• Advances in pediatric surgery
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• v.12 no.2
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• pp.192-201
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• 2006

There are considerable controversies in the management of congenital diaphragmatic hernia. By 1997, early operation, routine chest tube on the ipsilateral side and maintainingrespiratory alkalosis by hyperventilation were our principles (period I). With a transition period from 1998 to 1999, delayed operation with sufficient resuscitation, without routine chest tube, and permissive hypercapnia were adopted as our practice. High frequency oscillatory ventilation (HFOV) and nitric oxide (NO) were applied, if necessary, since year 2000(period II). Sixty-seven cases of neonatal Bochdalek hernia from 1989 to 2005 were reviewed retrospectively. There were 33 and 34 cases in period I and II, respectively. The neonatal survival rates were 60.6 % and 73.5 %, respectively, but the difference was not significant. In period I, prematurity, low birth weight, prenatal diagnosis, inborn, and associated anomalies were considered as the significant poor prognostic factors, all of which were converted to nonsignificant in period II. In summary, improved survival was not observed in later period. The factors considered to be significant for poor prognosis were converted to be nonsignificant after change of the management principle. Therefore, we recommend delayed operation after sufficient period of stabilization and the avoidance of the routine insertion of chest tube. The validity of NO and HFOV needs further investigation.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.248-252
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• 2010

Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA) in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG), and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE) and heart computed tomography (CT). She underwent a corrective operation by re-implantation, CABG, and unroofing.

• The korean journal of orthodontics
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• v.28 no.6 s.71
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• pp.893-904
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• 1998

There are varieties of severe malocclusions, which can be treated orthodontically, but with a great deal of effort. Anterior openbite, in particular, is one malocclusion thought to be more difficult to treat, and therefore, most of them have to be corrected by means of surgical intervention. To solve these problems, numerous studies pertinent to treatment modalities have been introduced with controversies on the effectiveness of treatment. Suggested treatment modalities for anterior openbite are based directly or indirectly on the neuromuscular and morphological features and on the etiologic and/or the environmental factors. Even though the vertical relationship of the face is increased due to the growth variation, the normal occlusal relationship can be achieved by the adequate dentoalveolar compensatory mechanism, but in the case of inadequate or negative dentoalveolar compensation, openbite is likely to be present. If the skeletal dysplasia is too severe to be solved by orthodontic treatment alone, combined treatment with surgery should be done to restore the function and the esthetics of the orofacial complex. In many cases, however, orthodontic alteration of the dentition pertinent to the given skeletal pattern with the proper diagnosis and treatment planning can bring satisfactory results. The treatment changes with the Multiloop Edgewise Archwire(MEAW) therapy occurred mainly in the dentoalveolar region and showed a considerable similarity to the natural dentoalveolar compensatory mechanism. In other words, the MEAW technique allows orthodontists to produce the natural dentoalveolar compensation orthodontically. Even if an openbite is corrected by the orthodontic dentoalveolar compensation suitable for the skeletal pattern, relapse may still occur by the persisting etiologic factors which originally prohibited the natural dentoalveolar compensation. The etiologic factors should be determined at the time of initial diagnosis and should be controlled during treatment and retention.

• Korean Journal of Logic
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• v.15 no.2
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• pp.273-294
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• 2012

In my previous article "An Inferentialist Account of Indicative Conditionals" and "An Inferentialist Account of Indicative Conditionals and Hasuk Song's Objections", I argued that the so-called Uncontested Principle is not uncontestable. According to the Uncontested Principle, an indicative conditional '$A{\rightarrow}C$' logically implies a material conditional '$A{\supset}C$'. In his recent paper "On the Recent Controversies surrounding the Uncontested Principle" Wonbae Choi presents three objections to my claim. First, my denial of the Uncontested Principle implies rejecting modus ponens. Second, my denial of the Uncontested Principle is tantamount to taking the truth-conditions of an indicative conditional as weaker than those of a material conditional, which are usually taken to be the weakest among conditionals. Third, my view that we can warrantedly assert '$A{\rightarrow}C$' even when 'A ${\therefore}$ C' is inductively justified is based on a misunderstanding of the way in which indicative conditionals are justified. In this paper I argue that Choi's objections are all based on misunderstandings of my view. First, I do not deny the validity of modus ponens (as a form of deductive reasoning). Second, the fact that the inductive warrantability of 'A ${\therefore}$ C' does not imply the truth of '$A{\supset}C$' does not show that the truth-conditions of an indicative conditional is weaker than those of a material conditional. Third, Choi's claim that a contingent conditional '$A{\rightarrow}C$' is true only when 'C' can be deductively derived from 'A' in conjunction with a hidden premiss is not well grounded, nor does it fit the facts.

