(R)}$Implant were chosen and classified into external parallel, internal parallel, external taper, internal taper groups. Finite elements analysis was conducted with ANSYS Multi Physics software. Fatigue fracture test was performed by connecting the mold to the dynamic load fatigue testing machine with maximum load of 600N and minimum load of 60N. The entire fatigue test was performed with frequency of 14Hz and fractured specimens were observed with Hitachi S-3000 H scanning electron microscope. The results were as follows: 1. In the fatigue test of 2 mm exposed implants group, Tapered type and external connected type had higher fatigue life. 2. In the fatigue test of 4 mm exposed implants group, Parallel type and external connected types had higher fatigue life. 3. The fracture patterns of all 4 mm exposed implant system appeared transversely near the dead space of the fixture. With a exposing level of 2 mm, all internally connected implant systems were fractured transversely at the platform of fixture facing the abutment. but externally connected ones were fractured at the fillet of abutment body and hexa of fixture or near the dead space of the fixture. 4. Many fatigue striations were observed near the crack initiation and propagation sites. The cleavage with facet or dimple fractures appeared at the final fracture sites. 5. Effective stress of buccal site with compressive stress is higher than that of lingual site with tensile stress, and effective stress acting on the fixture is higher than that of the abutment screw. Also, maximum effective stress acting on the parallel type fixtures is higher. It is careful to use the internal type implant system in posterior area.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.83-94
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• 2009

The aim of this study was to investigate the shear bond strength between zirconia ceramic and resin cement according to various surface treatments. The surface of each zirconia ceramic was subjected to one of the following treatments and then bonded Rely X Unicem or Rely X ARC resin cement; (1) Rocatec system and $50{\mu}m$ surface polishing, (2) No treatment and $50{\mu}m$ surface polishing, (3) Rocatec system and $1{\mu}m$ surface polishing, (4) No treatment and $1{\mu}m$ surface polishing. Each of eight bonding group was tested in shear bond strengths by universal testing machine(Z020, Zwick, Ulm, Germany) with crosshead speed of 1mm/min. The results were as follows; 1. Rocatec treatment groups showed greater bonding strengths than No Rocatec groups. There was significant difference of among groups(P<0.001) 2. For Rocatec groups, $50{\mu}m$ surface roughness groups showed greater bonding strengths than $1{\mu}m$ surface roughness groups.(P<0.001) But for No Rocatec groups, There was no significant difference of among groups(P>0.05) 3. Rely X Unicem groups showed greater bonding strengths than Rely X ARC groups. There was significant difference of among groups(P<0.01) Within the conditions of this study, Rocatec treatment was an effective way of increasing zirconia bonds to a resin cement, even in the case of self-adhesive resin cement.

• Journal of the Korean Society of Marine Environment & Safety
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• v.21 no.6
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• pp.672-678
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• 2015

The types of hazardous and noxious substances (HNS) being transported by sea in Korea are at about 6,000, HNS transport volume accounts for 19% of total tonnage shipped in Korea, and the increase rate of seaborne HNS trade in Korea is 2.5 times higher than the average increase rate of the world seaborne HNS trade. Reflecting this trend, HNS spill incidents have been frequently reported in Korean waters, and there are increasing social demands to develop HNS management technology for the preparedness, response, post-treatment and restoration in relation to HNS spill incidents at sea. In this study, a risk-based HNS prioritization system was developed and an HNS risk database was built with evaluation indices such as sea transport volume, physicochemical properties, toxicities, persistency, and bioaccumulation. Risk scores for human health and marine environments were calculated by multiplying scores for toxicity and exposure. The top-20 substances in the list of HNS were tabulated, and Aniline was ranked first place, but it needs to be managed not by individuals but by HNS groups with similar score levels. Limitations were identified in obtaining data of chronic toxicity and marine ecotoxicity due to lack of testing data. It is necessary to study on marine ecotoxicological test in the near future. Moreover, the priority list of HNS is expected to be utilized in the development of HNS management technology and the relevant technologies, after the expert's review process and making up for the lack of test data in the current research results.

• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.647-656
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• 1999

