• Title/Summary/Keyword: Internal evaluation

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The evaluation of image-guided catheter drainage in pleural effusion and empyema (흉수 및 농흉에서의 영상유도하 도관배액술의 유용성 평가)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.403-409
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    • 1996
  • Background : Pleural fluid collections may pose a difficult therapeutic problem. Complete drainage of complicated effusions or empyemas and reexpansion of atelectatic lung are important in obtaining a satisfactory clinical outcome. The usual approach to the diagnosis and treatment of patients with pleural effusion and empyema has been with needle thoracentesis and chest tube drainage. With chest tube drainage, technical difficulties and failures may occur as a result of improper tube drainage, particularly when there is a loculation or multiple and inaccesible collections. Fluoroscopic or sonographic guidance facilitates the proper tube insertion and drainage. Method : Twenty eight patients were required for tube drainage due to pleural fluid collections between January 1994 to February 1996. The author compared the results of drainage under applying each different method between blind chest tube insertion and image guided catheter insertion. Results : The conventional blind chest tube group comprised 14 patients; 6 empyema, 6 tuberculous effusion, and 2 parapneumonic effusion. The image guided catheter group of smaller french were composed of 14 patients; 2 empyema, 6 tuberculous effusion, 5 parapneumonic effusion, and 1 effusion of undetermined origin. Radiologic improvement with successful drainage was noticed in 79% with the blind chest tube group, whereas in 93% with the image guided catheter group. The complication with the latter method was unremarkable. Conclusion : Image guided catheter drainage was safe and highly successful in treating patients, not only with complicated effusion also with loculated empyema. Image guided catheter drainage offers an alternative in patients in whom closed drainage is required as the initial treatment.

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Evaluation of Surcharge toads Acting in Backfilled Space (되메움 공간의 상재하중 영향평가에 관한 연구)

  • Moon Chang-Yeul;Kim Hee-Dong;Choi Heon
    • Journal of the Korean Geotechnical Society
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    • v.20 no.9
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    • pp.167-176
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    • 2004
  • Underground structures will be affected by the additional surcharge loads such as traffic load et al. Terzaghi (1956) suggested the equation on the influences of surcharge loads in vertically backfilled spaces. In field, the shapes of backfill spaces are not always formed vertically. Then the Terzagi (1956) equation is not suitable to use because of boundary condition. This study suggests equation to calculate the stress in backfilled space caused by surcharge loads when the backfilled space is sloped symmetrically. The suggested equation is verified by carbon box test and numerical analysis. The experimental results show good agreement with the suggested equation but the numerical analysis result shows a little disagreement. The differences are estimated to be caused by the fact that ground made by carbon rod has become more dense and internal frction and wall friction has increased itself as surcharge load is added but that this increase can not be considered in the numerical analysis. The suggested equation shows good agreement with Terzaghi (1956) equation in case of sloped backfill ground. According to the results, it is considered that the suggested equation can be applied not only to sloped space but also to vertical space. Further investigation using full scale experiment is needed.

A Study on Stability Evaluation of the Nail-Anchor Mixed Support System

  • Kim, Hong-Taek;Cho, Yong-Kwon;Yoo, Han-Kyu
    • Journal of the Korean Geotechnical Society
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    • v.15 no.3
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    • pp.41-70
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    • 1999
  • The benefits of utilizing internal reinforced members, such as soil nails and ground anchors, in maintaining stable excavations and slopes have been known among geotechnical engineers to be very effective. Occasionally, however, both soil nails and ground anchors are simultaneously used in one excavation site. In the present study, a method of limit equilibrium stability analysis of the excavation zone reinforced with the vertically or horizontally mixed nail-anchor system is proposed to evaluate the global safety factor with respect to a sliding failure. The postulated failure wedges are determined based on the results of the $FLAC^{2D}\; 및\; FLAC^{3D}$ program analyses. This study also deals with a determination of the required thickness of the shotcrete facing. An excessive facing thickness may be required due to both the stress concentration and the relative displacement at the interface zone between the soil nailing system and the ground anchor system. A simple finite element method of analysis is presented to estimate the corresponding relative displacement at the interface zone between two different support systems. As an efficient resolution to reduce the facing thickness, the modified bearing plate system is also proposed. Finally with various analysis related to the effects of design parameters, the predicted displacements are compared with the results of the $FLAC^{2D}$ program analyses.

