• 한국산학기술학회논문지
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• 제19권5호
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• pp.681-688
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• 2018

최근 강화된 환경규제 및 높은 연비에 대한 요구로 인해 천연가스를 연료로 사용하는 선박이 증가하고 있다. 친환경 선박 연료로 대두되고 있는 LPG 혹은 메탄올을 사용한 선박의 요구도 증가하고 있다. 이러한 흐름의 연장선상으로 LPG 혹은 메탄올을 사용하는 ME-LGI 엔진에 대한 연구가 최근 활발히 이루어지고 있다. ME-LGI 엔진을 탑재한 선박은, 선박 항해 중 연료분사밸브의 작동 신뢰도를 지속적인 테스트를 통해 확인해야할 필요가 있다. 따라서 연료분사밸브 테스터의 개발은 ME-LGI 엔진의 상용화를 위해 반드시 필요하다. 이에 본 연구에서는 요구조건 분석, 기능분석, 설계 합성의 순서로 진행되는 시스템 엔지니어링 프로세스를 활용하여 ME-LGI 엔진용 연료분사밸브 테스터의 개념설계를 수행하였다. 요구조건 분석 단계에서 먼저 연료분사밸브의 작동 프로세스를 분석하였고, 밀폐 오일 누유 여부 확인의 필요성을 도출하였다. 그 다음 기능분석 단계에서 연료분사밸브 테스터의 기능 및 기능의 흐름을 수준별로 정의하였다. 이후 설계 합성 단계에서 각 기능에 해당하는 장비들을 설정하였고, 이를 바탕으로 process block diagram을 도출하였다. 또한 시스템 분석 및 조정 단계의 일환으로 초기위험도 분석을 수행하여 안전 방안을 개념설계 안에 추가하였다. 본 연구는 시스템 엔지니어링 프로세스가 개념설계에 적용되는 과정을 상세히 보여줌으로써 향후 타 시스템의 개념 설계 시 좋은 참고자료가 될 수 있을 것으로 기대된다.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.69-74
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• 2017

Background: Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. Methods: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. Results: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules ($204.4{\pm}102.9$ vs. $129.9{\pm}93.6pg/mL$, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased ($2.8{\pm}1.6$ vs. $3.2{\pm}1.9mm$, p=0.003), but the number of nodules did not change ($1.2{\pm}1.9$ vs. $1.4{\pm}2.0$, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. Conclusion: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10255-10262
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• 2015

High risk human papillomavirus (HR-HPV) E2 proteins play roles in transcriptional regulation and are commonly functionally disrupted when the HPV genome integrates into host chromosomes. Some 15-40% of cancer cases, however, contain an intact E2 gene or episomal HPV. In these cases, polymorphism of the E2 gene might be involved. This study aimed to determine polymorphisms of the E2 gene in episomal HPV16 detected in high grade squamous intraepithelial lesions and squamous cell carcinomas and altered functions compared to the E2 prototype. The E2 gene was amplified and sequenced. Two expression vectors containing E2 gene polymorphisms were constructed and transfected in SiHa and C33A cells, then E6 gene as well as Il-10 and TNF-${\alpha}$ expression was determined by quantitative RT-PCR. Expression vectors and reporter vectors containing the HPV16 long control region (LCR) were co-transfected and transcriptional activity was determined. The results showed that a total of 32 nucleotides and 23 amino acids were changed in all 20 cases of study, found in the transactivation (TA) domain, hinge (H) region and DNA binding (DB) domain with 14, 5 and 13 nucleotide positions. They mostly caused amino acid change. The expressing vectors containing different E2 gene polymorphisms showed E6 mRNA suppression, TNF-${\alpha}$ mRNA suppression and IL-10 induction but no statistically significant differences when compared to the E2 prototype. Moreover, promoter activity in HPV16 LCR was not affected by E2 protein with different gene polymorphisms, in contrast to nucleotide variations in LCR that showed an effect on transcription activity. These results demonstrated that E2 gene polymorphisms of episomal HPV16 did not affect transcriptional regulation and suggested that nucleotide variation as well as epigenetic modification of the LCR might play a role in inducing malignant transformation of cells containing episomal HPV16.

