• Health Policy and Management
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• v.19 no.3
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.33 no.1
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• pp.46-58
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• 1997

The energy saving is one of the most important factors for profit in marine transportation. In order to reduce the fuel oil consumtion the ship's propulsion efficiency must be increased as possible. The propulsion efficiency depends upon a combination of an engine and a propeller. The propeller has better efficiency as lower rotational speed. This situation led the engine manufacturers to design the engine that has low speed, long stroke and a small number of cylinders. Consequently, the variation of rotational torque became larger than before because of the longer delay-time in fuel oil injection process and an increased output per cylinder. As this new trends the conventional mechanical-hydrualic governors for engine speed control have been replaced by digital speed controllers which adopted the PID control or the optimal control algorithm. But these control algorithms have not enough robustness to suppress the variation of the delay-time and the parameter perturbation. In this paper we consider the delay-time and the perturbation of engine parameters as the modeling uncetainties. Next we design the robust servo controller which has zero offset in steady state engine speed, based on H sub($\infty$) control theory. The validity of the controller was investigated through the response simulation. We used a personal computer and an analog computer as the digital controller and the engine (plant) part respectively. And, we could certify that the designed controller maintains its robust servo performance even though the engine parameters may vary.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.30 no.1 s.244
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• pp.84-89
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• 2006

A wireless capsule endoscope has been developed to replace the conventional endoscope. However, the commercialized capsule endoscope moves passively by peristaltic waves, which has some limitations for doctors to diagnose more thoroughly and actively. In order to solve this problem, a locomotive mechanism is proposed for wireless capsule endoscopes. Based on the tests of various actuators, a piezo actuator is selected as a micro actuator for capsule endoscope. In general, piezo actuators are known to have limited displacement with high voltage supply. In order to overcome the limitation of common piezo actuator, the impact based piezo actuator, is developed to realize long stroke up 11mm. By using the impact based piezo actuator, a prototype of an earthworm-like locomotive mechanism was developed. In addition, the proposed locomotive mechanism has engraved clamps mimicked the claw of an insect. The earthworm-like locomotive mechanism has 15 mm in diameter and 30mm under retraction stage and 41 mm under elongation stage in total length. Hollow space is allocated to comprise essential endoscope components such as a camera, a communication module, bio sensors, and a battery. For the feasibility test of proposed locomotive mechanism, a series of experiments were carried out including in-vitro tests. Based on results of the experiments, we conclude that the proposed locomotive mechanism is effective to be used for micro capsule endoscopes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.7
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• pp.239-244
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• 2018

Both arterial dissection and atherosclerosis are major causes of cerebral infarction and appear to be occlusion or stenosis in magnetic resonance angiography(MRA) and computed tomographic angiography(CTA). But there are differences in treatment because they have different mechanisms. Recently, as high resolution magnetic resonance image(HR-MRI) develops, the image of blood vessel wall can be confirmed non-invasively. Though HR-MRI has become a very useful method for patients with suspected arterial dissection, differential diagnosis of the two diseases has not yet been fully established due to differences in the findings according to stages of arterial dissection and atherosclerosis. We investigated the differences between vertebral artery dissection and atherosclerosis through HR-MRI in two patients and confirmed the diagnosis by CTA follow-up. In addition to the previously established diagnostic criteria, we determined that the long and severe stenosis and recanalization suggest arterial dissection. Characteristics of arterial dissection confirmed by HR-MR and additional studies will be helpful for the treatment.

• Perspectives in Nursing Science
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• v.3 no.1
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• pp.47-60
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• 2006

BACKGROUND: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chronically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few studies explicitly investigated the role of informal caregivers in the management of other chronic conditions such as stroke or depression or physical consequences of long-term caregiving. While most studies were focused on negative aspects of caregiving, a few studies found it rewarding. Often the burden, stress, and socio-economic effects on the family caregiving for an elderly person were not sufficiently appreciated. CONCLUSIONS: Positive outcomes for both the caregiver and the care recipient are more likely to occur when effective levels of collaboration exist between health professionals and caregivers. As a first step, a better understanding of the caregiving experience such as caregiver characteristics, care recipient characteristics, and social stigma is important for nurses to minimize the burden of care so that appropriate interventions can be developed. In addition, further studies are needed to examine the role and needs of informal caregivers in the care of increasing number of frail and/or chronic ill elderly treated in the community.

