• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1200-1206
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• 2003

Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. Results : There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in $PaCO_2$. However, the control group showed a slight $CO_2$ retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. Conclusion : Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1090-1102
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• 2009

Purpose:To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. Methods:Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. Results:Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). Conclusion:Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.

• The Korean Journal of Pharmacology
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• v.28 no.2
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• pp.115-128
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• 1992

The training of male wistar rats for active conditioned response (ACR) was performed by one daily training session of 30 consecutive trials for 10 successive days using a two-way shuttle box, and the rats that showed 10 or more ACRs on the last day were treated for further 10 days with electroconvulsive shock (ECS : 50 mA, 0.5 msec; 100 Hz; 1.5 sec) and the following compounds. On the 20th day, all the rats were tested for the ACR rention. The ECS regimens were one ECS per day for 10 days with one day interval $(5{\times}ECS)$, one ECS at 3 hrs (ECS-3h), and one ECS at 24 hrs (ECS-24h), respectively, before the ACR retention test. And CDP-choline (cc: 250 mg/kg), spermine (SM: 10 mg/kg), ${\alpha}-difluoromethylornithine$ (DO: 250 mg/kg), or aminoguanidine (AG: 100 mg/kg) was administered by one daily i.p. injection for 10 days. The ACR number $(13.7{\pm}1.0)$ obtained on the last training day was increased by 37.23% on the 20th day in the control rats. And the ACR increase was significantly suppressed by 5-ECS, ECS-3h, CC, or SM but was little affected by ECS-24h, DO, or AG. However, the 5-ECS induced impairment of ACR retention was significantly suppressed by AG, SM, and CC in the order of potency but was little affected by DFMO. And the ECS-3h induced impairment was moderately worsened by SM or AG. The acetylcholine (ACh) of the rat hypothalamus (HT), hippocampus (HC), and entorhinal cortex (EC) was markedly increased by CC and moderately increased by SM, but little affected by ECS-3h, ECS-24h, DO, or AG. But $5{\times}ECS$ slightly increased the ACh content. The brain putrescine (Pt) content was significantly increased by AG and little affected by CC, SM, or DO. But the $5{\times}ECS$ markedy decreased the brain Pt content, and the decrease was significantly suppressed by CC, SM, or AG. CC induced the marked increases of the spermidine (Sd) and spermine (Sm) contents of all the areas. SM increased the Sd contents of all the areas and the EC-Sm content. DO decreased the brain Sd and Sm contents. And AG increased the HT-Sd content and the Sm contents of all the brain areas. The $5{\times}ECS$ induced decrease of the HC-Sm content was suppressed by CC, SM and AG. These results suggest that the improving effect of aminoguanidine on the $5{\times}ECS$ induced impairment of ACR retention may be ascribed in part to its activity as a diamine oxidase inhibitor.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.145-156
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• 2015

Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.1-10
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• 2012

Purpose: To evaluate dose distribution differences when the dose rates are randomly changed in intensity-modulated radiation therapy using a dynamic multileafcollimator. Materials and Methods: Two IMRT treatment plans including small-field and large-field plans were made using a commercial treatment planning system (Eclipse, Varian, Palo Alto, CA). Each plan had three sub-plans according to various dose rates of 100, 400, and 600 MU/min. A chamber array (2D-Array Seven729, PTW-Freiburg) was positioned between solid water phantom slabs to give measurement depth of 5 cm and backscattering depth of 5 cm. Beam deliveries were performed on the array detector using a 6 MV beam of a linear accelerator (Clinac 21EX, Varian, Palo Alto, CA) equipped with 120-leaf MLC (Millenium 120, Varian). At first, the beam was delivered with same dose rates as planned to obtain reference values. After the standard measurements, dose rates were then changed as follows: 1) for plans with 100 MU/min, dose rate was varied to 200, 300, 400, 500 and 600 MU/min, 2) for plans with 400 MU/min, dose rate was varied to 100, 200, 300, 500 and 600 MU/min, 3) for plans with 600 MU/min, dose rate was varied to 100, 200, 300, 400 and 500 MU/min. Finally, using an analysis software (Verisoft 3.1, PTW-Freiburg), the dose difference and distribution between the reference and dose-rate-varied measurements was evaluated. Results: For the small field plan, the local dose differences were -0.8, -1.1, -1.3, -1.5, and -1.6% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +0.9, +0.3, +0.1, -0.2, and -0.2% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.4, +0.8, +0.5, +0.3, and +0.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). On the other hand, for the large field plan, the pass-rate differences were -1.3, -1.6, -1.8, -2.0, and -2.4% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +2.0, +1.8, +0.5, -1.2, and -1.6% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.5, +1.9, +1.7, +1.9, and +1.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). In short, the dose difference of dose-rate variation was measured to the -2.4~+2.0%. Conclusion: Using the Varian linear accelerator with 120 MLC, the IMRT dose distribution is differed a little <(${\pm}3%$) even though the dose-rate is changed.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.31-39
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• 2011

