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Surgical Approaches to the Middle Cranial Base Tumors (중두개와저 종양에 대한 수술적 치료)

  • Kim, Il Seub;Rha, Hyung Kyun;Lee, Kyung Jin;Cho, Kyung Keun;Park, Sung Chan;Park, Hae Kwan;Cho, Jeung Ki;Kang, Jun Ki;Choi, Chang Rhack
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1079-1085
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    • 2001
  • Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

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Effect of Acupuncture on Regional Cerebral Blood Flow at Acupoints GV 20, GV. 26, LI. 4, ST. 36, SP. 6 Evaluated by Tc-99m ECD Brain SPECT (Tc-99m ECD 뇌혈류 SPECT를 이용한 백회, 인중, 합곡, 족삼리, 삼음교에서 체침의 뇌혈류에 대한 효과)

  • Song, Ho-Chun;Bom, Hee-Seung;Kang, Hwa-Jeong;Ahn, Soo-Gi;Kim, Seong-Min;Jeong, Hwan-Jeong;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.456-464
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    • 2000
  • Purpose: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. Materials and Methods: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM$^{(R)}$ for Windows$^{(R)}$. Results: Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. Conclusion: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.

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Concurrent Chemoradiotherapy in Locally Advanced Esophageal Cancer (국소적으로 진행된 식도암에서 동시항암화학방사선치료의 결과)

  • Byun, Sang-Jun;Kim, Jin-Hee;Kim, Ok-Bae;Song, Hong-Suk
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.20-27
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    • 2011
  • Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.

Design and Implementation of Quality Broker Architecture to Web Service Selection based on Autonomic Feedback (자율적 피드백 기반 웹 서비스 선정을 위한 품질 브로커 아키텍처의 설계 및 구현)

  • Seo, Young-Jun;Song, Young-Jae
    • The KIPS Transactions:PartD
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    • v.15D no.2
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    • pp.223-234
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    • 2008
  • Recently the web service area provides the efficient integrated environment of the internal and external of corporation and enterprise that wants the introduction of it is increasing. Also the web service develops and the new business model appears, the domestic enterprise environment and e-business environment are changing caused by web service. The web service which provides the similar function increases, most the method which searches the suitable service in demand of the user is more considered seriously. When it needs to choose one among the similar web services, service consumer generally needs quality information of web service. The problem, however, is that the advertised QoS information of a web service is not always trustworthy. A service provider may publish inaccurate QoS information to attract more customers, or the published QoS information may be out of date. Allowing current customers to rate the QoS they receive from a web service, and making these ratings public, can provide new customers with valuable information on how to rank services. This paper suggests the agent-based quality broker architecture which helps to find a service providing the optimum quality that the consumer needs in a position of service consumer. It is able to solve problem which modify quality requirements of the consumer from providing the architecture it selects a web service to consumer dynamically. Namely, the consumer is able to search the service which provides the optimal quality criteria through UDDI browser which is connected in quality broker server. To quality criteria value decision of each service the user intervention is excluded the maximum. In the existing selection architecture, the objective evaluation was difficult in subjective class of service selecting of the consumer. But the proposal architecture is able to secure an objectivity with the quality criteria value decision where the agent monitors binding information in consumer location. Namely, it solves QoS information of service which provider does not provide with QoS information sharing which is caused by with feedback of consumer side agents.

Real-time CRM Strategy of Big Data and Smart Offering System: KB Kookmin Card Case (KB국민카드의 빅데이터를 활용한 실시간 CRM 전략: 스마트 오퍼링 시스템)

