• Title/Summary/Keyword: Operating Evaluation

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A Methodology to Develop a Curriculum of Landscape Architecture based on National Competency Standards (국가직무능력표준(NCS) 기반 조경분야 교육과정 개발)

  • Byeon, Jae-Sang;Shin, Sang-Hyun;Ahn, Seong-Ro
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.2
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    • pp.23-39
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    • 2017
  • This study began from the question, "is there a way to efficiently apply industrial demand in the university curriculum?" Research focused on how to actively accept and respond to the era of the NCS (National Competency Standards). In order to apply NCS to individual departments of the university, industrial personnel must positively participate to form a practical-level curriculum by the NCS, which can be linked to the work and qualifications. A valid procedure for developing a curriculum based on the NCS of this study is as follows: First, the university must select a specific classification of NCS considering the relevant industry outlook, the speciality of professors in the university, the relationship with regional industries and the prospects for future employment, and the need for industrial manpower. Second, departments must establish a type of human resource that compromises goals for the university education and the missions of the chosen NCS. In this process, a unique competency unit of the university that can support the basic or applied subjects should be added to the task model. Third, the task model based on the NCS should be completed through the verification of each competency unit considering the acceptance or rejection in the curriculum. Fourth, subjects in response to each competency units within the task model should be developed while considering time and credits according to university regulations. After this, a clear subject description of how to operate and evaluate the contents of the curriculum should be created. Fifth, a roadmap for determining the period of operating subjects for each semester or year should be built. This roadmap will become a basis for the competency achievement frame to decide upon the adoption of a Process Evaluation Qualification System. In order for the NCS to be successfully established within the university, a consensus on the necessity of the NCS should be preceded by professors, students and staff members. Unlike a traditional curriculum by professors, the student-oriented NCS curriculum is needed sufficient understanding and empathy for the many sacrifices and commitment of the members of the university.

Dosimetric Evaluation of a Small Intraoral X-ray Tube for Dental Imaging (치과용 초소형 X-선 튜브의 선량평가)

  • Ji, Yunseo;Kim, YeonWoo;Lee, Rena
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.160-167
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    • 2015
  • Radiation exposure from medical diagnostic imaging procedures to patients is one of the most significant interests in diagnostic x-ray system. A miniature x-ray intraoral tube was developed for the first time in the world which can be inserted into the mouth for imaging. Dose evaluation should be carried out in order to utilize such an imaging device for clinical use. In this study, dose evaluation of the new x-ray unit was performed by 1) using a custom made in vivo Pig phantom, 2) determining exposure condition for the clinical use, and 3) measuring patient dose of the new system. On the basis of DRLs (Diagnostic Reference Level) recommended by KDFA (Korea Food & Drug Administration), the ESD (Entrance Skin Dose) and DAP (Dose Area Product) measurements for the new x-ray imaging device were designed and measured. The maximum voltage and current of the x-ray tubes used in this study were 55 kVp, and 300 mA. The active area of the detector was $72{\times}72mm$ with pixel size of $48{\mu}m$. To obtain the operating condition of the new system, pig jaw phantom images showing major tooth-associated tissues, such as clown, pulp cavity were acquired at 1 frame/sec. Changing the beam currents 20 to $80{\mu}A$, x-ray images of 50 frames were obtained for one beam current with optimum x-ray exposure setting. Pig jaw phantom images were acquired from two commercial x-ray imaging units and compared to the new x-ray device: CS 2100, Carestream Dental LLC and EXARO, HIOSSEN, Inc. Their exposure conditions were 60 kV, 7 mA, and 60 kV, 2 mA, respectively. Comparing the new x-ray device and conventional x-ray imaging units, images of the new x-ray device around teeth and their neighboring tissues turn out to be better in spite of its small x-ray field size. ESD of the new x-ray device was measured 1.369 mGy on the beam condition for the best image quality, 0.051 mAs, which is much less than DRLs recommended by IAEA (International Atomic Energy Agency) and KDFA, both. Its dose distribution in the x-ray field size was observed to be uniform with standard deviation of 5~10 %. DAP of the new x-ray device was $82.4mGy*cm^2$ less than DRL established by KDFA even though its x-ray field size was small. This study shows that the new x-ray imaging device offers better in image quality and lower radiation dose compared to the conventional intraoral units. In additions, methods and know-how for studies in x-ray features could be accumulated from this work.