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The Effects of Hospital Accreditation Program to the Organizational Culture, Job Satisfaction, Financial Performances and Patient Safety at Geriatric Hospital : About Busan Metrocity (의료기관 인증제도가 요양병원의 조직문화, 직무만족, 경영성과 및 환자안전에 미치는 영향 -부산지역을 중심으로-)

  • Shin, Moon-Ju
    • Journal of Digital Convergence
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    • v.12 no.10
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    • pp.455-466
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    • 2014
  • This study has been implemented to improve the quality in geriatric hospital through the Hospital Accreditation. So research a change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the Hospital Accreditation. For this, a survay was conducted from April 1 to July 20, 2014 to targeting staffs of eight geriatric hospital in the Busan city. Thus, a total of 283 questionnaires were used in the study. Firstly, It was found that change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the the Hospital Accreditation. Secondly, It was found that a statistical correlation among variables such as Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance. Thirdly, Organizational Culture, Job Satisfaction, Financial Performance had a positive effect on Patient Safety. Therefore, we should develop the Hospital Accreditation program with the internal assessment to implement health care quality and patient safety to ensure a complete job satisfaction of hospital staffs in the Hospital Accreditation program further improve the evaluation process of hospital care.

Operative Treatment of Tibial Plateau Fractures (경골과 골절의 수술적 치료 결과)

  • Shin, Duck-Seop;Seong, Byeong-Yeon;Kim, Dong-Won
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.187-198
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    • 2001
  • Background: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. Materials and Methods: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. Results: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. Conclusion: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

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Ultrasonographic Features of Intra-abdominal Abscess (복부내 농양의 초음파 소견)

  • Cho, Kil-Ho;Jung, Kyung-Hee;Hwang, Mi-Soo;Chang, Jae-Chun;Kwun, Koing-Bo;Min, Hyun-Sik
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.87-93
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    • 1985
  • Intraabdommal abscess usually causes distress with fever, leukocytosis, pain and toxicity. Diagnosis of intraabdominal abscess is occasionally difficult and It has high morbidity. However radiologic method, such as ultrasonography, CT scan, or RI scan are helpful to early detection of intraabdominal abscess. Among these methods, ultrasonography is a non-invasive technique and performed without discomfort to patient. And also differential diagnosis between cystic and solid lesion is very easy and sequential ultrasonography in same patient is valuable for the evaluation of treatment effect. We analyzed the ultrasonic features of 48 cases with intra-abdominal abscesses and the results are as follows; 1. In total 48 cases, the intra-abdominal abscesses were 30 cases, the retroperitoneal abscesses, 5 cases, and the visceral abscesses, 13 cases. 2. The causes of the intra-abdominal abscesses were perforating appendicitis (25 cases), postoperative complications (5 cases), pyogenic and amebic hepatic abscesses (13 cases), and the others (5 cases). 3. Round or oval shaped lesions were 26 cases (54%), irregular shape, 18 cases (38%), and multiple abscess formation in 4 cases (8 %). 4. The size of the lesions were between 5 and 10cm in diameter in 54% of total 48 cases, and the most frequent feature of the echo-pattern of the lesions was cystic with or without internal echogenicity (69%).

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The Reliability and Validity Test of Sasangin Diagnostic Questionnaire for Specialist(SDQ_S) (전문가용 사상체질진단지의 신뢰도와 타당도 검사)

