• Journal of Trauma and Injury
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• v.21 no.1
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• pp.28-35
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• 2008

Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

• Journal of Korean Society of Transportation
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• v.21 no.4
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• pp.113-132
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• 2003

Using nonradial data envelopment analysis(DEA) under assumptions of strong disposability and variable returns scale, this paper annually estimates productive. technical and allocative efficiencies of three publicly-owned rail transit properties which are different in terms of organizational type: Seoul Subway Corporation(SSC, local public corporation), the Seoul Metropolitan Electrified Railways sector (SMESRS) of Korea National Railroad(the national railway operator controlled by the Ministry of Construction and Transportation(MOCT)), and Busan Urban Transit Authority (BUTA, the national authority controlled by MOCT). Using the estimation results of Tobit regression analysis. the paper next computes their true productive, true technical and true allocative efficiencies, which reflect only the impacts of internal factors such as production activity by removing the impacts of external factors such as an organizational type and a track utilization rate. And the paper also computes an organizational efficiency and annually gross efficiencies for each property. The paper then conceptualized that the property produces a single output(car-kilometers) using four inputs(labor, electricity, car & maintenance and track) and uses unbalanced panel data consisted of annual observations on SSC, SMESRS and BUTA. The results obtained from DEA show that, on an average, SSC is the most efficient property on the productive and allocative sides, while SMESRS is the most technically-efficient one. On the other hand. BUTA is the most efficient one on the truly-productive and allocative sides, while SMESRS on the truly-technical side. Another important result is that the differences in true efficiency estimates among the three properties are considerably smaller than those in efficiency estimates. Besides. the most cost-efficient organizational type appears to be a local public corporation represented by SSC, which is also the most grossly-efficient property. These results suggest that a measure to sort out the impacts of external factors on the efficiency of rail transit properties is required to assess fairly it, and that a measure to restructure (establish) an existing(a new) rail transit property into a local public corporation(or authority) is required to improve its cost efficiency.

• Journal of Korean Society of Transportation
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• v.24 no.5 s.91
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• pp.89-108
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• 2006

Korea has been entering the ageing society as the population of age over 65 shared over 7% since the year 2000. The ageing society needs to have transportation facility considering elderly people's travel behavior. This study aims to understand the elderly people's travel behavior using recent data in Korea. The activity schedule approach begins with travel outcomes are part of an activitv scheduling decision. For tho?e approach. used discrete choice models (especially. Nested Logit Model) to address the basic modeling problem capturing decision interaction among the many choice dimensions of the immense activity schedule choice set The day activity schedule is viewed as a sot of tours and at-home activity episodes tied togather with overarching day activity pattern using the Seoul Metropolitan Area Transportation Survey data, which was conducted in June, 2002. Decisions about a specific tour in the schedule are conditioned by the choice of day activity pattern. The day activity scheduling model estimated in this study consists of tours interrelated in a day activity pattern. The day activity pattern model represents the basic decision of activity participation and priorities and places each activity in a configuration of tours and at-home episodes. Each pattern alternative is defined by the primary activity of the day, whether the primary activity occurs at home or away, and the type of tour for the primary activity. In travel mode choice of the elderly and non-workers, especially, travel cost was found to be important in understanding interpersonal variations in mode choice behavior though, travel time was found to be less important factor in choosing travel mode. In addition, although, generally, the elderly was likely to choose transit mode, private mode was preferred for the elderly over 75 years old owing to weakened physical health for such things as going up and down of stairs. Therefore. as entering the ageing society, transit mode should be invested heavily in transportation facility Planning tor improving elderly transportation service. Although the model has not yet been validated in before-and-after prediction studies. this study gives strong evidence of its behavioral soundness, current practicality. and potential for improving reliability of transportation Projects superior to those of the best existing systems in Korea.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.247-257
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• 1989

