• Title/Summary/Keyword: Case Review

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Adenoid Cystic Carcinoma of the Head and Neck (두경부의 Adenoid Cystic Carcinoma)

  • 박준식;설대위
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.14.2-14
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    • 1981
  • In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

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A Study on Location Selection for Rainwater Circulation System Elements at a City Level - Focusing on the Application of the Environmental and Ecological Plan of a Development - (도시차원의 빗물순환체계 요소별 입지선정에 관한 연구 - 개발예정지역의 환경생태계획 적용방안을 중심으로 -)

  • Kim, Hyo-Min;Kim, Kwi-Gon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.3
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    • pp.1-11
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    • 2012
  • This study focused on establishing a natural rainwater circulation system using rainwater meant for relatively large urban development projects such as a new town development. In particular, when the location selection techniques for individual elements of a natural rainwater circulation system are developed for the integrated rainwater management, changes in hydrological environment will be minimized and the natural water circulation would be restored to realize the low impact development (LID). In that case, not only the excess will be reduced but water space and green areas in a city would also increase to improve the urban sustainability. First of all, there were five elements selected for the location selection of a rainwater circulation system intended for the integrated rainwater management: rainwater collection, infiltration, filtration, retention and movement spaces. After generating these items, the location selection items and criteria were defined for each of the five elements. For a technique to apply the generated evaluation items and criteria, a grid cell analysis was conducted based m the suitability index theory, and thematic maps were overlapped through suitability assessment of each element and graded based on the suitability index. The priority areas were identified for each element. The developed technique was applied to a site where Gim-cheon Innovation City development is planned to review its feasibility and limitations. The combined score of the overlapped map for each element was separated into five levels: very low, low, moderate, high and very high. Finally, it was concluded that creating a rainwater circulation system conceptual map m the current land use plan based on the outcome of the application would be useful in building a water circulation system at the de1ailed space planning stage after environmental and ecological planning. Furthermore, we use the results of this study as a means for environment-friendly urban planning for sustainable urban development.

A Study On Irrigation Water Price Structure and Prescription (농업용수의 가격구조에 관한 연구)

  • 심기영
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.15 no.4
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    • pp.3170-3180
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    • 1973
  • This study of the subject will review past and present irrigation development in Korea. Particular attention will be given to water pricing structure and a case study on the purpose of rational operation and management of irrigation water and organizations, and the optimum irrigation water and organizations, and the optimum irrigation water fee inorder to reduce farmers burden and to rationalize the farmland associations management so as to achieve development of the rural environment. In 1971, the reservoir of the Farmland Improvement A sociation (FIA) produced only 775 millison $m^3$ of irrigation water or 77% of planned capacity of 1,015 million $m^3$. It was caused by inefficient maintenance of irrigation facilities; for instance, about 21% of reservoirs, pumping stations and weirs in Korea have been silted by soil erosion which hinder to water production according to an ADC survey. The first Irritation Association was established in 1906, whcih was renamed the Farmland Assoeiation by the Rural Development Enouragement Law in 1970. By the end of 1971, 411,000 ha of rice paddies were under the control of 267 associations nationwide. The average water price assessed by Associations nationwide rose from 790 won per 0.1 ha. in 1966 to 1,886 won in 1971. The annual growth rate was 20%. The highest water price in 1971 was 4,773 won her 0.1 ha. and the lowest was 437 won. This range was caused by differences in debt burden, geographic conditions and management efficiency among the Associations. In 1971, the number of Associations which exceeded the average water price of 1,886 won per 0.1 ha. was 144, or 55.1% of all Association. In determination of water price, there are two principles; one is determined by production cost such as installation cost of irrigation facilities, maintenance cost, management cost and depreciation ect. For instance, the Yong San River Development project was required 33.7 billion won for total construction and maintenance cost is 3.1 billion won for repayment, maintenance and management cost per year. The project produces 590 million $m^3$ of irrigation water annually. Accordingly, the water price per $m^3$ is 5.25 won. The other principle is determined by water value in the crop products and in compared with production of irrigated paddy and non-irrigated paddy. By using this method, water value in compared with paddy rice vs. upland rice(Average of 1967-1971) was 14.15 won per $m^3$ and irrigated paddy vs. non-irrigated paddy was 2.98 won per $m^3$. In contrast the irrigation fee in average association of 1967-1971 was 1.54 won per $m^3$. Accordingly, the current national average irrigation fee(water price) is resonable compared with its water value. In this study, it is found that the ceiling of water price in terms of water value is 2.98 won per $m^3$ or 2,530 won per 0.1 ha. However, in 1971 55% of the associations were above the average of nationwide irrigation fees. which shows the need for rationalization of the Association's management. In connection with rationalization of the Association's management, this study recommends the following matters. (1) Irrigation fee must be assessed according to the amount of water consumption taking intoaccount the farmer's ability. (2) Irrigation fee should be graded according to behefits and crop patterns. (3) Training personnel in the operation and procedures of water management to save O&M costs. (4) Insolvent farmland association should be integrated into larger, sound associations in the same GUN in order to reduce farmers' water cost. (5) The maintenance and repair of existing irrigation facilities is as important as expansion of facilities. (6) Establishment of a new Union of Farmland Association is required to promoted proper maintenance and to protect the huge investment in irrigation facilities by means of technical supervision and guidance.

