• 터널과지하공간
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• 제12권1호
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• pp.52-69
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• 2002

미국 뉴멕시코주 칼스바드 동부에 위치한 WIPP 사이트가 1999년 처분 운영을 개시하였다. 이 WIPP 사이트는 미국 DOE의 방위프로그램에 의한 부산물로서의 핵폐기물인 초우라늄 방사성 폐기물 (TRU 폐기물) 만을 전담 영구 처분하는 처분장으로 처분장 성능에 대해 책임을 지고 있는 미국 에너지성 (DOE)은 이 처분장의 운영허가를 위해 WIPP 운영을 위한 ＜규제부합 인정신청 (CCA)＞을 통하여 EPA로부터 허가를 얻어 1999년 3월에 첫 처분을 시작한 것이다. 이 CCA를 위한 성능평가 관련 연구는 미 샌디아연구소를 중심으로 수행되어, 장기간에 걸친 처분장 성능평가가 1996년에 모두 마무리지어졌다. 그 성능평가 연구의 결과나 과정은 비록 우리나라가 고려하고 있는 처분 환경과는 상당히 다른 지질 형태의 것이긴 해도 그 방법론에 대한 고찰은 이제 막 고준위 방사성 폐기물 처분관련 연구를 시작하는 단계에 있는 우리에게 교육적인 효과가 지대하다는 생각이다. 따라서 이 기술보고를 통해 이러한 WIPP 사이트의 성능평가에 관련되어 어떻게 어떠한 방법론을 도입하여 불확실성 및 민감도 분석연구가 수행되어졌는지, 그리고 정량적인 불확실성 분석의 결과를 요구하는 EPA 의 규제 기준을 어떠한 논리로 만족시켰는가에 대한 개략적인 검토를 수행하여 보았다.

• 성인간호학회지
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• 제18권5호
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• pp.819-827
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• 2006

Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

• 한국임상약학회지
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• 제24권1호
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• pp.26-32
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• 2014

Purpose: The aim of this study was to investigate drug prescription patterns for the treatment of asthma and chronic obstructive pulmonary disease (COPD) patients in Korea. Methods: Ambulatory adult patients who were diagnosed and received treatment for the asthma (ICD-10 code J45) or COPD (ICD-10 code J44) from January 2009 to September 2011 in two independent secondary hospitals in Korea were enrolled in this study. Prescribed drug lists were generated based on the evidence-based guidelines and prescribed drug dosage forms were identified from the patient medical records and computerized drug prescription databases of the study centers. Results: Total numbers of asthma and COPD patient enrolled in this study were 2,432 and 2,615, respectively. Individual prescription-based accumulated numbers of patient were 12,021 for asthma and 16,584 for COPD. The most commonly prescribed three drugs were oral predisolone, oral formoterol and oral montelukast for asthma and oral formoterol, oral doxofylline and inhaled tiotropium for COPD. Frequencies of oral drugs were 83.4% and 63.3% while inhalers were 16.4% and 30.2%, for asthma and COPD, respectively. Conclusion: The oral treatment was prescribed more in asthma and COPD patients than inhalers. To enhance the compliance of evidence-based guidelines for these chronic airway diseases, more realistic and specific strategies to increase the use of inhalers recommended as primary treatment options for asthma and COPD would be required.

• Journal of Radiation Protection and Research
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• 제25권2호
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• pp.75-80
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• 2000

월성원전 주변에서 실측된 공기중 및 솔잎중 삼중수소 농도와 INDAC 코드 예측치의 비교 평가를 수행하였다. 또한, 방사성물질의 환경중 방출유형, 풍속분류, 지형 고려 유무 등에 따른 삼중수소 예측치의 변화를 측정치와 비교 평가함으로써, 규제실무에 적용할 수 있는 최적 기상자료 입력방안을 도출하였다 공기중 및 솔잎중 삼중수소 농도와 INDAC 코드 예측치의 비교평가 결과, 월성원전 주변 삼중수소 농도 예측치는 측정값의 불착실성, 지현의 복잡성, 해륙풍의 영향 등의 제한점에도 불구하고 규제검증에 필요한 정도의 보수성을 유지하면서도 삼중수소의 거동을 잘 모사함을 확인할 수 있었다. 또한, INDAC 코드에 적용된 솔잎중 삼중수소 농도의 평가방법론 즉, 대기내 수분중의 삼중수소 농도의 절반이 식물체내에 골고루 분포되어 있다고 가정하는 것은 규제 검증에 필요한 보수성을 확보하고 있음을 알 수 있었다. 최적 기상자료 입력방안의 도출을 위한 민감도 분석 결과, 혼합방출 및 지형을 고려하지 않는 경우에는 실측치 대비 과소 평가되는 부분이 있어 규제실무에 적용하기에는 적합하지 않은 것으로 나타났다. 따라서, 혼합방출을 고려하는 경우에는 58m 기상자료와 지형자료에 근거하여 대기확산인자를 평가하여야 하는 것으로 나타났다.