A Study of Current Perception Threshold of Trigeminal Nerve after Tooth Implantation (치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구)

  • Lim, Hyun-Dae;Lee, Jung-Hyun;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.187-200
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    • 2007
  • This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.

Herbicidal Phytotoxicity under Adverse Environments and Countermeasures (불량환경하(不良環境下)에서의 제초제(除草劑) 약해(藥害)와 경감기술(輕減技術))

  • Kwon, Y.W.;Hwang, H.S.;Kang, B.H.
    • Korean Journal of Weed Science
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    • v.13 no.4
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    • pp.210-233
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    • 1993
  • The herbicide has become indispensable as much as nitrogen fertilizer in Korean agriculture from 1970 onwards. It is estimated that in 1991 more than 40 herbicides were registered for rice crop and treated to an area 1.41 times the rice acreage ; more than 30 herbicides were registered for field crops and treated to 89% of the crop area ; the treatment acreage of 3 non-selective foliar-applied herbicides reached 2,555 thousand hectares. During the last 25 years herbicides have benefited the Korean farmers substantially in labor, cost and time of farming. Any herbicide which causes crop injury in ordinary uses is not allowed to register in most country. Herbicides, however, can cause crop injury more or less when they are misused, abused or used under adverse environments. The herbicide use more than 100% of crop acreage means an increased probability of which herbicides are used wrong or under adverse situation. This is true as evidenced by that about 25% of farmers have experienced the herbicide caused crop injury more than once during last 10 years on authors' nationwide surveys in 1992 and 1993 ; one-half of the injury incidences were with crop yield loss greater than 10%. Crop injury caused by herbicide had not occurred to a serious extent in the 1960s when the herbicides fewer than 5 were used by farmers to the field less than 12% of total acreage. Farmers ascribed about 53% of the herbicidal injury incidences at their fields to their misuses such as overdose, careless or improper application, off-time application or wrong choice of the herbicide, etc. While 47% of the incidences were mainly due to adverse natural conditions. Such misuses can be reduced to a minimum through enhanced education/extension services for right uses and, although undesirable, increased farmers' experiences of phytotoxicity. The most difficult primary problem arises from lack of countermeasures for farmers to cope with various adverse environmental conditions. At present almost all the herbicides have"Do not use!" instructions on label to avoid crop injury under adverse environments. These "Do not use!" situations Include sandy, highly percolating, or infertile soils, cool water gushing paddy, poorly draining paddy, terraced paddy, too wet or dry soils, days of abnormally cool or high air temperature, etc. Meanwhile, the cultivated lands are under poor conditions : the average organic matter content ranges 2.5 to 2.8% in paddy soil and 2.0 to 2.6% in upland soil ; the canon exchange capacity ranges 8 to 12 m.e. ; approximately 43% of paddy and 56% of upland are of sandy to sandy gravel soil ; only 42% of paddy and 16% of upland fields are on flat land. The present situation would mean that about 40 to 50% of soil applied herbicides are used on the field where the label instructs "Do not use!". Yet no positive effort has been made for 25 years long by government or companies to develop countermeasures. It is a really sophisticated social problem. In the 1960s and 1970s a subside program to incoporate hillside red clayish soil into sandy paddy as well as campaign for increased application of compost to the field had been operating. Yet majority of the sandy soils remains sandy and the program and campaign had been stopped. With regard to this sandy soil problem the authors have developed a method of "split application of a herbicide onto sandy soil field". A model case study has been carried out with success and is introduced with key procedure in this paper. Climate is variable in its nature. Among the climatic components sudden fall or rise in temperature is hardly avoidable for a crop plant. Our spring air temperature fluctuates so much ; for example, the daily mean air temperature of Inchon city varied from 6.31 to $16.81^{\circ}C$ on April 20, early seeding time of crops, within${\times}$2Sd range of 30 year records. Seeding early in season means an increased liability to phytotoxicity, and this will be more evident in direct water-seeding of rice. About 20% of farmers depend on the cold underground-water pumped for rice irrigation. If the well is deep over 70m, the fresh water may be about $10^{\circ}C$ cold. The water should be warmed to about $20^{\circ}C$ before irrigation. This is not so practiced well by farmers. In addition to the forementioned adverse conditions there exist many other aspects to be amended. Among them the worst for liquid spray type herbicides is almost total lacking in proper knowledge of nozzle types and concern with even spray by the administrative, rural extension officers, company and farmers. Even not available in the market are the nozzles and sprayers appropriate for herbicides spray. Most people perceive all the pesticide sprayers same and concern much with the speed and easiness of spray, not with correct spray. There exist many points to be improved to minimize herbicidal phytotoxicity in Korea and many ways to achieve the goal. First of all it is suggested that 1) the present evaluation of a new herbicide at standard and double doses in registration trials is to be an evaluation for standard, double and triple doses to exploit the response slope in making decision for approval and recommendation of different dose for different situation on label, 2) the government is to recognize the facts and nature of the present problem to correct the present misperceptions and to develop an appropriate national program for improvement of soil conditions, spray equipment, extention manpower and services, 3) the researchers are to enhance researches on the countermeasures and 4) the herbicide makers/dealers are to correct their misperceptions and policy for sales, to develop database on the detailed use conditions of consumer one by one and to serve the consumers with direct counsel based on the database.

