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The Impact of Service Level Management(SLM) Process Maturity on Information Systems Success in Total Outsourcing: An Analytical Case Study (토털 아웃소싱 환경 하에서 IT서비스 수준관리(Service Level Management) 프로세스 성숙도가 정보시스템 성공에 미치는 영향에 관한 분석적 사례연구)

  • Cho, Geun Su;An, Joon Mo;Min, Hyoung Jin
    • Asia pacific journal of information systems
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    • v.23 no.2
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    • pp.21-39
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    • 2013
  • As the utilization of information technology and the turbulence of technological change increase in organizations, the adoption of IT outsourcing also grows to manage IT resource more effectively and efficiently. In this new way of IT management technique, service level management(SLM) process becomes critical to derive success from the outsourcing in the view of end users in organization. Even though much of the research on service level management or agreement have been done during last decades, the performance of the service level management process have not been evaluated in terms of final objectives of the management efforts or success from the view of end-users. This study explores the relationship between SLM maturity and IT outsourcing success from the users' point of view by a analytical case study in four client organizations under an IT outsourcing vendor, which is a member company of a major Korean conglomerate. For setting up a model for the analysis, previous researches on service level management process maturity and information systems success are reviewed. In particular, information systems success from users' point of view are reviewed based the DeLone and McLean's study, which is argued and accepted as a comprehensively tested model of information systems success currently. The model proposed in this study argues that SLM process maturity influences information systems success, which is evaluated in terms of information quality, systems quality, service quality, and net effect proposed by DeLone and McLean. SLM process maturity can be measured in planning process, implementation process and operation and evaluation process. Instruments for measuring the factors in the proposed constructs of information systems success and SL management process maturity were collected from previous researches and evaluated for securing reliability and validity, utilizing appropriate statistical methods and pilot tests before exploring the case study. Four cases from four different companies under one vendor company were utilized for the analysis. All of the cases had been contracted in SLA(Service Level Agreement) and had implemented ITIL(IT Infrastructure Library), Six Sigma and BSC(Balanced Scored Card) methods since last several years, which means that all the client organizations pursued concerted efforts to acquire quality services from IT outsourcing from the organization and users' point of view. For comparing the differences among the four organizations in IT out-sourcing sucess, T-test and non-parametric analysis have been applied on the data set collected from the organization using survey instruments. The process maturities of planning and implementation phases of SLM are found not to influence on any dimensions of information systems success from users' point of view. It was found that the SLM maturity in the phase of operations and evaluation could influence systems quality only from users' view. This result seems to be quite against the arguments in IT outsourcing practices in the fields, which emphasize usually the importance of planning and implementation processes upfront in IT outsourcing projects. According to after-the-fact observation by an expert in an organization participating in the study, their needs and motivations for outsourcing contracts had been quite familiar already to the vendors as long-term partners under a same conglomerate, so that the maturity in the phases of planning and implementation seems not to be differentiating factors for the success of IT outsourcing. This study will be the foundation for the future research in the area of IT outsourcing management and success, in particular in the service level management. And also, it could guide managers in practice in IT outsourcing management to focus on service level management process in operation and evaluation stage especially for long-term outsourcing contracts under very unique context like Korean IT outsourcing projects. This study has some limitations in generalization because the sample size is small and the context itself is confined in an unique environment. For future exploration, survey based research could be designed and implemented.

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A Study of the Attitudes of Nonpsychiatric Registered Nurses towards Mental illness and Mental Patients (비정신과 간호원의 정신질환 및 정신질환자에 대한 태도 조사 연구)

