• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• Radiation Oncology Journal
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• v.31 no.3
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• pp.125-130
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• 2013

Purpose: We investigated the role of radiotherapy (RT) for pancreatobiliary neuroendocrine tumors (PB-NETs). Materials and Methods: We identified 9 patients with PB-NETs who received RT between January 2005 and March 2012. Of these 9 patients, 4 were diagnosed with NETs in the pancreas and 5 were diagnosed with NETs in the gallbladder. All patients received RT to the primary tumor or resection bed with a median total irradiation dose of 50.4 Gy, with or without chemotherapy. Results: The tumor response rate and tumor control rate in the RT field were 60% and 100 %, respectively. All 4 patients who underwent surgery had no evidence of disease in the RT field. Of the 5 patients who received RT to the primary gross tumor, 1 had complete response, 2 had partial response, and 2 had stable disease in the RT field. The median time to progression was 11 months. Of the 9 patients, four patients had no progression, and 5 patients had progression of disease (locoregional, 2; distant, 2; locoregional/distant, 1). Of the 4 patients without progression, 3 were treated with RT in adjuvant or neoadjuvant setting, and one received RT to primary tumor. One patient experienced radiation-induced duodenitis at 3 months after concurrent chemoradiation without treatment-related mortality. Conclusion: RT can yield local control for advanced PB-NETs. RT should be considered an essential part of multimodality treatment in management of advanced PB-NETs.

• Radiation Oncology Journal
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• v.37 no.3
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• pp.193-200
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• 2019

Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD₂). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD₂) were significantly associated with OS. The high dose group (≥52 Gy, EQD₂) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.43-46
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• 2008

Background and Objectives : Clinical suspicion and appropriate diagnostic procedures are essential for the timely management of extrapulmonary type of mycobacterial disease. In the hope of suggesting a suitable guideline for the early diagnosis of laryngeal tuberculosis, the authors reviewed their clinical pathways and the characteristics of patients with laryngeal tuberculosis who were managed in the recent 10 years at a single tertiary referral hospital, Samsung Medical Center. Subjects and Method : Retrospective chart review was performed for the 25 adult patients with laryngeal tuberculosis. Among 25 cases, 12 were pathologically confirmed by laryngeal biopsy and the other 13 were clinically diagnosed by cumulative clinical information; definite laryngitis on laryngoscopy, positive AFB (acid fast bacillus) smear/culture or active pulmonary tuberculosis on chest X-ray, and substantial response to anti-tuberculosis medication. Results : Chest X-ray revealed active pulmonary tuberculosis in 72% of patients (N=18/25). Sputum AFB smear/culture was positive in 95% of all tested patients (N=21/22) and in 100% of the tested patients who have stable or no evidence of pulmonary tuberculosis (N=5/5). All patients except one who had coexisting laryngeal malignancy showed considerable improvement in their subjective symptoms and laryngeal findings within the first 2 months of anti-tuberculosis medications and they achieved complete response on subsequent sputum studies, chest X-ray and laryngeal findings after $7.0{\pm}2.3$ months of the medications. Conclusion : We suggest that chest X-ray and sputum AFB smear/culture to be the first step of work-up for the patients having laryngeal tuberculosis in suspicion since laryngeal tuberculosis is largely associated with active pulmonary tuberculosis and/or sputum AFB study offers high yield even in case of primary laryngeal tuberculosis. However laryngeal biopsy must be considered in case showing unsatisfactory response to the anti-tuberculosis medication for more than 2 months.

• Journal of Veterinary Clinics
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• v.35 no.3
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• pp.103-106
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• 2018

A 12-year-old castrated male Shih Tzu presented with suspected hearing loss. The patient had no history of head trauma or exposure to ototoxic drugs. The results of neurologic and physical examinations were normal. An otoscopic examination showed that both the tympanic membranes and the external ear canals had a normal appearance. However, the results of brainstem auditory evoked response tests confirmed sensorineural deafness in the right ear and indicated conduction disturbances and brainstem abnormalities in the left ear. Magnetic resonance imaging was performed to confirm the causes of the conduction disturbances and brainstem abnormalities. Inflammatory changes in the left middle ear were highly suspected to be responsible for the findings in the left ear. The results of these examinations confirmed complete hearing loss in the right ear and indicated otitis media in the left ear, which could have been the cause of the conduction disturbances.

• Journal of Power Electronics
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• v.6 no.1
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• pp.52-66
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• 2006

This paper proposes a wind energy conversion system connected to a grid using a self-excited induction generator (SEIG) based on the maximum power point tracking (MPPT) control scheme. The induction generator (IG) is controlled by the MPPT below the base speed and the maximum energy can be captured from the wind turbine. Therefore, the stator currents of the IG are optimally controlled using the indirect field orientation control (IFOC) according to the generator speed in order to maximize the generated power from the wind turbine. The SEIG feeds a (CRPWM) converter which regulates the DC-link voltage at a constant value where the speed of the IG is varied. Based on the IG d-q axes dynamic model in the synchronous reference frame at field orientation, high-performance synchronous current controllers with satisfactory performance are designed and analyzed. Utilizing these current controllers and IFOC, a fast dynamic response and low current harmonic distortion are attained. The regulated DC-link voltage feeds a grid connected CRPWM inverter. By using the virtual flux orientation control and the synchronous frame current regulators for the grid connected CRPWM inverter, a fast current response, low harmonic distortion and unity power factor are achieved. The complete system has been simulated with different wind velocities. The simulation results are presented to illustrate the effectiveness of the proposed MPPT control scheme for a wind energy system. In the simulation results, the d-q axes current controllers and DC-link voltage controller give prominent dynamic response in command tracking and load regulation characteristics.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.189-196
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• 1989