  • Pak, Yun-Seong;kim, Je-Shin;Park, Byung-Joo;Yoo, Jung-Hee;Lee, Jun-Hee;Koh, Byung-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.2
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    • pp.110-122
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    • 2016
  • Objectives The purpose of this study was to develop the Sasangin Diagnostic Questionnaire for Specialist(SDQ_S) and to evaluate the reliability and validity of SDQ_S for standardization of sasang constitutional diagnosis by korean medicine Specialist in clinical practice.Methods SDQ_S was developed through discussions of three sasang constitutional medical specialist. We recruited 210 subjects aged from 20 to 70, and conducted the evaluation of SDQ_S and sasang constitutional diagnosis. For the reliability test, internal consistency was examined by calculating the cronbach's α coefficient on 88 items excepted measurements of trunk, and independence and agreement was examined by chi-square test and McNemar test for 84 subjects which retested SDQ_S. For the validity test, discriminant functions was derived from the sample group(105 subjects), and they were applied to the test group(105 subjects). We identified the hit-ratio of SDQ_S in the test group.Results and Conclusions In the reliability test, the cronbach's α coefficient was 0.664 and 87 items(98.9%) have dependent relationships between 1st test and 2nd test. And 39 items(44.3%) have high agreements(0.8≤McNemar), 26 items(29.5%) have common agreements(0.4≤McNemar<0.8). In the validity test, four discriminant variables(Soeum Index, Taeeum Index, Torso Ratio I, Taeyang Index) were selected, and two discriminant functions were derived. Total hit-ratio was 74.2%, and hit-ratio of Taeeumin(76.7%) was higher than that of Soeumin(75.9%) and Soyangin(69.7%). SDQ_S has good reliability and validity for sasang constitutional diagnosis.

Rheological Changes of Dough and Breadmaking Qualities of Wheat Flour with Additions of Soy Flour (대두혼합식빵 제조시 대두첨가량에 따른 반죽과 식빵의 물성 변화)

  • 김인호;하상철;이인구
    • Food Science and Preservation
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    • v.9 no.4
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    • pp.418-424
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    • 2002
  • This study was undertaken to develop the optimum baking formular and process in making the improved soy-wheat composite breads furtified with soy flour, which has been known for a source of biologically active phytochemicals and for more vegetable proteins as well. The effects of the addition of soy flour on a rheological properties of dough, on the sensory characteristics of breads, and on the possibilities of commercialization of these functional breads were investigated. As the added amount of soy flour increased, water absorption, development time and the weakness value of dough were increased, but dough stability were decreased in the farinograph. In the extensograph, the more soy flour was added, the less the extensibility and the resistance to extention were shown. As the amount of soy flour increased, gelatinazation point was increased in the amylograph, but the maxium viscosity was decreased. As the added amount of soy flour was increased, b value(yellowness) was obviously increased, L value(lightness) was slightly decreased. However, a value(redness) was not nearly changed in the color of cut loaves. In sensory evaluation, the more soy flour was added, the less the external, the internal characteristics and the eating qualities were shown. Accorting to the addition of soy flour, the toughness and the brittleness tended to be increased proportionally. The dough of 10% soy-wheat composite flour(SF10) was the most favorable on the baking performance.

A Study on Developing an Objective Evaluation Method of the Signs and Symptoms of Temporomandibular Joint Internal Derangement (악관절내장증의 증상과 징후의 객관적 평가법의 개발에 관한 연구)