Thirty patients with nonresectable hepatocellular carcinoma (HCC) due to either locally advanced lesion or association with liver cirrhosis, treated with combined radiotherapy and hyperthermia between April 1988 and July 1988, at Dept. of Radiation Oncology, Yonsei university College of medicine, were analysed. External radiotherapy of a total dose of 3060cGy/3.5 wks was given. Hyperthermia was given twice a week with a total of 6 treatment sessions using 8MHz radiofrequency capacitive type heating device, i.e., Thermotron RF-8 and Cancermia. In all cases hyperthermia was given within 30 minutes after radiotherapy for 30~60min. Temperature was measured by inserting thermocouple into the tumor mass under the ultrasonographic guidance only for those who had not bleeding tendency. As a result, partial response (PR) was achieved in 12 patients (40%), and symptomatic improvement was observed in 22 patients (78.6%) among 28 patients who had suffered from abdominal pain. The most significant factor affecting the tumor response rate was the type of tumor (single massive: 10/14, 71.4%; diffuse infiltrative: 2/10, 20%; multinodular:0/6, 0%; p<0.005). There were not any significant side effects relating to combined treatment. The overall 1 year survival rate was 34%, with 50% in the PR group and 22% in the no response group (NR), respectively. Median survival was 6.5 months and longer for those of PR than of NR (11 mos. vs 5, p<0.05). In conclusion, combined radiotherapy and hyperthermia appeared to be effective in local control and symptomatic palliation of HCC. Further study including a larger number of the patients to confirm its effect in survival and detrimental side effect should be urged.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.58-66
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• 2006

Purpose: Renal irradiation can lead to the development of radiation nephropathy, and this is characterized by the accumulation of extracellular matrix and final fibrosis. To determine the possible role of the glomerular epithelial cell, the radiation-induced changes in the expression of its genes associated with the extracellular matrix were analyzed. Materials and Methods: Rat glomerular epithelial cells (GEpC) were irradiated with a single dose of 0, 2, 5, 10 and 20 Gy with using 6 MV LINAC (Siemens, USA), and the samples were collected 6, 24, 48 and 72 hours post-irradiation, respectively. Northern blotting, western blotting and zymography were used to measure the expression level of fibronectin (Fn), plasminogen activator inhibitor-1 (Pai-1), matrix metalloproteinases-2, 9 (MMP-2, 9), tissue inhibitor of metalloproteinase-2 (TIMP-2), tissue-type plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA). Results: Irradiation with a single dose of 10 Gy resulted in a significant increase in Fn mRNA since 24 hours post-irradiation, and a single dose of 5 and 10 Gy significantly increased the Fn immunoreactive protein measured 48 hours post-irradiation. An increase in Pai-1 mRNA and protein was also observed and especially, a single dose of 10 Gy significantly increased the mRNA measured 24 and 48 hours post-irradiation. The active MMP-2 measured 24 hours post-irradiation slightly increased in a dose dependent manner, but this increase did not reach statistical significance. The levels of MMP-9, TIMP-2, t-PA and u-PA appeared unaltered after irradiation. Conclusion: Irradiation of the glomerular epithelial cells altered the expression of genes associated with the extracellular matrix, implying that the glomerular epithelial cell may be involved in the development of radiation nephropathy.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.44-50
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• 2006

Puroose: This study evaluated the late rectal complications in cervix cancer patients following treatment with external beam radiotherapy (EBRT) and high dose rate intracavitary radiation (HDR ICR). The factors affecting the risk of developing late rectal complications and its incidence were analyzed and discussed. Materials and Methods: The records of 105 patients with cervix cancer who were treated with radical radiotherapy using HDR ICR between July, 1995 and December, 2001 were retrospectively reviewed. The median dose of EBRT was 50.4Gy $(41.4{\sim}56.4 Gy)$ with a daily fraction size of 1.8Gy. A total of $5{\sim}7$ (median: 6) fractions of HDR ICR were given twice weekly with a fraction size of $4{\sim}5 Gy$ (median: 4Gy) to A point using an Ir (Iridium)-192 source. The median dose of ICR was 24 Gy $(20{\sim}35 Gy)$. During HDR ICR, the rectal dose was measured in vivo by a semiconductor dosimeter. The median follow-up period was 32 months, ranging from 5 to 84 months. Results: Of the 105 patients, 12 patients (11%) developed late rectal complications: 7 patients with grade 1 or 2, 4 patients with grade 3 and 1 patient with grade 4. Rectal bleeding was the most frequent chief complaint. The complications usually began to occur $5{\sim}32$ (median: 12) months after the completion of radiotherapy. Multivariate analysis revealed that the measured cumulative rectal BED over 115 Gy3 (Deq over 69 Gy) and the depth (D) of a 5 Gy isodose volume more than 50 mm were the independent predictors for late rectal complications. Conclusion: With evaluating the cumulative rectal BED and the depth of a 5 Gy isodose volume as predictors, we can individualize treatment planning to reduce the probability of late rectal complications.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.246-252
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• 2002