  • 박예숙
    • Journal of Korean Academy of Nursing
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    • v.3 no.2
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    • pp.31-43
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    • 1973
  • The trend in modern nursing is toward the performance of comprehensive nursing care. Psychiatric nursing emphasizes education which enables the nurse to understand the underlying difficulties being expressed through a wide range of emotions and through practice to be more adept in her selection of a manner of approach which best meets the needs of a given situation. Presently, in Korea, there is nothing in the literature regarding evaluation of the effect of psychiatric nursing education on the attitudes of nurses towards mental illness and mentally ill patients. This stud!1 was attempted in order to understand 1) some of the problems in psychiatric nursing education 2) some of tile factors which affect the attitudes of nurses towards mental illness and mental patients. A questionnaire, a Korean translation of the "Opinions about Mental illness Scale" by Cohen and Stranding, 1962, was administered to 188 nonpsychiatric registered nurses employed in Yonsei University Hospital (Y. Hospital) and Seoul National University Hospital (S. Hospital) located in the city of Seoul. All of the nurses were directly involved with adult patient care. They graduated from various nursing schools. The data was collected during the period of October 2 to October 16,1972. The age, educational background , marital status, type of previous psychiatric experience, experience as a graduate nurse and close personal relationship with someone who was a psychiatric patient were compared with the O.M.I. scores. The mean and standard errors for each of the comparison groups were computed and tile relationships calculated by a t-test. The results of the study are summarized as follow: 1. There is no significant difference between the age of the nurses and their attitudes toward mental illness and mental patients. 2. There is no significant difference between the. educational backgrounds of the nurses and their attitudes toward mental illness and mental patients. 3. There is a significant difference in the nurses ′student psychiatric nursing experience and their attitudes towards mental illness and mental patients for the nurses in 5. Hospital only. The nurses who had 3-4 week of student psychiatric nursing experience had a significantly higher mean score for Benevolence (factor B) than nurses whose student psychiatric experience had been less than 1 Ivcek (P<0.05). The nurses who had 1-2 weeks, 3-4 weeks and more than 4 weeks of student psychiatric nursing experience had significantly higher mean scores for Interpersonal Ethology (factor E) than nurses whose student psychiatric had been less than 1 week (p<0.05), 4. There is a significant difference in the nurses′student psychiatric nursing experience by types of institution and their attitudes towards mental illness and mental patients for S. Hospital nurses only. The nurses who had their student psychiatric nursing experience in the government psychiatric hospitals recorded significantly higher mean score for Authoritarianism (factor A) than nurses who had their. experience in private psychiatric hospitals (p<0.05). 5. There is no significant difference in the nurses′psychiatric nursing experience as a graduate nurse and their attitudes toward mental illness and mental patients. 6. There is no significant difference in the nature and variety of the nurses′experience as a graduate nurse and their attitude toward mental illness and mental patients. 7. There is no significant difference in the presence or absence of a close personal relationship with a mentally ill person and the nurses′attitude toward mental illness and mental patients. 8. There is no significant difference in the nurses′ marital status and their attitude toward mental illness and mental patients. 9. There is no significant difference between the nurses who were employed ill S. and Y. hospitals and their attitudes towards mental illness and mental patients. Major suggestion for further study was to have more larger and wider scale research for establishing of the reliability and validity of the Korean translation of the O.H.I. Scale.

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Ontology-based Course Mentoring System (온톨로지 기반의 수강지도 시스템)

  • Oh, Kyeong-Jin;Yoon, Ui-Nyoung;Jo, Geun-Sik
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.149-162
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    • 2014
  • Course guidance is a mentoring process which is performed before students register for coming classes. The course guidance plays a very important role to students in checking degree audits of students and mentoring classes which will be taken in coming semester. Also, it is intimately involved with a graduation assessment or a completion of ABEEK certification. Currently, course guidance is manually performed by some advisers at most of universities in Korea because they have no electronic systems for the course guidance. By the lack of the systems, the advisers should analyze each degree audit of students and curriculum information of their own departments. This process often causes the human error during the course guidance process due to the complexity of the process. The electronic system thus is essential to avoid the human error for the course guidance. If the relation data model-based system is applied to the mentoring process, then the problems in manual way can be solved. However, the relational data model-based systems have some limitations. Curriculums of a department and certification systems can be changed depending on a new policy of a university or surrounding environments. If the curriculums and the systems are changed, a scheme of the existing system should be changed in accordance with the variations. It is also not sufficient to provide semantic search due to the difficulty of extracting semantic relationships between subjects. In this paper, we model a course mentoring ontology based on the analysis of a curriculum of computer science department, a structure of degree audit, and ABEEK certification. Ontology-based course guidance system is also proposed to overcome the limitation of the existing methods and to provide the effectiveness of course mentoring process for both of advisors and students. In the proposed system, all data of the system consists of ontology instances. To create ontology instances, ontology population module is developed by using JENA framework which is for building semantic web and linked data applications. In the ontology population module, the mapping rules to connect parts of degree audit to certain parts of course mentoring ontology are designed. All ontology instances are generated based on degree audits of students who participate in course mentoring test. The generated instances are saved to JENA TDB as a triple repository after an inference process using JENA inference engine. A user interface for course guidance is implemented by using Java and JENA framework. Once a advisor or a student input student's information such as student name and student number at an information request form in user interface, the proposed system provides mentoring results based on a degree audit of current student and rules to check scores for each part of a curriculum such as special cultural subject, major subject, and MSC subject containing math and basic science. Recall and precision are used to evaluate the performance of the proposed system. The recall is used to check that the proposed system retrieves all relevant subjects. The precision is used to check whether the retrieved subjects are relevant to the mentoring results. An officer of computer science department attends the verification on the results derived from the proposed system. Experimental results using real data of the participating students show that the proposed course guidance system based on course mentoring ontology provides correct course mentoring results to students at all times. Advisors can also reduce their time cost to analyze a degree audit of corresponding student and to calculate each score for the each part. As a result, the proposed system based on ontology techniques solves the difficulty of mentoring methods in manual way and the proposed system derive correct mentoring results as human conduct.

