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류지호,민문기,이대섭,염석란,이성화,왕일재,조석주,황성연,이준호,김용환 대한의학회 2019 Journal of Korean medical science Vol.34 No.14
Background: The 5-level triage tool, the Korean Triage and Acuity Scale (KTAS), was developed based on the Canadian Triage and Acuity Scale and has been used for triage in all emergency medical institutions in Korea since 2016. This study evaluated the association between the decrease in level number and the change in its relative importance for disposition in the emergency department (ED). Methods: Using the registry of the National Emergency Department Information System (NEDIS) ver. 3.1, data regarding consecutive emergency patients from March 2017 to October 2017 were reviewed retrospectively. Reconfiguring KTAS levels, a total of 15 multinomial logistic regression models (KTAS_0 to KTAS_14), including the KTAS, its variants, and covariates were constructed to determine significant factors affecting ED disposition. The relative importance of each model was obtained using a dominance analysis. Results: A total of 79,771 patients were included in the analysis. In the model KTAS_0, the KTAS and 8 covariates were found to be significantly related to ED disposition. The KTAS and the decision maker of each ED visit, whether it was the physician or others, had the largest relative importance, 34.8% and 31.4%, respectively (P < 0.001). In other models of KTAS variants, including 4-level, 3-level and 2-level, the rates of the KTAS decreased to 31.8% (interquartile range [IQR], 28.9–34.2), 26.4% (IQR, 23.2–31.0), and 18.7% (IQR, 7.5–24.9), respectively (P = 0.016). On the other hand, the rates for covariates tended to be larger for smaller triage levels and so there was a significant interaction effect between the KTAS and the covariates according to the triage level (P < 0.001).Conclusion: The 5-level triage tool, the KTAS, had the largest relative importance among the predictors affecting ED disposition only at its original level. Therefore, it is recommended that no attempt should be made to reduce the number of levels in the triage tool.
플라즈마 용사법에 의한 지르코니아 코팅에서의 잔류응력에 대한 연구
류지호,강춘식 대한용접접합학회 1989 대한용접·접합학회지 Vol.7 No.4
Zirconia coatings are performed by the plasma spraying on the substrate of Al-Si alloy. In case of plasma sprayed ceramic coatings, it is important to control properly residual stress occurred during cooling process. Residual stress in coating layer varies with sprayed conditions and is influenced greatly by the coating layer thickness. Surface residual stress due to coating layer thickness is measured by X-ray diffraction method and the residual stress in coating layer is estimated by the deflection of coating layer when the restraint force in substrate was removed. When zirconia was coated on the substrate, tensile residual stress remains on zirconia coated surface layer. The tensile stress is increased to 0.35mm thickness and after 0.45mm thickness it is decreased abrouptly. A thick bond and composite coating reduce the zirconia surface stress and composite coating controls effectively the thick zirconia surface stress.