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A Contemplation on Measures to Advance Logistics Centers (물류센터 선진화를 위한 발전 방안에 대한 소고)

  • Sun, Il-Suck;Lee, Won-Dong
    • Journal of Distribution Science
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    • v.9 no.1
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    • pp.17-27
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    • 2011
  • As the world becomes more globalized, business competition becomes fiercer, while consumers' needs for less expensive quality products are on the increase. Business operations make an effort to secure a competitive edge in costs and services, and the logistics industry, that is, the industry operating the storing and transporting of goods, once thought to be an expense, begins to be considered as the third cash cow, a source of new income. Logistics centers are central to storage, loading and unloading of deliveries, packaging operations, and dispensing goods' information. As hubs for various deliveries, they also serve as a core infrastructure to smoothly coordinate manufacturing and selling, using varied information and operation systems. Logistics centers are increasingly on the rise as centers of business supply activities, growing beyond their previous role of primarily storing goods. They are no longer just facilities; they have become logistics strongholds that encompass various features from demand forecast to the regulation of supply, manufacturing, and sales by realizing SCM, taking into account marketability and the operation of service and products. However, despite these changes in logistics operations, some centers have been unable to shed their past roles as warehouses. For the continuous development of logistics centers, various measures would be needed, including a revision of current supporting policies, formulating effective management plans, and establishing systematic standards for founding, managing, and controlling logistics centers. To this end, the research explored previous studies on the use and effectiveness of logistics centers. From a theoretical perspective, an evaluation of the overall introduction, purposes, and transitions in the use of logistics centers found issues to ponder and suggested measures to promote and further advance logistics centers. First, a fact-finding survey to establish demand forecast and standardization is needed. As logistics newspapers predicted that after 2012 supply would exceed demand, causing rents to fall, the business environment for logistics centers has faltered. However, since there is a shortage of fact-finding surveys regarding actual demand for domestic logistic centers, it is hard to predict what the future holds for this industry. Accordingly, the first priority should be to get to the essence of the current market situation by conducting accurate domestic and international fact-finding surveys. Based on those, management and evaluation indicators should be developed to build the foundation for the consistent advancement of logistics centers. Second, many policies for logistics centers should be revised or developed. Above all, a guideline for fair trade between a shipper and a commercial logistics center should be enacted. Since there are no standards for fair trade between them, rampant unfair trades according to market practices have brought chaos to market orders, and now the logistics industry is confronting its own difficulties. Therefore, unfair trade cases that currently plague logistics centers should be gathered by the industry and fair trade guidelines should be established and implemented. In addition, restrictive employment regulations for foreign workers should be eased, and logistics centers should be charged industry rates for the use of electricity. Third, various measures should be taken to improve the management environment. First, we need to find out how to activate value-added logistics. Because the traditional purpose of logistics centers was storage and loading/unloading of goods, their profitability had a limit, and the need arose to find a new angle to create a value added service. Logistic centers have been perceived as support for a company's storage, manufacturing, and sales needs, not as creators of profits. The center's role in the company's economics has been lowering costs. However, as the logistics' management environment spiraled, along with its storage purpose, developing a new feature of profit creation should be a desirable goal, and to achieve that, value added logistics should be promoted. Logistics centers can also be improved through cost estimation. In the meantime, they have achieved some strides in facility development but have still fallen behind in others, particularly in management functioning. Lax management has been rampant because the industry has not developed a concept of cost estimation. The centers have since made an effort toward unification, standardization, and informatization while realizing cost reductions by establishing systems for effective management, but it has been hard to produce profits. Thus, there is an urgent need to estimate costs by determining a basic cost range for each division of work at logistics centers. This undertaking can be the first step to improving the ineffective aspects of how they operate. Ongoing research and constant efforts have been made to improve the level of effectiveness in the manufacturing industry, but studies on resource management in logistics centers are hardly enough. Thus, a plan to calculate the optimal level of resources necessary to operate a logistics center should be developed and implemented in management behavior, for example, by standardizing the hours of operation. If logistics centers, shippers, related trade groups, academic figures, and other experts could launch a committee to work with the government and maintain an ongoing relationship, the constraint and cooperation among members would help lead to coherent development plans for logistics centers. If the government continues its efforts to provide financial support, nurture professional workers, and maintain safety management, we can anticipate the continuous advancement of logistics centers.