The Applicable Laws to International Intellectual Property License Contracts under the Rome I Regulation (국제 지식재산권 라이센스 계약 분쟁의 준거법 결정 원칙으로서 로마I 규정의 적용에 관한 연구)

  • Moon, Hwa-Kyung
    • Journal of Legislation Research
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    • no.44
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    • pp.487-538
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    • 2013
  • It is the most critical issue in recent international intellectual property licence disputes to decide the applicable laws to the license contracts. As Korea and the European Union(EU) reached free trade agreement(FTA), and the EU-Korea FTA entered into force on July 1, 2011, the FTA has boosted social, economic, cultural exchanges between the two. As a result of the increased transactions in those sectors, legal disputes are also expected to grow. This situation calls for extensive research and understanding of the choice of law principles applicable to international intellectual property license contracts in the EU. To decide the laws applicable to issues arising from international intellectual property license contracts disputes, the characterization of those issues is necessary for the purpose of applying private international law principles to them. In terms of characterization, intellectual property license contracts fall within contractual matters. In the EU, the primary rule of choice of law principles in contractual obligations is the Rome I Regulation. Because the choice of law rules, such as private international law principles, the Rome Convention(1980), and the Rome I Regulation, differ in the time of application, it is essential to clarify the time factor of related contracts. For example, the Rome I Regulation applies to contracts which were concluded as from December 17, 2009. Although party autonomy in international contracts disputes is generally allowed, if there is no choice of law agreement between the parties to the contracts, the objective test rule of private international law doctrine could be the best option. Following this doctrine, the Rome I Regulation Article 4, Paragraph 1 provides the governing law rules based on the types of contracts, but there is no room for intellectual property license contracts. After all, as the rule for governing law of those contracts, the Rome I Regulation Article 4, Paragraph 2 should be applied and if there are countries which are more closely connected to the contracts under the Rome I Regulation Article 4, Paragraph 3, the laws of those countries become the governing laws of the contracts. Nevertheless, if it is not possible to decide the applicable laws to the license contracts, the Rome I Regulation Article 4, Paragraph 4 should be applied in the last resort and the laws of the countries which are the most closely connected to the contracts govern the license contracts. Therefore, this research on the laws applicable to intellectual property license contracts under the Rome I Regulation suggests more systematic and effective solutions for future disputes in which Korea and the EU countries play the significant role as the connecting factors in the conflict of laws rules. Moreover, it helps to establish comprehensive and theoretical understanding of applying the Korean Private International Law to multifarious choice-of-law cases.

An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them (산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구)

  • 박주봉
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

A Study on Hepatomegaly and Facial Telangiectasia in a Group of the Insured (간종대(肝腫大)와 안면모세혈관확장(顔面毛細血管擴張)의 보험의학적연구(保險醫學的硏究))

