• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.213-221
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• 2001

Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

• Radiation Oncology Journal
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• v.20 no.1
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• pp.41-52
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• 2002

Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.150-156
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• 2003

Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.621-627
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• 1999

Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

• Journal of Nutrition and Health
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• v.45 no.6
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• pp.562-576
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• 2012

Han-sik is a term in Korean that may indicate any Korean dish or food. At present, there is no general consensus on the definition of Han-sik among scholars or professionals in related fields. The aim of this study was to investigate perceptions of Han-sik by professionals in the fields of food, nutrition, and culinary arts using 512 dishes and foods commonly consumed by Koreans using the 4th Korean National Health and Nutrition Survey. A total of 117 professionals out of 185 initially contacted professionals participated in this online survey. We calculated the rate of respondents with a positive answer, that is "It is Han-sik', on each dish and food from the 512 items in 28 dish groups. Items were categorized into five groups according to their Han-sik perception rate: over 90%, 75-89%, 50-74%, 25-49%, and below 25%. Most items in the three dish groups 'Seasoned vegetables, cooked (Namul Suk-chae)', 'Kimchis', and 'Salt-fermented foods (Jeotgal)' showed high perception rates of Han-sik, with a higher than 90% positive response. Items in 'Soups', 'Stews', and 'Steamed foods' dish groups also showed high perception rates of Han-sik. However, no item showed a greater than 90% Han-sik perception rate in 'Fried foods (Twigim)', 'Meat, poultry and fishes', 'Legumes, nuts, and seeds', 'Milk and milk products', 'Sugars and confectioneries', and 'Soup'. Most items in the 'Milk and milk products', 'Sugars and confectioneries', and 'Soup' groups belonged to the lowest perception rate of below 25%. There was a significant difference in the proportion of items perceived as Han-sik by the length of living abroad to (p < 0.05). In summary, the perception rate of Han-sik seemed to be affected by the cooking method, ingredients, and length of time living abroad by the professionals. Further studies targeting subjects with different characteristics and socioeconomic status are warranted to define the concept of Han-sik.

• Korean Journal of Poultry Science
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• v.35 no.3
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• pp.291-302
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• 2008

To acquire essentially necessary basic data to establish feeding system by verifying appropriate dietary energy and protein level for the growth of commercial slow growing broiler chicks within the country, two experiments were conducted for 5 weeks. One day old, 1,404 male and female broiler chicks were used for the experiments, and 26 chicks were placed at each pen. The energy level of feed was maintained about 3,000 or 3,100 kg/kcal for whole breeding period of 5 weeks, and protein content was adjusted about 20, 21, and 22% during the first two weeks and the content was adjusted to 18, 19, 20, 21, and 22% from the 3 to 5 weeks old of the experiment. The categories of body weight and feed intake amount were monitored to calculate the productivity and blood sampling was conducted for the analysis at the end of each experiment. Experiment 1:Although the productivity by the ME content difference during $0{\sim}2$ weeks did not have significant difference and the body weight increase by the difference of CP content and feed intake amount did not have much difference, the feed requirement rate was statistically improved in CP 21 and 22% treatment groups compared to the CP 20% group (P<0.05). The feed ME 3,100 kcal/kg treated group during $3{\sim}5$ weeks after starting the experiment revealed to show improved feed requirement rate (P<0.05). Within the period of experiment, the CP 22% treated group resulted to show significant body weight increase compared to the groups treated with low levels of CP (P<0.05) and the feed requirement rate was improved in high CP treated group compared to low CP treated groups, but the feed intake amount did not show significant difference between treated groups. During the experiment period, the body weight increase and feed requirement rate revealed to interact between ME and CP (P<0.05). During the whole experiment period of the 5 weeks, the feed requirement rate was improved in ME 3,100 kcal/kg treated group than the groups treated with ME 3,000 kcal/kg, and the CP (20) 18% treatment groups resulted to show higher values than other treatment groups (P<0.05). Body weight increase was high in CP (22) 22% treated groups than those of CP (21) 21% and (20) 18% treated groups, and the interaction between ME and CP was found at body weight increase and feed requirement rate (P<0.05). Although blood albumin and total cholesterol levels were elevated in ME 3,100 kcal/kg treated group than ME 3,000 kcal/kg treated group, but neutral fat content was reduced (P<0.05). On the other hand, the total cholesterol content was increased in CP (22) 21% treated group than CP (22) 20% and CP (20) 18% treated groups (P<0.05). Experiment 2: The body weight increase in 0-2 weeks was higher in ME 3,100 kcal/kg treated group than ME 3,000 kcal/kg treated group, and it was highly improved in CP 22% treated group than CP 20% treated group by showing the interaction between CP and ME (P<0.05). The significant improvement of feed requirement rate was observed in CP 21% and 22% treated groups compared to CP 20% treated group (P<0.05). The productivity between the growth period from 3 to 5 weeks of age and whole growth period resulted to show no significant difference. Although no difference was observed in blood composition between treated groups, the interaction of ME and CP on cholesterol content was accepted at the range of P<0.05). Therefore, it is considered that the appropriate dietary protein level within feed for the physiology of growing broiler chicks was 22% or more for the first two weeks and protein level of 21% or 20% from 3 to 5 weeks old for the maximization of productivity. Even if the energy level within feed had some partial effects on the productivity, but did not show consistency. So, further experiments needto be conducted by differentiating the energy level.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.99-106
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• 2007

Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

• Journal of Korea Technology Innovation Society
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• v.10 no.1
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• pp.73-97
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• 2007

R&D into future technologies should be conducted in conjunction with technological innovation strategies that are linked to corporate survival within a framework of information and knowledge-based competitiveness. As such, future technology strategies should be ensured through open R&D organizations. The development of future technologies should not be conducted simply on the basis of future forecasts, but should take into account customer needs in advance and reflect them in the development of the future technologies or services. This research aims to select as segmentation variables the customers' attitude towards accepting future telecommunication technologies and their value orientation in their everyday life, as these factors wilt have the greatest effect on the demand for future telecommunication services and thus segment the future telecom service market. Likewise, such research seeks to segment the market from the stage of technology R&D activities and employ the results to formulate technology development strategies. Based on the customer attitude towards accepting new technologies, two groups were induced, and a hierarchical customer segmentation model was provided to conduct secondary segmentation of the two groups on the basis of their respective customer value orientation. A survey was conducted in June 2006 on 800 consumers aged 15 to 69, residing in Seoul and five other major South Korean cities, through one-on-one interviews. The samples were divided into two sub-groups according to their level of acceptance of new technology; a sub-group demonstrating a high level of technology acceptance (39.4%) and another sub-group with a comparatively lower level of technology acceptance (60.6%). These two sub-groups were further divided each into 5 smaller sub-groups (10 total smaller sub-groups) through two rounds of segmentation. The ten sub-groups were then analyzed in their detailed characteristics, including general demographic characteristics, usage patterns in existing telecom services such as mobile service, broadband internet and wireless internet and the status of ownership of a computing or information device and the desire or intention to purchase one. Through these steps, we were able to statistically prove that each of these 10 sub-groups responded to telecom services as independent markets. We found that each segmented group responds as an independent individual market. Through correspondence analysis, the target segmentation groups were positioned in such a way as to facilitate the entry of future telecommunication services into the market, as well as their diffusion and transferability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.94-102
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• 2001

