ISO/IEC/IEEE 15288 기반 양산단계 무기체계 부품국산화 체계공학 개발관리 절차 적용 연구

김장은 ( Jang Eun Kim ),심보현 ( Bo Hyun Shim ),조유습 ( Yu Seup Cho ),성인철 ( In Chul Sung ),한동석 ( Dong Seog Han ) 한국품질경영학회 2016 품질경영학회지 Vol.44 No.3

Purpose: In this study, we propose that how to approach a effective system engineering and optimize system engineering management process for the mass production weapon system parts localization development process and success in DTaQ. Methods: To approach a effective system engineering for the mass production weapon system parts localization, we analyze a weapon system acquisition process and system engineering process of Republic of Korea and DTaQ parts localization business regulations in advance. after results of analysis of them, we implement a optimized parts localization development system engineering based on ISO/IEC/IEEE 15288. Results: In order to apply International Standard ISO/IEC/IEEE 15288 to the mass production weapon system parts localization development process, we compare the mass production weapon system parts localization acquisition environment with ISO/IEC/IEEE 15288 and analyze them. therefore, It is possible to implement a part of concept stage and development stage of ISO/IEC/IEEE total life cycle stage for the mass production weapon system parts localization development process. To achieve the technical review milestones of DTaQ parts localization business regulations in the selected stages of ISO/IEC/IEEE, the development and management agency perform 2 high rank process and 19 low rank process specified in ISO/IEC/IEEE. Conclusion: When the development and management agency perform the mass production weapon system parts localization development using the proposed system engineering approach, they should easily meet milestone through the clarified requirement and simplified System Engineering output documents in limited development period.

농촌지역 모성의 산전관리서비스 이용양상과 그 결정요인

김장락,박정한,이재경,서상홍,방준용,Kim, Jang-Rak,Park, Jung-Han,Lee, Jae-Kyong,Seo, Sang-Hong,Bang, Joon-Yong 대한예방의학회 1993 Journal of Preventive Medicine and Public Health Vol.26 No.4

농촌지역의 모성을 대상으로 산전관리서비스 이용양상과 그 결정요인을 규명하기 위하여 서부 경남 3개군(합천군, 사천군, 진양군)에서 1990년 7월 1일부터 1991년 6월 30일 사이에 분만한 모성 1,489명중 65.5%인 976명을 훈련된 면보건요원들이 1992년 1월 3일에서 1992년 2월 15일사이에 면담조사하였다. 의료서비스 이용의 관련요인을 포괄적으로 포함하는 Anderson의 의료이용 행태모형을 기본분석모형으로 하고 종속변수는 산전진찰의 회수, 그것을 설명하는 독립변수로는 의료요구요인, 개인의 속성요인, 가능성요인 그리고 기타요인의 변수들을 설정하였다. 조사대상자들의 산전진찰 수진율은 97.3%로 높은 편이었으나 10회 이상의 수진율은 20.6%로 전문가에 의해 추천되는 정상임신시 $10{\sim}12$회의 산전진찰회수에는 미흡하였다. 산전진찰의 저이용(미수진 또는 4회 이하의 수진)은 모성의 낮은 교육수준, 출생아의 출생순위가 두번째 이상, 의료보호 대상자, 의원이 없는 지역, 임신중 진단된 질병이 없을 때 그리고 모성의 직업이 농업인 경우 등과 관련이 있었다. 그러나 거주지 군의 변수(즉 지역내 모자보건센터 유무)는 유의한 관련성이 없었다. 산전진찰의 저이용은 인구학적 변수라 할 수 있는 출생아의 출생순위, 의료요구요인인 임신중 진단된 질병의 유무와도 높은 관련성이 있기는 하나, 더 많은 부분이 어머니의 교육수준, 어머니의 직업이라는 사회구조적 요인과 의료보장의 종류, 지역내 의원의 유무라는 가능성요인과 관련이 있어 균점을 이루지 못하고 있다. 또 변경성이란 견지에서 보면 변경성이 높은 가능성요인에 의해서 상당부분 설명되고 있어 보건정책적으로 해결 가능성이 있는 것을 시사한다. 예를 들면 의료보호 대상자와 의원이 없는 지역 산모들의 산전진찰 서비스의 접근성을 높히는 방안을 마련하는 것을 고려할 수 있다. To study the pattern of prenatal care utilization and its determinants in rural Korea, 976 mothers (65.5%) out of 1,489 living mothers in Chinyang, Sachon and Hapchon Counties in Kyongsangnam Province who had delivered a baby between July 1, 1990 and June 30, 1991 were interviewed by the Myon health workers from January 3 through February 15, 1992. The Anderson's behavioral model for health service utilization was applied to develop the frames for analysis. The dependent variable was a number of prenatal care visits. And the independent variables included In the model were the variables pertaining to the predisposing, enabling, medical need and other components. The proportion of mother who had ever received the prenatal care service for the index pregnancy was 97.3%. However, the proportion of mothers who had made more than 10 visits was only 20.6%, which indicated that majority of mothers had paid far less visits than recommended $10{\sim}12$ visits for each normal pregnancy. The low utilization of prenatal care services (none or less than 4 visits) was related to mother's low educational level, the high birth order, beneficiary of the medical aid, the absence of clinic in the community, no diagnosed disease of mother during pregnancy, and mothers engaged in farming. Inequity of access seemed to exist because social structure variables and the variables of enabling component were important predictors. And there seemed to be high mutability in equalizing the distribution of prenatal care services because the variables of enabling component such as type of medical security and whether there was a clinic or not in the community were substantially important.

