• 한국의료질향상학회지
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• 제2권2호
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• pp.112-129
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• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• 대한안전경영과학회:학술대회논문집
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• 대한안전경영과학회 2004년도 춘계학술대회
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• pp.271-276
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• 2004

The risk assessment model is an important subsystem for effective establishment and operation of EMS (environment management system). In case of poor risk assessment long-term and large-scale failure expense might be brought. Managing policy, target and other indices based on risk assessment can guarantee successful EMS. In this paper, we aim at comparative analysis of various risk methods and propose an alternative risk assessment model for EMS.

• 복합신소재구조학회 논문집
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• 제5권2호
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• pp.27-32
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• 2014

Since the collapse of historical masonry structures in Europe in the late 1990's, the interests in understanding the long-term effect of masonry under sustained compressive stresses have increased. That requires combining the significance of time-dependent effects of creep with the effect of damage due to overstress to realize the evolution of cracks and then failure in masonry. Meanwhile, composite analysis of masonry columns was proven effective for realizing ultimate strength capacity of masonry column. In this study, a simplified mechanical model with step-by-step in time analysis was proposed to incorporate the interaction of damage and creep to estimate the maximum stress occurred in masonry. It was examined that the interaction of creep and damage in masonry can accelerate the failure of masonry.

• 대한치과기공학회지
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• 제46권2호
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• pp.21-27
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• 2024

Purpose: This study aimed to analyze the stress distribution and deformation in implant abutments made from titanium (Ti-6Al-4V), zirconia, and polyetheretherketone (PEEK), including their screws and fixtures, under various loading conditions using finite element analysis (FEA). Methods: Three-dimensional models of the mandible with implant abutments were created using Siemens NX software (NX10.0.0.24, Siemens). FEA was conducted using Abaqus to simulate occlusal loads and assess stress distribution and deformation. Material properties such as Young's modulus and Poisson's ratio were assigned to each component based on literature and experimental data. Results: The FEA results revealed distinct stress distribution patterns among the materials. Titanium alloy abutments exhibited the highest stress resistance and the most uniform stress distribution, making them highly suitable for long-term stability. Zirconia abutments showed strong mechanical properties with higher stress concentration, indicating potential vulnerability to fracture despite their aesthetic advantages. PEEK abutments demonstrated the least stress resistance and higher deformation compared to other abutment materials, but offered superior shock absorption, though they posed a higher risk of mechanical failure under high load conditions. Conclusion: The study emphasizes the importance of selecting appropriate materials for dental implants. Titanium offers durability and uniform stress distribution, making it highly suitable for long-term stability. Zirconia provides aesthetic benefits but has a higher risk of fracture compared to titanium. PEEK excels in shock absorption but has a higher risk of mechanical failure compared to both titanium and zirconia. These insights can guide improved implant designs and material choices for various clinical needs.

• 구강회복응용과학지
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• 제38권2호
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• pp.97-109
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• 2022

목적: 3년 이상 기능한 임플란트의 장기 추적을 통해 임플란트 실패에 기여하는 위험지표를 조사하고 변연골소실(MBL)간의 상관관계를 분석하는 것이다. 연구 재료 및 방법: 2003년부터 2017년까지 전남대학교 치과병원에서 임플란트 수술 기왕력이 있는 환자의 진료기록부를 토대로 후향적 조사 시행하였다. 환자의 인구통계학적 변수 및 임상적 변수와 임플란트 주위 변연골소실 평가를 위한 치근단 방사선 사진을 사용하여 임플란트 생존율을 분석하였다. 환자의 임상변수와 임플란트 실패의 상관관계를 규명하기 위해 후진소거법을 이용한 다중회귀분석 시행하였고, 임플란트 장기생존율과 MBL 및 초기 안정성 간의 상관관계를 규명하기위해 Pearson 상관분석 시행하였다. 결과: 다중회귀분석 결과 지대주 연결 유형(β = -.189, P < .05), SPT 유무(β = -.163, P < .05), 당뇨(β = -.164, P < .05), 골수염(β = -.211, P < .05)이 MBL과 음의 상관관계가 있었다. 임플란트 장기 성공률에 항응고제, 임플란트 2차수술 시 PTV값이 영향을 미쳤다. 결론: 임플란트 장기 성공을 위해서는 적절한 지대주 연결 유형을 선택해야 하며, 주기적 SPT가 필요하다. 당뇨병, 골다공증 같은 전신 질환과 항응고제 사용 질환을 고려해야한다. 또한 임플란트 2차 수술시 높은 PTV가 임플란트 장기 생존율과 상관관계가 있기 때문에 보철 수복 전 초기 안정성을 신중히 고려해야한다.