• 한국유통학회지:유통연구
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• 제12권2호
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• pp.23-49
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• 2007

본 연구는 혁신적인 서비스전달채널의 수용과정을 설명하는데 있어, 기존의 수용관련 연구에서 논의되어온 수용대상에 대한 지각된 속성을 혜택, 비용 및 위험 차원에서 구성요인을 통합하여 각 요인이 수용의도에 미치는 직 간접적 영향관계를 살펴보고, 또한 기존 연구에서 간과되어왔던 이미 이용 중에 있는 기존채널에 대한 이용경험 요인이 기존채널과의 관계에 대한 장기지향성 즉, 지속적 이용의도의 형성과정 및 신규 서비스전달채널의 수용의도에 미치는 영향과정을 모형화하고 실증적 검증을 시도하고 있다. 연구결과, 기존 연구에서 주로 수행되었던 신규 수용대상의 특성에 대한 지각뿐만 아니라 사회교환이론에 기반한 기존채널에 대한 만족도와 대안적 채널의 매력도 등 과정적 변수로서 태도요인의 고려를 통해 상호작용적인 관점에서 수용행동의 결정과정을 설명하는 것이 타당함을 보여주었다. 통합된 구성개념으로서 수용채널의 특성에 대한 지각은 수용채널에 대한 매력도에 유의한 영향관계를 미치는 것으로 나타났으며, 과정적 태도변수로서 기존채널에 대한 만족도와 신규채널에 대한 매력도는 수용행동에 긍정적인 영향을 미치는 것으로 나타났다. 이러한 실증결과를 바탕으로 다채널 이용 상황에서의 신규 서비스채널의 수용은 기존채널의 이용을 종결시키는 것이 아니기 때문에 신규채널의 수용을 기존 서비스채널의 이용경험과 대안의 매력도 등 다차원적 측면에서 고려하여야 할 것이고, 수용 후 확산에 대한 문제 또한 기존채널의 이용 연속선상에서 기존채널과 신규채널을 모두 고려해야 되는 등 통합적인 마케팅전략에 대한 관리적 시사점을 제시하였다.

• 보험의학회지
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• 제24권
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• pp.97-117
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• 2005

Internally Korean insurance market is that whole life products' growth are becoming slowdown that's why new insurance products have appeared on the market in consideration of consumer's needs recently. Externally domestic insurance market competitions has drifted from insurance industry to whole financial industry since bankasurance started. Life insurance companies should open up a new market to survive from severe competitions. Worksite marketing can be an alternative. An insurer make arrangements with an employer about an insurance terms which an insurer offers in Worksite marketing. Then eligible individuals enroll in the plans at their own discretion and pay 100 percent of the premium for coverage through payroll deductions. An employer doesn't need to pay extra money for additional benefit but can raise employee's loyalty and satisfaction of company through worksite marketing. An employee can be covered at discounted premium rate and less strict underwriting guidelines to an insurer compared to individual insurance. In developed countries specially U.S insurance market, Worksite marketing is getting very popular and growing rapidly due to the advantages. Worksite marketing has both individual insurance characters and group insurance characters. Individual insurance characters are that employees enroll in the plans at their own discretion and pay 100 percent of the premium for coverage. Group insurance characters are that actively at work and participation etc. An insurer have to reflect these two characters on Worksite marketing when an insurance company work out a plan for developing products and underwriting guidelines. When an insurer devise worksite products, one should consider participation level which means percentage of eligible employees participating. Participation is related to anti-selection. As we know underwriting is essential for every kind of insurance, especially underwriting plays major role in worksite marketing. We can see that in the below. Firstly, it has a function in calculation of premium rate. When calculate premium rate for worksite products underwriters have to estimate expected participation level and risk factors. So underwriters and acturies keep in close contact with each other. Secondly, underwriting methods are important. When an insurer underwrite worksite products, there are three kinds of underwriting methods. These are Simplified issue underwriting, Full underwriting and Guaranteed issue underwriting. Simplified issue underwriting typically requires no medical examination, but usually requires supplying satisfactory answers to one or several health and/or lifestyle questions. Full underwriting requires a complete medical history questionnaire that may further require an exam. Guaranteed issue underwriting means that coverage is issued without the employee having to provide evidence of insurability. When insurer set the GI limit are usually based on the type of industry, number of eligible employees, the average amount of coverage and participation level. In addition to insurer should have a clear definition of eligible employee on the insurance provision and application form. It will minimize possibility of trouble claims and anti-selection. An insurer also establish preexisting condition exclusion and special guidelines for late entrants. When an insurer introduce Worksite marketing to Korean insurance market, an insurer has to examine market research to analyze potential market and strategy of sales most of all. Also an insurer should review real situation of the U.S, England and Japanese market etc. There are a lot of new technologies about worksite marketing process that an insurer should learn. When an insurer consider many things which we explained it can be a real alternative.