  • Im, Young-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.4 no.1
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    • pp.110-132
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    • 1987
  • A study on hepatomegaly detected by abdominal palpation, and facial telangiectasia in a total of 3,418 insured persons medically examined at the Honam Medical Room of Dong Bang Life Insurance Company Ltd. from February, 1984 to August, 1985 was undertaken. The results were as follows: 1) Hepatomegaly was found in 383 cases(27.5%) among the 1,395 insureds of male and in 163 cases(8.1%) among the 2,023 insureds of female. The difference of incidence of hepatomegaly between all males and females showed statistical significance(p<0.001). In each age group, the incidence of hepatomegaly in :nale was higher than that in female. The incidence of hepatomegaly in each age group in male increased cnosiderably with age; it showed 11.6%,16.2%, 42.6% and 52.9% from second to sixth decade in order, thereafter in seventh decade it decreased to 26.7%, While the incidence of hepatomegaly in female increased slightly in each age group. 2) Facial telangiectasia was found in 318 cases(22.8%) among all males and in 157 cases(7.8%) among all females. The difference of incidence of telangiectasia between all males and females showed statistical significance(p<0.001). In each age group, the incidence of telangiectasia in male was higher than that in female, except of second decade. The incidence of facial telangiectasia in each age group in male increased considerably with age; while it increased slightly in female. 3) Facial telangiectasia accompanied by hepatomegaly was found in 235 cases(61.4%) among 383 cases of hepatomegaly in male and in 69 cases(42.3%) among 163 cases of hepatomegaly in female. The difference of incidence of telangiectasia between males and females show ed statistical significance(p<0.001). 4) Facial telangiectasia without spider angiomata accompanied by hepatomegaly was found in 201 cases(52.5%) among 383 cases of hepatomegaly in all males and in 67 casgs(41.4%) among 163 cases of hepatomegaly in all females; facial spider angiomata accompanied by hepatomegaly was found in 34 cases(8.9%) among 383 cases of hepatomegaly in all males and in 2 cases(1.2%) among 163 cases of hepatomegaly in all females. 5) Abnormal SGOT activity was found in 19 cases(7.9%) among 242 cases of hepatomegaly in all males and in one case(1.5%) among 67 cases of hepatomegaly in all females. The difference of incidence of abnormal SGOT activity showed statistical significance(p<0.001). The incidence of abnormal SGOT activity by the size of hepatomegaly, that is, palpated <1 finger's breadth, <2 fingers' breadth and ${\geqq}2$ fingers' breadth, revealed 2.2%, 6.0% and 60.0% respectively in all males, while abnormal SGOT activity was found only one case in fifth decade among 67 cases of hepatomegaly in all females. 6) In ordinary medical examination(the insured amount is low) abnormal SGOT activity was found in 7 cases(4.8%) among 146 cases of hepatomegaly palpated $1\frac{1}{2}$ fingers' breadth and under, while it was not found in 37 cases of the same sized hepatomegaly in all females. Above mentioned 7 cases are thought to be very significant because 7 cases occupy 35% in 20 cases of abnormal SGOT activity with hepatomegaly. 7) Abnormal SGOT activity was found in 12 cases(4.4%) among 273 cases of hepatomegaly of "not firm" consistency, while it was found in 8 cases(22.2%) among 36 cases of hepatomegaly of "firm" consistency. The difference of incidence of abnormal SGOT activity showed statistical significance(p<0.05). 8) Abnormal SGOT activity was found in 5 cases(17.9%) among 28 cases of spider angiomata with hepatomegaly, while it was found in 10 cases(7.3%) among 166 cases of telangiectasia without spider angiomata with hepatomegaly. Owing to a small number of cases, statistical significance was not recognized, but the incidence of abnormal SGOT activity in spider angiomata cases with hepatomegaly is apt to be higher than that in telangiectasia cases without spider angiomata with hepatomegaly. 9) The incidence of abnormal SGOT activity is apt to be higher with age in male group; abnormal SGOT activity was not found among 4 cases of hepatomegaly in second decade and it was 3.8% in third decade, 4.5% in fourth decade, 9.3% in fifth decade, 17.5% in sixth decade and 33.3% in seventh decade, while the incidence of it was only one case among 67 cases in all females. 10) It is believed that the performance of liver function test to the subjects with hepatomegaly even in ordinary medical examination(the insured amount is low) will give considerable contribution for medical selection of hepatomegaly risk. 11) Age of the insured(young or old), presence of facial telangiectasia or spider angiomata especially and their severity, and consistency of enlarged liver(firm or not) should be considered to increase accuracy in evaluating hepatomegaly risk.

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A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment (지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例))

  • Sohn, Chang-Ho;Shin, Min-Sup;Hong, Kang-E;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.85-95
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    • 1996
  • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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Development of a Device for Estimating the Optimal Artificial Insemination Time of Individually Stalled Sows Using Image Processing (영상처리기법을 이용한 스톨 사육 모돈의 인공수정적기 예측 장치 개발)