The purpose of this study was to investigate the shear bond strength and marginal microleakage of composite to enamel and dentin according to different treatment methods when the applied bonding agent was contaminated by artificial saliva. For the shear bond strength test, the buccal and occlusal surfaces of one hundred twenty molar teeth were ground to expose enamel(n=60) and dentin surfaces(n=60). The specimens were randomly assigned into control and 5 experimental groups with 10 samples in each group. In control group, a bonding system(Scotchbond$^{TM}$ Multi-Purpose plus) and a composite resin(Z-100$^{TM}$) was bonded on the specimens according to manufacture's directions. Experimental groups were subdivided into 5 groups. After polymerization of an adhesive, they were contaminated with at artificial saliva on enamel and dentin surfaces: Experimental group 1 ; artificial saliva was dried with compressed air. Experimental group 2 ; artificial saliva was rinsed with air-water spray and dried. Experimental group 3 ; artificial saliva was rinsed, dried and applied an adhesive. Experimental group 4 ; artificial saliva was rinsed, dried, and then etched using phosphoric acid followed by an adhesive. Experimental group 5, artificial saliva was rinsed, dried, and then etched with phosphoric acid followed by consecutive application of both a primer and an adhesive. Composite resin(Z-100$^{TM}$) was bonded on saliva-treated enamel and dentin surfaces. The shear bond strengths were measured by universal testing machine(AGS-1000 4D, Shimaduzu Co. Japan) with a crosshead speed of 5mm/minute under 50kg load cell. Failure modes of fracture sites were examined under stereomicroscope. The data were analyzed by one-way ANOVA and Tukey's test. For the marginal microleakage test, Class V cavities were prepared on the buccal surfaces of sixty molars. The specimens were divided into control and experimental groups. Cavities in experimental group were contaminated with artificial saliva and those surfaces in each experimental groups received the same treatments as for the shear test. Cavities were filled with Z-100. Specimens were immersed in 0.5% basic fuchsin dye for 24 hours and embedded in transparent acrylic resin and sectioned buccolingually with diamond wheel saw. Four sections were obtained from the one specimen. Marginal microleakages of enamel and dentin were scored under streomicroscope and averaged from four sections. The data were analyzed by Kruskal-Wallis test and Fisher's LSD. The results of this study were as follows. 1. The shear bond strength to enamel showed lower value in experimental group 1(13.20${\pm}$2.94MPa) and experimental group 2(13.20${\pm}$2.94MPa) than in control(20.03${\pm}$4.47MPa), experimental group 4(20.96${\pm}$4.25MPa) and experimental group 5(21.25${\pm}$4.48MPa) (p<0.05). 2. The shear bond strength to dentin showed lower value in experimental group 1(9.35${\pm}$4.11MPa) and experimental group 2(9.83${\pm}$4.11MPa) than in control group(17.86${\pm}$4.03MPa), experimental group 4(15.04${\pm}$3.22MPa) and experimental group 5(14.33${\pm}$3.00MPa) (p<0.05). 3. Both on enamel and dentin surfaces, experimental group 1 and 2 showed many adhesive failures, but control and experimental group 3, 4 and 5 showed mixed and cohesive failures. 4. Enamel marginal microleakage was the highest in experimental group 1 and there was a significant difference in comparison with other groups (p<0.05). 5. Dentin marginal microleakages of experimental group 1 and 2 were higher than those of other groups (p<0.05). This result suggests that treatment methods, re-etching with 35% phosphoric acid followed by re-application of adhesive or repeating all adhesive procedures, will produce good effect on both shear bond strength and microleakage of composite to enamel and dentin if the polymerized bonding agent was contaminated by saliva.

• Restorative Dentistry and Endodontics
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• v.32 no.3
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• pp.222-235
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• 2007

The objectives of this study was to evaluate the effect of thermocycling on the ${\mu}TBS$ (microtensile bond strength) to dentin with four different adhesive systems to examine the bonding durability. Freshly extracted $3^{rd}$ molar teeth were exposed occlusal dentin surfaces, and randomly distributed into 8 adhesive groups 3-steps total-etching (Scotchbond Multi-Purpose Plus; SM, All Bond-2; AB), 2-steps total-etching (Single Bond; SB, One Step plus; OS), 2-steps self-etching (Clearfil SE Bond; SE, AdheSE AD) and single-step self-etching systems (Promp L-Pop; PL, Xeno III; XE) Each adhesive system in 8 adhesives groups was applied on prepared dentin surface as an instruction and resin composite (Z250) was placed incrementally and light-cured. The bonded specimens were sectioned with low-speed diamond saw to obtain $1\times1mm$ sticks after 24 hours of storage at $37^{\circ}C$ distilled water and proceeded thermocycling at the pre-determined cycles of 0, 1,000 and 2,000. The ${\mu}TBS$ test was carried out with EZ-tester at 1mm/min. The results of bond strength test were statistically analyzed using one-way ANOVA/ Duncan's test at the a < 0.05 confidence level. Also, the fracture mode of debonded surface and the interface were examined under SEM. The results of this study were as follows ; 1. 3-step total etching adhesives showed stable, but bond strength of 2-step adhesives were decreased as thermocycling stress. 2. SE showed the highest bond strength, but single step adhesives (PL, XE) had the lowest value both before and after thermocycling. 3 Most of adhesives showed adhesive failure. The total-etching systems were prone to adhesive failure and the single-step systems were mixed failure after thermocycling. Within limited results of this study, the bond strength of adhesive system was material specific and the bonding durability was affected by the bonding step/ procedure of adhesive Simplified bonding procedures do not necessarily imply improved bonding performance.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.2
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• pp.33-41
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• 2004

