• Journal of Rhinology
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• v.25 no.2
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• pp.75-79
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• 2018

Background and Objectives: To investigate the common site of recurrent epistaxis after initial intervention such as packing and cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. Subjects and Method: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis between October 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. We performed electrocautery when a bleeding site was found. Results: The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septum around the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication during the one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxis after electrocautery and underwent endoscopic sphenopalatine artery ligation. Conclusion: In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examination through a surgical approach and electrocautery for suspected bleeding are effective.

• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.96-104
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• 2022

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

• Journal of the Korean Geosynthetics Society
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• v.21 no.4
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• pp.101-109
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• 2022

This study describes the results of model experiment to analyze the effect of backfill material types on the behavior of underground facility. In the model experiment, backfill materials around the existing underground facility were applied with soil (Jumunjin standard sand) and CLSM. The displacement of underground facility was analyzed for each excavation stage considering the separation distance between the excavation surface and the backfill area based on the experimental results. When soil was applied as a backfill material, the soil on the back of the excavation surface collapsed by excavation and formed an angle of repose, and the process of slope stability was repeated at each excavation stage. In addition, the displacement of underground facility began to occur in the excavation stage that the failure line of soil passes the installation location of the underground facility. When CLSM was applied as a backfill material, there was almost no horizontal and vertical displacement of the ground regardless of the separation distance from the excavation surface even when excavation proceeded to the backfill depth. Therefore, this result showed that it can have a resistance effect against the lateral earth pressure generated and the collapse of the original ground by adjacent excavation, if a backfill material with high stiffness such as CLSM is applied.

• Smart Structures and Systems
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• v.29 no.4
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• pp.625-640
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• 2022

Maglev rail joints are vital components serving as connections between the adjacent F-type rail sections in maglev guideway. Damage to maglev rail joints such as bolt looseness may result in rough suspension gap fluctuation, failure of suspension control, and even sudden clash between the electromagnets and F-type rail. The condition monitoring of maglev rail joints is therefore highly desirable to maintain safe operation of maglev. In this connection, an online damage detection approach based on three-dimensional (3D) convolutional neural network (CNN) and time-frequency characterization is developed for simultaneous detection of multiple damage of maglev rail joints in this paper. The training and testing data used for condition evaluation of maglev rail joints consist of two months of acceleration recordings, which were acquired in-situ from different rail joints by an integrated online monitoring system during a maglev train running on a test line. Short-time Fourier transform (STFT) method is applied to transform the raw monitoring data into time-frequency spectrograms (TFS). Three CNN architectures, i.e., small-sized CNN (S-CNN), middle-sized CNN (M-CNN), and large-sized CNN (L-CNN), are configured for trial calculation and the M-CNN model with excellent prediction accuracy and high computational efficiency is finally optioned for multiple damage detection of maglev rail joints. Results show that the rail joints in three different conditions (bolt-looseness-caused rail step, misalignment-caused lateral dislocation, and normal condition) are successfully identified by the proposed approach, even when using data collected from rail joints from which no data were used in the CNN training. The capability of the proposed method is further examined by using the data collected after the loosed bolts have been replaced. In addition, by comparison with the results of CNN using frequency spectrum and traditional neural network using TFS, the proposed TFS-CNN framework is proven more accurate and robust for multiple damage detection of maglev rail joints.

• Journal of the Korea Society for Simulation
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• v.18 no.3
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• pp.103-112
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• 2009

