• 한국국방경영분석학회지
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• 제17권1호
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• pp.61-83
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• 1991

There has been a great deal of research dealing with the optimal replacement of stochastically deteriorating equipment and research in queueing systems with a finite calling population. However. there has been a lack of research which combines these two areas to deal with optimal replacement for a fixed number of machines and a limited number of repairmen. In this research, an optimal control policy for replacement involving two machines and one repairman is developed by investigating a class of age replacement policies in the context of controlling a G/M/1 queueing system with a finite calling population. The control policy to be imposed on this problem is an age-dependent control policy, described by the control limit $t^{\ast}$. The control limit is operational only when the repairman is idle; that is. if both machines are working, as soon as a machine reaches the age $t^{\ast}$ it is taken out of service for replacememt. We obtain the ${\epsilon}$-optimal control age which will minimize the long-run average system cost. An algorithm is developed that is applicable to general failure time distributions and cost functions. The algorithm does not require the condition of unimodality for implementation.

• 한국수자원학회:학술대회논문집
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• 한국수자원학회 2021년도 학술발표회
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• pp.145-145
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• 2021

Water distribution networks (WDNs) are designed to satisfy water requirement of an urban community. One of the central issues in human history is providing sufficient quality and quantity of water through WDNs. A WDN consists of a great number of pipelines with different ages, lengths, materials, and sizes in varying degrees of deterioration. The available annual budget for rehabilitation of these infrastructures only covers part of the network; thus it is important to manage the limited budget in the most cost-effective manner. In this study, a novel pipe replacement scheduling approach is proposed in order to smooth the annual investment time series based on a life cycle cost assessment. The proposed approach is applied to a real WDN currently operating in South Korea. The proposed scheduling plan considers both the annual budget limitation and the optimum investment on pipes' useful life. A non-dominated sorting genetic algorithm is used to solve a multi-objective optimization problem. Three decision-making objectives, including the minimum imposed LCC of the network, the minimum standard deviation of annual cost, and the minimum average age of the network, are considered to find optimal pipe replacement planning over long-term time period. The results indicate that the proposed scheduling structure provides efficient and cost-effective rehabilitation management of water network with consistent annual budget.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.89-96
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• 2024

The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.

• 대한한의학회지
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• 제43권3호
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• pp.164-180
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• 2022

Objectives: The purpose of this study was to evaluate the effects of shenfu injection on myocardial protective effects after mitral valve replacement surgery. Methods: We searched four international databases (PUBMED, Embase, Web of Science and CNKI) and three domestic electronic databases (OASIS, RISS and NDSL) for relevant studies. We used following keywords 'shenfu', 'valve replacement', 'mitral valve' at PUBMED, Embase and Web of Science; '二尖瓣', '参附注射液', '瓣膜' at CNKI and '이첨판', '판막', '삼부' at domestic databases. The search range included randomized controlled trials. When appropriate, meta-analyses were performed. Results: Seven randomized controlled trials were selected. All studies used Shenfu injection after mitral valve replacement surgery. We analyzed myocardial damage, cardiac function, patients' recovery rate, with various evaluation indicators. We also used meta-analysis for CK-MB, cTnI, MDA and voluntary recovery of heartbeat. CK-MB was analyzed in two subgroups: 8 hours and 24 hours after surgery. Std was -2.34(95% CI -4.10, -0.58) for 8 hours and -1.95(95% CI -4.79 to 0.88) for 24 hours. 8 hours showed statistically significant difference. cTnI appeared significant decrease with Std of -2.13(95% CI -2.60, -1.66). MDA showed significant decrease with Std of -0.95(95% CI -1.43 to -0.47). Voluntary recovery of heartbeat significantly increased with the odd ratio of 4.34(95% CI 1.76, 10.70). Conclusions: We suggest that Shenfu injection after Mitral valve replacement surgery may have significant myocardial protective effects in terms of reducing myocardial damages, reactive oxygen species, increasing cardiac function and patients' recovery after surgery. However, the evidence is limited, further research is required.

