• Nuclear Engineering and Technology
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• 제33권6호
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• pp.566-584
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• 2001

In this paper, the progressive deformation and the creep-fatigue damage for the conceptually designed reactor internals of KALIMER(Korea Advanced Liquid MEtal Reactor) are carried out by using the elastic analysis method in the RCC-MR code for normal operating conditions including the thermal load, seismic load (OBE) and dead weight. The maximum operating temperature of this reactor is 53$0^{\circ}C$ and the total service lifetime is 30 years. Thus, the time- dependent creep and stress-rupture effects become quite important in the structural design. The effects of the thermal induced membrane stress on the creep-fatigue damage are investigated with the risk of the elastic follow-up. To calculate the thermal stress, detailed thermal analyses considering conduction, convection and radiation heat transfer mechanisms are carried out with the ANSYS program. Using the results of the elastic analysis, the progressive deformation and creep-fatigue damages are calculated step by step using the RCC-MR in detail. This paper ill be a very useful guide for an actual application of the high temperature structural design of the nuclear power plant accounting for the time-dependent creep and stress-rupture effects.

• Clinics in Shoulder and Elbow
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• 제24권4호
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• pp.245-252
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• 2021

Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA. Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA. Demographic data and disease characteristics were collected through medical chart reviews. Additionally, we contacted all four patients that were alive at the time of the study by phone to assess any current elbow complications. Local tissue rearrangement was used for soft-tissue reconstruction in six patients, and a pedicle flap was used in three patients. The median follow-up period was 1.3 years (range, 6 months-14.7 years). Results: Seven patients (78%) underwent reoperation. Four patients (44%) had a reoperation for soft-tissue complications, including dehiscence or nonhealing of infected wounds. Five patients (56%) had a reoperation for implant-related complications, including three infections and two peri-prosthetic fractures. At the final follow-ups, six patients (67%) achieved successful wound healing and two patients had continued wound healing issues, while two patients had an antibiotic spacer in situ and one patient underwent an above-the-elbow amputation. Conclusions: This study reports a complication rate of 78% for soft-tissue reconstructions after TEA. Successful soft-tissue healing was achieved in 67% of patients, but at the cost of multiple surgeries. Early definitive soft-tissue reconstruction could prove to be preferable to minor interventions such as irrigation, debridement, and local tissue advancement, or smaller soft-tissue reconstructions using local tissue rearrangement or a pedicled flap at a later stage.

• 한국멀티미디어학회논문지
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• 제19권2호
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• pp.163-169
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• 2016

In Korea, prostate cancer accounted for generating growth rate second the following thyroid cancer, because of western dietary habits. Survival rate of prostate cancer after clinical behavior is changed depend on follow-up management. A telemedicine have been applied to replacement of medical specialist in rural area, and a quick reaction to emergency situation. Our study developed prostate 3-dimensional (3D) visualization program and designed prostate aftercare system architecture, called smart care, using a device that can access the Internet. Region of interest (ROI) in prostate was manually segmented by physicians and visualized to 3D objects and sent to PACS Server as DICOM images. So, medical personnel could confirm patients' data along with 3D images not only PACS system, but also portable device like a smart phone. As a result, we conducted the aftercare service to 98 patients and visualize 3D prostate images. 3D images had advantage to instinctively apprehend where lesion is and make patients to understand state of their disease easily. In the future, should conduct an aftercare service to more patients, and will obtain numerical index through follow-up study to an accurate analysis.

• 보건교육건강증진학회지
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• 제16권2호
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• pp.205-233
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• 1999

This study is an effort to make policy suggestions by analysing the current health examination program as a benefit service provided by the national health insurance system, including health screening for the insured, screening of cancer and chronic diseases for their dependents. Analyses found some issues being gave attention to; 1) The insured under the community health insurance system do not get the health examination benefit. A program for them should be set to have equity in benefit services. 2) Low rates of using screen services compromise purpose and the efficiency the services have first intended to. An immediate attention should be made to increase low rate of use of screen test to detect chronic diseases in particular. 3) Selection of diseases and test items covered by health examination program does not reflect the need of the insured, but to reflect financial resources of the national health insurance system. 4) Lack of health screening facilities and their geographical maldistribution is observed, which with preference of a general hospital as a screening post by the insured may lead to unreliable test. 5) A follow-up system should have been developed for the suspected classified by test results of carrying chronic diseases. They should be cared for within the health examination program. Public health care systems incorporate such a system, along with caring for those who are in need of having a health counselling on preventive care. In conclusion, the national health insurance system should be a medical insurance of giving a higher priority on preventive care benefits, health examination program in particular. That could be done by making rearrangements of test items, screening methods and system, rationalizing current reimbursement system of service fee, increasing accessibility to and utilization of the services, and making an establishment of follow-up system.

• Journal of Periodontal and Implant Science
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• 제46권6호
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• pp.396-404
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• 2016

Purpose: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. Methods: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. Results: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. Conclusions: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.