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A Study on the Performance Evaluation of G2B Procurement Process Innovation by Using MAS: Korea G2B KONEPS Case (멀티에이전트시스템(MAS)을 이용한 G2B 조달 프로세스 혁신의 효과평가에 관한 연구 : 나라장터 G2B사례)

  • Seo, Won-Jun;Lee, Dae-Cheor;Lim, Gyoo-Gun
    • Journal of Intelligence and Information Systems
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    • v.18 no.2
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    • pp.157-175
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    • 2012
  • It is difficult to evaluate the performance of process innovation of e-procurement which has large scale and complex processes. The existing evaluation methods for measuring the effects of process innovation have been mainly done with statistically quantitative methods by analyzing operational data or with qualitative methods by conducting surveys and interviews. However, these methods have some limitations to evaluate the effects because the performance evaluation of e-procurement process innovation should consider the interactions among participants who are active either directly or indirectly through the processes. This study considers the e-procurement process as a complex system and develops a simulation model based on MAS(Multi-Agent System) to evaluate the effects of e-procurement process innovation. Multi-agent based simulation allows observing interaction patterns of objects in virtual world through relationship among objects and their behavioral mechanism. Agent-based simulation is suitable especially for complex business problems. In this study, we used Netlogo Version 4.1.3 as a MAS simulation tool which was developed in Northwestern University. To do this, we developed a interaction model of agents in MAS environment. We defined process agents and task agents, and assigned their behavioral characteristics. The developed simulation model was applied to G2B system (KONEPS: Korea ON-line E-Procurement System) of Public Procurement Service (PPS) in Korea and used to evaluate the innovation effects of the G2B system. KONEPS is a successfully established e-procurement system started in the year 2002. KONEPS is a representative e-Procurement system which integrates characteristics of e-commerce into government for business procurement activities. KONEPS deserves the international recognition considering the annual transaction volume of 56 billion dollars, daily exchanges of electronic documents, users consisted of 121,000 suppliers and 37,000 public organizations, and the 4.5 billion dollars of cost saving. For the simulation, we analyzed the e-procurement of process of KONEPS into eight sub processes such as 'process 1: search products and acquisition of proposal', 'process 2 : review the methods of contracts and item features', 'process 3 : a notice of bid', 'process 4 : registration and confirmation of qualification', 'process 5 : bidding', 'process 6 : a screening test', 'process 7 : contracts', and 'process 8 : invoice and payment'. For the parameter settings of the agents behavior, we collected some data from the transactional database of PPS and some information by conducting a survey. The used data for the simulation are 'participants (government organizations, local government organizations and public institutions)', 'the number of bidding per year', 'the number of total contracts', 'the number of shopping mall transactions', 'the rate of contracts between bidding and shopping mall', 'the successful bidding ratio', and the estimated time for each process. The comparison was done for the difference of time consumption between 'before the innovation (As-was)' and 'after the innovation (As-is).' The results showed that there were productivity improvements in every eight sub processes. The decrease ratio of 'average number of task processing' was 92.7% and the decrease ratio of 'average time of task processing' was 95.4% in entire processes when we use G2B system comparing to the conventional method. Also, this study found that the process innovation effect will be enhanced if the task process related to the 'contract' can be improved. This study shows the usability and possibility of using MAS in process innovation evaluation and its modeling.

An Analysis of the Cognition of Professionals Regarding the Validity of Planting Design Change that Occurred in the Landscape Construction of a Major Private Company (민간기업 조경공사에서 나타나는 식재설계 변경 타당성에 대한 전문가 인식 분석)