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Design and Implementation of MongoDB-based Unstructured Log Processing System over Cloud Computing Environment (클라우드 환경에서 MongoDB 기반의 비정형 로그 처리 시스템 설계 및 구현)

  • Kim, Myoungjin;Han, Seungho;Cui, Yun;Lee, Hanku
    • Journal of Internet Computing and Services
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    • v.14 no.6
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    • pp.71-84
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    • 2013
  • Log data, which record the multitude of information created when operating computer systems, are utilized in many processes, from carrying out computer system inspection and process optimization to providing customized user optimization. In this paper, we propose a MongoDB-based unstructured log processing system in a cloud environment for processing the massive amount of log data of banks. Most of the log data generated during banking operations come from handling a client's business. Therefore, in order to gather, store, categorize, and analyze the log data generated while processing the client's business, a separate log data processing system needs to be established. However, the realization of flexible storage expansion functions for processing a massive amount of unstructured log data and executing a considerable number of functions to categorize and analyze the stored unstructured log data is difficult in existing computer environments. Thus, in this study, we use cloud computing technology to realize a cloud-based log data processing system for processing unstructured log data that are difficult to process using the existing computing infrastructure's analysis tools and management system. The proposed system uses the IaaS (Infrastructure as a Service) cloud environment to provide a flexible expansion of computing resources and includes the ability to flexibly expand resources such as storage space and memory under conditions such as extended storage or rapid increase in log data. Moreover, to overcome the processing limits of the existing analysis tool when a real-time analysis of the aggregated unstructured log data is required, the proposed system includes a Hadoop-based analysis module for quick and reliable parallel-distributed processing of the massive amount of log data. Furthermore, because the HDFS (Hadoop Distributed File System) stores data by generating copies of the block units of the aggregated log data, the proposed system offers automatic restore functions for the system to continually operate after it recovers from a malfunction. Finally, by establishing a distributed database using the NoSQL-based Mongo DB, the proposed system provides methods of effectively processing unstructured log data. Relational databases such as the MySQL databases have complex schemas that are inappropriate for processing unstructured log data. Further, strict schemas like those of relational databases cannot expand nodes in the case wherein the stored data are distributed to various nodes when the amount of data rapidly increases. NoSQL does not provide the complex computations that relational databases may provide but can easily expand the database through node dispersion when the amount of data increases rapidly; it is a non-relational database with an appropriate structure for processing unstructured data. The data models of the NoSQL are usually classified as Key-Value, column-oriented, and document-oriented types. Of these, the representative document-oriented data model, MongoDB, which has a free schema structure, is used in the proposed system. MongoDB is introduced to the proposed system because it makes it easy to process unstructured log data through a flexible schema structure, facilitates flexible node expansion when the amount of data is rapidly increasing, and provides an Auto-Sharding function that automatically expands storage. The proposed system is composed of a log collector module, a log graph generator module, a MongoDB module, a Hadoop-based analysis module, and a MySQL module. When the log data generated over the entire client business process of each bank are sent to the cloud server, the log collector module collects and classifies data according to the type of log data and distributes it to the MongoDB module and the MySQL module. The log graph generator module generates the results of the log analysis of the MongoDB module, Hadoop-based analysis module, and the MySQL module per analysis time and type of the aggregated log data, and provides them to the user through a web interface. Log data that require a real-time log data analysis are stored in the MySQL module and provided real-time by the log graph generator module. The aggregated log data per unit time are stored in the MongoDB module and plotted in a graph according to the user's various analysis conditions. The aggregated log data in the MongoDB module are parallel-distributed and processed by the Hadoop-based analysis module. A comparative evaluation is carried out against a log data processing system that uses only MySQL for inserting log data and estimating query performance; this evaluation proves the proposed system's superiority. Moreover, an optimal chunk size is confirmed through the log data insert performance evaluation of MongoDB for various chunk sizes.