Purpose: Helical Tomotherapy allows only coplanar beam delivery because it does not allow couch rotation. We investigated a method to introduce non-coplanar beam by tilting a patient's head for Tomotherapy. The aim of this study was to compare intrafractional movement during Tomotherapy between coplanar and non-coplanar patient's setup. Materials and Methods: Helical Tomotherapy was used for treating eight patients with intracranial tumor. The subjects were divided into three groups: one group (coplanar) of 2 patients who lay on S-plate with supine position and wore thermoplastic mask for immobilizing the head, second group (non-coplanar) of 3 patients who lay on S-plate with supine position and whose head was tilted with Variable Axis Baseplate and wore thermoplastic mask, and third group (non-coplanar plus mouthpiece) of 3 patients whose head was tilted and wore a mouthpiece immobilization device and thermoplastic mask. The patients were treated with Tomotherapy after treatment planning with Tomotherapy Planning System. Megavoltage computed tomography (MVCT) was performed before and after treatment, and the intrafractional error was measured with lateral(X), longitudinal(Y), vertical(Z) direction movements and vector ($\sqrt{x^2+y^2+z^2}$) value for assessing overall movement. Results: Intrafractional error was compared among three groups by taking the error of MVCT taken after the treatment. As the correction values (X, Y, Z) between MVCT image taken after treatment and CT-simulation image are close to zero, the patient movement is small. When the mean values of movement of each direction for non-coplanar setup were compared with coplanar setup group, X-axis movement was decreased by 13%, but Y-axis and Z-axis movement were increased by 109% and 88%, respectively. Movements of Y-axis and Z-axis with non-coplanar setup were relatively greater than that of X-axis since a tilted head tended to slip down. The mean of X-axis movement of the group who used a mouthpiece was greater by 9.4% than the group who did not use, but the mean of Y-axis movement was lower by at least 64%, and the mean of Z-axis was lower by at least 67%, and the mean of Z-axis was lower by at least 67%, and the vector was lower by at least 59% with the use of a mouthpiece. Among these 8 patients, one patient whose tumor was located on left frontal lobe and left basal ganglia received reduced radiation dose of 38% in right eye, 23% in left eye, 30% in optic chiasm, 27% in brain stem, and 8% in normal brain with non-coplanar method. Conclusion: Tomotherapy only allows coplanar delivery of IMRT treatment. To complement this shortcoming, Tomotherapy can be used with non-coplanar method by artificially tilting the patient's head and using an oral immobilization instrument to minimize the movement of patient, when intracranial tumor locates near critical organs or has to be treated with high dose radiation.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.34 no.1
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• pp.40-52
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• 2016