Purpose : It has been recognized that interaction of the Fas : Fas ligand plays an important role in radiation-induced apoptosis. The purpose of this study was to investigate the role of Fas mutation in radiation-induced apoptosis in vivo. Materials and Method : Mice with mutations in Fas, $MRL/Mpj-Fas^{Ipr}$, and its normal control, MRL/Mpj, were used in this study. Eight-week old male mice were given whole body radiation. After irradiation, the mice were killed and their spleens were collected at different time intervals. Tissue samples were stained with hematoxylin-eosin and the numbers of apoptotic cells were scored. Regulating molecules of apoptosis including p53, Bcl-2, Bax, $Bcl-X_L,\;and\;Bcl-X_S$ were also analyzed by Western blotting. Results : At 25 Gy irradiation, the level of apoptosis reached the peak value at 8 hr after radiation and recovered to the normal value at 24 hr after radiation in MRL/Mpj mice. In contrast, the peak apoptosis level appeared at 4 hr after radiation in $MRL/Mpj-Fas^{Ipr}$. At 8 hr after radiation, the levels of apoptosis in MRL/Mpj mice and $MRL/Mpj-Fas^{Ipr}$ mice were $52.3{\pm}7.8\%\;and\;8.0{\pm}8.6\%$, respectively (p<0.05). The expression of apoptosis regulating molecules, p53, $Bcl-X_L\;and\;Bcl-X_S$, increased in MRL/Mpj mice in response to radiation; p53 with a peak level of 3-fold at 8 h, $Bcl-X_L$ with a peak level of 3.3-fold at 12 h, and $Bcl-X_S$ with a peak level of 3-fold at 12 h after 25 Gy radiation. Bcl-2 and Bax did not show significant change in MRL/Mpj mice. However in $MRL/Mpj-Fas^{Ipr}$ mice, the expression levels of p53, Bcl-2, Bax, $BCl-X_L\;and\;BCl-X_S$ showed no significant change. Conclusion : The level of radiation-induced apoptosis was lower in Fas mutated mice, Ipr, than in control mice. This seemed to be related to the lack of radiation-induced p53 activation in the Ipr mice. This result suggests that Fas plays an important role in radiation-induced apoptosis in vivo.

• Journal of Wetlands Research
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• v.12 no.1
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• pp.1-14
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• 2010

Changes in wetland soil properties of two constructed wetlands after their constructions were compared to those of a natural wetland to determine if they could be used for the evaluation of the success of constructed wetlands and the assessment of their functions. One natural wetland as a reference wetland and two constructed wetlands(treatment wetland and experimental wetland) with different contaminant inflow characteristics were selected for this study. Major physicochemical properties of wetland soil such as soil texture, water content, pH, CEC(cation exchange capacity), organic matter content, total nitrogen, and available phosphorus were monitored to investigate the effects of inundation and accumulation of organic matters and nutrients on the wetland soil development. There was a clear difference in soil texture between the natural wetland and the constructed ones, with the high sand content in the constructed wetlands as compared to the high clay content in the natural one. Gradual increases of silt and clay contents over time were observed in the constructed wetlands. The soil of the natural wetland was higher in water content and organic matter but lower in pH than those of the constructed wetlands. The pH of the constructed wetlands reached near neutral ranges after initial increase. CEC and nutrient concentrations of the constructed wetlands seemed to be affected mainly by outside inflows of organic matter and contaminants. Concentrations of organic matter and nutrients decreased over time in the experimental wetland where surface and deep soils with different characteristics were mixed during its construction, suggesting that changes in soil properties during wetland constructions may affect the development of wetland soils or wetland biogeochemistry. This study showed that changes in physicochemical properties of soils in constructed wetlands could be used to assess the success of constructed wetlands and their functions, and also the importance of reference wetlands for the appropriate assessment.