수중 환경 소음 모델이 적용된 의사 스펙트럼 시간영역 법 합성환경 수중음향채널 모델링 및 시뮬레이션

김장은,김동길,한동석,Kim, Jang-Eun,Kim, Dong-Gil,Han, Dong-Seog 한국시뮬레이션학회 2016 한국시뮬레이션학회 논문지 Vol.25 No.3

수중환경에서 운영되는 무기체계 획득을 위한 설계/개발을 진행하기 위해 수중음향채널 모델링 및 시뮬레이션을 통한 분석은 필수적이다. 일반적으로 수중음향채널 분석을 위해 사용되는 수중음향 전파 수치해석 모델은 음선이론 법, 정규방식 법, 포물선방정식 법, 파수적분 법이 있으나 다중 주파수 분석일 경우 유효성과 신호처리 및 분석에 제한적이다. 본 논문은 단일 및 다중 주파수 분석 및 신호처리 및 분석이 용이한 기존 의사 스펙트럼 시간영역 법 수중음향 수치해석 모델에 수중환경 소음 모델을 적용하여 실제 수중환경과 유사한 합성환경 수중음향채널을 모델링 하였다. 이렇게 구현된 합성환경 수중음향채널 모델의 유효성을 확인하기 위해 단일 주파수 신호 시나리오 4가지 다중 주파수 신호 시나리오 4가지 및 잠수함 기동에 따른 방사소음 분석 시나리오 시뮬레이션을 통해 의사 스펙트럼 시간영역 법 합성환경 수중음향채널 모델 유효성을 확인하였다. It is necessary to analyze underwater acoustics channel(UAC) modeling and simulation for underwater weapon system development and acquisition. In order to analyze UAC, there are underwater acoustics propagation numerical analysis models(Ray theory, Parabolic equation, Normal-mode, Wavenumber integration). However, If these models are used for multiple frequency signal analysis, they are inaccurate to calculate result of analysis effectiveness and restricted for signal processing and analysis. In this paper, to overcome this problem, we propose simple/multiple frequency signal analysis model of the Pseudospectral Time-Domain Method synthetic environment UAC applied to underwater environment noise model as like as realistic underwater environment. In order to confirm the validation of the model, we performed the 9 scenarios simulation(4 scenarios of single frequency signal, 4 scenarios of multiple frequency signal, 1 scenario of single/multiple frequency signal like submarine radiated noise) for validation and confirmed the validation of this model through the simulation model.