  • Kim, D.J.;Yeon, S.C.;Chang, H.H.
    • Journal of Animal Science and Technology
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    • v.49 no.5
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    • pp.677-688
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    • 2007
  • 돼지를 포함한 대부분의 동물은 일정한 발정주기를 가지고 일정한 시기에 배란을 하는 자연배란동물이지만, 토끼, 고양이, 밍크 등의 암놈은 교미자극에 의해 배란이 일어나는 유기배란동물이다. 또한 1년에 한 번만 발정하는 단발정동물과 1년에 수차례 발정하는 다발정동물이 있다. 이 중에서 모돈은 1년에 수차례 발정하는 다발정 동물로서 발정기에 들면 비발정기와는 다른 행동을 나타낸다(Diehl 등, 2001). 양돈가의 수익을 최대화하기 위해서는 비생산일수를 최소로 줄여야 한다. 모돈의 비생산일수를 줄일 수 있는 한 가지 방법은 성공적으로 교배를 시키는 것이다. 이처럼 성공적으로 교배를 시키기 위해서는 수정적기를 정확히 예측해야 한다. 만약 수정적기를 정확히 판단하지 못하여 수태가 되지 않으면, 비생산일수가 늘어나 손실을 입게 된다. 따라서 수정적기를 정확히 판단하는 것은 모돈의 성공적인 인공수정에 있어서 중요한 요소이다. 수정적기는 배란이 일어나기 전 10시간에서 12시간 사이이며, 발정이 시작되는 시점을 기준으로 하였을 때 경산돈의 경우 26시간에서 34시간 사이이고 미경산돈의 경우는 18시간에서 26시간 사이이다(Evans 등, 2001). 현재 하루에 두 번 모돈의 발정을 확인하는 것이 일반화되어 있으며, 이 때 웅돈을 접촉시키거나 육안관찰을 통하여 발정 유무를 판단한다. 이러한 방법에는 숙련된 기술과 풍부한 경험이 요구될 뿐만 아니라 총 소요노동력의 30% 정도가 요구된다(Perez 등, 1986). 하루에 두 번밖에 발정을 감지하지 않기 때문에 발정이 언제 시작되었는지를 정확히 알 수 없으며, 또한 발정의 대부분이 새벽에 시작되므로 수정적기를 정확히 판단하기란 매우 어렵다. 만약 발정을 감지했더라도 적기에 인공수정을 하지 못한다면, 수태율이 낮아지므로 경제적 손실이 초래된다. 현재 이러한 문제점 때문에 2회에서 3회에 걸쳐 인공수정을 하고 있으나 이에 따른 소요비용과 소요노동력 등은 양돈가의 부담을 가중시키는 요인이 되고 있다. 돼지는 발정기가 되면 비발정기에 나타내지 않던 외음부의 냄새를 맡는 행동, 귀를 세우는 행동 및 승가허용 행동 등을 나타낸다(Diehl 등, 2001). 또한 돼지는 비발정기에 비하여 발정기에 더 많은 활동량을 나타낸다(Altman, 1941; Erez and Hartsock, 1990). Freson 등(1998)은 스톨에서 개별적으로 사육되고 있는 모돈의 활동량을 적외선센서를 이용하여 측정함으로써 발정을 86%까지 감지하였다고 보고하였다. 그러나 이 연구는 단지 모돈의 발정을 감지하였을 뿐 번식관리에 있어서 가장 중요한 수정적기의 판단 기준을 제시하지 못하였다. 따라서, 본 연구는 스톨에서 사육되는 모돈의 활동량을 측정함으로써 발정시작시각을 감지하고 이를 기준으로 인공수정적기를 예측할 수 있는 인공수정적기 예측 장치를 개발한 후 이의 성능을 농장실증실험을 통하여 시험하고자 수행되었다.

Optimal Operation of Gas Engine for Biogas Plant in Sewage Treatment Plant (하수처리장 바이오가스 플랜트의 가스엔진 최적 운영 방안)

  • Kim, Gill Jung;Kim, Lae Hyun
    • Journal of Energy Engineering
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    • v.28 no.2
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    • pp.18-35
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    • 2019
  • The Korea District Heating Corporation operates a gas engine generator with a capacity of $4500m^3 /day$ of biogas generated from the sewage treatment plant of the Nanji Water Recycling Center and 1,500 kW. However, the actual operation experience of the biogas power plant is insufficient, and due to lack of accumulated technology and know-how, frequent breakdown and stoppage of the gas engine causes a lot of economic loss. Therefore, it is necessary to prepare technical fundamental measures for stable operation of the power plant In this study, a series of process problems of the gas engine plant using the biogas generated in the sewage treatment plant of the Nanji Water Recovery Center were identified and the optimization of the actual operation was made by minimizing the problems in each step. In order to purify the gas, which is the main cause of the failure stop, the conditions for establishing the quality standard of the adsorption capacity of the activated carbon were established through the analysis of the components and the adsorption test for the active carbon being used at present. In addition, the system was applied to actual operation by applying standards for replacement cycle of activated carbon to minimize impurities, strengthening measurement period of hydrogen sulfide, localization of activated carbon, and strengthening and improving the operation standards of the plant. As a result, the operating performance of gas engine # 1 was increased by 530% and the operation of the second engine was increased by 250%. In addition, improvement of vent line equipment has reduced work process and increased normal operation time and operation rate. In terms of economic efficiency, it also showed a sales increase of KRW 77,000 / year. By applying the strengthening and improvement measures of operating standards, it is possible to reduce the stoppage of the biogas plant, increase the utilization rate, It is judged to be an operational plan.