Test Bed Studies with Highly Efficient Amine CO2 Solvent (KoSol-4) (고효율 습식 아민 CO2 흡수제(KoSol-4)를 적용한 Test bed 성능시험)

  • Lee, Ji Hyun;Kwak, No-Sang;Lee, In Young;Jang, Kyung Ryoung;Jang, Se Gyu;Lee, Kyung Ja;Han, Gwang Su;Oh, Dong-Hun;Shim, Jae-Goo
    • Korean Chemical Engineering Research
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    • v.51 no.2
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    • pp.267-271
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    • 2013
  • Test bed studies with highly efficient amine $CO_2$ solvent (KoSol-4) developed by KEPCO research institute were performed. For the first time in Korea, evaluation of post-combustion $CO_2$ capture technology to capture 2 ton $CO_2$/day from a slipstream of the flue gas from a coal-fired power station was performed. Also the analysis of solvent regeneration energy was conducted to suggest the reliable performance data of the KoSol-4 solvent. For this purpose, we have tested 5 campaigns changing the operating conditions of the solvent flow rate and the stripper pressure. The overall results of these campaigns showed that the $CO_2$ removal rate met the technical guideline ($CO_2$ removal rate: 90%) suggested by IEA-GHG and that the regeneration energy of the KoSol-4 showed about 3.0~3.2 GJ/$tCO_2$ which was, compared to that of the commercial solvent MEA (Monoethanolamine), about 25% reduction of regeneration energy. Based on these results, we could confirm the good performance of the KoSol-4 solvent and the $CO_2$ capture process developed by KEPCO research institute. And also it was expected that the cost of $CO_2$ avoided could be reduced drastically if the KoSol-4 is applied to the commercial scale $CO_2$ capture plant.

The status of 「Logic and Writing in Home Economics Education」 course and the students' perception about the course (「가정과 논리 및 논술」 교과목의 운영 실태 및 가정교육과 학생의 인식)

  • Choi, Min-Ji;Chae, Jung-Hyun;Jun, Mi-Kyung
    • Journal of Korean Home Economics Education Association
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    • v.27 no.1
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    • pp.51-65
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    • 2015
  • The purpose of the study was to describe the operating status of "Logic and Writing in Home Economics Education(HEE)" course and the students' perception about the course. For this study, the syllabuses of "Logic and Writing" course in HE education department were reviewed. The survey method was used in this descriptive study. Respondents in this study were 116 students taking the "Logic and Writing in Home Economics Education" course. Questionnaires from the students were collected through on-line and off-line mail. The results of the study were as the follows: First, goals of the "Logic and Writing in HE Education" course were as the follows in order: to enhance writing skill about various subjects related to Home Economics; to foster HE teachers' professionalism through persuasive power logically; to foster writing skill logically; to prepare HE teacher recruitment exam; and to foster teaching skills to enhance students' writing. The student evaluation methods in the course were mainly attendance, examination, tasks, discussion and presentation, and class participation. Second, degree of satisfaction of students taking the course was higher than average. The student respondents perceived that the course was helpful to improve their logical thinking and critical analytical skill, writing skill related to HE education and education, ability to express one's opinion clearly and exactly, understanding of the fundamental concept of logic and the structure and method of the essay, comprehensive understanding of HE education, and ability to solve the problems specifically. However, they responded that it was difficult to practice writing, to discuss and debate frequently, to follow uncertain assessment criteria, and to present frequently. They wanted the instructor to give the feedback more frequently.

