• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권1호
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• pp.85-96
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• 2024

Objective: Congenital intracranial pial arteriovenous fistula (PAVF) is a rare cerebral vascular pathology characterized by a direct shunt between one or more pial feeding arteries and a cortical draining vein. Transarterial endovascular embolization (TAE) is widely considered first line therapy. Curative TAE may not be achievable in the multi-hole variant due to the potential to harbor innumerable small feeding arteries. Transvenous embolization (TVE) may be considered to target the final common outlet of the lesion. Here, we present a series of four patients with complex multi-hole congenital PAVF treated with staged TAE followed by TVE. Methods: A retrospective review was conducted on patients who underwent treatment for congenital, multi-hole PAVFs treated by a combined TAE/TVE approach at our institution since 2013. Results: We identified four patients with multi-hole PAVF treated by a combined TAE/TVE. Median age was 5.2 (0-14.7) years. Median follow-up of 8 (1-15) months by catheter angiography and 38 (23-53) months by MRI/MRA was obtained. TVE achieved complete occlusion in three patients that proved durable on radiographic follow-up and demonstrated excellent clinical outcomes with a modified Rankin Score (mRS) of 0 or 1. Complete occlusion of the draining vein was not achieved by TVE in one case. This patient is graded as pediatric mRS=5 three years post-procedure. Conclusions: With thorough technical considerations, our series indicates that TVE of multi-hole PAVF that are refractory to TAE is feasible and effective in arresting the consequences of chronic, high-flow AV shunting produced by this pathology.

• 한국도로학회논문집
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• 제4권4호
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• pp.23-39
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• 2002

본 논문은 아스팔트 포장의 소성변형 저항성 추정을 보다 쉽게 하기 위하여 새로운 시험법 및 장비를 개발하기 위한 연구이다. 본 연구에서는 다양한 종류의 아스팔트 혼합물을 사용하여 소성변형 저항성과의 상관성이 높게 나타나는 변형강도를 개발하기 위하여 하중봉의 직경(D) 3, 4cm, 각 봉의 하단을 다양하게 원형절삭(r)한 김 테스터를 개발하였다. 이를 이용하여 마샬시험과 같이 공시체를 $60^{\circ}C$에 수침처리하고 같은 속도의 정하중을 공시체에 다짐방향으로 가하여 최대하중 ($P_{max}$)과 이때의 수직 변위 (y)를 구하였다. 변형강도는 개발된 식 $K_D = 4P_{max}/{\pi}(D-2(r-\sqrt{2ry-y^2}))^2$으로 구하였으며 소성변형 특성치와 평균 $R^2$이 0.77이상의 높은 상관성을 보였다. 따라서 이 시험방법은 마샬안정도보다 훨씬 소성변형과의 상관관계가 큰 측정치를 얻을 수 있는 방법임을 알 수 있었으며, 특히 기존의 마샬시험기를 그대로 사용하고 공시체도 기존의 방법대로 제조 및 처리하도록 하여 적용이 빠를 것으로 판단된다. 향후 다양한 골재입도, 최대치수, r 등에서도 타당성과 상관성 검증을 통해 시험법을 표준화한다면 실용화 가능성이 매우 클 것이다.

• 생물환경조절학회지
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• 제3권1호
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• pp.42-51
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• 1994

대다수 농산물과 마찬가지로 건조표고의 등급판정은 외관특징에 주로 의존한다. 표고 갓의 전후면에 걸친 복잡하고 다양한 외관특징들로 인하여 표고의 등급판정은 임의로 추출한 표고샘플에 대하여 전문가가 수작업으로 판정하고 있으며, 선별작업 역시 전적으로 수작업에 의존하고 있다. 단순한 반복작업으로 보이는 농산물의 등급판정은 사실 시각과 촉각을 위시한 고도의 감각신경계를 통하여 상호 복잡하게 얽혀 들어오는 정보를 지능적으로 처리하는 고기능의 작업이다. 농산물의 경우, 외관특성을 비롯한 물성은 종류별로 그 경계치를 일괄적으로 명확하게 규정할 수 없기 때문에 대개는 오차를 포함한 통계적 접근에 의하여 규정하고 있다. 따라서 농산작업에 있어서는 농산물 물성이 갖는 모호성을 효율적으로 처리할 수 있는 가변적인 작업구조 및 정보처리가 필수적으로 요구된다. 본 연구에서는 인간 뇌의 정보처리 기능을 부분적으로 구현할 수 있는 인공신경회로망을 컴퓨터 시각 시스템에 적용하여 단순 기하도형의 분류 및 표고의 등급판정을 성공적으로 수행하였다. 회로망 입력으로는 컴퓨터시각 시스템을 이용하여 건조표고의 정성적 외관특징을 자동으로 추출한 후 정량화한 특징점 값들을 이용하였다. 신경회로망의 학습은 표본 추출한 등급표고와 이들의 정량적 특징점 값들을 입출력 쌍으로 하여 수행하였다. 학습한 회로망의 등급판정 성능시험은 표본추출한 미지의 표고에 대한 컴퓨터 영상 특징점 값들을 입력하여 수행하였다.