  • Choi, Jaewon;Sohn, Bongjin;Lim, Hyuna
    • Journal of Intelligence and Information Systems
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    • v.25 no.2
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    • pp.1-23
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    • 2019
  • Big data refers to data that is difficult to store, manage, and analyze by existing software. As the lifestyle changes of consumers increase the size and types of needs that consumers desire, they are investing a lot of time and money to understand the needs of consumers. Companies in various industries utilize Big Data to improve their products and services to meet their needs, analyze unstructured data, and respond to real-time responses to products and services. The financial industry operates a decision support system that uses financial data to develop financial products and manage customer risks. The use of big data by financial institutions can effectively create added value of the value chain, and it is possible to develop a more advanced customer relationship management strategy. Financial institutions can utilize the purchase data and unstructured data generated by the credit card, and it becomes possible to confirm and satisfy the customer's desire. CRM has a granular process that can be measured in real time as it grows with information knowledge systems. With the development of information service and CRM, the platform has change and it has become possible to meet consumer needs in various environments. Recently, as the needs of consumers have diversified, more companies are providing systematic marketing services using data mining and advanced CRM (Customer Relationship Management) techniques. KB Kookmin Card, which started as a credit card business in 1980, introduced early stabilization of processes and computer systems, and actively participated in introducing new technologies and systems. In 2011, the bank and credit card companies separated, leading the 'Hye-dam Card' and 'One Card' markets, which were deviated from the existing concept. In 2017, the total use of domestic credit cards and check cards grew by 5.6% year-on-year to 886 trillion won. In 2018, we received a long-term rating of AA + as a result of our credit card evaluation. We confirmed that our credit rating was at the top of the list through effective marketing strategies and services. At present, Kookmin Card emphasizes strategies to meet the individual needs of customers and to maximize the lifetime value of consumers by utilizing payment data of customers. KB Kookmin Card combines internal and external big data and conducts marketing in real time or builds a system for monitoring. KB Kookmin Card has built a marketing system that detects realtime behavior using big data such as visiting the homepage and purchasing history by using the customer card information. It is designed to enable customers to capture action events in real time and execute marketing by utilizing the stores, locations, amounts, usage pattern, etc. of the card transactions. We have created more than 280 different scenarios based on the customer's life cycle and are conducting marketing plans to accommodate various customer groups in real time. We operate a smart offering system, which is a highly efficient marketing management system that detects customers' card usage, customer behavior, and location information in real time, and provides further refinement services by combining with various apps. This study aims to identify the traditional CRM to the current CRM strategy through the process of changing the CRM strategy. Finally, I will confirm the current CRM strategy through KB Kookmin card's big data utilization strategy and marketing activities and propose a marketing plan for KB Kookmin card's future CRM strategy. KB Kookmin Card should invest in securing ICT technology and human resources, which are becoming more sophisticated for the success and continuous growth of smart offering system. It is necessary to establish a strategy for securing profit from a long-term perspective and systematically proceed. Especially, in the current situation where privacy violation and personal information leakage issues are being addressed, efforts should be made to induce customers' recognition of marketing using customer information and to form corporate image emphasizing security.

Studies on the Spacial Compositions and the Characteristics of the Alter System at Daebodan in the Changdeok Palace (창덕궁 대보단(大報壇)의 공간구성과 단제(壇制) 특성에 관한 고찰)

  • Jung, Woo Jin;Sim, Woo Kyung
    • Korean Journal of Heritage: History & Science
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    • v.46 no.1
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    • pp.318-345
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    • 2013
  • This study was carried out with a focus on the factor on the periodical space organization of Daebodan (大報壇: the altar of great recompense) in Changdeok Palace, which is significant in terms of political history in the late Chosun Dynasty, and consider the factors in the formation of the structural system through historical records and drawings. Daebodan has the ideology of righteousness to the Ming Dynasty which the hierarchy of the Joseon Dynasty. who felt the crisis of the domination order, imposed as a solution after the Manchu war of 1636. In addition, Daebodan was built by complex factors that entailed the self-esteem of the 'Joseon Centralism Ideology (朝鮮中華)' and the desire of the sacrificial rituals for Heaven that were imminent to the kings of Joseon. Superficially, Daebodan has the spatial organization of the Sajik (社稷) Altar and the placement of an annex building, but had the applied placement due to limited topography and access to the backyard. Furthermore, the lateral structure of Daebodan multiply accepted various factors of the nine step's stairs, the hight of five cheok (尺), the circumstance of two floors that were showed in the altar and platform with small fences and an imperial order including the internal form of Hwangjangbang (黃帳房). Moreover, the name of the alter came from 'the Jiaote Sheng Book of Rites(禮記 郊特牲)' representing 'the suburban sacrifice ritual for Heaven (郊天)', and it was built by not only combining the system of the Sajik Altar in the Joseon Dynasty and China but also avoiding 'excessive etiquette (僭禮).' The point is a remarkable feature shown by the structural system of Daebodan. Thus, it is considered that the 'Notion of Confucian-Cultural Succession (中華繼承意識)' and the desire of the sacrificial rituals for Heaven were expressed by the structure and form of altar. This study examined the process of the creation, expansion, decline and disposal of Daebodan in a chronological order, and found that the ruling ideology of the governing elite by the political and cultural background of the era at each transitional point was reflected in the spatial formation of the altar. On the other hand, as a result of performing a field survey to find the location in accordance with Daebodan in drawing materials, there remains items such as worked stones from Daebodan, precast pavers and fragments of proof tile discovered in the surrounding of tora vine (Actinidia arguta) which is a natural monument of Changdeok Palace. As such, verification through future excavation and investigation is required.