Buyongjeong, a pavilion in the Rear Garden of Changdeok Palace, was appointed as Treasure No. 1763 on March 2, 2012, by the South Korea government since it shows significant symmetry and proportion on its unique planar shape, spatial configuration, building decoration, and so forth. However, the designation of Treasure selection was mainly evaluated by concrete science, in that the selection has not clearly articulated how and why Buoungjeong was constructed as a present unique form. Therefore, this study aims to clarify the identity of Buyongjeong at the time of construction by considering its historical, ideological, philosophical background and building intention. Summary are as follows: First, Construction backgrounds and characters of Buyongjeong: Right after the enthronement, King Jeongjo had founded Kyujanggak(奎章閣), and sponsored civil ministers who were elected by the national examination, as a part of political reform. In addition, he established his own political system by respecting "Kaksin(閣臣)", Kyujanggak's officials as much as "Kain(家人)", internal family members. King Jeongjo's aggressive political reform finally enabled King's lieges to visit King's Rear Garden. In the reign of King Jeongjo's 16th year(1792), Naekaksangjohoe(內閣賞釣會) based on "Kaksin" was officially launched and the Rear Garden visitation became a regular meeting. The Rear Garden visitation consisted of "Sanghwajoeoyeon(賞花釣魚宴)" - enjoying flowers and fishing, and activities of "Nanjeongsugye". Afterward, it eventually became a huge national event since high rank government officials participated the event. King Jeongjo shared the cultural activities with government officials together to Buyongjeong as a place to fulfill his royal politics. Second, The geographical location and spatial characteristics of Buyongjeong: On the enthronement of King Jeongjo(1776), he renovated Taeksujae. Above all, aligning and linking Gaeyuwa - Taeksujae - a cicular island - Eosumun - Kyujangkak along with the construction axis is an evidence for King Jeongjo to determine how the current Kyujangkak zone was prepared and designed to fulfill King Jeonjo's political ideals. In 17th year(1793) of the reign of King Jeongjo, Taeksujae, originally a square shaped pavilion, was modified and expanded with ranks to provide a place to get along with the King and officials. The northern part of Buyongjeong, placed on pond, was designed for the King's place and constructed one rank higher than others. Discernment on windows and doors were made with "Ajasal" - a special pattern for the King. The western and eastern parts were for government officials. The center part was prepared for a place where government officials were granted an audience with the King, who was located in the nortern part of Buyongjeong. Government officials from the western and eastern parts of Buyongjeong, could enter the central part of the Buyongjeong from the southern part by detouring the corner of Buyongjeong. After all, Buyongjeong is a specially designed garden building, which was constructed to be a royal palace utilizing its minimal space. Third, Cultural Values of Buyongjeong: The Buyongjeong area exhibits a trait that it had been continuously developed and it had reflected complex King's private garden cultures from King Sejo, Injo, Hyunjong, Sukjong, Jeongjo and so forth. In particular, King Jeongjo had succeded physical, social and imaginary environments established by former kings and invited their government officials for his royal politics. As a central place for his royal politics, King Jeongjo completed Buyongjeong. Therefore, the value of Buyongjeong, as a garden building reflecting permanency of the Joseon Dynasty, can be highly evaluated. In addition, as it reflects Confucianism in the pavilion - represented by distinguishing hierarchical ranks, it is a unique example to exhibit its distinctiveness in a royal garden.

• Journal of Distribution Science
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• v.9 no.4
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• pp.5-13
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• 2011

This study provides analysis of the effectiveness of domestic marketing strategies of the Korean coffee shop "Caffe Bene". It bases its evaluation on statistical outputs of 'choice attributes,' "market segmentation," demographic characteristics," and "satisfaction differences." The results are summarized in four points. First, five choice attributes were extracted from factor analysis: price, atmosphere, comfort, taste, and location; these are related to coffee shop selection behavior. Based on these five factors, cluster analysis was conducted, with statistical results classifying customers into three major groups: atmosphere oriented; comfort oriented; and taste oriented. Second, discriminant analysis tested cluster analysis and showed two discriminant functions: location and atmosphere. Third, cross-tabulation analysis based on demographic characteristics showed distinctive demographic characteristics within the three groups. Atmosphere oriented group, early-20s, as women of all ages was found to be 'walking down the street 'and 'through acquaintances' in many cases, as the cognitive path, and mostly found the store through 'outdoor advertising', and 'introduction'. Comfort oriented group was mainly women who are students in their early twenties or professionals, and appeared as a group to be very loyal because of high recommendation to other customers compared to other groups. Taste oriented group, unlike the other group, was mainly late-20s' college graduates, and was confirmed, as low loyalty, with lower recommendation activity. Fourth, to analyze satisfaction differences, one-way ANOVA was conducted. It shows that groups which show high satisfaction in the five main factors also show high menu satisfaction and high overall satisfaction. This results show that segmented marketing strategies are necessary because customers are considering price, atmosphere, comfort, taste, location when they choose coffee shop and demographics show different attributes based on segmented groups. For example, atmosphere oriented group is satisfied with shop interior and comfort while dissatisfied with price because most of the customers in this group are early 20s and do not have great financial capability. Thus, price discounting marketing strategies based on individual situations through CRM system is critical. Comfort oriented group shows high satisfaction level about location and shop comfort. Also, in this group, there are many early 20s female customers, students, and self-employed people. This group customers show high word of mouth tendency, hence providing positive brand image to the customers would be important. In case of taste oriented group, while the scores of taste and location are high, word of mouth score is low. This group is mainly composed of educated and professional many late 20s customers, therefore, menu differentiation, increasing quality of coffee taste and price discrimination is critical to increase customers' satisfaction. However, it is hard to generalize the results of study to other coffee shop brand, because this study have researched only one domestic coffee shop, Caffe Bene. Thus if future study expand the scope of locations, brands, and occupations, the results of the study would provide more generalizable results. Finally, research of customer satisfactions of menu, trust, loyalty, and switching cost would be critical in the future study.