• Pediatric Infection and Vaccine
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• 제29권1호
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• pp.28-36
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• 2022

목적: 5-11세 소아에서 코로나19 백신의 효능과 안전성을 평가하기 위해서 체계적 문헌고찰을 시행하였다. 방법: 2022년 1월 4일까지 Ovid-MEDLINE 및 medRxiv를 검색하여 문헌을 선정하고 자료를 추출하였다. 근거 수준을 평가하기 위해 GRADE 도구를 사용하였다. 결과: 총 1,675 건의 연구가 일차적으로 검색되었고 최종적으로 5편의 연구가 포함되었다. 서로 다른 4개의 코로나19 백신(BNT162b2, mRNA-1273, CoronaVac, BBIBP-CorV)에 대한 무작위 대조군 연구 결과들은 5-11세 연령에서 각 백신의 양호한 면역원성과 안전성을 보여주었다. 미국에서 5-11세 소아 연령에서 BNT162b2 백신 접종 후 이상사례 모니터링 연구에서는 승인 전 임상시험을 통해 예상되었던 국소반응 및 전신반응이 보고되었으나 중대한 이상사례는 거의 보고되지 않았다. 결론: 5-11세 연령에서 코로나19 백신 접종에 대한 데이터는 제한적이다. 이 연령에서 코로나19 백신의 안전성과 효과에 대한 체계적인 평가를 위해 지속적이고 포괄적인 모니터링이 필요할 것으로 보인다.

• Korean Journal of Radiology
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• 제21권4호
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• pp.422-430
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• 2020

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

• 대한음성학회:학술대회논문집
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• 대한음성학회 2000년도 7월 학술대회지
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• pp.235-240
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• 2000

In the age of global communication, more human exchange is extended at the grass-roots level. In the old days, language policy and language planning was based on one nation-state with one language. But high waves of globalizaiton have allowed extended human flow of exchange beyond one's national border on a daily basis. Under such circumstances, homogeneity in Japan may not allow Japanese to speak and communicate only in Japanese and only with Japanese people. In Japan, an advisory report was made to the Ministry of Education in June 1996 about what education should be like in the 21st century. In this report, an introduction of English at public elementary schools was for the first time made. A basic policy of English instruction at the elementary school level was revealed. With this concept, English instruction is not required at the elementary school level but each school has their own choice of introducing English as their curriculum starting April 2002. As Baker, Colin (1996) indicates the age of three as being the threshold diving a child becoming bilingual naturally or by formal instruction. Threre is a movement towards making second language acquisition more naturalistic in an educational setting, developing communicative competence in a more or less formal way. From the lesson of the Canadian immersion success, Genesee (1987) stresses the importance of early language instruction. It is clear that from a psycho-linguistic perspective, most children acquire basic communication skills in their first language apparently effortlessly and without systematic and formal instruction during the first six or seven years of life. This innate capacity diminishes with age, thereby making language learning increasingly difficult. The author, being a returnee, experienced considerable difficulty acquiring L2, and especially achieving native-like competence. There will be many hurdles to conquer until Japanese students are able to reach at least a communicative level in English. It has been mentioned that English is not taught to clear the college entrance examination, but to communicate. However, Japanese college entrance examination still makes students focus more on the grammar-translation method. This is expected to shift to a more communication stressed approach. Japan does not have to aim at becoming an official bilingual country, but at least communicative English should be taught at every level in school Mito College is a small two-year co-ed college in Japan. Students at Mito College are basically notgood at English. It has only one department for business and economics, and English is required for all freshmen. It is necessary for me to make my classes enjoyable and attractive so that students can at least get motivated to learn English. My major target is communicative English so that students may be prepared to use English in various business settings. As an experiment to introduce more communicative English, the author has made the following syllabus design. This program aims at training students speak and enjoy English. 90-minute class (only 190-minute session per week is most common in Japanese colleges) is divided into two: The first half is to train students orally using Graded Direct Method. The latter half uses different materials each time so that students can learn and enjoy English culture and language simultaneously. There are no quizes or examinations in my one-academic year program. However, all students are required to make an original English poem by the end of the spring semester. 2-6 students work together in a group on one poem. Students coming to Mito College, Japan have one of the lowest English levels in all of Japan. However, an attached example of one poem made by a group shows that students can improve their creativity as long as they are kept encouraged. At the end of the fall semester, all students are then required individually to make a 3-minute original English speech. An example of that speech contest will be presented at the Convention in Seoul.