• Journal of the Korean Society of Radiology
• /
• v.84 no.2
• /
• pp.418-426
• /
• 2023

Purpose Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization. Materials and Methods First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery. Results Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding. Conclusion The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails.

• Clinical Endoscopy
• /
• v.55 no.5
• /
• pp.655-664
• /
• 2022

Background/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions. Methods: We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events. Results: En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm²/min). Perforation and postoperative bleeding were observed in one patient in each group. Conclusions: PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

• The Korean journal of internal medicine
• /
• v.39 no.3
• /
• pp.439-447
• /
• 2024

Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and ¹³C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.6
• /
• pp.987-996
• /
• 1996

Background : We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods : Twenty-six out of 106 patients with either acute ventilatory failure (VF: $PaCO_2$ > 43 mm Hg with pH < 7.35) or oxygenation failure (OF: $PaO_2/AO_2$ < 300 mm Hg with $pH{\geq}7.35$) requiring mechanical ventilation were managed by NIV (CPAP + pressure suppon, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M : F=7 : $55.4{\pm}14.6$ yrs) and 15 out of 87 cases with OF (17.2%) (M : F=12 : 3, $50.6{\pm}15.6$ yrs) were s uilable for NIY. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of YF and 40% (6/15) of OF were successfully managed on NIV and were weruled from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV ($34{\pm}9$ /min pre-NIV, $26{\pm}6$ /min at 12 hour of NIV, p=0.045), while $PaCO_2$ ($87.3{\pm}20.6$ mm Hg pre-NIV, $81.2{\pm}9.1$ mm Hg at 24 hour of NIV) and pH ($7.26{\pm}0.04$, $7.32{\pm}0.02$, respectively, p <0.05) were both significantly decreased at 24 hour of NIV In NIV for oxygenation failure, $PaCO_2$ were not different between the successful and the failed cases at pre-NIV and till 12 hours after NIV. The $PaO_2/FIO_2$ ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6 : at baseline, 0.5h, 6h, 12h : $120.0{\pm}19.6$, $218.9{\pm}98.3$, $191.3{\pm}55.2$, $232.8{\pm}17.6$ mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9 : $127.9{\pm}63.0$, $116.8{\pm}24.4$, $100.6{\pm}34.6$, $129.8{\pm}50.3$ mm Hg, respectively, p=0.5319). Conclusion : From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rale before the reduction in $PaCO_2$ level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of $PaO_2/FIO_2$ ratio at 0.5h after application is thought to be a predictor of successful NIV.

• Clinical and Experimental Pediatrics
• /
• v.50 no.11
• /
• pp.1061-1066
• /
• 2007

Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.

• Journal of Technology Innovation
• /
• v.5 no.2
• /
• pp.1-21
• /
• 1997

The objective of this paper is to think about what structural reforms of the Korean government S&T development management system might be. Korean society is currently experiencing a drastic socio-economic transformation. The results of this transformation should be reflected on the determining process of the directions and breadths of structural reforms of government S&T development management system. Because the government system design will be based on the premises of socio-economic conditions under which administrative activities perform and also this socio-economic changes can influence on changes of the premises of government management system design. Moreover, S&T development management system is a subsystem of government system so that the directions of structural reform of those subsystems should be considered in the broad framework changes in the development management system of the government. For the last forty years, the Korean government S&T development management system has been based on the premises including transformation from an agrarian society to an industrial society, authoritarianism and centrally controlled institutions, and exteremely small portions of private investments for science and thechonology R & D of the total. Recently, however, the premises of Korean government S&T development management system have rapidly changed. the characteristics of these changes are including tranformation from an industrial society to a knowledge and information intensive society, globalization, localization, and relatively large portion of private investments for science and technology R & C of the total. The basis of government reforms in Korea was the realization of the performances and values through the enhancement of national competitive capacity, attainment of lean government, decentralization and autonomy. However, the Korean government has attached a symbolic value of strategic organizations representing strong policy intentions of government for the science and technology based development. Most problems associated with the Korean government S&T development management system have grown worse during 1990s. Many people perceive that considerable part of this problem was generated because the government could not properly adapt itself to new administrative environment and the paradigm shift in its role. First of all, the Korean government S&T development management system as a whole failed to develop an integrated vision under which processes in formulating science and thechology development goals and developing consistent government plans concerning science and technology development are guided. Second, most of the local governments have little organizational capacity and manpowers to handle localized activities to promote science and technology in their regions. Third, the measure to coordinate and set priorities to invest resources for the development of science and technology was not effective. Fourth, the Most has been losing its reputation as the symbol of ideological commitment of the top policy maker to promote science and technology. Various ideas to reform government S&T development management system have been suggested recently. Most frequently cited ideas are as follow : (ⅰ)strengthen the functions of MoST by supplementing the strong incentive and regulatory measures; (ⅱ)create a new Ministry of Education, Science & Technology and Research by merging the Ministry of Education and the MoST; (ⅲ)create a new Ministry of Science & Technology and Industry ; and(ⅳ)create a National Science and Technology Policy Council under the chairmanship of the President. Four alternatives suggested have been widely discussed among the interested parties and they each have merits as well as weaknesses. The first alternative could be seen as an alternative which cannot resolve current conflicts among various ministries concerning priority setting and resource allocation. However, this alternatives can be seen as a way of showing the top policymaker's strong intention to emphasize science and technology based development. Second alternative is giving a strategic to emphasize on the training and supplying qualified manpower to meet knowledge and information intensive future society. This alternative is considered to be consistent with the new administrative paradigm emphasizing lean government and decentralization. However, opponents are worrying about the linkages and cooperative research between university and industry could be weakening. The third alternative has been adopted mostly in nations which have strong basic science research but weak industrial innovation traditions. Main weakness of this alternative for Korea is that Korean science and technology development system has no strong basic science and technology research traditions. The fourth alternative is consistent with new administrative paradigms and government reform bases. However, opponents to this alternative are worried that the intensive development of science and technology because of Korea's low potential research capabilities in science and technology development. Considerning the present Korean socio-economic situation which demands highly qualified human resources and development strategies which emphasizes the accumulations of knowledge-based stocks, I would like to suggest the route of creating a new Ministry of Education, Science & Technology and Research by intergrating education administration functions and science & technology development function into one ministry.