견관절경 수술시 초음파를 이용한 팔신경얼기차단에서 저용량의 Levobupivacaine의 통증조절 효과

김장재 ( Jang Jae Kim ),김치효 ( Chi Hyo Kim ),김윤진 ( Youn Jin Kim ),김동연 ( Dong Yeon Kim ),한종인 ( Jong In Han ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3

Background: Ultrasound guided-interscalene brachial plexus block (US-ISBPB) becomes more popular and has higher success rate. The aim of this study was to assess the analgesic effectiveness of US-ISBPB with low dose levobupivacaine for arthroscopic shoulder surgery. Methods: The thirty patients undergoing elective arthroscopic shoulder surgery were randomly assigned to two groups: Group B0.5, and Group B0.25 received ultrasound-guided ISBPB using same volume 10 ml of 0.5% levobupivacaine and 0.25% levobupivacaine, respectively. General anesthesia was standardized. All patients received continuous intra-articular infusion of a local anesthetic. Remifentanil consumption during operation, verbal numerical rating scales (VNRS) after operation were assessed. The need for rescue analgesics in post-anesthesia care unit (PACU), sleep quality, and complications were documented. Results: There were no significant differences in VNRS at 20 min, 30 min, 60 min, 120 min, 8 h, 24 h after surgery, remifentanil consumption during operation, the number of patients required rescue analgesics in the PACU, sleep quality, and complication up to 24 h after surgery. Conclusions: Ultrasound-guided interscalene brachial plexus block with levobupivacaine, 10 ml of 0.5% and 0.25%, provides effective analgesia after arthroscopic shoulder surgery. (Korean J Anesthesiol 2009;57:302∼7)

유전 역학적 연구와 생명윤리 및 개인정보 보호

김장한(Jang Han Kim) 한국역학회 2007 Epidemiology and Health Vol.29 No.1

  Unlike the classical genetic study which dealt with the mendelian inheritances of relatively small number of patients, the genetic epidemiology study needs the large scaled genetic data base. The main ethical and legal problems of these kinds of studies are research design, informed consent, long term follow-up of research subjects, data sharing and benefit sharing. Classically, the informed consent was an important right but if these kinds of large scaled and long period studies were involved, the newly developing rights should be more stressed. The bioethics and biosafety act and governmental regulations for the genetic study and gene bank also shows those considerations.   In EU, the general consent is considered acceptable if the approval of all future projects is fulfilled by a research ethics committee and the participants" right to withdraw samples at any times. In U.S.A., strict restriction is required for future experiments, but if the research involves no more than minimal risk to the subject, the waiver or alternation will not affect adversely the rights and welfare of subjects and the research could not be practicably carried out without the waiver or alteration, the specific future consents could be exempted. Long term follow up of research patients is needed to provide the newly developed information which would be helpful for the patients. Data sharing is needed to prevent the exclusive possession of genetic information. Benefit sharing is the newly coming up debates on how to manage the conflicts of interests between tissue-donors and scientific researchers. The context and inventory of human rights for the research is changing and still under construction.

의료전문가주의-역사적 관점에서 본 사회적 책무에 관하여

김장한 ( Jang Han Kim ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.3

What is medical professionalism and does it matter to the patients? Medical professionals take responsibility for their judgements and the consequences that ensue. Traditionally medical professionalism is defined as a set of values, behaviors, and relationships which support the trust the public has in doctors. The public is well aware that absence of professionalism is harmful to their interests. However, the exercise of medical professionalism is endangered by the political and cultural environment. The values of professionalism have been changed throughout the medical history and the meaning of it was also changed according to social theories. Traditional medical professionalism was based on the virtue of autonomy, self-regulation and competency etc. However, in the new millenium era, the meaning of professionalism has changed under the concept of responsibility which includes the classical virtues. The meaning of professionalism nowadays is only based on the structure and conflicting theories which cannot solve all the issues surrounding professionalism in medical practice. The conditions of medical practice are critical determinants for the future of professionalism. The interaction between doctor and patient is central to the medical care, and medical professionalism has roots in almost every aspect of medical care. I argue that doctors have responsibility to act according to the values which have been determined by the medical profession, history and surrounding society. The new millennium medical professionalism which based on the responsibility could initiate a public dialogue about the role of the doctor in creating a fairer society. (Korean J Gastroenterol 2015;65:165-172)