Purpose : Film has been the primary tool in coincidence testing between the light field and the radiation field, which constitutes the quality assurance list of a linear accelerator. But there is a great chance of errors being different among the observer when using film. Thus this study set out to use the BIS(Beam Image System) in addition to film in comparing and evaluating coincidence results between the two fields and in searching for the improvement measures. Materials & Methods : Photon beam of 6 and 15MV was exposed to film and the BIS using a linear accelerator. The light and radiation fields were each $50{\times}50,\;100{\times}100,\;and\;200{\times}200mm^2$. The gantry angle was $0^{\circ}$ when using film and $0^{\circ}\;and\;270^{\circ}$ when using the BIS. The devices adopted to test coincidence between the two fields were a ruler and film scanner when using film. With the BIS, the width of the scanned light and radiation fields was measured for errors with setting the X and Y axis. Results : The visual measurements of the observer with film resulted that the radiation field was bigger than the light field and that their maximum error was 1.9mm. The results were the same with the measurements using the film scanner except for the average error, which was less than 1.9mm. On the contrary, the measurements using the BIS showed that the light field was bigger than the radiation field at the gantry angle of $0^{\circ}\;and\;270^{\circ}$. The maximum error was 0.96mm, and the error range was $<{\pm}2mm$ both in the X and Y axis. The average error of ${\Delta}X$, Y was the smallest in the order of the visual film measurements, film scanner measurements, and BIS measurements Conclusion . This requires a careful measurement for accurate quality assurance since errors are much different according to each observer that tests coincidence between visual fields with film. And an observer needs to use another image device or develop a measuring device of his own if it seems necessary for accurate measurements.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2358-2370
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• 2010

This research aims to empirically analyze the factors that affect the success of technology marketing by Korean universities. The total of 207 universities which successfully made technology transfers from 2006 to 2008 was examined to test the nine hypotheses. For the purpose of testing the hypotheses, technology infrastructure (research costs and the number of SCIE papers), the compensation system for the patents (application and registration), the number of patents (application and registration), TLO staff (the number of people in charge of technology transfer and the job experience in industries), the compensation system for technology transfers (researchers and contributors), and attitudes of university management and industries were analyzed with structural equation methods to figure out their effects on the revenues of technology transfer. The results of this research are summarized as follows. First, technology infrastructures of universities were found to have positive effects on securing patents. As the university research costs in the field of science and technology are increases, the research capabilities are enhanced and this a larger number of researchers are conducted. Second, this research shows that compensation systems for patent application and registration in universities have motivated researchers to take out patents for the outputs of their research. Third, the number of patents universities possess was found to have a positive effect on technology transfer. An increase in the number of patents universities possess implies an increase in the diversity and excellence of the target technologies for transfer. Fourth, the number of patents universities possess turned out to have a positive effect on TLO staff. The number of experts in charge of technology transfer including technology dealers, valuation analysis and patent attorneys should be increased as target technologies for transfer increase according to the increase of patents possessed. Because the technologies are transferee from universities to businesses, businesses (job) experience of TLO staff in industries are also important. This research is meaningful because it has identified the factors affecting the results of technology transfer by employing structural equation methods. In particular, an official governmental survey data for the academic-industrial cooperation were analyzed systematically in terms of technology infrastructure, compensation systems related to patents, the number of patents, TLO staff, compensation systems for technology transfer, and attitudes of university management and industries. All these facts might could differentiate this study from the previous studies.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.76-82
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• 2017

Purpose Whole body bone scan is one of the most frequently performed in nuclear medicine. Basically, both the anterior and posterior views are acquired simultaneously. Occasionally, it is difficult to distinguish the lesion by only the anterior view and the posterior view. In this case, accurate location of the lesion through SPECT / CT or additional static scan images are important. Therefore, in this study, various improvement activities have been carried out in order to enhance the work capacity of technologists. In this study, we investigate the effect of technologist training and standardized work process processes on bone scan error reduction. Materials and Methods Several systems have been introduced in sequence for the application of new processes. The first is the implementation of education and testing with physicians, the second is the classification of patients who are expected to undergo further scanning, introducing a pre-filtration system that allows technologists to check in advance, and finally, The communication system called NMQA is applied. From January, 2014 to December, 2016, we examined the whole body bone scan patients who visited the Department of Nuclear Medicine, Asan Medical Center, Seoul, Korea Results We investigated errors based on the Bone Scan NMQA sent from January 2014 to December 2016. The number of tests in which NMQA was transmitted over the entire bone scan during the survey period was calculated as a percentage. The annual output is 141 cases in 2014, 88 cases in 2015, and 86 cases in 2016. The rate of NMQA has decreased to 0.88% in 2014, 0.53% in 2015 and 0.45% in 2016. Conclusion The incidence of NMQA has decreased since 2014 when the new process was applied. However, we believe that it will be necessary to accumulate data continuously in the future because of insufficient data until statistically confirming its usefulness. This study confirmed the necessity of standardized work and education to improve the quality of Bone Scan image, and it is thought that update is needed for continuous research and interest in the future.