• Title/Summary/Keyword: CM at Risk

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공공토목사업 CM 발주를 위한 단계별 업무지원 시스템 구축 (Development of a Business Support System by Phase for Delivering Construction Management Contract in the Government Civil Project)

  • 채영석;박서영;문현석;김선영;강인석
    • 한국건설관리학회논문집
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    • 제12권5호
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    • pp.81-92
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    • 2011
  • 위험형 CM(CM at Risk) 제도의 시행과 함께 토목시설물에도 CM계약사례가 증가할 것으로 예상되어, 국토해양부 등에서는 CM 업무지침을 공표하고 있다. 현재 공표된 CM 업무지침은 CM 계약 이후의 업무지침이지만, CM 발주사례가 부족한 토목사설을 포함한 공공사업에서는 CM 발주 자체에 필요한 CM발주의 가획단계부터 CM 업자 (Construction Manager, CMr) 선정까지의 업무지침이 필요한 실정이다. 따라서 본 연구에서는 발주처의 건설사업관리 발주업무를 발주 기획단계부터 CMr 선정단계까지 표준화된 프로세스 모형으로 구축하였으며, 이를 위해 CM발주 업무분류체계를 구성하였다. 또한 연구에서는 구축된 모형에 근거한 CM 발주지원 시스템을 개발하여 시스템의 실무 운영성을 검증하였다. 이러한 연구는 CM 발주사례가 부족한 발주처의 CM 발주업무 지원체계로 활용성을 가질 수 있다.

Effect of Wearable Passive Back Support Exoskeleton on the Peak Muscle Activation of the Erector Spinae Muscles During Lifting

  • Hee-Eun Ahn;Tae-Lim Yoon
    • 한국전문물리치료학회지
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    • 제31권1호
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    • pp.1-7
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    • 2024
  • Background: Using wearable passive back-support exoskeletons in workplace has attracted attention as devices that support the posture of workers, enhance their physical capabilities, and reduce physical risk factors. Objects: This study aimed to investigate the effect of a wearable passive back-support exoskeleton on the activity of the erector spinae muscles during lifting tasks at various heights. Methods: Twenty healthy adult males were selected as subjects. Electromyography (EMG) was used to assess the activity of the erector spinae muscles while performing lifting tasks at three distinct heights (30, 40, and 50 cm), with and without the application of the Wearable Passive Back Support Exoskeleton. EMG data were gathered before and after the application of the orthosis. Results: The use of the Wearable Passive Back Support Exoskeleton resulted in a significant decrease in muscle activity when lifting a 10 kg object from heights of 30 and 40 cm (p < 0.05). Additionally, there was a significant reduction in muscle activity when lifting from a height of 50 cm compared with that at lower heights (p < 0.05). Conclusion: The use of a wearable passive back-support exoskeleton led to a decrease in the activity of the erector spinae muscles during lifting tasks, irrespective of the object's height. Our results suggest that the orthosis we tested may help decrease risk of lower back injuries during lifting.

Thyroid Nodules with Isolated Macrocalcifications: Malignancy Risk of Isolated Macrocalcifications and Postoperative Risk Stratification of Malignant Tumors Manifesting as Isolated Macrocalcifications