• 한국산업보건학회지
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• 제31권4호
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• pp.540-548
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• 2021

Introduction: Preplacement health examination (PHE) is performed when a worker starts a certain work task which is designated as having occupational risks by the Ministry of Employment and Labor (MOEL). All data related to health examination except PHE are reported to the MOEL by the law. This study has been performed to understand the status of PHE at certain workplaces. Methods: PHE data gathered in a university hospital were analyzed and they were followed with results of the special health examination (SHE) in 2019 and 2020. Those who were evaluated as unfit to work as it was, were interviewed directly or indirectly through an occupational health manager to follow up the management status of their recognized health problems. Results: The unfit to work (unFTW) rate of PHE was 2.8%, and was not different according to the size of workplace or having occupational health service. The major cause of unfit to work was the uncontrolled life-style diseases such as hypertension and diabetes. The rate of SHE followed by PHE was 31.1%. It was not different by the unFTW rates, however, they were different according to having a full time in-house occupational health manager. Thirty-one among 71 examinees who were evaluated as unFTW underwent SHE after controlling their health condition and were finally evaluated as fit to work. Nineteen among 31 started to take medicine and eight have been placed in the work without designated risks. Conclusion: PHE can be used for new workers, who may have unknown or uncontrolled life-style diseases, to be asked to manage life-style diseases as well as work-related risks such as shift work. In order to have a better tracking system for work-related risks, the information of PHE should be analyzed together with other data from health examination.

• 대한한의학회지
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• 제40권3호
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• pp.1-20
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• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• 대한한의학회지
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• 제43권1호
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• pp.112-135
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• 2022

Objectives: The objective of this study was to summarize clinical studies conducted over the last five years that investigated the effect of acupuncture on Parkinson's disease and to propose a better process of study. Methods: Research Information Sharing Service (RISS), Korea Studies Information Service (KISS), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, and China National Knowledge Infrastructure (CNKI) were systemically searched for clinical trials that had investigated the effect of acupuncture on the course of Parkinson's disease from May 2016 to April 2021. Results: A total of 23 studies met all the inclusion criteria. In most reports, acupuncture had significant positive effects on the course of Parkinson's disease. Furthermore, there were no serious adverse events associated with acupuncture in any of the studies. In addition to the acupuncture methods that showed effectiveness in previous studies, various types of acupuncture have been used to treat sub-symptoms of Parkinson's disease. The outcome measures were subdivided through individual symptom evaluation and mechanical analysis. Follow-up assessments were also performed to analyze the continuous effect. Conclusion: In the clinical studies conducted over the last five years, many studies investigated the various types of acupuncture used to treat Parkinson's disease and the segmentation and diversification of outcome measures focusing on individual symptoms, and a new approach for excluding placebo effects through follow-up studies has been made. Further attempts like these are needed to overcome methodological flaws in studies on the effects of acupuncture on Parkinson's disease.

• Journal of Preventive Medicine and Public Health
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• 제51권6호
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• pp.281-288
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• 2018

Objectives: We investigated the association between cholecystectomy or appendectomy and the subsequent risk of colorectal cancer (CRC) in the Korean population. Methods: A retrospective cohort study was conducted with the National Health Insurance Service-National Sample Cohort of Korea; this sample was followed up from January 1, 2002, until the date of CRC incidence, loss to follow-up, or December 31, 2015. The exposure status of cholecystectomy and appendectomy was treated as a time-varying covariate. The calculated risk of CRC was stratified by follow-up period, and the association between these surgical procedures and CRC was investigated by a Cox regression model applying appropriate lag periods. Results: A total of 707 663 individuals were identified for analysis. The study population was followed up for an average of 13.66 years, and 4324 CRC cases were identified. The hazard ratio (HR) of CRC was elevated in the first year after cholecystectomy (HR, 1.71; 95% confidence interval [CI], 1.01 to 2.89) and in the first year and 2-3 years after appendectomy (HR, 4.22; 95% CI, 2.87 to 6.20; HR, 2.34; 95% CI, 1.36 to 4.03, respectively). The HRs of CRC after applying 1 year of lag after cholecystectomy and 3 years of lag after appendectomy were 0.80 (95% CI, 0.57 to 1.13) and 0.77 (95% CI, 0.51 to 1.16), respectively. Conclusions: The risk of CRC increased in the first year after cholecystectomy and appendectomy, implying the possibility of bias. When appropriate lag periods after surgery were applied, no association was found between cholecystectomy or appendectomy and CRC.

• 대한토목학회논문집
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• 제32권4D호
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• pp.397-406
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• 2012

기부채납은 본래의 공익과 사익의 합리적인 조정수단으로써 운영되는 것과 달리 효용성 및 사후관리의 문제 등의 많은 문제점이 제기되고 있는 실정이다. 이에 본 연구는 실제 기부채납이 된 공공시설의 현황분석을 통해 문제점을 살펴보았으며, 실질적으로 이용하는 주민들의 의식조사를 통해 개선방향을 도출하는 것을 목적으로 한다. 기부채납 공공시설 현황분석 및 이용자 의식조사분석에 따른 문제점은 자투리땅에 조성되는 위치 및 입지여건의 문제, 단지 내 시설로 인식 및 이용되는 문제, 거주자들의 이용 및 안전을 고려하지 않은 가로시설물 조성 및 사후관리의 문제, 주변지역현황을 고려하지 않은 효용성의 문제점을 도출하였다. 각 문제점에 따른 기부채납 공공시설의 효율적인 운영을 위한 개선방안으로는 첫째, 이용률 및 효율성을 높일 수 있도록 기부채납 공공시설의 위치 및 입지여건을 고려한 계획이 수립되어야하며 둘째, 기부채납 공공시설의 이용성 증진을 위한 각 지자체별 홍보가 필요하다. 셋째, 공공의 시설이라는 인지를 위한 표지 및 안내판 등의 기부채납 공공시설 인지의 의무화를 시행하며, 넷째, 효율적인 사후관리를 위한 공공시설의 운영을 주민, SH LH공사 등에게 위임하는 방안과, 마지막으로 해당 지역에 필요한 공공시설을 파악할 수 있는 공공시설서비스 지도를 작성하여 기부채납 시 활용될 수 있도록 제안하여야 한다고 사료된다.