• 대한토목학회논문집
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• 제26권1A호
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• pp.11-19
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• 2006

본 연구에서는 현수교의 선박충돌해석을 위한 설계선박을 결정하기 위하여 선박충돌위험도해석을 수행한다. 선박충돌에 대한 설계선박을 결정하기 위하여 AASHTO 설계기준에서 제시한 3개의 선박충돌 설계방법 중 확률기반 해석방법인 Method II를 사용한다. 선박충돌 위험에 노출된 각각의 교각에 대해 선박충돌위험도 평가를 하여 교각의 충돌설계수평강도를 결정한다. 해석과정은 반복적인 것으로 교량부재의 충돌저항강도를 가정하고 연간파괴빈도를 계산하여 허용기준이 만족하도록 설계 변수를 수정한다. 허용기준은 예상연간파괴빈도에 근거한 가중치를 이용하여 교각에 할당한다. 해석결과에서 안전성과 경제성을 얻기 위해 이 할당방법을 주탑집중 할당방법과 비교한다. 비록 주탑집중 할당방법이 주탑에 비해 과대평가되는 교각의 설계수평강도를 적절히 수정할 경우 보다 경제적인 결과를 가져오지만, 가중치에 의한 할당방법이 설계인자의 특성을 정량적으로 고려하기 때문에 더 합리적인 것으로 보인다. 그리고 선박충돌위험도 평가로부터 얻어지는 충돌설계수평강도에 상응하는 각각의 교각에 대한 설계선박이 결정된다. 같은 교량에 대해서도 충돌설계수평강도가 수로 및 교량의 특성과 선박통행량에 따라 상당히 변화한다. 따라서 허용기준의 할당과 설계선박 선정에 대한 많은 연구가 요구된다.

• 대한토목학회논문집
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• 제26권1A호
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• pp.1-9
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• 2006

선박충돌의 위험이 있는 교량의 교각에 대해 연파괴빈도 계산을 수행하였다. 이러한 해석을 통해 각각의 교각에 대한 선박충돌 수평내하력을 결정할 수 있다. 교각의 수평내하력은 선박충돌 위험도 평가로부터 예측된 연파괴빈도와 허용기준을 비교하는 확률기반 해석과정을 통해 결정된다. 해석과정은 교량 각 부재요소에 대한 초기 충돌저항력을 가정하여 계산된 연파괴빈도가 허용기준을 만족하도록 해석변수를 반복 수정하면서 해를 찾는 과정이다. 일반적으로 선박충돌 위험이 있는 교각들에 대한 연파괴빈도 허용기준의 분배는 설계자의 공학적 판단에 근거한다. 본 연구에서는 선박충돌 위험도 평가로부터 사전 계산되는 연파괴빈도 할당 가중치에 의해 각각의 교각에 허용기준을 분배하였다. 주탑과 교각 등 교량 부재요소의 설계 수평내하력을 결정하기 위해 주탑과 교각의 충격저항력 비를 변수로 수치해석을 수행하였다. 설계 수평내하력은 수로의 기하형상, 수심, 교각의 배치, 선박 통행량의 특성에 의해 동일한 교량에서도 많은 변화가 있다. 따라서 연파괴빈도의 분배 모델과 수평내하력 결정에 대한 많은 연구가 요구된다.