• Korean Journal of Construction Engineering and Management
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• v.16 no.3
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• pp.152-164
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• 2015

Enhancing clarity and transparency of the pricing guide for technical services for public construction works enables the prediction and reimbursement of the service cost for project owners and bidders, while it would also yield benefits for engineers who carry out the construction tasks. In order to improve the global competitiveness of construction service industry, the government revised its pricing guide for techical services for construction works recently, moving away from its previous percentage-of-construction-cost method towards the Cost Plus a Fee Method. However, since the Cost Plus a Fee Method results in the rise of the service price by 153%~197%, there is the need for a review on the method and basis of the adjustment in order to avoid controversies regarding the application of the revised method. In this context, this paper analysed the 2014 revision of the pricing guide for technical services for public construction works through comparison with foreign cases including those of the US and the UK. The analysis yielded the conclusion that, while the shift towards Cost Plus a Fee Method which is widely used in advanced economies is a very meaningful change in large measure, certain aspects still remain problematic. Unlike in advanced economies, the detailed break-down shows the direct labor cost includes certain indirect expenses. Also, indirec expenses are admitted so comprehensively as to include overhead costs and technology royalties. These problems results in redundant estimation of certain expenses, and obstructs transparency in spending details. This paper proposes various improvement measures to address these issues.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.41-46
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• 2010

Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.43-47
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• 2012

Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.151-155
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• 2011

Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

• Journal of Korean Society on Water Environment
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• v.26 no.1
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• pp.1-9
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• 2010

Technology-Based Effluent Limitations (TBELs) is a permit limits for a pollutant that is based on the capability of a treatment technology to reduce the pollutant to a certain concentration. Widely practiced for regulations of industrial wastewater in US, TBELs has been accepted as an effective means that can achieve balanced goals between complete elimination of pollutants discharge and economic feasibility for industries. The review of TBELs application in US and the applicability of TBELs to the domestic industry categories was given in three papers. In the first paper, the development and practices of TBELs in US were reviewed including case studies. The developments of TBELs in US in the four major categories, the metal products & machinery, the petroleum refining, the porcelain enameling and the meat & poultry products were reviewed. The applicability of TBELs to the domestic industrial categories was also assessed. In the second paper, the pollution loads analysis for domestic industrial wastewater was conducted based on risk assessment indicator using Toxic Weighting Factors (TWFs). This is an essential part to determine the priority of TBELs application for the domestic industrial categories. In the last paper, the application of TBELs to the domestic industries was demonstrated through a case-study for the pulp/paper/paperboard category. Direct application of TBELs of US into the Korean regulation system may not be desirable because the specific goals and the environment for the regulations for the two countries may not be identical. For example, unlike US, Korea does not adopt the individual permit system for pollution sources. However, among the unproductive and exhaustive controversies over the uniform regulations regardless of the industrial categories in Korea, the introduction of the principles of TBELs are inevitable and more extensive study for applications of TBELs optimized for Korean regulation system will be necessary.

• Journal of the Korean Society for Marine Environment & Energy
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• v.14 no.1
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• pp.51-64
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• 2011

Carbon dioxide Capture and Storage (CCS) is one of the key players in greenhouse gas (GHG) reduction portfolio for mitigating climate change. CCS makes simultaneously it possible not only to reduce a huge amount of carbon dioxide directly from the emission sources (e.g., coal power plant) but also to maintain the carbon concentrated-energy and/or industry infrastructure. Internationally, the United Nations Framework Convention on Climate Change (UNFCCC) is dealing the agenda for considering the possibility of including CCS project as one of Clean Development Mechanism (CDM) projects. Despite its usefulness, however, there are the controversies in including CCS as the CDM project, whose issues include i) non-permanence, including long-term permanence, ii) measuring, reporting and verification (MRV), iii) environmental impacts, iv) project activity boundaries, v) international law, vi) liability, vii) the potential for perverse outcomes, viii) safety, and ix) insurance coverage and compensation for damages caused due to seepage or leakage. In this paper, those issues in considering CCS as CDM are summarized and analyzed in order to suggest some considerations to policy makers in realizing the CCS project in Korea in the future.