Comparison of Tomato Growth and Yield according to Solar Radiation by Location in Multi-span Greenhouses (연동온실 내 위치별 일사량에 따른 토마토의 생육 및 수량 비교)

  • Shin, Hyun Ho;Choi, Man Kwon;Ryu, Hee Ryong;Cho, Myeong Whan;Kim, Jin Hyun;Seo, Tae Cheol;Yu, In Ho;Kim, Seung Yu;Lee, Choung Kuen
    • Journal of Bio-Environment Control
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    • v.31 no.4
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    • pp.504-512
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    • 2022
  • To examine the distribution of internal solar radiation within various locations in multi-span greenhouses, the solar radiation, light transmittance, and accumulated radiation at the central and lateral sections were analyzed by dividing 8:30 to 12:30 in the morning and 12:35 to 16:30 in the afternoon. The growth and yield of tomatoes within these sections were also compared. In the morning, the solar radiation of the central section and the side section was 275.2 W·m-2 and 314.9 W·m-2, while in the afternoon, it was 314.9 W·m-2 and 313.9 W·m-2, respectively. The light transmittance and accumulated radiation were also low, confirming the low distribution of solar radiation in the central (connecting) section of the multi-span greenhouses. The growth survey revealed no significant difference. The final yield of tomatoes per plant was 4,828 g in the central section and 4,851 g in the lateral section, but there was no significant difference in the central section compared to the lateral section by 0.5%. However, the amount of solar radiation as per time in the central section is higher than the light compensation point, 60 W·m-2, and slightly lower than the light saturation point of tomatoes, i.e., 281 W·m-2. The results of this study can help in greenhouse design based on the insolation environment.

Zeolitization of the Dacitic Tuff in the Miocene Janggi Basin, SE Korea (장기분지 데사이트질 응회암의 불석화작용)

  • Kim, Jinju;Jeong, Jong Ok;Shinn, Young-Jae;Sohn, Young Kwan
    • Economic and Environmental Geology
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    • v.55 no.1
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    • pp.63-76
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    • 2022
  • Dacitic tuffs, 97 to 118 m thick, were recovered from the lower part of the subsurface Seongdongri Formation, Janggi Basin, which was drilled to assess the potential for underground storage of carbon dioxide. The tuffs are divided into four depositional units(Unit 1 to 4) based on internal structures and particle componentry. Unit 1 and Units 3/4 are ignimbrites that accumulated in subaerial and subaqueous settings, respectively, whereas Unit 2 is braided-stream deposits that accumulated during a volcanic quiescence, and no dacitic tuff is observed. A series of analysis shows that mordenite and clinoptilolite mainly fill the vesicles of glass shards, suggesting their formation by replacement and dissolution of volcanic glass and precipitation from interstitial water during burial and diagenesis. Glass-replaced clinoptilolite has higher Si/Al ratios and Na contents than the vesicle-filling clinoptilolite in Units 3. However, the composition of clinoptilolite becomes identical in Unit 4, irrespective of the occurrence and location. This suggests that the Si/Al ratio and pH in the interstitial water increased with time because of the replacement and leaching of volcanic glass, and that the composition of interstitial water was different between the eastern and western parts of the basin during the formation of the clinoptilolite in Units 1 and 3. It is also inferred that the formation of the two zeolite minerals was sequential according to the depositional units, i.e., the clinoptilolite formed after the growth of mordenite. To summarize, during a volcanic quiescence after the deposition of Unit 1, pH was higher in the western part of the basin because of eastward tilting of the basin floor, and the zeolite ceased to grow because of the closure of the pore space as a result of the growth of smectite. On the other hand, clinoptilolite could grow in the eastern part of the basin in an open system affected by groundwater, where braided stream was developed. Afterwards, Units 3 and 4 were submerged under water because of the basin subsidence, and the alkali content of the interstitial water increased gradually, eventually becoming identical in the eastern and western parts of the basin. This study thus shows that volcanic deposits of similar composition can have variable distribution of zeolite mineral depending on the drainage and depositional environment of basins.

