• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.93.1-93.11
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• 2018

The introduction of checkpoint inhibitors revolutionized immuno-oncology. The efficacy of traditional immunotherapeutics, like vaccines and immunostimulants was very limited due to persistent immune-escape strategies of cancer cells. Checkpoint inhibitors target these escape mechanisms and re-direct the immune system to anti-tumor toxicity. Phenomenal results have been reported in entities like melanoma, where no other therapy was able to demonstrate survival benefit, before the introduction of immunotherapeutics. The first experience in ovarian cancer (OC) was reported for nivolumab, a fully human anti-programmed cell death protein 1 (PD1) antibody, in 2015. While the data are extraordinary for a mono-immunotherapeutic agent and very promising, they do not match up to the revolutionary results in entities like melanoma. The key to exceptional treatment response in OC, could be the identification of the most immunogenic patients. We hypothyse that BRCA mutation could be a predictor of improved response in OC. The underlying DNA-repair-deficiancy should result in increased immunogenicity because of higher mutational load and more neoantigen presentation. This hypothesis was not tested to date and should be subject to future trials. The present article gives an overview of the immunologic background of checkpoint inhibition (CI). It presents current data on nivolumab and other checkpoint-inhibitors in solid tumors and OC specifically and depicts important topics in the management of this novel substance group, such as side effect control, diagnostic PD-1/programmed cell death-ligand 1 (PD-L1) expression assessment and management of pseudoprogression.

• 한국지열·수열에너지학회논문집
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• 제18권4호
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• pp.12-21
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• 2022

Steam assisted gravity drainage(SAGD) is a process that drills well in the underground oil sands layer, injects hightemperature steam, lowers the viscosity of buried bitumen, and recovers it to the ground. Recently, direct contact steam generator(DCSG) is being developed to maximize steam efficiency for SAGD process. The DCSG requires high technology to achieve pressurized combustion and steam generation in accordance with underground pressurized conditions. Therefore, it is necessary to develop a combustion technology that can control the heat load and exhaust gas composition. In this study, process analysis of high-pressurized DCSG was conducted to apply oxygen enrichment technology in which nitrogen of the air was partially removed for increasing steam production and reducing fuel consumption. As the process analysis conditions, methane as the fuel and normal air or oxygen enriched air as the oxidizing agent were applied to high-pressurized DCSG process model. A simple combustion reaction program was used to calculate the property variations for combustion temperature, steam ratio and residual heat in exhaust gas. As a major results, the steam production efficiency of DCSG using the pure oxygen was about 6% higher than that of the normal air due to the reducing nitrogen in the air. The results of this study will be used as operating data to test the demonstration device.

• 조명전기설비학회논문지
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• 제21권6호
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• pp.117-125
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• 2007

연료전지 발전시스템에서는 DC-DC 승압용 컨버터와 DC-AC 인버터가 필요하다. 그러므로 본 논문에서는 연료전지의 전압을 380[VDC]로 승압하기 위한 절연형 DC-DC 컨버터와 단상 220[VAC]로 변환하기 위한 LC필터를 가진 PWM 인버터로 구성된 전력변환장치를 제안하였다. 특히 제안한 연료전지 시스템용 고효율 DC-DC 컨버터는 위상천이 PWM 제어법을 이용하여 부분 공진에 의한 ZVS를 실현하였으며, 일정 스위칭 주파수화 및 스위치의 스위칭 손실, 피크 전압과 전류를 저감시켰다. 그리고, 정류회로에 2개의 인덕터를 첨가하여 리플성분이 저감된 직류전압과 전류를 부하측에 안정하게 공급할 수 있었다. 또한, 넓은 출력 전압 조정에도 효율을 92[%]정도 얻을 수 있다. 이상과 같이 결과는 시뮬레이션과 실험을 통하여 그 타당성을 확인하였다.