• Proceedings of the KIEE Conference
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• 2005.10b
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• pp.38-40
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• 2005

Microdrive with high precision and light mass enough to install on mouse head was fabricated for recording the reliable signal of neuron cell to understand the brain study. The proposed microdrive has three H-form PZT actuators and its guide structure. The microdrive operation principle is based on the well known inchworm principle. The synchronization of three PZT actuators is able to produce the linear motion along the guide structure. Our proposed microdrive has a precise accuracy of about 100nm and a long stroke of about 5mm. The electrode which is used for the recording of the action potential of the neuron cell was fixed at one of PZT actuators. The proposed microdrive was suited to acquisition of signals from in vivo extra-cellular single-unit recoding. On the condition of the anesthetized mouse, the single-unit signals could be recorded by using the proposed microdrive. In addition, applying the PZT microdrive to an alert mouse, we try to implant it on a mouse brain skull to explore single neuron firing.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.34 no.2
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• pp.227-235
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• 2010

This paper introduces the design of a bridge transport system with a telescopic tube for positioning equipment to perform remote handling tasks in a radioactive facility. It consists of an extensible and retractable telescopic tube assembly for z-direction motion, a cabling system for management of power and signal cables, and a trolley system for transverse motion and accommodating servo drives. The working environment for the bridge transport system with the telescopic tube requires strict geometrical constraints, including a short height, short telescopic tube length when retracted, and a long stroke. These constraints were met by solving a nonlinear programming problem involving the optimal dimensions. This paper introduces a cabling system for effective management of cables with changeable lengths to accommodate telescopic motions and a selection guide for servo drives that are sufficient to drive the system.

• Journal of the Korean Society for Precision Engineering
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• v.30 no.3
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• pp.254-259
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• 2013

Ball screw system is widely used as a precision mechanical linear actuator that translates rotational motion to linear motion for its high efficiency, great stiffness and long life. Recently, according to the requirements of high accuracy and stiffness, the pre-load on the ball screw which means of remove the backlash in the ball screw is usually used. Because of the preload which means the frictional resistance between the screw and nut, becomes a dominating heat source and it generates thermal deformation of ball screw which is the reason for low accuracy of the positioning decision. There are several methods to solve the problem that includes temperature control, thermal stable design and error compensation. In the past years, researchers focused on the error compensation technique for its ability to correct ball screw error effectively rather than the capabilities of careful machine design and manufacturing. Significant amounts of researches have been done to real-time error compensation. But in this paper, we developed a series of cooling methods to get thermal equilibrium in the ball screw system. So we find the optimum cooling type for improving positioning error which caused by thermal deformation in the ball screw system.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.227-232
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• 2007

Objectives : The purpose of this study was to determine the population-attributable risk (PAR) and estimate the total medical expenditure of the Korean National Health Insurance (KNHI) due to smoking. Methods : We used data from the Korean Cancer Prevention Study of 1,178,138 Koreans aged 30 to 95. These data were available from 1992 to 2003 and covered a long-term follow-up period among the Korean population. Results : The total medical expenditure of KNHI related to smoking increased by 27% from $324.9 million in 1999 to $413.7 million in 2003. By specific diseases, smoking-attributable KNHI medical expenditure was the highest for lung cancer ($74.2 million), followed by stroke ($65.3 million), COPD ($50.1 million), CHO ($49 million) and stomach cancer ($30 million). A total of 1.3 million KNHI patients were suffering from smoking-related diseases in 2003. We predicted rises in total KNHI medical expenditure related to smoking to $675.1 million (63% increase compared with that of 2003) and in the total number of KNHI patients suffering from smoking-related diseases to about 2.6million (an approximate 100% increase compared with those in 2003) in 2015. Conclusions : We found a substantial economic burden related to the high smoking prevalence in South Korea.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.26 no.1
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• pp.88-100
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• 1990

Since sea state changes engine load instantaneously, the speed governing apparatus is essential for marine engine to maintain constant speed regardless of the load. As governing apparatuses, mechanical, pneumatic, and electric governors have been employed. But, recently, according to the introduction of low speed-ling stroke engines to increase thermal efficiency, the development of governor which has better response characteristics is requisite. In this paper, to design the governor that meets above requirement, author made a performance test for the existing PID control digital governor with the aid of computer simulation, and investigated digital governor applying the optimal control algorithm, then, executed computer simulation by the same way. As the result of simulations, found that the former let engine have large overshoot and long settling time at low speed, on the other hand, the latter made engine have better response. If we design and invent a good observer for delay time element so that the optimal control theory can be applied, better governor will be expected.