• The Korean Journal of Air & Space Law and Policy
• /
• v.24 no.2
• /
• pp.69-104
• /
• 2009

This study is to know the Enhancement of Aviation Safety for Low Cost Carrier in Korea through the long and mid term air safety policy. Especially, the aviation safety authorities of the developed countries in aviation establish action plans under the system plan of central government. Then the countries implement those plans systematically to the related aviation business so that they promote efficient air safety policy implementation. At this time, the Korean government should present the vision about an air safety and systematic strategic plan to cope with the future aviation industry change. Also, it is needed to establish a specific aviation safety action plan. Namely, an air safety master plan and long-term road map must be established. This paper deduces some implications through the abroad cases of aviation safety plan, and then tries to find the applying method of the implications to Korea in the rapidly changing aviation market in the 21st century. It is expected that this paper will help the Korean aviation industry to play a major role in the future. In oder to get suggestions aviation policies of advanced countries with regard to aviation safety, we have looked at the aviation policies of the U.S., the U.K., Australia and Japan, and also LCC's states overseas, LCC's safety policies in Korea, and aviation safety status. Since existing LCCs and new LCCs based in Korea have become the new concept, this new market for LCC has been booming recently. Around Southeast Asia, while there are some LCCs including Air Asia which is supported by the government of Malaysia with emphasis on safety, there are other LCCs, which have failed to achieve confidence in safety and have led to aircraft accidents and financial mismanagement, so we need to verify the safety of overseas LCCs, try to improve domestic LCCs in order to fly international routes and aid international aviation safety. LCCs have been increasing lately thanks to open skies policy and a wide variety of flights.lines. Air Busan, Jin Air, Jeju air, Eastar Air are in service. so the risk of new potential hazards may increase. Therefore it is necessary to take the initiative in aviation markets inside and outside of Korea and the safety management of new LCCs should be taken more seriously than ever before. Among overseas aviation safety policies, we need to implement the FAA's Filght Plan which has a specific Business Plan. I hope this thesis will help improve aviation safety locally and internationally.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.1
• /
• pp.25-39
• /
• 2011

In animal studies, Magnesium (Mg) - incorporated oxidized implants showed significant enhancement of the bone response. This prospective clinical trial was performed to investigate the success rate, implant stability and marginal bone loss of Mg oxidized clinical implant. The experimental protocol was approved by Institutional Review Board of the Gangneung-Wonju National University Dental Hospital. Fifty healthy patients had partial edentulism were included in this study. Mg oxidized clinical implants (Implant M, Shinhung, Korea) were installed and restored with conventional protocol. The patients were recalled at 1, 3, 6 months after functional loading. Implant stability quotient (ISQ) was measured and periapical radiographic images were obtained. Amount of marginal bone loss was calculated with calibrated images from periapical radiographs. Repeated measured analysis of variance and post hoc Tukey test were used to compare the mean ISQ and bone level. A total of 101 implants were analyzed. The mean ISQ values increased continuously with time lapse from 68.4 at fixture installation to 71.5 at 6 months after loading. Implant stability was correlated with gender, fixture diameter, bone quality and implant sites. The mean marginal bone loss during 6 months after loading was 0.26 mm. There was no failed implant and six-month success rate was 100%. Within the limitations of this study, the six-month success rate of Mg oxidized implant was satisfactory. The implant stability and marginal bone level were excellent. However, further longer clinical studies will be needed to confirm the success of Mg oxidized clinical implant.