• 한국가스학회지
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• 제26권3호
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• pp.45-53
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• 2022

디젤엔진의 배출물 개선을 위해 탄소수가 낮은 천연가스를 혼합하여 사용하는 천연가스-디젤 혼소 연소가 각광받고 있다. 특히 자발화 특성에 차이가 있는 디젤과 천연가스의 특성을 이용한 반응성 제어 압축착화(reactivity controlled compression ignition, RCCI) 연소 전략을 통해 기존 디젤엔진의 효율과 배출가스를 동시에 개선시키는 연구가 활발하게 진행되어 왔다. 상사점보다 앞당겨진 디젤 직접 분사시기 적용을 통해 실린더 전체 영역의 균일 혼합기를 형성하여 전체적으로 희박한 자발화 기반 연소를 달성함으로써 질소산화물 (NOx) 및 입자상물질 (PM) 저감과 제동열효율 개선을 동시에 달성할 수 있다. 하지만 매우 희박한 저부하 영역에서 불완전 연소량이 증가하는 단점이 존재하며, 안정적인 연소 구현을 위해 디젤 분사시기가 민감하게 제어되어야 하는 어려움도 존재한다. 본 연구에서는 앞서 언급된 저부하 영역에서의 천연가스-디젤 혼소 엔진의 효율 및 배기 개선을 확인하고, 동시에 발전용 엔진 구동 영역에서 디젤 분사시기에 따른 연소안정성을 평가하였다. 실험에는 6 L급 상용디젤 엔진이 사용되었으며, 1,800 rpm, 50% 부하 영역 (~50 kW)에서 실험이 진행되었다. 제동효율 및 연소안정성을 개선하기 위한 전략으로 분무 패턴이 다른 2개의 인젝터를 적용하였으며, 천연가스/디젤 비율과 디젤 분사시기를 바꿔가면서 실험이 진행되었다. 실험 결과, 협각 분사가 추가된 수정 인젝터에서 제동 열효율이 증가하는 것을 확인하였다. 또한 연소안정성 및 출력, 그리고 강화된 배기 규제를 고려하였을 때 수정 인젝터의 분무 패턴이 예혼합연소 형성에 적합하였고 이를 통해 질소산화물 배출량을 Tier-V 기준치인 0.4 g/kWh 이하로 저감함으로써 RCCI 연소 가능 영역을 확장할 수 있음을 실험적으로 확인하였다.

• 대한치과보철학회지
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• 제45권2호
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• pp.263-273
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• 2007

Statement of problem: Alteration of tooth function is assumed to be changed by stress/strain on the adjacent alveolar bone, producing changes in morphology similar to those described for other load-bearing bones. When teeth are removed, opposing teeth will not be functioned. When edentulous area is restored by implant prostheses, opposing teeth will be received physiologic mechanical stimuli. Purpose: The aim of this study was to evaluate the bone changes around the teeth opposing implant restoration installed mandibular posterior area. Material and method: Eight patients who had mandibular posterior edentulous area were treated with implants. Radiographs of the opposing teeth were taken at implant prostheses delivery(baseline), 3 months, and 6 months later. Customized film holding device was fabricated to standardize the projection geometry for serial radiographs of opposing teeth. Direct digital image was obtained. Gray values of region of interest at each digital image were measured and compared according to time lapse. Repeated measured analysis of variance and post-hoc Scheffe's test were performed at the 95% significance level. Results: Alveolar bone changes around the natural teeth opposing the posterior implant in mandible showed statistically significant difference compared to control group(P<0.05). And gray values of alveolar bone around the teeth opposing implants were increased. There were no statistically significant differences of alveolar bone changes between crestal group and middle group and between mesial group and distal group according to time lapse(P>0.05). There were no statistically significant differences of alveolar bone changes among mesial-crestal group, mesial-middle group, distal-crestal group, distal-middle group, and control group(P>0.05). Conclusion: Alveolar bone around the natural teeth opposing the implant prosthesis showed gradual bony apposition.

• 한국항공우주학회지
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• 제45권4호
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• pp.300-309
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• 2017

우주비행체는 우주공간에서 소형 추력기를 통해 연소가스를 노즐 외부로 배출시킴으로써 궤도보정 및 자세제어에 필요한 반작용 모멘텀을 발생시킨다. 이때 배출된 배기가스가 우주비행체의 표면과 충돌하면서 발생된 교란 힘 및 교란토크, 열 부하, 표면 오염 등은 우주비행체의 수명 단축 및 기능저하를 유발시킬 수 있으므로 추력기 배기가스 거동에 관한 예측은 우주비행체 설계시 매우 중요한 절차라고 할 수 있다. 본 연구에서는 우주비행체의 자세제어용 추력기로 사용되는 10 N급 이원추진제 추력기의 배기가스 거동을 수치적으로 해석함으로써 우주비행체 설계에 필요한 핵심기술을 확보하는 것이 목적이다. 이를 위해 모노메틸하이드라진(MMH) 연료와 사산화이질소(NTO) 산화제의 화학평형반응과 추력기 노즐 내부 연속체 영역 계산을 수행한 후 배기가스 해석을 위한 직접모사법(DSMC)의 유입조건으로 적용하였다. 해석 결과, 이원추진제 추력기 노즐 부근에서 배기가스의 화학종 박리와 같은 비평형 팽창과 후방유동의 특성들을 예측할 수 있었다.