Simulation and Feasibility Analysis of Aging Urban Park Refurbishment Project through the Application of Japan's Park-PFI System (일본 공모설치관리제도(Park-PFI)의 적용을 통한 노후 도시공원 정비사업 시뮬레이션 및 타당성 분석)

  • Kim, Yong-Gook;Kim, Young-Hyeon;Kim, Min-Seo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.51 no.5
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    • pp.13-29
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    • 2023
  • Urban parks are social infrastructure supporting citizens' health, quality of life, and community formation. As the proportion of urban parks that have been established for more than 20 years is increasing, the need for refurbishment to improve the physical space environment and enhance the functions of aging urban parks is increasing. Since the government's refurbishment of aging urban parks has limitations in securing financial resources and promoting attractiveness, they must be promoted through public-private partnerships. Japan, which suffered from the problem of aging urban parks, has successfully promoted several park refurbishment projects by introducing the Park-PFI through the revision of the 「Urban Park Act」 in 2017. This study examines and analyzes the characteristics of the Japan Park-PFI as an alternative to improving the quality of aging domestic urban park services through public-private partnerships and the validity of the aging urban park refurbishment projects through Park-PFI. The main findings are as follows. First, it is necessary to start discussions on introducing Japan's Park-PFI according to the domestic conditions as a means of public-private partnership to improve the service quality and diversify the functions of aging urban parks. In order to introduce Park-PFI social discussions and follow-up studies on the deterioration of urban parks. Must be conducted. The installation of private capital and profit facilities and improvements of related regulations, such as the 「Parks and Green Spaces Act」 and the 「Public Property Act」, is required. Second, it is judged that the Park-PFI project is a policy alternative that can enhance the benefits to citizens, local governments, and private operators under the premise that the need to refurbish aging urban parks is high and the location is suitable for promoting the project. As a result of a pilot application of the Park-PFI project to Seyeong Park, an aging urban park located in Bupyeong-gu, Incheon, it was analyzed to be profitable in terms of the profitability index (PI), net present value (FNPV), and internal rate of return (FIRR). It is considered possible to participate in the business sector. At the local government level, private capital is used to improve the physical space environment of aging urban parks, as well as the refurbishment of the urban parks by utilizing financial resources generated by returning a portion of the facility usage fees and profits (0.5% of annual sales) of private operators. It was found that management budgets could be secured.

A Study of Su Shi(蘇軾)'s Philosophy and Garden Management - A Basic Study Focused on Baiheju(白鶴居) - (소식의 사상과 원림 경영 연구 - 백학거를 중심으로 한 기초 연구 -)

  • Shin, Hyun-Sil
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.4
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    • pp.21-29
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    • 2023
  • The Northern Song Dynasty, the heyday of cultural and artistic achievements, brought significant changes to the history of gardens in China. The developments and contemplations that had evolved during the previous Tang Dynasty became intertwined with literature, painting, and art, leading to garden being perceived as works of art. In particular, the emergence of Su Shi(蘇軾) that permeated literature and art during the Northern Song Dynasty, had an impact beyond individual garden creation, influencing the development of public gardens and the diversification of garden. His long exile periods served as an opportunity to understand and reflect the local culture and characteristics, influencing the development of the garden. This study focuses on the ideology of Su Shi(蘇軾) that managed various gardens, examining the relationship between his exlie life and ideology. To do so, the study examines the form of the literati's gardens managed by Su Shi(蘇軾), with a particular emphasis on the Baiheju(白鶴居) garden in Huizhou, revealing the following characteristics and values. First, Su Shi(蘇軾), who was proficient in the Three Houses: Confucianism, Buddhism, and Taoism, combined his philosophy and unique perspective techniques with the location and composition elements of Baiheju(白鶴居) to enjoy the landscape. Although the ancient residence has a simple form, it possesses expansiveness through the combination of internal and external views. The interior is designed to be perceived as a single space, but it allows overlapping experiences of space and simultaneous appreciation of different sceneries. On the other hand, the spatial layout incorporates a hierarchical order to establish a sense of order. Second, the garden reflects the local characteristics, featuring numerous tropical plants and presenting vibrant and contrasting colors with structures. The planting forms embrace the concept of "huosei seikou" (活色生香) to enhance the color harmoniously. Additionally, the garden incorporates the poet's spiritual world, projecting it onto the garden as a contemplative place for spiritual nourishment and exploration of the ideal realm. For the pursuit of serenity and profound contemplation, the selected plantings are simple yet distinctive, providing rhythm and depth to the garden space. Third, Baiheju(白鶴居) has undergone changes over the years, but fundamentally, the form and elements of the garden shaped by Su Shi(蘇軾)'s descendants persist, confirming its heritage value.