• Journal of Nutrition and Health
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• v.42 no.8
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• pp.770-783
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• 2009

The school foodservice was quantitatively extended by policy of government all the while. There was carried out the survey of customer satisfaction about school foodservice by the ministry of education, science, and technology since 2006 years. Therefore, the purpose of this study was to grasp an improvement of the scores of school foodservice' quality attributes and satisfaction as compared with the preceding year by respondents and school type (elementary school, middle school, and high school). An annual survey was practiced to respondents (students, parents, and faculty) on september 2007 years and 2008 years in 16 cities and provinces. The statistics was analyzed to descriptive analysis and t-test for SPSS 12.0. The scores of school foodservice' quality attributes and overall customer satisfaction were almost increased to students, parents, and faculty and especially, big elevation in middle school. There was big increased the quality attributes such as 'providing information on foodservice', 'pleasant foodservice environment', 'kindness offered by employee' in elementary school, middle school, and high school to total respondents. An overall satisfaction in school foodservice was improved from 69.2 score to 71.9 score. On students, scores of overall satisfaction was increased from 72.9 to 74.0 as students of elementary school and from 61.5 to 65.8 as students of middle school (p < .001). Therefore, for improvement and development of school foodservice, there should be a necessary for an operator of school foodservice and an office of education to make an effort.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.61-71
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• 2015

Purpose : 3D Printers are used to create three-dimensional models based on blueprints. Based on this characteristic, it is feasible to develop a bolus that can minimize the air gap between skin and bolus in radiotherapy. This study aims to compare and analyze air gap and target dose at the branded 1 cm bolus with the developed customized bolus using 3D printers. Materials and Methods : RANDO phantom with a protruded tumor was used to procure images using CT simulator. CT DICOM file was transferred into the STL file, equivalent to 3D printers. Using this, customized bolus molding box (maintaining the 1 cm width) was created by processing 3D printers, and paraffin was melted to develop the customized bolus. The air gap of customized bolus and the branded 1 cm bolus was checked, and the differences in air gap was used to compare $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$ and $V_{95%}$ in treatment plan through Eclipse. Results : Customized bolus production period took about 3 days. The total volume of air gap was average $3.9cm^3$ at the customized bolus. And it was average $29.6cm^3$ at the branded 1 cm bolus. The customized bolus developed by the 3D printer was more useful in minimizing the air gap than the branded 1 cm bolus. In the 6 MV photon, at the customized bolus, $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of GTV were 102.8%, 88.1%, 99.1%, 95.0%, 94.4% and the $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of branded 1cm bolus were 101.4%, 92.0%, 98.2%, 95.2%, 95.7%, respectively. In the proton, at the customized bolus, $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of GTV were 104.1%, 84.0%, 101.2%, 95.1%, 99.8% and the $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of branded 1cm bolus were 104.8%, 87.9%, 101.5%, 94.9%, 99.9%, respectively. Thus, in treatment plan, there was no significant difference between the customized bolus and 1 cm bolus. However, the normal tissue nearby the GTV showed relatively lower radiation dose. Conclusion : The customized bolus developed by 3D printers was effective in minimizing the air gap, especially when it is used against the treatment area with irregular surface. However, the air gap between branded bolus and skin was not enough to cause a change in target dose. On the other hand, in the chest wall could confirm that dose decrease for small the air gap. Customized bolus production period took about 3 days and the development cost was quite expensive. Therefore, the commercialization of customized bolus developed by 3D printers requires low-cost 3D printer materials, adequate for the use of bolus.