• 지역사회간호학회지
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• 제14권2호
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• pp.190-199
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• 2003

This study was conducted to determine the factors affecting job satisfaction in workers by using the Job Stress Model proposed by the National Institute for Occupational Safety and Health (NIOSH). Data were collected from December 1 to December 30, 1999. The subjects were 2,133 workers employed at 155 work sites, who were examined using NIOSH Job Stress questionnaire translated by the Korea Occupational Safety ${\pounds}|$ Health Academy and Occupational Safety ${\pounds}|$ Health Research Institute. SAS/PC program was used for statistical analysis using descriptive analysis. Pearson's correlation coefficient, ANOVA, and Stepwise multiple regression analysis. The results of this study were as follows. 1. According to general characteristics of the subjects, job satisfaction was high in those with less number of children. 2. By work condition, job satisfaction was higher in those who were working in a permanent job position, were working with regular time basis than with shift basis, were working in regular shift hours than in changing shift hours, were working for a short period, and were working less hours and overtime works per week. 3. In terms of physical work environment, job satisfaction was significantly related to 10 physical environmental factors. In other words, job satisfaction was high in workers who were working in an environment with no noise, bright light, temperature adjusted to an appropriate level during summer and winter, humidity adjusted to an appropriate level. well ventilation, clean air, no exposure to hazardous substance during work hour, overall pleasant work environment and not crowded work space. 4. By work-related factors, job satisfaction was high in those with less ambiguity about future job and role, high job control/autonomy, and less workload. On the other hand, job satisfaction was low in those with little utilization of competencies, and much role conflict at work and workload. 5. As for the relationships between job satisfaction and the non-work related factors, job satisfaction was high in workers who were volunteering at different organizations or active in religious activities for 5-10 hours per week. 6. In the relationships between job satisfaction and buffering factors, significantly positive correlations were found between job satisfaction and factors such as support by direct superior, support by peers, and support by spouse, friend and family. 7. There were nine factors that affected job satisfaction in the workers: age, number of children, work hours per week, noise, temperature at the work site during summer, uncomfortable physical environment, role ambiguity, role conflict, ambiguity in job future, work load, no utilization of competencies and social support from direct supervisor. These nine factors accounted for 26% of the total variance in the multiple regression analysis. In conclusion. the following are proposed based on the results of this study. 1. The most important physical environmental factors affecting job satisfaction in workers were noise, role ambiguity, and work load, suggesting a need to develop strategies or programs to manage these factors at work sites. 2. A support system that could promote job satisfaction is needed by emphasizing the roles of occupational health nurses who may be stationed at work sites and manage the factors that could generate job stress. 3. Job satisfaction is one of the three acute responses to stress proposed in NIOSH job stress model (job satisfaction. physical discomfort and industrial accidents). Therefore, further studies need to be conducted on the other two issues.

• 대한치과보철학회지
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• 제32권1호
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• pp.148-169
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• 1994

The concept of biologic attachment of load-bearing implants has developed over the past decades as an alternative to the difficulties associated with long term implantation using mechanical fixation and bone cement. The choice of implant material is also as critical an element as site preparation or insertion procedure. The properties of implants that affect host tissue responses are not limited to chemical composition alone, but also include shape, surface characteristics, site of implantation, and mechanical interaction with host tissues. Initial mechanical interlocking prevents micromotion and may be a prerequisite for direct bone apposition. A hard tightening of screws does not necessarily mean a stronger fixation and final tightening of the fixtures is dependent on the experience of the operator. Removal torque is lower than insertion torque. The purpose of this study was to investigate differences in the removal torques at the bone-implant interface of polished and sandblasted Titanium. This experiment will give insight into important factors that must be considered when interpreting in vivo screwing forces on implants during the connection of the transmucosal abutments. We evaluated the significance of different surface textures by comparison of the withdrawal forces necessary for removal of otherwise identical rough and polished implants of Titanium and also evaluated interfacial response on the light microscopic level to implant surface. And the priority of the area of insertion on osseointegration were evaluated. 9 Titanium implants - among them, 3 were for the developmental - of either a smooth or rough surface finish were inserted in the dog mandible in the right side. 3 months later Kanon Torque Gauge was used to unscrew the implants. The results were as follows : 1. No significant difference was seen in the removal torque due to variation in surface treatment, 23 Ncm for the sandblasted and 23.33 Ncm for the polished surface (p>0.05). 2. Implants in the anterior (25 Ncm) mandible showed better resistance to unscrewing in comparison to ones in the posterior (18 Ncm) region (p<0.05). 3. Developmental fixtures (22 Ncm) had similar pullout strength to the control group (p>0.05).