Bayesian MBLRP 모형을 이용한 시간강수량 모의 기법 개발

김장경,권현한,김동균,Kim, Jang Gyeong,Kwon, Hyun Han,Kim, Dong Kyun 대한토목학회 2014 대한토목학회논문집 Vol.34 No.3

추계학적 강수발생 및 모의기법은 수문학적 모형의 입력 자료로써 널리 이용되고 있다. 그러나 Modified Bartlett-Lewis Rectangular Pulse(MBLRP)와 같은 추계학적 포아송 클러스터 강수생성 모형에 대해서 국부최적화 방법을 통한 매개변수 추정 방법은 매개변수의 신뢰성에 상당한 영향을 주는 것으로 알려져 있다. 최근에는 MBLRP 모형의 국부해추정 문제를 해소하기 위하여 Particle Swarm Optimization (PSO) 또는 Shuffled Complex Evolution developed at The University of Arizona (SCE-UA) 등 매개변수 추정 성능이 우수한 전역최적화기법이 도입되고 있지만, 제한된 매개변수 공간에서 항상 신뢰성 있는 매개변수 추정이 가능한 것은 아니다. 뿐만 아니라, 모형의 매개변수들이 갖고 있는 불확실성에 관한 연구는 아직 충분히 논의되지 않았다. 이러한 관점에서 본 연구는 Bayesian 기법과 연계한 MBLRP 모형을 개발하였으며 각 매개변수들의 사후분포(Posterior Distribution)를 유도하여 매개변수가 내포하는 불확실성을 정량적으로 평가하였다. 그 결과 관측값에 대한 시간단위 이하 강수발생 통계치를 효과적으로 복원하고 있음을 확인할 수 있었다. Stochastic rainfall generators or stochastic simulation have been widely employed to generate synthetic rainfall sequences which can be used in hydrologic models as inputs. The calibration of Poisson cluster stochastic rainfall generator (e.g. Modified Bartlett-Lewis Rectangular Pulse, MBLRP) is seriously affected by local minima that is usually estimated from the local optimization algorithm. In this regard, global optimization techniques such as particle swarm optimization and shuffled complex evolution algorithm have been proposed to better estimate the parameters. Although the global search algorithm is designed to avoid the local minima, reliable parameter estimation of MBLRP model is not always feasible especially in a limited parameter space. In addition, uncertainty associated with parameters in the MBLRP rainfall generator has not been properly addressed yet. In this sense, this study aims to develop and test a Bayesian model based parameter estimation method for the MBLRP rainfall generator that allow us to derive the posterior distribution of the model parameters. It was found that the HBM based MBLRP model showed better performance in terms of reproducing rainfall statistic and underlying distribution of hourly rainfall series.

[지정토론문] 환자연명의료결정법의 제정과 과제

김장한(Kim, Jang-Han) 한국법학원 2017 저스티스 Vol.- No.158-3

혈청 펩시노겐치를 이용한 위암 및 위선종의 집단검진

김장락,최진학,김영채,이옥재,조규일,이한우,홍대용,Kim, Jang-Rak,Choi, Jin-Hak,Kim, Young-Chai,Lee, Ok-Jae,Cho, Kyu-Il,Lee, Han-Woo,Hong, Dae-Yong 대한예방의학회 1994 Journal of Preventive Medicine and Public Health Vol.27 No.4