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Utility of B-type Natriuretic Peptide in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군 환자에 있어서 B-type Natriuretic Peptide의 유용성)

  • Rhee, Chin Kook;Joo, Young Bin;Kim, Seok Chan;Park, Sung Hak;Lee, Sook Young;Koh, Yoon Seok;Kim, Young Kyoon
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.389-397
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    • 2007
  • Background B-type natriuretic peptide (BNP) has been shown to be strong mortality predictors in a wide variety of cardiovascular syndromes. Little is known about BNP in patients with acute respiratory distress syndrome (ARDS). We studied whether BNP can predict mortality in patients with ARDS. Method Echocardiographic study was done to all patients with ARDS, and we excluded patient with low ejection fraction (less than 50%) or showing any features of diastolic dysfunction. 47 patients were enrolled between December, 2003 and February, 2006. Parameters including BNP were obtained within 24h hours at the time of enrollment. Result Mean BNP concentrations and APACHE II scores differed between the survivors and nonsurvivors (BNP, $219.5{\pm}57.7pg/mL$ vs $492.3{\pm}88.8pg/mL$; p=0.013, APACHE II score, $17.4{\pm}1.6$ vs $23.1{\pm}1.3$, p=0.009, respectively). With the use of the threshold value for BNP of 585 pg/mL, the specificity for the prediction of mortality was 94%. The threshold value for APACHE II of 15.5 showed sensitivity of 87%. 'APACHE II + $11{\times}logBNP$' showed sensitivity 63%, and specificity 82%, using threshold value for 46.14. Conclusion BNP concentrations and APCHE II scores were more elevated in nonsurvivors than survivors in patients with ARDS who have normal ejection fraction. BNP can predict mortality. Further study should be done.

Cardiac Injury due to Thoracic Trauma (흉부외상에 의한 심장손상)

  • Kim, Han-Yong;Kim, Myoung-Young;Park, Jae-Hong;Chei, Chang-Seck;Hwang, Sang-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.831-836
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    • 2007
  • Background: Cardiac injuries are the most commonly overlooked injuries in patients who die from trauma. Patients who survive blunt cardiac rupture or penetrating injuries are rare and the incidence is not well defined. Many patients require urgent or emergency operations and operative mortality is very high. Material and Method: A retrospective review of 26 patients with cardiac injuries due to thoracic trauma undergoing emergency thoracotomy from January 1997 to December 2005. Result: There were 17 male and 9 female patients, with a mean age of $45.3{\pm}16.2\;(range:\;17{\sim}80)$. Thirteen patients (50%) were injured in motor vehicle accidents, and five patients (19%) in motorcycle accidents. Six patients (23%) were injured by knives, and two patients (8%) were injured by falling. Anatomic injuries included right atrium (12 [46%]), left atrium (1 [4%]), right ventricle (5 [19%]), left ventricle (5 [19%]), and cardiac chambers (2 [7%]). Diagnosis was made by computer tomography in 12 patients and sonography in 14 patients. The average times from admission to operating room was $89.2{\pm}86.7\;min\;(range:\;10{\sim}335)$. The average time for diagnosis was $51.3{\pm}13.6\;min\;(range:\;5{\sim}280)$. The mean Revised Trauma Score (RTS) was $6.7{\pm}0.8$, and the Glasgow Coma Scale (GCS), was $12.8{\pm}2.8$. The overall mortality rate was 12% (3 out of 26 patients). Conclusion: The mortality rate from cardiac injury is very high. The survival rate can be increased only by a high index of suspicion, aggressive expeditious diagnostic evaluation, and prompt appropriate surgical management.