  • Hye Yun Gwon;Dong Gyu Na;Byeong-Joo Noh;Wooyul Paik;So Jin Yoon;Soo-Jung Choi;Dong Rock Shin
    • Korean Journal of Radiology
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    • 제21권5호
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    • pp.605-613
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    • 2020
  • Objective: To determine the malignancy risk of isolated macrocalcifications (a calcified nodule with complete posterior acoustic shadowing) detected on ultrasonography (US) and to evaluate the postoperative American Thyroid Association (ATA) risk stratification of malignant tumors manifesting as isolated macrocalcifications. Materials and Methods: A total of 3852 thyroid nodules (≥ 1 cm) of 3061 consecutive patients who had undergone biopsy between January 2011 and June 2018 were included in this study. We assessed the prevalence, malignancy rate, and size distribution of isolated macrocalcifications and evaluated the histopathologic features and postoperative ATA risk stratification of malignant tumors manifesting as isolated macrocalcifications. Results: Isolated macrocalcifications were found in 38 (1.2%) of the 3061 patients. Final diagnosis was established in 30 (78.9%) nodules; seven malignant tumors were diagnosed as papillary thyroid carcinomas (PTCs). The malignancy rate of the isolated macrocalcifications was 23.3% in the 30 nodules with final diagnoses and 18.4% in all nodules. Among the six surgically-treated malignant tumors, five (83.3%) had an extrathyroidal extension (ETE) (minor ETE 1, gross ETE 4), and two (33.3%) had macroscopic lymph node metastasis. Four (66.7%) malignant tumors were categorized as high-risk tumors, one as an intermediate-risk tumor, and one as a low-risk tumor using the ATA risk stratification. Histopathologically, out of the six malignant tumors, ossifications were noted in four (66.7%) and predominant calcifications in two (33.3%). Conclusion: The US pattern of isolated macrocalcifications (≥ 1 cm) showed an intermediate malignancy risk (at least 18.4%). All malignant tumors were PTCs, and most showed an aggressive behavior and a high or intermediate postoperative ATA risk.

자궁경부암 근접방사선치료 시 2차원, 3차원 치료계획 비교평가 (Comparison of 2D and 3D Brachytherapy Planning for Cervical Cancer)

  • 김정훈
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권2호
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    • pp.303-309
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    • 2017
  • 본 연구에서는 자궁경부암의 치료를 위한 전산화단층촬영(computer tomography)영상을 이용한 3차원 근접치료계획의 유용성을 알고자 하였다. 10명의 자궁경부암 환자에서 2차원 근접치료계획을 시행하였고, 동일 자세로 전산화단층촬영을 시행하였다. 3차원 근접치료계획 프로그램(ECLIPSE treatment planning system v6.5, Varian Medical System, USA)를 이용하였으며, 고위험임상표적체적(High risk CTV, HR CTV)에 5 Gy를 처방하였다. 3차원 근접치료계획의 제한은 적어도 고위험임상표적체적의 90%에 처방선량인 5 Gy가 조사되도록, 방광의 $2cm^3$에 7.5 Gy 미만으로 들어가도록 그리고 직장의 $2cm^3$에 5 Gy 미만이 들어가도록 하였다. 계획의 평가는 선량체적표(dose-volume histograms; DVHs)를 이용하여 육안적종양체적(Gross tumor volume for brachytherapy; $GTV_B$), 고위험임상표적체적, 직장과 방광에 조사되는 선량을 구하였다. 크기가 큰 종양이나 자궁의 위치이상이 있는 환자에서 Point A에 처방한 2차원 근접치료계획을 하였을 경우에는 고위험임상표적체적이 충분히 포함되지 않았다. 그러나 3차원 근접치료계획은 이러한 환자들에서 직장이나 방광의 선량을 증가시키지 않고 고위험임상표적체적을 잘 포함할 수 있었다. 2차원 근접치료계획에서 높은 선량부터 $2cm^3$에 들어가는 직장선량은 10명 중 1명에서, $2cm^3$에 들어가는 방광선량은 6명에서 5 Gy를 넘었으므로 ICRU (International Commission on Radiation Units) 방광선량이 직장선량에 비해 과소평가됨을 확인할 수 있었다. 자궁경부암 환자에서 전산화단층촬영 이용한 3차원 근접치료계획은 종양과 위험장기에 대한 선량평가가 가능하므로, 직장과 방광의 부작용을 증가시키지 않으면서 크기가 큰 종양이나 자궁의 위치이상이 있는 환자에서 위치 설정의 오류를 줄일 수 있을 것으로 생각된다.

정신분열병 입원 환자에서의 대사 증후군 유병률 연구 (The Prevalence of Metabolic Syndrome in Inpatients with Schizophrenia)