  • 김영구;이승우;정성창
    • Journal of Oral Medicine and Pain
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    • v.22 no.1
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    • pp.31-44
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    • 1997
  • 저자들은 악관절내장증의 증상과 징후의 객관적 평가법을 개발하기 위하여 서울대학교치과 병원 구강진단과 악안면동통진료실을 내원한 환자중 좌우 양 관절중 한 관절 이상의 관절에 악관절내장이 있는 남자 8명(평균연령 19.9$\pm$2.9세), 여자 34명(평균연령:32.8$\pm$11.8세) 총 42명(84개 관절)에 대하여 VAS 및 압통역치 측정, 악관절조영술, 골신티그래피 검사 및 악관절 활액의 분석을 시행하였다. 악관절 동통의 심도는 VAS로 측정을 하였으며 PPT는 electronic algometer로 평가를 하였다. 악관절조영사진을 얻기 직전 활액을 채취하였으며 그 성분중 Hyaluronic acid, 총단백질, IgG, IgM과 albumin을 분석하여 그 상관관계를 분석한 결과 다음과 같은 결론을 얻었다. 1. 악관절 내장증으로 내원한 환자 42명, 총 84개 관절중, 무통성이고 관절잡음이 없는 경우가 7개 관절, 무통성이고 단순관절음만 존재하는 경우가 18개 관절, 동통 및 단순관절음이 존재하는 경우가 18개 관절, 간헐적인 폐구 과두걸림이 있는 경우가 11개 관절, 급성 폐구성 과두걸림의 경우가 11개 관절, 만성 폐구성 과두걸림의 경우가 3개 관절, 퇴행성 관절질환이 존재하는 경우가 16개 관절이었다. 2. 연구대상중 18명의 환자, 총 36개 관절에 대한 골 신티그래피 검사 결과, 활동성으로 나타난 경우가 33개 관절이었고 이중 23개 관절이 동통성이었으며, 활동 상태 관절의 VAS 항목과 압통역치 항목 및 여러 검사 항목들은 비활동 상태 관절의 항목과 유의한 차이를 나타내지 않았다. 3. 악관절내장의 진행정도에 따른 악관절부위의 동통의 측정에 있어서는 압통역치의 측정보다는 VAS에 의한 방법이 더 유용하며 특히, 후방부의 촉진시에 유의한 정보를 얻을 수 있었다. 4. 악관절 내장즈으이 진행 단계에 따라, VAS항목과 압통역치 항목을 비교해 본 결고, 주기적인 과두걸림(II) 단계에서 가장 높은 VAS 수치와 가장 낮은 압통역치를 나타내었으며 상방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계와 증상 및 징후가 없는(0) 단계 사이와 후방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계 및 퇴행성 관절 질환(V) 단계와 증상 및 징후가 없는(0) 단계 사이에서만 유의성을 나타내었다. 5. 활액내 총단백질량, albumin 량, IgG 및 IgM 농도는 악과?ㄹ 내장증의 진행에 따라 유의성을 나타내지는 않았으나 퇴행성 관절 질환(V) 단계에서 증가되는 양상을 나타내었다. 6. 활액내 hyaluronic acid의 농도는 악관절 내장증의 진행에 따라 유의성을 나타내지는 않았으나 만성 폐구성 과두걸림(IV) 단계에서 감소되는 양상을 나타내었다.

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An Extended Benefit-Cost Analysis of Land Consolidation and On-farm Development Project -With Respect to Jigok Land Consolidation and On-farm Development Project in Seosan, Chungnam Province, Korea- (경지정리사업의 확장편익-비용분석 - 충남서산시 지곡지구를 중심으로 -)

  • Lim, Jae-Hwan;Lee, Min-Soo
    • Korean Journal of Agricultural Science
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    • v.29 no.1
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    • pp.66-83
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    • 2002
  • The economic feasibility analysis including benefit-cost ratio and internal rate of return of a land consolidation and on-farm development project was mainly depended upon the direct benefits and costs arising during project life. Therefore the projects were neglected in allocating the government's financial funds and loans on account of the low economic rate of return of the project. Accordingly the extended benefit-cost analysis method should be introduced and adapted to cover not only the benefit s such as non-market values of environmental and food security fun ct ions of the project but also market values of the project outputs. The main purposes of this study are (1) to prepare a guide line for economic feasibility analysis based on the IBRD and ADB guidelines, (2) to estimate the benefits from productivity increase, labor saving, savings of O&M cost of farm mechanization and project facilities, savings of farmer's burden for their public health, increasing environmental and public functional value of paddy fields, improving food security condition and formation of peaceful and uncontroversial rural society by implementing the land consolidation and on-farm development, (3) to introduce the newly adapted analytical method as the extended benefit cost analysis which could make possible to be included the values of non-market goods such as the food security and the environmental public function of paddy fields. To carry out this study, the existing publications on the guidelines for economic agricultural projects were reviewed and consultation was made with a For the post evaluation study of the land consolidation and on-farm development project, field survey in Jigok and other comparative area were made to get available information. According to the project completion report, Jigok land consolidation and on-farm development project has 55ha of benefit area out of 69ha of gross area. The project was started in November 11th, 2000 and completed october 30th, 2001. The total project costs were amounted to 2,548 million won and the annual project benefits were estimated at 335million won evaluated by domestic market prices. The ERR(Economic Rate of Return) and SRR(Social Rate of Return) of the project based on the shadow pricing system were estimated at 4.4% and 16% respectively. On the other hand, the ERR and SRR based on the domestic market value system were amounted to 6.37% and 14.62%. In conclusion, Korean land consolidation and on-farm development projects have not carried out from the view point of economic rate of return under shadow pricing system but from the view point of domestic pricing system. For the future feasibility studies on land consolidation projects have to be carried out including the non-market values as environmental and food security function of the projects.

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