  • Park, Jae-Young;Cho, Se-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.6
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    • pp.101-110
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    • 2014
  • This study analyzes the validity of the type classification of the type and design changes of apartment landscaping planting construction design changes that were completed in the private sector, efficiently manages the design changes that are displayed over landscaping planting work in general in the future, and performs research by placing the object underlying the presentation. The results are as follows. First, the percentage that occurred in the planting construction of design changes that have occurred in the apartment landscaping construction was carried out in the private sector and accounted for 61.8%. This indicates that part of the planting is a major design change. Second, as the cause of such a design change to be those associated with the field conditions such as lack of main construction period. In particular, due to a change in oral, appeared 7-48 times design changes of one review design change approval is complex, design changes of planting construction had shown a feature that occurs in multiple simultaneous. Third, the 7 types of Design Changes in planting design were delineated as 'design changes for consideration of the user', 'design changes for image improvement', 'design changes for ease of maintenance', 'design changes due to the mismatch of design statement', 'design changes due to the relationship with the engineering species of other', 'design changes due to lack of field study', and 'design changes due to the consideration of feasibility.' Fourth, 'design changes for consideration of the user' and 'design changes for image improvement' were found in more than half of the frequency of the overall changes. This differed from the results shown in public corporations. Fifth, if planting construction design change process, private companies, it was found that is showing the approval of the practice after the previous construction of the construction cost savings due to construction time. However, in the case of a public corporation, these exhibited a different aspect from the private sector and show a design change procedure that reflects the changes after the design change events in the field have occurred. The above results, the type of landscaping works in planting design change of public enterprises, regardless of the private sector, is the same in the seven types, the main reason of and procedures for design changes, indicating that there are other respects. In design change, it may be desirable to apply becomes liquidity rationality and efficiency of the dimension, depending on the nature of the landscape construction.

Development and Application of the High Speed Weigh-in-motion for Overweight Enforcement (고속축하중측정시스템 개발과 과적단속시스템 적용방안 연구)

  • Kwon, Soon-Min;Suh, Young-Chan
    • International Journal of Highway Engineering
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    • v.11 no.4
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    • pp.69-78
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    • 2009
  • Korea has achieved significant economic growth with building the Gyeongbu Expressway. As the number of new road construction projects has decreased, it becomes more important to maintain optimal status of the current road networks. One of the best ways to accomplish it is weight enforcement as active control measure of traffic load. This study is to develop High-speed Weigh-in-motion System in order to enhance efficiency of weight enforcement, and to analyze patterns of overloaded trucks on highways through the system. Furthermore, it is to review possibilities of developing overweight control system with application of the HS-WIM system. The HS-WIM system developed by this study consists of two sets of an axle load sensor, a loop sensor and a wandering sensor on each lane. A wandering sensor detects whether a travelling vehicle is off the lane or not with the function of checking the location of tire imprint. The sensor of the WIM system has better function of classifying types of vehicles than other existing systems by detecting wheel distance and tire type such as single or dual tire. As a result, its measurement errors regarding 12 types of vehicle classification are very low, which is an advantage of the sensor. The verification tests of the system under all conditions showed that the mean measurement errors of axle weight and gross axle weight were within 15 percent and 7 percent respectively. According to the WIM rate standard of the COST-323, the WIM system of this study is ranked at B(10). It means the system is appropriate for the purpose of design, maintenance and valuation of road infrastructure. The WIM system in testing a 5-axle cargo truck, the most frequently overloaded vehicle among 12 types of vehicles, is ranked at A(5) which means the system is available to control overloaded vehicles. In this case, the measurement errors of axle load and gross axle load were within 8 percent and 5 percent respectively. Weight analysis of all types of vehicles on highways showed that the most frequently overloaded vehicles were type 5, 6, 7 and 12 among 12 vehicle types. As a result, it is necessary to use more effective overweight enforcement system for vehicles which are seriously overloaded due to their lift axles. Traffic volume data depending upon vehicle types is basic information for road design and construction, maintenance, analysis of traffic flow, road policies as well as research.

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Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

The Surgical Case Analysis of Congenital Heart Disease -A review of 1,060 Cases (선천성 심장병의 외과적 고찰)

  • Jo, Sam-Hyeon;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1316-1322
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    • 1996
  • From May 1977 to December 1994, 1.060 cases of open heart surge y for congenital heart disease were performed under cardiopulmonary bypass in Chonnam University Hospital They were divided into two groups; group A(677 cases, from May 1977 lo December 1989), group B(38B cases, from January 1990 to December 1994), to be compared and analized. Of the 1, 060 cases, there were 889 acyanotic (83.9%) and 171 cyanotic(16.1%). The operative mortality was 7.8% in group A and 5.7% in group B (total : 6.6%). The operative mortality for group A was 25% in cyanotic disease and 3.7% in acyanotic disease, respectively in group B, it was 23.8%, 3.2%. There were 19 patients (3.8%) and 78 patients(20.4%) with body weight under 10kg in group A and group B respectively. The operative mortality for these patients were 31.6% in A group and 16.1% in B group. In result, increasing trend in congenital heart disease in patients under 10 kg of body weight has been noted, whereas mortality has decreased. The operative mortality of tetralogy of Fallot has decreased in group B t an group A. These results suggest that the operative result have improved in recent years.

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Gastrointestinal Foreign Bodies: Review of 96 Cases (소아의 위장관 이물에 대한 고찰)

  • Lee, Min-Rye;Kang, Ki-Su;Jung, Hae-Sung;Seo, Ji-Hyoun;Lim, Jae-Young;Park, Chan-Hoo;Choi, Myoung-Bum;Woo, Hyang-Ok;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.136-142
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    • 2002
  • Purpose: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. Methods: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. Results: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. Conclusion: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.

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Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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