• Journal of Wetlands Research
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• v.15 no.1
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• pp.149-157
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• 2013

The weirs built so far are mainly overflow type weirs overflowing to the upstream. Main advantages of overflow type weirs are, effective water resources management and easy design, construction and maintenance due to many accumulated studies. However, due to the special feature of the overflow type weir where water overflows through the upstream of the weir, the silt coming from the upstream is not discharged to the downstream of the weir. This increases the river bed and reduces the reservoir capacity, and as a result, the weir loses its function. A underflow type weir with a water gate has been implemented in order to solve such sediment deposit and weir maintenance problems. However due to the design problem of recently constructed underflow type weirs, the river bed of the downstream of a weir has been scoured. And this leds to a structural problem. In this study, the flow characteristics of overflow type weirs and underflow type weir, hydraulic jump length analysis depending on change of water depth and the amount of specific energy loss generated per unit length depending on a weir type have been compared and analyzed, for the effective design and management of the weirs. The experiment results show that, when identical upstream conditions of underflow type weir and an overflow type weir were maintained, the hydraulic jump length was up to twice longer with Fr(Froude number) 3.5 of the hydraulic jump length at the underflow type weir, and the hydraulic jump length gradually decreased as the downstream water depth increased. The comparative analysis result of the amount of specific energy loss generated per unit length showed that the amount of energy loss per unit length was twice higher for an overlfow type weir than a underflow type weir. Therefore, in case of a underflow type facility, an additional energy reduction facility is determined to be necessary for safety of water construction structures.

• Journal of Wetlands Research
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• v.15 no.3
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• pp.347-356
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• 2013

To provide the information for the wetland management considering the water treatment ability of macrophytes, the growth characteristics and primary production by reed (Phragmites australis) and cattail (Typha angustifolia), and the decomposition rate of organic matter produced were investigated in two sub-wetlands (Banweol and Donhwa wetlands) of the Sihwa Constructed Wetland (CW) with different chemistry of inflows. The shoot height of P. australis and Typha angustifolia began to increase in March, and reached its peaks in July and August (340cm and 320cm, respectively). The shoot density of P. australis ranging $100{\sim}170EA/m^2$ was higher than that of T. angustifolia (max. $78EA/m^2$). Standing biomass of P. australis ranged from $1,350{\sim}1,980gDM/m^2$, with maximal biomass in Banwol Upper Wetland. And it was larger in upper wetlands than lower wetlands. On the other hand standing biomass of T. angustifolia ($1,940gDM/m^2$) was similar to that of P. australis in Banwol Upper Wetland. Primary productivity of P. australis was in the order of Banwol Upper Wetland ($2,050gDM/m^2/yr$) > Donghwa Lower Wetland ($1,840gDM/m^2/yr$) > Banwol Lowerr Wetland ($1,570gDM/m^2/yr$) ${\fallingdotseq}$ Donghwa Lower Wetland ($1,540gDM/m^2/yr$), and that of T. angustifolia ($2,210gDM/m^2/yr$) was higher than P. australis. Annual production of organic matter produced by P. australis and T. angustifolia was 845 ton DM/yr (423 ton C/yr), and about 90% was comprised of that by P. australis. From the litter decomposition rate (k) (P. australis: leaf 0.0062/day, stem 0.0018/day; T. angustifolia: leaf 0.0031/day, stem 0.0018/day), leaf was rapid degraded compare to stem in both P. australis and T. angustifolia. The litter decomposition rate of leaf was two times rapid P. australis than T. angustifolia, whereas that of stem was same in both. Annual litter decomposition amount of P. australis than T. angustifolia was 285 ton C/yr(67.3% of organic matter produced by macrophytes), indicating that 32.7% of organic matter produced by macrophytes is accumulated in the Sihwa CW.