• Journal of Chest Surgery
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• 제49권3호
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• pp.165-170
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• 2016

Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

• 한국수자원학회논문집
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• 제47권10호
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• pp.891-906
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• 2014

본 연구는 수계관리 측면에서 물 공급의 기준이 되는 하류 제어지점에서 발생할 수 있는 물 부족을 최소 허용하면서 저수지군 최적 운영방안을 제공할 수 있도록 위험도 평가기준을 목적함수 및 제약조건에 반영한 hedging rule을 혼합정수계획법(MIP, Mixed Integer Programming)으로 구성하고 이에 대한 이행도를 분석함으로써 기존의 용수공급 신뢰도에 중점을 두었던 저수지군 최적 운영 분석기법을 개선하고자 하였다. 이를 위해 한강수계 5개 저수지(소양강댐, 충주댐, 화천댐, 청평댐, 팔당댐)군을 대상으로 수계관리를 위한 모형을 구축하였으며, 한강수계 내에 총 8개의 가상 제어지점을 구성하여 댐 하류 제어지점에서의 물 부족에 대해 위험도를 평가하였으며, 개발된 hedging rule의 적정성을 검증하기 위하여 2개의 유입량 계열('93. 1월~'97. 12월, '99. 1월~'03. 12월)에 대하여 적용 검토하였다. 팔당댐 하류 제어지점의 월별 최소유량을 비교하면 '93. 1월~'97. 12월의 모의기간에서는 hedging rule 적용 시 $317.5{\times}10^6m^3$으로 단독운영의 $310.6{\times}10^6m^3$, 연계운영의 $56.3{\times}10^6m^3$ 보다 많은 유량을 보였으며, '99. 1월~'03. 12월의모의기간에서도 hedging rule 적용시 $243.7{\times}10^6m^3$ 으로 단독운영의 $204.2{\times}10^6m^3$, 연계운영의 $111.2{\times}10^6m^3$에 비해 최소 유량이 많은 것을 확인하였으며, 이는 제안한 hedging rule에 의해 하류 제어지점에서의 최대 물 부족량이 감소하는 결과를 보여주고 있다.

• 간호행정학회지
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• 제6권3호
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• pp.333-345
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• 2000

The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.443-449
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• 2015

Background: Myeloproliferative disorders (MPDs) are clonal hematologic malignancies originating at the level of the pluripotent hematopoietic stem cell. Matrix metalloproteases (MMPs) are proteolytic enzymes that contribute to all stages of malignancy progression. Genetic variants in the MMP genes may influence the biological function of these enzymes and change their role in carcinogenesis and progression. To our knowledge, this is the first investigation of associations between the -735 C/T and -1562 C/T polymorphisms in the MMP2 and MMP9 genes, respectively, and the risk of essential thrombocytosis (ET), and polycythemia vera (PV). Materials and Methods: The case-control study included JAK2V617F mutation positive 102 ET and PV patients and 111 controls. Polymorphisms were determined by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and electrophoresis. Results: No statistically significant differences were detected between patient (ET+PV) and control groups regarding genotype distribution for MMP2 gene-735 C/T and MMP9 gene -1562 C/T polymorphisms and C/T allele frequency (p>0.050). Statistically borderline significance was observed between PV and control groups regarding genotype distribution for the MMP9 gene -1562 C/T polymorphism (p=0.050, OR=2.26, 95%Cl=0.99-5.16). Conclusions: Consequently this study supported that CC genotype of MMP9 gene -1562 C/T polymorphism may be related with PV even if with borderline significance.

• 기본간호학회지
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• 제4권1호
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• pp.43-60
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• 1997

This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.