• Journal of mucopolysaccharidosis and rare diseases
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• 제4권1호
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• pp.21-25
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• 2018

Fabry disease is a hereditary lysosomal storage disorder caused by the reduction or absence of lysosomal enzyme alpha-galactosidase A and the accumulation of glycosphingolipids, such as globotriaosylceramide (Gb3), in various organs, including the heart. The prevention of cardiac involvement in Fabry disease can only be achieved by enzyme replacement therapy (ERT), and the method of assessing the efficacy of ERT should be confirmed. Changes in the electrocardiogram, such as the shortening of PQ interval, prolongation of QTc and repolarization abnormalities as well as left ventricular hypertrophy in voltage criteria, can be used to identify Fabry disease patients; however, the usefulness of electrocardiograms for evaluating the efficacy of ERT is limited. The assessment of left ventricular hypertrophy using echocardiography has been established to evaluate the efficacy of ERT during long-term period. A new technique involving speckled tracking method might be useful for detecting early cardiac dysfunction and identifying the effect of ERT for a relatively short period. The estimation of left ventricular hypertrophy using cardiac magnetic resonance (CMR) is also useful for assessing the efficacy of ERT. Identifying late gadolinium enhancement in CMR may affect the effectiveness of ERT, and the new technique of T1 mapping might be useful for monitoring the accumulation of Gb3 during ERT. Histopathology in cardiac biopsy specimens is another potentially useful method for identifying the accumulation of GB3; however, the use of histopathology to evaluate of the efficacy of ERT is limited because of the invasive nature of an endomyocardial biopsy.

• Journal of Chest Surgery
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• 제26권9호
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• pp.667-676
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• 1993

Boprosthetic cardiac valves fail from biological and metabolic as well as mechanical reasons, and the limited durability is the main factor of marked withdrawal in their clinical use. Starting the use of bioprosthetic valves in 1976, up to the end of 1992, the consecutive 178 patients have undergone re-replacement of glutaraldehyde-treated xenograft valves for primary tissue failure [PTF]among the patients who had initial valve replacement at Seoul national University Hospital. The explanted valves were 69 porcine aortic [51 Hancock, 12 Angell-Shiley and 6 Carentier-Edwards] and 141 bovine pericardial [129 standard-profile and 12 low-profile ionescu-Shiley] valwes, with an overall incidence of PTF of 15.2%. The operative mortality rate of re-replacement was 5.1%. Calcific degeneration and tissue damage in relation to calcification were the most frequent modes of PTF on gross examinatin of the explanted valves resulting hemodynamically in valvular regurgitation. The number of Hancocg porcine and the standard-profile Ionescu-Shiley valves in valves in mitral position failed more often from tissue damage [tears, holes, and loss or destruction of cuspal tissue] than calcification [68.3% vs. 39.0%, p<0.01] with resultant regurgitation in 61%, the Ionescu-Shiley valves in the same position in 53%. The tendency of more calcification than tissue damage[71.3% vs. 33.3%, p<0.001]with stenosis in 53%. The tendency of more calcification and immobility of cusps in the latter group was partly explainable by the inclusion of patients of pediatric age. Observation made in this study suggest : many of bioprosthetic valves would fail from calcification and tissue damage : some fail prematurely because of mechanical stress probably owing to the valve design in construction ; andeven those valves escaped early damage would be subject to calcify in the prolonged follow-up period. In conclusion, at the present time, the clinical use of bioprostheticxenograft valves seems to be quite limited until further improvement in biocompatibility and refinement in valve design in manufacture are achieved.

• 대한유전성대사질환학회지
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• 제14권1호
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• pp.37-41
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• 2014

Fabry disease is an X-linked disease caused by deficiency of the lysosomal enzyme alpha-galactosidase A. Affected males present anhydrosis, acroparesthesia and angiokeratoma, and subsequently cardiac, cerebral and renal complications are followed. Females and atypical variants show heterogeneous clinical symptoms. In 2001, two recombinant enzymes were approved for Fabry disease: agalsidase alpha and agalsidase beta. Since the introduction of enzyme replacement therapy (ERT), the number of long-term follow-up studies has been reported. Long-term ERT showed effectiveness on renal function in patients with chronic kidney disease, decrease or stabilization of left ventricular mass, and improvement of pain and quality of life. However, there were limited effects on cerebrovascular events and their mortality. Current literatures on the clinical effect of ERT have reported limited datain adult patients who have already advanced disease. Therefore, further study for pre-symptomatic patients and atypical variants is needed to verify the impact of ERT. This review summarized recent progresses in ERT and limitations of long-term effect of ERT in patients with Fabry disease.