  • 노재우;조연수;조애화
    • 생물정신의학
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    • 제18권1호
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    • pp.46-54
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    • 2011
  • Objectives : The objective of this study is to assess the prevalence and risk factors of metabolic syndrome (MS) among inpatients with schizophrenia, and to compare with general population. Methods : Nine hundreds seventy inpatients were included to assess the prevalence of MS from two mental hospitals in Yong-in city. Assessment of MS was performed based on modified American Heart Association criteria with abdominal obesity threshold of 90cm for men, 85cm for women. Comparative analysis was performed using age- and gender matched sample from Korea Health and Nutritional Examination Survey III. For evaluating risk factors, analysis included 766 inpatients taking consistent medications at least for 30 days. Results : The prevalence of MS of inpatients with schizophrenia was 26.2%, in females it was 33.2%, compared to 20.2% in males(p < 0.001). Compared to general population, the prevalence of MS was significantly lower in male and higher in female patients. In terms of criteria prevalence, who met abdominal circumference criterion were more prevalent in patient group(p < 0.001). After multivariate analysis, female gender and old age remained as risk factors of MS. Conclusions : The prevalence of MS of inpatients with schizophrenia was 26.2% and significantly low compared to general population. Female gender and old age were risk factors of MS.

화목보일러 화재위험성에 관한 실험적 연구 (An Experimental Study on the Fire Risk of a Firewood Boiler)

  • 이성룡
    • 한국화재소방학회논문지
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    • 제29권3호
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    • pp.37-42
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    • 2015
  • 본 연구에서는 농촌지역을 중심으로 대표적인 겨울철 난방기구인 화목보일러 화재위험성을 평가하였다. 화목보일러 연료투입구 주변 및 연통의 온도를 측정하였으며, 연통 내부에 축적되는 타르의 화재 위험성을 평가하였다. 연료 투입구개방 상태에서 전방의 온도를 측정한 결과 화목 투입구로부터 40 cm 이상 떨어진 영역에서는 온도가 약 $40^{\circ}C$ 이하를 유지하였다. 본 연구에서는 연료 투입구 외부로 비산되는 불티가 60 cm 이내의 범위에 비산되었다. 연통 내부에서는 온도가 $600^{\circ}C$ 이상까지 상승하였으며, 화목보일러 본체로부터 2 m 떨어진 위치의 연통 내부에서 온도가 $420^{\circ}C$ 이상 도달하였다. 연통 내부의 타르를 수거하여 발화온도를 측정한 결과 약 $398^{\circ}C$를 기록하였다. 화목보일러 본체 및 연통 표면에서 온도가 약 $300^{\circ}C$ 이상 도달하였으며 가연물이 접촉될 경우 착화되었다.

Cone-Beam CT-Guided Percutaneous Transthoracic Needle Lung Biopsy of Juxtaphrenic Lesions: Diagnostic Accuracy and Complications

  • Wonju Hong;Soon Ho Yoon;Jin Mo Goo;Chang Min Park
    • Korean Journal of Radiology
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    • 제22권7호
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    • pp.1203-1212
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    • 2021
  • Objective: To investigate the diagnostic accuracy and complications of cone-beam CT-guided percutaneous transthoracic needle biopsy (PTNB) of juxtaphrenic lesions and identify the risk factors for diagnostic failure and complications. Materials and Methods: In total, 336 PTNB procedures for lung lesions (mean size ± standard deviation [SD], 4.3 ± 2.3 cm) abutting the diaphragm in 326 patients (189 male and 137 female; mean age ± SD, 65.2 ± 11.4 years) performed between January 2010 and December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PTNB procedures for the diagnosis of malignancy were measured based on the intention-to-diagnose principle. The risk factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 92.7% (293/316), 91.3% (219/240), 91.4% (74/81), 96.9% (219/226), and 77.9% (74/95), respectively. There were 23 diagnostic failures (7.3%), and lesion sizes ≤ 2 cm (p = 0.045) were the only significant risk factors for diagnostic failure. Complications occurred in 98 cases (29.2%), including 89 cases of pneumothorax (26.5%) and 7 cases of hemoptysis (2.1%). The multivariable analysis showed that old age (> 65 years) (p = 0.002), lesion size of ≤ 2 cm (p = 0.003), emphysema (p = 0.006), and distance from the pleura to the target lesion (> 2 cm) (p = 0.010) were significant risk factors for complications. Conclusion: The diagnostic accuracy of cone-beam CT-guided PTNB of juxtaphrenic lesions for malignancy was fairly high, and the target lesion size was the only significant predictor of diagnostic failure. Complications of cone-beam CT-guided PTNB of juxtaphrenic lesions occurred at a reasonable rate.