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7825-7829
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• 2015

Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

• 한국수자원학회:학술대회논문집
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• 한국수자원학회 2015년도 학술발표회
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• pp.237-237
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• 2015

The district of Marlborough has had more than its share of river management projects over the past 150 years, each one uniquely affecting the geomorphology and flood hazard of the Wairau Plains. A major early project was to block the Opawa distributary channel at Conders Bend. The Opawa distributary channel took a third and more of Wairau River floodwaters and was a major increasing threat to Blenheim. The blocking of the Opawa required the Wairau and Lower Wairau rivers to carry greater flood flows more often. Consequently the Lower Wairau River was breaking out of its stopbanks approximately every seven years. The idea of diverting flood waters at Tuamarina by providing a direct diversion to the sea through the beach ridges was conceptualised back around the 1920s however, limits on resources and machinery meant the mission of excavating this diversion didn't become feasible until the 1960s. In 1964 a 10 m wide pilot channel was cut from the sea to Tuamarina with an initial capacity of $700m^3/s$. It was expected that floods would eventually scour this 'Wairau Diversion' to its design channel width of 150 m. This did take many more years than initially thought but after approximately 50 years with a little mechanical assistance the Wairau Diversion reached an adequate capacity. Using the power of the river to erode the channel out to its design width and depth was a brilliant idea that saved many thousands of dollars in construction costs and it is somewhat ironic that it is that very same concept that is now being used to deal with the aggradation problem that the Wairau Diversion has caused. The introduction of the Wairau Diversion did provide some flood relief to the lower reaches of the river but unfortunately as the Diversion channel was eroding and enlarging the Lower Wairau River was aggrading and reducing in capacity due to its inability to pass its sediment load with reduced flood flows. It is estimated that approximately $2,000,000m^3$ of sediment was deposited on the bed of the Lower Wairau River in the time between the Diversion's introduction in 1964 and 2010, raising the Lower Wairau's bed upwards of 1.5m in some locations. A numerical morphological model (MIKE-11 ST) was used to assess a number of options which led to the decision and resource consent to construct an erodible (fuse plug) bank at the head of the Wairau Diversion to divert more frequent scouring-flows ($+400m^3/s$)down the Lower Wairau River. Full control gates were ruled out on the grounds of expense. The initial construction of the erodible bank followed in late 2009 with the bank's level at the fuse location set to overtop and begin washing out at a combined Wairau flow of $1,400m^3/s$ which avoids berm flooding in the Lower Wairau. In the three years since the erodible bank was first constructed the Wairau River has sustained 14 events with recorded flows at Tuamarina above $1,000m^3/s$ and three of events in excess of $2,500m^3/s$. These freshes and floods have resulted in washout and rebuild of the erodible bank eight times with a combined rebuild expenditure of $80,000. Marlborough District Council's Rivers & Drainage Department maintains a regular monitoring program for the bed of the Lower Wairau River, which consists of recurrently surveying a series of standard cross sections and estimating the mean bed level (MBL) at each section as well as an overall MBL change over time. A survey was carried out just prior to the installation of the erodible bank and another survey was carried out earlier this year. The results from this latest survey show for the first time since construction of the Wairau Diversion the Lower Wairau River is enlarging. It is estimated that the entire bed of the Lower Wairau has eroded down by an overall average of 60 mm since the introduction of the erodible bank which equates to a total volume of $260,000m^3$. At a cost of $$0.30/m^3$ this represents excellent value compared to mechanical dredging which would likely be in excess of $$10/m^3$. This confirms that the idea of using the river to enlarge the channel is again working for the Wairau River system and that in time nature's "excavator" will provide a channel capacity that will continue to meet design requirements.