• 한국구조물진단유지관리공학회 논문집
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• 제19권2호
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• pp.125-132
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• 2015

본 연구에서는 석회석 미분말을 이용하여 제조한 콘크리트의 굳지 않은 및 굳은 특성을 실험적으로 평가하였다. 석회석 시멘트 제조시 석회석 혼입률은 10%, 15%, 25% 및 35% 범위이며, 보통 포틀랜드 시멘트를 이용하여 제조한 기준 콘크리트 (OPC)와 비교하였다. 혼입률 35%까지 슬럼프, 공기량의 굳지 않은 특성은 기준 시험체와 유사한 특성을 나타내었지만 혼입률이 증가할수록 응결시간은 지연되었다. 석회석 혼입률 15%까지는 압축 및 휨강도, 급속 동결융해 저항성능의 경우 기준 OPC 콘크리트와 동등수준을 확보할 수 있는 것으로 나타났지만, 탄산화 저항성능 향상을 위한 보완은 필요한 것으로 나타났다. 혼입률 25%, 35% 배합은 기준 콘크리트 성능에 비해 압축강도 및 휨강도의 저하가 발생되었다. 치환률이 증가할수록 제한된 수산화칼슘량으로 인해 탄산화 저항성능은 모든 배합에서 감소하였다. 강도감소 및 탄산화저항성능을 고려할 경우, 15% 수준의 석회석 미분말 치환은 가능할 것으로 판단된다.

• 정보과학회 논문지
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• 제42권8호
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• pp.947-953
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• 2015

PRAM은 바이트 단위의 쓰기와 비휘발성의 특징을 모두 가지고 있으며, DRAM보다 높은 밀 집도가 기대되기 때문에 DRAM을 대체할 수 있을 것으로 예상된다. 이에, PRAM 기반의 버퍼 캐시 교체정책에 대한 연구가 활발하게 진행되고 있다. 그러나 대부분의 기존 연구는 PRAM의 수명 및 느린 쓰기 성능에만 집중함으로써 PRAM의 바이트 단위의 쓰기 성능을 제한적으로 이용한다. 이에, 본 논문에서는 PRAM의 바이트 단위의 쓰기 성능과 스토리지의 성능을 모두 고려한 새로운 버퍼 캐시 교체 정책을 제안 한다. 제안 기법은 바이트 단위의 쓰기 성능을 이용하기 위해 작은 크기의 쓰기 요청이 빈번한 페이지를 PRAM에 유지시키며 DRAM과 PRAM사이의 선택적 페이지 이동을 통해 PRAM의 쓰기 횟수를 감소시킨다. 실험 결과, 제안 기법은 CLOCK 알고리즘에 비해 최고 92%까지 PRAM의 쓰기 횟수를 감소시키고 PRAM 테스트 보드에서 최대 62%까지 수행시간을 향상시키는 것을 확인하였다.

• Asian Journal of Innovation and Policy
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• 제7권1호
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• pp.207-234
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• 2018

A manufacturer of a durable good typically purchases supplies, including parts for assembly - that are also useful for repairs - from independent "original equipment suppliers" with which it contracts. The manufacturer is a branded monopolist of its final assembled product. To put into effect also a monopoly of the replacement parts, it must stipulate in its arrangements with independent suppliers of the parts that they not supply such patented parts to any other buyer. Durable good owners would then only be able to obtain their requirements of replacement parts from the same company that supplied the durable. This would amount to a tie-in of replacement parts to the direct purchase of new durables. And that describes the apparently widespread practice of automobile manufacturers in India, as exposed in a recent case before the Competition Commission of India (Samsher Kataria v Honda Siel Cars India Limited and others). Here, I will argue that such tie-in enabled automotive manufacturers to more fully appropriate consumer surplus, which induced them to lower the price of new cars, sell more cars and also sell more repair parts. The tie-in expanded the auto parts industry and promoted new entry. The main restraint on expansion of India's automotive manufacturing is not monopoly. It is government protection in the form of tariffs on automobiles and auto parts.