• 한국철도학회:학술대회논문집
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• 한국철도학회 2011년도 정기총회 및 추계학술대회 논문집
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• pp.707-710
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• 2011

System safety is defined as the state where the hazard risks due to internal system, interface, operation and maintenance are controlled as acceptable levels. It is represented and evaluated either with the risk level of each risk factor with the consideration of operation environments or with Safety Integrity Level (SIL) which is the system functional safety without considering application environments. The assessment results are issued in forms of certificates and they are reused in many cases. However, the conditions and restrictions for different application environments vary in each case, therefore, additional evaluation on the preconditions of assessment in comparison with the actual application environment must be carried out. For the area of train control, TR 50506-1 has been established based on the IEC 62425 (international standard for safety of train control system by RSSB) and EN 50129 (Europe standard) for the further assessment. In this paper, the analysis on TR 5056-1 has been conducted in depth. The purpose of the study is to determine the requirements for inter-acceptability including scope, procedures, principles, examination and suitability. The results can be utilized for the system safety maintenance when new devices or components are introduced in conventional systems.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.83-89
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• 2013

Background: The prevalence of extended-spectrum ${\beta}$-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment. Methods: A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected. Results: Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia. Conclusion: Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.47-55
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• 2022

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.

• 대한의생명과학회지
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• 제29권4호
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• pp.220-230
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• 2023

Identification of the pathogens causing infection is important in terms of patient's health management and infection control. Synovial fluids could be used as clinical samples to detect causative pathogens of prosthetic joint infections (PJIs) using molecular diagnostic assays, therefore, normalization and validation of clinical samples are necessary. Microbial culture is considered the gold standard for all infections, including PJIs. Recently, molecular diagnostic methods have been developed to overcome the limitation of microbial culture. Therefore, guideline for validating clinical samples to provide reliable results of molecular diagnostic assays for infectious diseases is required in clinical field. The present study aimed to develop an accurate validating method of synovial fluid clinical samples using GAPDH gene as an internal control to perform the quantitative PCR TaqMan probe assay to detect pathogens causing PJIs.

• 한국화재소방학회논문지
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• 제33권6호
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• pp.87-94
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• 2019

국민권익위원회 2018년 7월 17일 보도 자료에 의하면 방탈출카페, 실내양궁장 등 신종업종이 다중이용업에서 제외되어 지정을 검토하고 화재예방 대책을 수립하도록 소방청에 권고하였다. 본 연구는 Delphi 기법으로 다중이용업 신종업종의 화재위험평가 측정영역 및 측정지표를 계층화하고 적합도(3.00 이상) 분석결과, 적합도 평균값이 4.25로서 적합성을 확보하였다. AHP 분석결과, 화재위험평가 측정영역의 일관성 비율은 4.0%로서 CR ≤ 0.1(10%) 보다 낮게 분석되었고 하위 측정지표의 일관성 비율도 0.1%~3.6%로서 모두 일관성이 있음을 확인하였다. 통합 측정지표의 중요도와 우선순위는 영업장 내부통로의 형태 및 출구의 피난능력(0.316), 점화원관리(0.141), 고유위험(0.106), 화재감지시스템의 적절성 및 적응성(0.097), 가연물관리(0.084), 피난안내 및 피난설비(0.075), 내화구조 및 마감재료(0.060), 구획 및 비상구(0.049), 연소확대위험(0.046), 소화설비의 적절성 및 적응성(0.026)의 순으로 도출 되었다. 본 연구는 향후, 화재위험평가지표 개발 연구의 중요한 자료로 널리 활용 될 것이다.

• 해양환경안전학회지
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• 제25권2호
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• pp.159-168
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• 2019

본 연구는 수중활동에서 나타나는 인체의 생리적 변화와 알코올 섭취로 인한 생리적 변화를 살펴보고 알코올 섭취가 스쿠버다이버에게 미치는 영향을 규명하는데 그 목적이 있다. 미국 내부통제연구소위원회의 내부통제 프레임워크를 기초로 본 연구에 적합하도록 새롭게 정립한 '리스크 평가 및 분석(RAA, risk assessment and analysis)' 기법을 활용하여 알코올 섭취 전과 후의 리스크 분석을 실시하였다. RAA기법은 리스크 간 상관관계를 분석하는 1단계, 리스크를 정량화하고 리스크 데이터베이스를 구축하는 2단계, 그리고 이를 도식화하여 리스크맵을 분석하는 3단계로 이루어져 있다. RAA기법을 통해 알코올 섭취로 인한 수중활동의 리스크수준이 전반적으로 증가하여 고위험군의 비율이 높아진 것을 확인하였고 리스크수준의 정량화와 고위험군 분류를 통해 리스크관리 측면에서 우선통제대상을 지정할 수 있었다. 본 연구 결과는 알코올 섭취 후 행해지는 스쿠버다이빙의 위험성을 명확하게 알리고 이에 대한 스쿠버다이버들의 의식 개선을 도모하여 보다 안전한 스쿠버다이빙 환경을 제시할 수 있을 것으로 기대한다.