• Korean Journal of Poultry Science
• /
• v.40 no.1
• /
• pp.57-65
• /
• 2013

This study was conducted to evaluate the effect of dietary Weissella koreensis (Wk), a prominent kimchi lactic acid bacteria supplementation on growth performance, nutrients utilization, gut microbiota and meat characteristics in broiler chicken. Both live and killed Wk was compared to know which could be more efficacious as a feed probiotics. Three Wk supplemented groups and no Wk supplemented group were designated according to supplementation levels and cell status. Those were; Control (no Wk), 0.1 % live Wk (LWk 0.1), 0.5% live Wk (LWk 0.5) and 0.5% killed Wk (KWk 0.5). Body weight gain and feed conversion efficiency were improved (P<0.05) by dietary LWk supplementation. KWk did not exert any benefit on growth performance. Crude protein utilizability of KWk supplemented diet was lower (P<0.05) than that of other diets. However, there were no differences among treatments in other nutrients utilization. Serum IgG concentration and relative weight of bursa of Fabricius was highest (P<0.05) in broiler chicken fed KWk 0.5 diet. Cecal anaerobic lactic acid bacteria count of LWk groups were higher (P<0.05) than those of control and KWk 0.5 groups. Dietary Wk supplementation failed to lower the count of cecal and fecal E. coli. There was no effect of dietary Wk on TBARS values and fatty acids profile of broiler leg meat. However, the dietary supplementation of Wk exerted characteristic difference on electronic nose flavor of broiler meat. This study showed that dietary supplementation of LWk was able to improve body weight gain, feed conversion efficiency and cecal lactic acid bacterial count in broiler chicken. Further, the result of this study implemented that a live kimchi lactic acid bacteria, LWk, but not killed Wk, could be used as a probiotic feed supplement for broiler.

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.6
• /
• pp.611-618
• /
• 2004

Background : Idiopathic pulmonary fibrosis(IPF), a subtype of IIP(idiopathic interstitial pneumonia), is a fatal disease with a 3-5 year median survival. Many attempts at treating this condition have failed to demonstrate a survival benefit in IPF. Recently Ziesche et $al^{12}$ reported the efficacy of IFN-${\gamma}$ for treating IPF but there is still some controversy. The aim of this study was to determine the efficacy of IFN-${\gamma}$ in patients with advanced IPF who had not been responsive to steroid and cytotoxic agents. Method : Nine patients with advanced IPF(age: $55.4{\pm}15.3$ years, Male: Female=8:1) were enrolled. One year treatment regime with 2 million IU of IFN-${\gamma}$ administered subcutaneously three times a week, and low dose prednisolone(10-30 mg/d) was also used. In the case of a definite aggravation and serious side effects, the IFN-${\gamma}$ was discontinued. During the IFN-${\gamma}$ trial, a pulmonary function test and chest radiography were checked every three month throughout the study. Result : 1) Among 9 patients, only 4 patients were able to complete the 12 month treatment with IFN-${\gamma}$, and 5 patients died during the treatment period. 2) No improvement either in the respiratory symptoms or pulmonary functions were observed any of the patients, even in those who completed the 12 months trial of IFN-${\gamma}$, 3) At the time of IFN-${\gamma}$ trial, the survivors who finished the IFN-${\gamma}$ treatment for 12 months had a higher oxygen level($81.3{\pm}2.8$ vs. $67.4{\pm}8.4$, P=0.024) and a better pulmonary function(FVC: $61.3{\pm}5.1$ % predicted vs. $45.7{\pm}12.3%$, P=0.048, and $D_Lco$: $45.0{\pm}5.0%$ predicted vs. $30.8{\pm}11.2%$, P=0.048) than the non-survivors. Conclusion : Our data suggested that IFN-${\gamma}$ therapy was not effective in the patients with advanced IPF refractory compared with other therapeutic agents. Furthermore, these results suggest that severe impairment of the pulmonary function and hypoxemia during the IFN-${\gamma}$ therapy requires special attention.