• Proceedings of the KSME Conference
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• 2008.11b
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• pp.2845-2849
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• 2008

Long Term Asset Management(LTAM) means a plan developed by using LCM(Life Cycle Management) process for optimum life cycle management of significant plant assets at each plant across the fleet. As a part of development of LTAM Strategies on nuclear turbines, a method so as to determine the future failure rates for low pressure turbine facilities at a nuclear plant was studied and developed by using both plant specific and industry-wide performance data. INPO's EPIX data were analyzed and some failure rate evaluation values considering preventive maintenance practices were calculated by using EPRI's PM Basis software. As the result, failure rate functions applicable to a priori and a posteriori replacement of low pressure turbines at a nuclear plant were developed and utilized in an assessment of economics of LCM alternatives on the nuclear turbine facilities in the respects of 40-year and 60-year operation bases.

• Preventive Nutrition and Food Science
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• v.4 no.4
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• pp.226-230
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• 1999

This study was done to determine how added vegetable oils affect the physical, chemical and microbial properties of experimental frozen desserts. There were no differences in the percentages of total fat and total solids in the seven frozen desserts. Freezing points did not differ among treatments. There were significant differences in viscosity among the frozen desserts containing up to 80% of vegetable oils. Oil substitution at 30% or higher significantly decreased viscosity when compared to the milk fat control. The hardness of frozen desserts decreased significantly with increasing addition of oils. Oil substitution at 20% or higher significantly decreased hardness. Substitution of canola and soybean oils for milk fat increased melting rate. Initiation of fluid release in the control was slower than in frozen products with added oils. The SPC values and coliform counts of all frozen products were not significantly changed. Cholesterol content decreased significantly in the products as the vegetable oil content was raised. Frozen desserts containing 10% or 60% of vegetable oils in the total fat contained 91.8%, 73.5% or 32.5%, respectively, of the cholesterol in the control.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.65 no.8
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• pp.1457-1465
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• 2016

A RCM approach to maintenance of the catenary system of electric railway is proposed. The proposed RCM approach provides a maintenance-oriented FMECA procedure to derive critical failure modes by analyzing failure effects and a RCM decision logic tree to suggest optimal maintenance works for the derived failure modes. By applying the proposed RCM procedures to the catenary system of high speed railway, it is suggested that strand breaks of dropper and voltage equalizing wire, and trolly wire wear-out are the critical failure modes for whom maintenance works based on condition monitoring should be applied instead of conventional time-based preventive maintenance. It is also proposed by reliability analysis that replacement time of dropper can be reduced from 18 years to 10 years. These results show that the proposed RCM approach can optimize the maintenance procedures of catenary system.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.38 no.11
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• pp.1245-1256
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• 2014

The physical nature of fatigue shows the considerable amount of scatter from intrinsic and extrinsic factors. In this study, some degradation models, such as the gamma process model, were reviewed in terms of uncertainties associated with the continuous, gradual, and monotonic nature of fatigue crack growth. Statistically varying fatigue crack growth data obtained from Lu and Meeker were used as an example to demonstrate the use of the gamma process model. This model can describe the condition and lifetime as statistical distribution curves whose shapes vary with cycles. From the skewness of the statistical distribution curves, it was confirmed that the median is suitable for being considered as the expected life. The use of the gamma process model enables the optimum replacement period and percentile life to be employed as criteria for preventive maintenance policy.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.1
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• pp.54-57
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• 2010

Foreign body aspiration (FBA) into the tracheobronchial tree could be life threatening requiringprompt intervention. Any objects placed in the oral cavity put patients at a risk of aspirating or swallowing the objects slipped or broken by physical injuries. Here, we report a case of 30 yr old patient with FBA during gold crown replacement was successfully treated with the use of the flexible bronchoscope. Case: A 30 yr old woman was admitted to Seoul National Dental Hospitalfor an amalgam restoration. She was scheduled to gold crown restoration for replacement of the damaged amalgam at #37 site. After performing crown lengthening procedure, the aspiration of gold crown occurred during the cementation of the crown. After aspiration, the patients complained of the subjective distress of respiration. Chest radiograph revealed that gold crown was enlodged to the left bronchus. Flexible fiberoptics was inserted to the bronchus to remove the aspirated crown. Fiberoptic assisted removal of the aspiratedcrown was successfully performed. After removal, there was no radiopaque material in the left bronchus on follow-up chest radiograph. Discussion: When aspiration of dental materials occurs, flexible fiberoptic can be used in the treatment of FBA. It is also very useful to take preventive management such as rubber dam, application of dental floss in dental procedure where there is high likelihood of FBA.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.350-355
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• 2016

Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.230-239
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• 2016

Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.249-251
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• 2016

Objectives: Nail salon owners in New York City (NYC) are required to provide their workers with gloves and it is their responsibility to maintain healthy, safe working spaces for their employees. The purpose of this study was to determine the frequency with which nail salon workers wear protective gloves. Methods: A Freedom of Information Law request was submitted to New York Department of State's Division of Licensing Services for a full list of nail salons in Manhattan, NYC. A sample population of 800 nail salons was identified and a simple random sample (without replacement) of 30% (n=240) was selected using a random number generator. Researchers visited each nail salon from October to December of 2015, posing as a potential customer to determine if nail salon workers were wearing gloves. Results: Among the 169 salons in which one or more workers was observed providng services, a total of 562 workers were observed. For 149 salons, in which one or more worker was observed providing services, none of the workers were wearing gloves. In contrast, in six of the salons observed, in which one or more workers was providing services, all of the workers (1 in 2 sites, 2 in 1 site, 3 in 2 sites, and 4 in 1 site) were wearing gloves. Almost three-quarters of the total number of workers observed (n=415, 73.8%) were not wearing gloves. Conclusions: The findings of this study indicate that, despite recent media attention and legislation, the majority of nail salon workers we observed were not wearing protective gloves when providing services.

• Journal of Preventive Medicine and Public Health
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• v.51 no.5
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• pp.257-262
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• 2018

Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.