To evaluate the validity of serum pepsinogen levels as a screening tool for gastric cancer and adenoma, immunoradiometric assays of serum pepsinogen I level (PG I), II level (PG II) and esphagogastroduodenal endoscopies were done in 757 health examinees. Serum PG I level was higher in subjects with active duodenal ulcer (n=45, $75.2{\pm}34.3{\mu}g/l(mean{\pm}standard\;deviation)$, p<0.01) and gastroduodenal ulcers (n=8, $75.6{\pm}19.8{\mu}g/l$, p<0.05), and was lower in those with gastric adenoma(n=4, $37.7{\pm}37.2{\mu}g/l$, p<0.2) than those with normal, mild gastritis findings or ulcer scars (n=378, $56.6{\pm}24.9{\mu}g/l$. Serum PG II level was higher in subjects with active duodenal ulcer($17.2{\pm}13.8{\mu}g/l$, p<0.2), active gastro-duodenal ulcers ($18.3{\pm}7.4{\mu}g/l$, p<0.2) and gastric carcinoma (n=3, $23.8{\pm}10.9{\mu}g/l$, p<0.05) than those with normal, mild gastritis findings or ulcer scars $(14.5{\pm}7.9{\mu}g/l)$. Serum PG I/PG II ratio was higher in subjects with active duodenal ulcer($5.1{\pm}1.6$, p<0.05) and was lower in those with chronic gastritis(n=107, $4.1{\pm}1.7$, p<0.05), gastric polyp(n=19, $3.9{\pm}1.4$, p<0.2), gastric adenoma(n=4, $2.1{\pm}1.9$, p<0.01) and gastric carcinoma(n=3, $2.7{\pm}1.2$, p<0.1) than those with normal, mild gastritis findings or ulcer scars ($4.5{\pm}1.7$). Serum PG II level increased with age until 6th decade, whereas serum PG I/PG II ratio decreased with age in 378 subjects with normal, mild gastritis findings or ulcer scars. The screening criteria of serum PG I<$70{\mu}g/l$ and PG I/PG II ratio<3.0 for detecting gastric cancer and adenoma gave a positive rate of 15.7%, sensitivity of 57.1% and specificity of 84.7%.

'생명윤리및안전에관한법률'의 분석

김장한(Jang Han Kim) 한국생명윤리학회 2004 생명윤리 Vol.5 No.1

"Bioethics and Biosafety Act" was enacted in 2004.1.29. and will be in effect from 2005.1.1. except the inhibition of human cloning (article 11), the inhibition of implementation of different species (article 12) and its punishment clauses which were in effect immediately after enactment. This act is composed 9 chapters and 55 articles. In general rules (chapter 1), the aim, definitions, obligations and the principle of self determination are described. In ethical committee (chapter 2), the national and institutional review board have a ground to be founded. In embryonal research (chapter 3), human reproductive cloning is prohibited but the research on residual human embryo and therapeutic cloning using somatic cell nuclear transfer (SCNT) is permitted. Severe ethical debates were raised against this legislation. In genetic examination(chapter 4), the protection of genetic privacy, informed consent and withdrawal, access to and call for research records, request to abolish the genetic material is well equipped. But discrimination in favor of public sector is considered to violate the equal protection (article 24). In protection and use of genetic information (chapter 5), the discrimination due to the genetic difference is prohibited. The gene banking is permitted and the genetic information offer is allowed under the permission of institutional review board and should be noticed to the ministry of Health and Welfare. Personal information should be excluded from the genetic information offer. If medical documents are issued other than patient, genetic information should not be included. In gene therapy (chapter 6), for the treatment of life threatening disease or if the benefit of gene therapy overwhelms that of other therapy or officially determined disease for treatment or prevention, gene therapy is allowed. But the sperm, egg, embryo and fetus could not be objects of gene therapy (article 36). This act will function as general principles of biomedical researches. But ethical debates are still on going and spread widely. The main debates are the allowance of human embryonal research and SCNT therapeutic cloning. Along with that, stem cell research including the use of fetal tissue, maternal protection will be the next themes to be discussed. Still we don't have any regulations. The genetic information as a common property of all mankind, we have to find a way to use it in a fair. Gene therapy could have effect beyond the generations, so the safety and quality of therapeutics is to be guaranteed. The proportions and authority of national and institutional ethical board should be adjusted for well￢functioning. We take a first step to regulate the bioethical and biosafety problems. More efforts will be needed to solve these problems.