In a nuclear power plant (NPP), periodic sensor calibrations are required to assure sensors are operating correctly. However, only a few faulty sensors are found to be calibrated. For the safe operation of an NPP and the reduction of unnecessary calibration, on-line calibration monitoring is needed. In this paper, principal component-based Auto-Associative support vector regression (PCSVR) was proposed for the sensor signal validation of the NPP. It utilizes the attractive merits of principal component analysis (PCA) for extracting predominant feature vectors and AASVR because it easily represents complicated processes that are difficult to model with analytical and mechanistic models. With the use of real plant startup data from the Kori Nuclear Power Plant Unit 3, SVR hyperparameters were optimized by the response surface methodology (RSM). Moreover the statistical techniques are integrated with PCSVR for the failure detection. The residuals between the estimated signals and the measured signals are tested by the Shewhart Control Chart, Exponentially Weighted Moving Average (EWMA), Cumulative Sum (CUSUM) and generalized likelihood ratio test (GLRT) to detect whether the sensors are failed or not. This study shows the GLRT can be a candidate for the detection of sensor drift.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.37-44
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• 1998

Purpose: This study aimed at evaluating the therapeutic outcome, cost effectiveness and recurrence rate in children with H. pylori infection after the treatment using various medications. Methods: Seventy five children (mean age $11.4{\pm}2.5$ years) were given an endoscopy with biopsy and H. pylori status assessed by CLO test and histologic examination (Warthin Starry stain). Children were given one of following medications such as DA ($Denol^{(R)}$ and amoxycillin), OA (omeprazole and amoxycillin), DC ($Denol^{(R)}$ and clarithromycin) as primary treatment. And one of following medications such as DAM ($Denol^{(R)}$, amoxycillin and metronidazole), DC, OA, OC (omeprazole and clarithromycin) were used in children who failed the eradication of H. pylori. Results: The endoscopic diagnoses were: nodular gastritis (46 cases), gastric ulcer (9), duodenal ulcer (6), superficial gastritis (6), and normal (8). H. pylori eradication rate was 91% (63 of 69 children) on 4 weeks course of DA, 50% (1 of 2 cases who had treatment failure on DA) on DAM, and 75% (3 of 4 cases who treated on DC primarily) and 50% (1 of 2 cases who had treatment failure on DA) on DC, and 100% on OA (all of 2) and on OC (all of 1 who failed on DA). In 3 of 7 children in whom H. pylori had not been eradicated by primary medications (DA 6 and DC 1 case), H. pylori was re-eradicated by secondary medications (DA 1, DAM 1 and DC 1 case). But in remaining 4 cases, H. pylori infection persisted. Reinfection of H. pylori was found in 4 of 75 children between 3 months and 3 years after completion of the treatment of DA, yielding recurrence rate of 5.3%. In 2 of 4 cases who had relapsed, H. pylori was re-eradicated by secondary medications (OC 1 and DA 1 case). But in remaining 2 cases, H. pylori infection persisted. Conclusion: These results suggest that dual therapy with $Denol^{(R)}$ and amoxycillin is the effective medications in treating H. pylori infection in children. Concerning the cost effectiveness, it can be recommended as first line treatment of choice as well.

• Asia pacific journal of information systems
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• v.22 no.2
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• pp.21-38
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• 2012

