• Journal of Gastric Cancer
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• v.16 no.3
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• pp.191-194
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• 2016

Hypercalcemia of malignancy due to metastatic gastric adenocarcinoma is extremely rare; in fact, to the best of our knowledge, only three case reports of hypercalcemia associated with metastatic gastric adenocarcinoma have been published in the literature to date. Herein, we report a rare case involving a 61-year-old African-American female who had hypercalcemia at initial presentation and who was later diagnosed with poorly differentiated gastric adenocarcinoma with extensive liver metastases, without bone involvement. She was found to have elevated parathyroid hormone-related peptide and normal parathyroid hormone levels. Despite aggressive treatment, she died within a few months of diagnosis.

• Journal of the Korean Society of Propulsion Engineers
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• v.22 no.3
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• pp.65-71
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• 2018

There is no significant difference in the initial viscosity of a propellant applied with yellow iron oxide and red iron oxide. In addition, the thermal decomposition rate of the material with added yellow iron oxide is faster than that with the addition of red iron oxide. Specifically, it was confirmed that the pressure exponent was 18% lower at high temperature and high pressure with yellow iron oxide than with red iron oxide. The initial viscosity was lowest at 71% of the large particle to small particle ratio.

• Journal of the Korean Institute of Intelligent Systems
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• v.14 no.5
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• pp.517-524
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• 2004

The fuzzy set theory has been wide used in clustering of machine learning with data mining since fuzzy theory has been introduced in 1960s. In particular, fuzzy C-means algorithm is a popular fuzzy clustering algorithm up to date. An element is assigned to any cluster with each membership value using fuzzy C-means algorithm. This algorithm is affected from the location of initial cluster center and the proper cluster size like a general clustering algorithm as K-means algorithm. This setting up for initial clustering is subjective. So, we get improper results according to circumstances. In this paper, we propose a cluster merging using enhanced density based fuzzy C-means clustering algorithm for solving this problem. Our algorithm determines initial cluster size and center using the properties of training data. Proposed algorithm uses grid for deciding initial cluster center and size. For experiments, objective machine learning data are used for performance comparison between our algorithm and others.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.174-180
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• 2018

Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

• Proceedings of the Korean Vacuum Society Conference
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• 1998.02a
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• pp.44-44
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• 1998

It was observed that the friction coefficient decreased with increasing Si concentration in the l ilms. Furthermore, the friction behavior became more s때ble even when very small amount of S Si of less than 0.5 at. % was incorporatA:회 By analyzing the composition of the debris f formed, we could show that the low and stabilized friction coefficient is in마nately relatA:었 w with the formation of the Si rich oxide debris. These result supports the mechanism that the h hydrated silica debris is the reason for low friction coefficient in humid environment. Second e evidence of the role of Si rich oxide debris could be found in the triOO-chemical reactions d during initial stage of triho-test. When the Si concen$\sigma$ation was less than 5 at.%, initial t transient period of high friction coefficient was commonly observed. Mter the transient period, m the friction coefficient becomes lower with increasing contact cycles. The initial $\sigma$ansient p peri여 becomes shorter and the starting and maximum friction coefficients in $\sigma$ansient 야,riod d decreased with increasing Si concentration. Composition of the debris on the wear scar s surface was analyzed by Auger spe따'Oscopy at v뼈ous stages in the initial transient period. W We observed that when the friction coefficient increased in earlier stage of the $\sigma$'ansient p period, iron and oxygen was observed in the debris. However, decrease in the 당iction c coefficient in the later stage of the transient period was associated with the formation of s silicon rich oxide debris. This result also supports the friction mechanism of Si-DLC films t that the formation of Si rich oxide debris results in low friction coefficient in ambient a atmosphere. atmosphere.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.17-23
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• 2014

Objectives: This study evaluated the efficacy of Endosolv-R and Xylene in softening epoxy resin based sealer after 1 to 2 min exposure. Materials and Methods: Sixty Teflon molds ($6mm{\times}1.5mm$ in inner diameter and depth) were equally divided into 3 groups of 20 each. AH 26 (Dentsply/De Trey), AH Plus (Dentsply/De Trey), Adseal (Meta-Biomed) were manipulated and placed in the molds allotted to each group and allowed to set at $37^{\circ}C$ in 100% humidity for 2 wk. Each group was further divided into 2 subgroups according to the solvents used, i.e. Xylene (Lobachemie) and Endosolv-R (Septodont). Specimens in each subgroup were exposed to respective solvents for 1 and 2 min and the corresponding Vicker's microhardness (HV) was assessed. Data was analysed by Mauchly's test and two-way analysis of variance (ANOVA) with repeated measures, and one-way ANOVA. Results: Initial hardness was significantly different among the three sealers with AH Plus having the greatest and Adseal having the least. After 2 min, Xylene softened AH Plus and Adseal sealer to 11% and 25% of their initial microhardness, respectively (p < 0.001), whereas AH 26 was least affected, maintaining 89.4% of its initial microhardness. After 2 min, Endosolv-R softened AH 26, AH Plus and Adseal to 12.7, 5.6 and 8.1% of their initial microhardness, respectively (p < 0.001). Conclusions: Endosolv-R was a significantly more effective short term softener for all the tested sealers after 2 min whereas Xylene was an effective short term softener against AH plus and Adseal but less effective against AH 26.