Bullying has recently become a serious social problem in Korean society. Bullying, which is defined as a phenomenon that one particular student is intensively and continuously harassed or ostracized by a group of students, is apt to produce harmful effects on bullies as well as victims. Bullying has many causes including those originated from the personality of victims and bullies. This study is designed to investigate the difference in personality trait between victims, bullies, victims/bullies, and neither. The subjects of this study were 215(115 male and 100 female) 6th-grade students in the primary school in Seoul. Questionnares were distributed to the students and their carers. The student carers were also asked to answer the questions for a survey called the Korean Personality Invertory for Children(KPI-C). SPSS was used for the statistical analysis of the collected test information；ANOVA, post hoc scheffe test, and T-test were used to analyze the differences between the tested groups. The result of the study is as follows. 1) The victims, bullies, victims/bullies and neither totaled respectively 11(5.1%), 56(26.0%), 11(5.1%) and 137(63.7%). 115 were male and 100 were female. 2) The frequency of victimized is as follows：1 time is 15(7.0%), 2 times is 4(1.9%) and more than 3 times is 3(1.4%). The frequency of bullying is as follows；1 time is 40(18.6%), 2 times is 17 (7.9%) and more than 3 times is 10(4.7%). 3) The differences between froups in KPI-C test is as follows. (1) The ESR(p=.00) scale was significantly lower in the victims group than in the neither group and the HPR(p=.00) scale and PSY(p<.01) scale were significantly higher in the former than in the latter. (2) The ESR(p=.00) scale was significantly lower in the victims/bullies group than in the neither group and the SOM(p=.00) scale and HPR(p=.00) scale were significantly higher in the formaer than in the latter. (3) The SOC(p=.00) scale, PSY(p<.01) scale and AUT(p=.00) scale were significantly higher in the victims group than in the bullies group. (4) There is statistically no difference between the bullies group and the neither group. To conclusion, Victims need to learn how to cope with harsh situations, or they will have to face difficulties in relationships. Even after they experience bullying, they may not realize why they have been bullied, or speak out for themselves.

• The Korean Journal of Air & Space Law and Policy
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• v.31 no.2
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• pp.145-176
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• 2016

Aviation safety can be secured through regulations and policies of various areas and thorough execution of them on the field. Recently, for aviation safety management Korea is making efforts to prevent aviation accidents by taking various measures: such as selecting and promoting major strategic goals for each sector; establishing National Aviation Safety Program, including the Second Basic Plan for Aviation Policy; and improving aviation related legislations. Obstacle limitation surface is to be established and publicly notified to ensure safe take-off and landing as well as aviation safety during the circling of aircraft around airports. This study intends to review current aviation obstacle management system which was designed to make sure that buildings and structures do not exceed the height of obstacle limitation surface and identify its operating problems based on my field experience. Also, in this study, I would like to propose ways to improve the system in legal and regulatory aspects. Nowadays, due to the request of residents in the vicinity of airports, discussions and studies on aviational review are being actively carried out. Also, related ordinance and specific procedures will be established soon. However, in addition to this, I would like to propose the ways to improve shortcomings of current system caused by the lack of regulations and legislations for obstacle management. In order to execute obstacle limitation surface regulation, there has to be limits on constructing new buildings, causing real restriction for the residents living in the vicinity of airports on exercising their property rights. In this sense, it is regarded as a sensitive issue since a number of related civil complaints are filed and swift but accurate decision making is required. According to Aviation Act, currently airport operators are handling this task under the cooperation with local governments. Thus, administrative activities of local governments that have the authority to give permits for installation of buildings and structures are critically important. The law requires to carry out precise surveying of vast area and to report the outcome to the government every five years. However, there can be many problems, such as changes in the number of obstacles due to the error in the survey, or failure to apply for consultation with local governments on the exercise of construction permission. However, there is neither standards for allowable errors, preventive measures, nor penalty for the violation of appropriate procedures. As such, only follow-up measures can be taken. Nevertheless, once construction of a building is completed violating the obstacle limitation surface, practically it is difficult to take any measures, including the elimination of the building, because the owner of the building would have been following legal process for the construction by getting permit from the government. In order to address this problem, I believe penalty provision for the violation of Aviation Act needs to be added. Also, it is required to apply the same standards of allowable error stipulated in Building Act to precise surveying in the aviation field. Hence, I would like to propose the ways to improve current system in an effective manner.