Twenty five patients with tumors of the brain stem were treated with radiotherapy between 1979 and 1987. Histological diagnosis could be obtained in 6 cases, and other 19 patients were diagnosed by neurologic findings and CT or MRI. Eighteen patients were treated by radical radiotherapy and 6 patients received both operation and radiotherapy, while 1 patient received chemotherapy after radiotherapy. Total dose ranged from 50 Gy to 55 Gy. By an clinical scoring scale at 2 months after radiotherapy, no complete response was obtained, but 16 cases achieved partial response, 2 cases were stable, and 4 cases were deteriorated. The overall survival rate at 3 years was $36\%$ Age, performance status at diagnosis, degree of cranial nerve involvement, CT pattern of post-contrast enhancement, and clinical responese by scoring scale were correlated with survival.

• Wind and Structures
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• v.19 no.4
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• pp.443-465
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• 2014

Hyperbolic thin-shell cooling towers have complicated vibration modes, and are very sensitive to the effects of group towers and wind-induced vibrations. Traditional aero-elastic models of cooling towers are usually designed based on the method of stiffness simulation by continuous medium thin shell materials. However, the method has some shortages in actual engineering applications, so the so-called "equivalent beam-net design method" of aero-elastic models of cooling towers is proposed in the paper and an aero-elastic model with a proportion of 1: 200 based on the method above with integrated pressure measurements and vibration measurements has been designed and carried out in TJ-3 wind tunnel of Tongji university. According to the wind tunnel test, this paper discusses the impacts of self-excited force effect on the surface wind pressure of a large-scale cooling tower and the results show that the impact of self-excited force on the distribution characteristics of average surface wind pressure is very small, but the impact on the form of distribution and numerical value of fluctuating wind pressure is relatively large. Combing with the Complete Quadratic Combination method (hereafter referred to as CQC method), the paper further studies the numerical sizes and distribution characteristics of background components, resonant components, cross-term components and total fluctuating wind-induced vibration responses of some typical nodes which indicate that the resonance response is dominant in the fluctuating wind-induced vibration response and cross-term components are not negligible for wind-induced vibration responses of super-large cooling towers.

• Journal of the Korean Society of School Health
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• v.34 no.1
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• pp.13-21
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• 2021

Purpose: This research was conducted to investigate the characteristics of emotional exhaustion that Korean school nurses suffer, to suggest policy implications to address this issue, and to propose preventive and supervisory measures regarding emotional exhaustion experienced by school nurses in elementary, middle, and high schools in Korea. Methods: A survey was conducted under the authorization of Chungcheongnam-do Office of Education. Out of 400 copies first distributed, 376 copies were returned. Among the 376 copies, 117 copies which were judged insincere or from teachers with less than 1 year of experience were exclded from the study. Through this process, only 259 copies were finally selected. Results: As a result of assessing the fit of the model, it was found that 𝑥²=67.247 (df=28, p<.001), GFI=.953, AGFI=.911, TLI=0.936, CFI=0.965 and RMSEA=.074. Emotional exhaustion was found to have a direct effect on job demand (β=.26) and an indirect effect on stress response (β=.31). The total effect was β=.57. There was a positive complete indirect effect of β=.52 between emotional intelligence and emotional exhaustion. The total effect was not significant, respectively. Conclusion: Since job demands of school nurses affect emotional exhaustion, it is necessary to reconstruct their jobs and operations to alleviate their job demands.

• Earthquakes and Structures
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• v.16 no.1
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• pp.11-28
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• 2019

This article investigates the response of Integral Abutment Bridges (IAB) when subjected to a sequence of seasonal thermal loading of the deck followed by ground seismic shaking in the longitudinal direction. Particular emphasis is placed on the effect of pre-seismic thermal Soil-Structure Interaction (SSI) on the seismic performance of the IAB, as well as on the ability of various backfills configurations, to minimize the unfavorable SSI effects. A series of two-dimensional numerical analyses were performed for this purpose, on a complete backfill-integral bridge-foundation soil system, subjected to seasonal cyclic thermal loading of the deck, followed by ground seismic shaking, employing ABAQUS. Various backfill configurations were investigated, including conventional dense cohesionless backfills, mechanically stabilized backfills and backfills isolated by means of compressive inclusions. The responses of the investigated configurations, in terms of backfill deformations and earth pressures, and bridge resultants and displacements, were compared with each other, as well as with relevant predictions from analyses, where the pre-seismic thermal SSI effects were neglected. The effects of pre-seismic thermal SSI on the seismic response of the coupled IAB-soil system were more evident in cases of conventional backfills, while they were almost negligible in case of IAB with mechanically stabilized backfills and isolated abutments. Along these lines, reasonable assumptions should be made in the seismic analysis of IAB with conventional sand backfills, to account for pre-seismic thermal SSI effects. On the contrary, the analysis of the SSI effects, caused by thermal and seismic loading, can be disaggregated in cases of IAB with isolated backfills.