Until recently, successful implementation of ERP systems has been a popular topic among ERP researchers, who have attempted to identify its various contributing factors. None of these efforts, however, explicitly recognize the need to identify disparities that can exist between organizational information requirements and ERP systems. Since ERP systems are in fact "packages" -that is, software programs developed by independent software vendors for sale to organizations that use them-they are designed to meet the general needs of numerous organizations, rather than the unique needs of a particular organization, as is the case with custom-developed software. By adopting standard packages, organizations can substantially reduce many of the potential implementation risks commonly associated with custom-developed software. However, it is also true that the nature of the package itself could be a risk factor as the features and functions of the ERP systems may not completely comply with a particular organization's informational requirements. In this study, based on the organizational memory mismatch perspective that was derived from organizational memory theory and cognitive dissonance theory, we define the nature of disparities, which we call "mismatches," and propose that the mismatch between organizational information requirements and ERP systems is one of the primary determinants in the successful implementation of ERP systems. Furthermore, we suggest that customization efforts as a coping strategy for mismatches can play a significant role in increasing the possibilities of success. In order to examine the contention we propose in this study, we employed a survey-based field study of ERP project team members, resulting in a total of 77 responses. The results of this study show that, as anticipated from the organizational memory mismatch perspective, the mismatch between organizational information requirements and ERP systems makes a significantly negative impact on the implementation success of ERP systems. This finding confirms our hypothesis that the more mismatch there is, the more difficult successful ERP implementation is, and thus requires more attention to be drawn to mismatch as a major failure source in ERP implementation. This study also found that as a coping strategy on mismatch, the effects of customization are significant. In other words, utilizing the appropriate customization method could lead to the implementation success of ERP systems. This is somewhat interesting because it runs counter to the argument of some literature and ERP vendors that minimized customization (or even the lack thereof) is required for successful ERP implementation. In many ERP projects, there is a tendency among ERP developers to adopt default ERP functions without any customization, adhering to the slogan of "the introduction of best practices." However, this study asserts that we cannot expect successful implementation if we don't attempt to customize ERP systems when mismatches exist. For a more detailed analysis, we identified three types of mismatches-Non-ERP, Non-Procedure, and Hybrid. Among these, only Non-ERP mismatches (a situation in which ERP systems cannot support the existing information needs that are currently fulfilled) were found to have a direct influence on the implementation of ERP systems. Neither Non-Procedure nor Hybrid mismatches were found to have significant impact in the ERP context. These findings provide meaningful insights since they could serve as the basis for discussing how the ERP implementation process should be defined and what activities should be included in the implementation process. They show that ERP developers may not want to include organizational (or business processes) changes in the implementation process, suggesting that doing so could lead to failed implementation. And in fact, this suggestion eventually turned out to be true when we found that the application of process customization led to higher possibilities of failure. From these discussions, we are convinced that Non-ERP is the only type of mismatch we need to focus on during the implementation process, implying that organizational changes must be made before, rather than during, the implementation process. Finally, this study found that among the various customization approaches, bolt-on development methods in particular seemed to have significantly positive effects. Interestingly again, this finding is not in the same line of thought as that of the vendors in the ERP industry. The vendors' recommendations are to apply as many best practices as possible, thereby resulting in the minimization of customization and utilization of bolt-on development methods. They particularly advise against changing the source code and rather recommend employing, when necessary, the method of programming additional software code using the computer language of the vendor. As previously stated, however, our study found active customization, especially bolt-on development methods, to have positive effects on ERP, and found source code changes in particular to have the most significant effects. Moreover, our study found programming additional software to be ineffective, suggesting there is much difference between ERP developers and vendors in viewpoints and strategies toward ERP customization. In summary, mismatches are inherent in the ERP implementation context and play an important role in determining its success. Considering the significance of mismatches, this study proposes a new model for successful ERP implementation, developed from the organizational memory mismatch perspective, and provides many insights by empirically confirming the model's usefulness.

• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.248-260
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• 2004

Background : As an effective regimen for isoniazid (INH)-resistant pulmonary tuberculosis, several treatment regimens have been recommended by many experts. In Korea, a standard regimen has not been established for INH-resistant tuberculosis, and the treatment by individual physicians has been performed on an empirical bases. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the treatment outcomes of patients with INH-resistant tuberculosis. Materials and Methods : Sixty of 69 patients reported to have INH-resistant tuberculosis from 1994 to 2001 were retrospectively analyzed. Exclusion criteria included: death from other causes, with the exceptions of tuberculosis and incomplete treatment, including a patient's transfer-out. Results : A previous tuberculosis history was found in 28 (46.7%) patients. The sputum smear for acid-fast bacilli was positive in 44 (73.3%) patients, and 30 (50.0%) had cavitary disease. Streptomycin resistance coexisted in 25.0% of isolates. INH was to be prescribed continuously, even after INH resistance was reported, in 86.0% of patients. The treatment regimens were diverse between the patients according to drug regimen composition and treatment duration. The most frequent prescribed regimen included rifampin, ethambutol and pyrazinamide, with and without INH, for the full 12-month term of treatment. Treatment failure occurred in 13 (21.7%) patients. Cavitary disease (p=0.005) and a treatment regimen with second-line drugs, excluding rifampin (p=0.015), were associated with treatment failure. One patient experienced a relapse. Conclusions : Standardized treatment guidelines will be needed in Korea to improve the treatment efficacy for INH-resistant tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.975-991
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• 1997