• Magazine of the Korean Society of Agricultural Engineers
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• v.41 no.4
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• pp.77-85
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• 1999

In this study, a computer program considering initial imperfection of axisymmetric reinforced concrete shell which plastic deformation by large external loading was developed . Initial imperfection of dome was assumed as 'dimple type' which can be expressed as Wi=(Wo/h)(1-x$^2$)$^3$. The developed model applied to the analysis of dynamic response of axisymmetric reinforced concrete shell when it has initial imperfection. The initial imperfection of 0.0, -5.0, and 5cm and steel and steel layer ratio 0,3, and 5% were tested for numerical examples . The results can be summarized as follows ; 1. Dynmaic response of vertical deflection at dome crown showed slow increased if it has not inital imperfection . But the response showed relatively high amplitude when initial imperfection was inner directed (opposite direction to loading). Similar trends also appeared for different steel layer ratios. 2. Dynamic responses of radial displacement at the junction of dome and wall showed the highest amplitude when initial imperfection was inward directed (opposite direction to loading). The lowest amplitude occurred when initial imperfection was outward directed (same direction to loading). Vibration period also delayed for inward directed initial imperfection . These trends were obvious as steel layer ratio increasing. 3. The effects of imperfection for the dynamic response of radial displacement a the center of wall scarely appeared. The effects of initial imperfection of dome on the dynmaic response of the wall can be neglected. 4. Effect of steel on the dynmic response of axisymmetric shell structure was great when initial imperfection did not exist. And the effect of direction of initial imperfection (inward or outward) did not show big difference.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.248-254
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• 2022

Purpose: To analyze the data of trauma patients with undetected injuries at the time of initial resuscitation during the primary and secondary surveys. Methods: We retrospectively reviewed the medical records of 807 patients who were hospitalized at the National Trauma Center, Seoul, Korea from June 1, 2019 to June 30, 2021. Results: In trauma patients with an Injury Severity Score ≥16 accounted for 27.5% in the non-missed injury group (non-MIG), but this rate was considerably higher at 71.2% in MIG. The mean hospitalization longer in MIG (50.90±39.56) than in non-MIG (24.74±26.11). The proportion of patients with missed injuries detected through tertiary trauma survey (TTS) was 28 patients (23.5%) within 24 hours, 90 patients (75.6%) after 24 hours to before discharge. The majority of missed injuries were fractures (82.4%) and ligament tears (8.4%), which required consultation with the orthopedic department. The final diagnoses of missed injuries were confirmed by computed tomography (44.5%), magnetic resonance imaging (19.3%), X-ray (19.3%), bone scan (11.8%), and physical examination (5.0%). Conclusions: TTS is considered a useful process for detecting missed injuries that were not identified at the time of initial resuscitation in the primary and secondary surveys. In the future, to detect missed injuries quickly, it is necessary to develop a suitable TTS program for each trauma center. In addition, further research is needed to verify the effectiveness of the protocolized TTS and survey chart to improve the effectiveness of TTS.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.522-529
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• 2005

Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

• Progress in Medical Physics
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• v.34 no.3
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• pp.33-39
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• 2023

Purpose: FLASH radiotherapy (RT) using ultra-high dose rate (>40 Gy/s) radiation is being studied worldwide. However, experimental studies such as preclinical studies using small animals are difficult to perform due to the limited availability of irradiation devices and methods for generating a FLASH beam. In this paper, we report the initial dosimetry results of a prototype electron linear accelerator (LINAC)-based irradiation system to perform ultra-high dose rate (UHDR) preclinical experiments. Methods: The present study used the prototype electron LINAC developed by the Research Center of Dongnam Institute of Radiological and Medical Sciences (DIRAMS) in Korea. We investigated the beam current dependence of the depth dose to determine the optimal beam current for preclinical experiments. The dose rate in the UHDR region was measured by film dosimetry. Results: Depth dose measurements showed that the optimal beam current for preclinical experiments was approximately 33 mA, corresponding to a mean energy of 4.4 MeV. Additionally, the average dose rates of 80.4 Gy/s and 162.0 Gy/s at a source-to-phantom surface distance of 30 cm were obtained at pulse repetition frequencies of 100 Hz and 200 Hz, respectively. The dose per pulse and instantaneous dose rate were estimated to be approximately 0.80 Gy and 3.8×10⁵ Gy/s, respectively. Conclusions: Film dosimetry verified the appropriate dose rates to perform FLASH RT preclinical studies using the developed electron-beam irradiator. However, further research on the development of innovative beam monitoring systems and stabilization of the accelerator beam is required.