• 대한의용생체공학회:의공학회지
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• 제44권6호
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• pp.363-376
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• 2023

According to the COVID-19, development of various medical software based on IoT(Internet of Things) was accelerated. Especially, interest in a central software system that can remotely monitor and control ventilators is increasing to solve problems related to the continuous increase in severe COVID-19 patients. Since medical device software is closely related to human life, this study aims to develop central monitoring system that can remotely monitor and control multiple ventilators in compliance with medical device software development standards and to verify performance of system. In addition, to ensure the safety and reliability of this central monitoring system, this study also specifies risk management requirements that can identify hazardous situations and evaluate potential hazards and confirms the implementation of cybersecurity to protect against potential cyber threats, which can have serious consequences for patient safety. As a result, we obtained medical device software manufacturing certificates from MFDS(Ministry of Food and Drug Safety) through technical documents about performance verification, risk management and cybersecurity application.The purpose of this study is to conduct a usability assessment to ensure that ergonomic design has been applied so that the ventilator central monitoring system can improve user satisfaction, efficiency, and safety. The rapid spread of COVID-19, which began in 2019, caused significant damage global medical system. In this situation, the need for a system to monitor multiple patients with ventilators was highlighted as a solution for various problems. Since medical device software is closely related to human life, ensuring their safety and satisfaction is important before their actual deployment in the field. In this study, a total of 21 participants consisting of respiratory staffs conducted usability test according to the use scenarios in the simulated use environment. Nine use scenarios were conducted to derive an average task success rate and opinions on user interface were collected through five-point Likert scale satisfaction evaluation and questionnaire. Participants conducted a total of nine use scenario tasks with an average success rate of 93% and five-point Likert scale satisfaction survey showed a high satisfaction result of 4.7 points on average. Users evaluated that the device would be useful for effectively managing multiple patients with ventilators. However, improvements are required for interfaces associated with task that do not exceed the threshold for task success rate. In addition, even medical devices with sufficient safety and efficiency cannot guarantee absolute safety, so it is suggested to continuously evaluate user feedback even after introducing them to the actual site.

• 대한간호학회지
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• 제25권2호
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• pp.372-389
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• 1995

The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

• 대한간호학회지
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• 제20권2호
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• Clinical and Experimental Pediatrics
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• 제51권7호
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• pp.747-753
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• 2008

목 적 : 제1형 당뇨병은 동맥경화증의 주요 위험인자 중의 하나로 이러한 동맥경화증의 초기 변화가 소아청소년기부터 시작된다는 것은 잘 알려진 사실이다. 성인에서는 초음파를 이용한 경동맥 내중막 두께가 동맥경화증의 독립적인 대리 표식자로 널리 이용되고 있으나, 소아청소년기에 관한 연구는 흔하지 않다. 이에 저자들은 제1형 당뇨병을 가진 소아들을 대상으로 경동맥 내막-중막 두께 및 경동맥 혈관 탄성 지수 측정을 통해 혈관의 동맥경화 상태를 조기에 평가하고, 이러한 혈관의 변화와 여러 동맥경화 위험인자들과의 관련성을 파악하여 조기 동맥경화의 선별 검사로 경동맥 내막-중막 두께의 유용성 등에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 대구지역 3차 병원 소아과에서 제1형 당뇨병으로 진단받고 치료 중인 환자 23명과 동일 연령 및 성별의 건강한 소아, 청소년 19명을 대상으로 신체계측을 하고 공복상태에서 혈청콜레스테롤 및 당화혈색소를 측정하였다. 또한 고해상도 초음파를 이용하여 심장 주기에 따른 우측 경동맥의 내경 및 내중막 두께를 측정하였으며 공식에 따라 경동맥 유순도 및 신전도를 구하였다. 결 과 : 두 군 간의 성별, 연령, 혈압과 혈청콜레스테롤 등은 차이가 없었다. 경동맥 초음파 소견에서 당뇨군의 경동맥 내막-중막 두께는 의미 있게 증가되었으나 유순도와 신전도의 차이는 없었다. 당화혈색소와 고밀도혈청콜레스테롤은 다른 동맥경화의 위험인자와 독립적으로 경동맥 내막-중막 두께에 영향을 미치는 것으로 나타났다. 결 론 : 제1형 소아 당뇨 환아의 경우 정상 환아에 비해 경동맥 내막-중막 두께가 의미 있게 증가되어 있고, 이것이 혈당 조절 정도나 혈청 지질치와 같은 심혈관계의 위험인자와 깊은 상관관계를 나타내는 것으로 보아 소아 당뇨 환아에서 동맥경화의 발생을 조기에 파악하는 선별 검사로서 경동맥 내막-증막 두께는 유용하다고 생각된다.