• The Journal of Advanced Prosthodontics
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• 제14권3호
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• pp.182-202
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• 2022

PURPOSE. The aim of this study is to summarize various biomechanical aspects in evaluating the long-term stability of dental implants based on finite element method (FEM). MATERIALS AND METHODS. A comprehensive search was performed among published studies over the last 20 years in three databases; PubMed, Scopus, and Google Scholar. The studies are arranged in a comparative table based on their publication date. Also, the variety of modeling is shown in the form of graphs and tables. Various aspects of the studies conducted were discussed here. RESULTS. By reviewing the titles and abstracts, 9 main categories were extracted and discussed as follows: implant materials, the focus of the study on bone or implant as well as the interface area, type of loading, element shape, parts of the model, boundary conditions, failure criteria, statistical analysis, and experimental tests performed to validate the results. It was found that most of the studied articles contain a model of the jaw bone (cortical and cancellous bone). The material properties were generally derived from the literature. Approximately 43% of the studies attempted to examine the implant and surrounding bone simultaneously. Almost 42% of the studies performed experimental tests to validate the modeling. CONCLUSION. Based on the results of the studies reviewed, there is no "optimal" design guideline, but more reliable design of implant is possible. This review study can be a starting point for more detailed investigations of dental implant longevity.

• 한국신뢰성학회지:신뢰성응용연구
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• 제16권3호
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• pp.180-191
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• 2016

Purpose: The purpose of this study was to develop the accelerated life test method for Constant Electrical Potential Electrolysis gas sensor (CEPE gas sensor). Methods: The parts and modules of CEPE gas sensor were analyzed by using Reliability Block Diagram (RBD). Failure Mode and Effect Analysis (FMEA) and Quality Function Deployment (QFD) methods were performed for each part to determine the most affecting stress factor in its life cycle. The long term testing was conducted at three different dry heat levels and the acceleration factor was developed by using Arrhenius relationship. Conclusion: The acceleration factor for CEPE gas sensor was developed by using FMEA, QFD, and statistical analysis for its failure data. Also qualification tests were designed to meet the target life.

• 한국가스학회지
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• 제7권2호
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• pp.1-6
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• 2003

본 연구에서는 이미 개발되어 있는 부식결함의 잔존강도를 평가식을 이용하여 파단, 대누출, 소누출의 손상모드 예측하는 절차를 제시하였다. 또한 이 손상모드에 따라 손상확률을 예측할 수 있는 방법을 제시하고 여기에 부식속도 정보를 결합하면 일정기간 경과 후 손상확률도 예측할 수 있음을 보였다. 이 결과는 노후배관의 수명 또는 교체주기의 예측에 매우 유용하게 활용될 수 있을 것이라 판단된다.

• Journal of Chest Surgery
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• 제57권1호
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• pp.53-61
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• 2024

Background: In the treatment of esophageal cancer, a gastric conduit is typically the first choice. However, when the stomach is not a viable option, the usual alternative is a colon conduit. This study compared the long-term surgical outcomes of gastric and colon conduits over the same interval and aimed to identify factors influencing the prognosis. Methods: A retrospective review was conducted of patients who underwent esophagectomy followed by reconstruction for primary esophageal cancer between January 2006 and December 2020. Results: The study included 1,545 patients, with a gastric conduit used for 1,429 (92.5%) and a colon conduit for 116 (7.5%). Using propensity-matched analysis, 116 patients were selected from each group for comparison. No significant difference was observed in longterm survival between the gastric and colon conduit groups, irrespective of anastomosis level and pathological stage. A higher proportion of patients in the colon conduit group experienced postoperative complications compared to the gastric conduit group (57.8% vs. 25%, p<0.001). Multivariable analysis revealed that age over 65 years, body mass index below 22.0 kg/m², neoadjuvant therapy, postoperative anastomotic leakage, and renal failure were risk factors for overall survival in patients with a colon conduit. Regarding conduit-related complications, cervical nastomosis was the only significant risk factor among those with a colon conduit. Conclusion: Despite the association of colon conduits with high morbidity rates relative to gastric conduits, the long-term outcomes of colon conduits were acceptable. More consideration should be given perioperatively to the use of a colon conduit, particularly in cases involving cervical anastomosis.

• 대한심미치과학회지
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• 제27권2호
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• pp.75-81
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• 2018

본 연구의 목적은 기존의 다른 포스트-코어 재료와의 유한요소분석(FEA)의 비교를 통한 치과용 포스트-코어 재료로서의 고성능 폴리머 PEKK의 생체역학 및 장기 안전성을 평가하는 데 있다. 상악 중절치를 모델링 하였으며, 구개 표면에서 치아의 장축에 $45^{\circ}$의 각도로 50N의 반복 하중을 가했다. 전통적으로 사용 된 포스트 코어 재료와 비교하기 위해 3가지 재료 (금, 유리 섬유 및 PEKK)를 시뮬레이션하여 결과를 상호 비교 해 보았다. 상아질보다 낮은 탄성 계수를 갖는 PEKK는 종래의 포스트 코어 재료보다 비교적 치근에 유리한 응력 분포를 보여 주었다. 그러나, PEKK 포스트-코어 시스템은 금속 또는 유리 섬유 포스트-코어 시스템보다 장기간의 반복하중에 대해 타락 및 크라운 파손의 가능성이 더 높을 가능성이 있다.