• Hip & pelvis
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• 제36권2호
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• pp.144-154
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• 2024

Purpose: The objective of this study was to assess postoperative direct medical expenses and medical utilization of elderly patients who underwent either hemiarthroplasty (HA) or internal fixation (IF) for treatment of a femoral intertrochanteric fracture and to analyze differences according to surgical methods and age groups. Materials and Methods: Data from the 2011 to 2018 Korean National Health Insurance Review & Assessment Service database were used. Risk-set matching was performed for selection of controls representing patients with the same sex, age, and year of surgery. A comparative interrupted time series analysis was performed for evaluation of differences in medical expenses and utilization between the two groups. Results: A total of 10,405 patients who underwent IF surgery and 10,405 control patients who underwent HA surgery were included. Medical expenses were 18% lower in the IF group compared to the HA group during the first year after the fracture (difference-in-difference [DID] estimate ratio 0.82, 95% confidence interval [CI] 0.77-0.87, P<0.001), and 9% lower in the second year (DID estimate ratio 0.91, 95% CI 0.85-0.99, P=0.018). Length of hospital stay was significantly shorter in the IF group compared to the HA group during the first two years after time zero in the age ≥80 group. Conclusion: A noticeable increase in medical expenses was observed for patients who underwent HA for treatment of intertrochanteric fractures compared to those who underwent IF over a two-year period after surgery. Therefore, consideration of such findings is critical when designing healthcare policy support for management of intertrochanteric fractures.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7139-7142
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• 2015

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin > 12 ng/ml and HOMA > 4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

• Structural Engineering and Mechanics
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• 제43권1호
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• pp.127-145
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• 2012

One of the most important and challenging steps in seismic vulnerability and performance assessment of highway bridges is the determination of the bridge component damage parameters and their corresponding limit states. These parameters are very essential for defining bridge damage state as well as determining the performance of highway bridges under a seismic event. Therefore, realistic damage limit states are required in the development of reliable fragility curves, which are employed in the seismic risk assessment packages for mitigation purposes. In this article, qualitative damage assessment criteria for ordinary highway bridges are taken into account considering the critical bridge components in terms of proper engineering demand parameters (EDPs). Seismic damage of bridges is strongly related to the deformation of bridge components as well as member internal forces imposed due to seismic actions. A simple approach is proposed for determining the acceptance criteria and damage limit states for use in seismic performance and vulnerability assessment of ordinary highway bridges in Turkey constructed after the 1990s. Physical damage of bridge components is represented by three damage limit states: serviceability, damage control, and collapse prevention. Inelastic deformation and shear force demand of the bent components (column and cap beam), and superstructure displacement are the most common causes for the seismic damage of the highway bridges. Each damage limit state is quantified with respect to the EDPs: i.e. curvature and shear force demand of RC bent components and superstructure relative displacement.

• 대한한의학회지
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• 제24권4호
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• pp.19-24
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• 2003

Background and Purposes : Smoking is a well-known risk factor for ischemic stroke. It may contribute to s1Toke by inducing the aggregation of platelets and formation of atheroma, reducing cerebral blood flow, and increasing fibrinogen. However, the relative risk varies according to different ethnicity and area. Therefore, we performed this study to assess the risk of smoking for ischemic s1Toke in Korea. Methods : Cigarette smoking habit was studied in 308 patients with ischemic s1Toke and in 348 age- and sex-matched control subjects who had no history of stroke using case control methods. In multiple logistic regression analysis, smoking had a significant value of odds ratio adjusted for hypertension, diabetes mellitus, and hyperlipidemia. Results : The adjusted odds ratio (AOR) and 95％ confidence interval (CI) was significant in the medium smokers (AOR, 1.92; 95％ CI, 1.11 to 3.33: p< 0.05) and heavy smokers (AOR, 2.80; 95％ CI, 1.64 to 4.78: p< 0.05). Furthermore, the OR was higher in hypertensive subjects than in normotensive subjects compared to non-smokers (AOR, 1.98; 95％ CI, 1.01 to 3.85: p< 0.05). Conclusions : Our findings suggest that smoking is an independent risk factor for ischemic stroke in Korea.