Background : Many patients with isoniazid and rifampin-resistant pulmonary tuberculosis have organisms that are also resistant to other first-line drugs. Despite of aggressive retreatment chemotherapy, the results are often unsuccessful, with a failure rate approaching 40%. Recently, there has been a revival of resectional surgery for the treatment of multidrug-resistant pulmonary tuberculosis. Methods : A retrospective analyses of the case records and radiographic findings were done. Between January 1991 and December 1995, 14 human immunodeficiency virus (HIV)-seronegative patients with multidrug-resistant pulmonary tuberculosis were selected for resection to supplement chemotherapy. All patients had organisms resistant to many of the first-line drugs, including both isoniazid and rifampin. Results : Despite of aggressive therapy for median duration of 9.5 months, 12 of the 14 patients (86%) were still sputum smear and/or culture positive at the time of surgery. The disease was generally extensive. Although main lesions of the disease including thick-walled cavities were localized in one lung, lesser amounts of contralateral disease were demonstrated in 10 of 14 (71%). Types of surgery performed were pneumonectomy including extrapleural pneumonectomy in six patients, lobectomy or lobectomy plus in six patients, and segmentectomy in two patients. The resected lung appeared to have poor function ; preoperative perfusion lung scan showed only 4.8% of the total perfusion to the resected portion of the lung. There were no operative deaths. Two patients had major postoperative complications including empyema with bronchopleural fistula and prolonged air leak, respectively. Of the 14 patients, 13 (93%) remained sputum-culture-negative for M. tuberculosis for a median duration of 23 months and one remained continuously sputum smear and culture positive for M. tuberculosis. Conclusion : On the basis of comparison with historical controls, adjunctive resectional surgery appears to play a significant beneficial role in the management of patients with multidrug-resistant pulmonary tuberculosis if the disease is localized and there are adequate reserve in pulmonary function.

• Journal of Life Science
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• v.14 no.6 s.67
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• pp.906-912
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• 2004

Helicobacter pylori infection is highly prevalent, as high as 2/3 of whole population infected, in Korea. H. pylori infection initiates inflammation by induction of interleukin-8 through type IV secretion of CagA. It was recently suggested that induction failure of IL-8 is not associated with defect in cag PAI but associated with cagE locus diversity. This study was designed to investigate ability of 11-8 in-duction according to sequence variation within the cagE gene, cagA TP motifs and vacA m-types in vitro study using AGS cell-line, and to evaluate its association with different clinical outcome. Seventy-four H. pylori stains were isolated from 23 patients with gastric cancer (Ca), 24 subjects with gastritis (G) and 27 patients with duodenal ulcer (Du) in Kangnam St. Mary's Hospital, Seoul, Korea. cagE gene diversity was confirmed by the PCR-RFLP methods with MboI/NlaIII and tyrosine phosphate motifs (TPMs) of cagA was determined TPM-A and C by using DdeI/Tsp5091 restriction enzyme and TPM-B was determend by Real time PCR the method of Owen et al. and IL-8 was measured by ELISA assay. IL-8 activity was positively detected in 59 among 74 strains $(79.7\%)$. IL-8 secretion was significantly increased in MboI A and MboI B type compared to MboI C type and in MboI/NlaIII A-C and B-C type than C-C type. 1L-8 activity was not associated with either the number or composition of cagA tyrosine phosphorylation motifs and vacA m-type. There was no significant difference in IL-8 activity among patient groups. cagE gene diversity is thought to be mainly associated with the induction of IL-8 in H. pylori infection.