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Postoperative Clinical Courses According to the Length of Preoperative Drug Therapy in Pulmonary Tuberculosis (폐결핵 환자의 수술전 항결핵제 투여기간에 따른 수술후 임상경과)

  • Kwon, Eun-Su;Kim, Dae-Yun;Park, Seung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.775-785
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    • 1999
  • Background : Though surgery plays an important role in the management of patients with Mycobacterium tuberculosis infection, there is little information regarding the timing of resection. We tried to find out the ideal timing of operation. Method: A retrospective review was performed in 69 patients underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1997. They were categorized into various groups according to the length of preoperative specific drug therapy. The rates of treatment failure, realpse and complication in each group were compared statistically by $x^2$-test. Results: Eighty one point two percent were men and 18.8 % women with a median age of 33 years(range, 16 to 63 years). The mean number of resistant drugs was 3.l(range, 0 to 9). Patients were treated preoperatively with multidrug regimens, which mean number of preoperative specific drugs was 4.6, in an effort to reduce the mycobacterial burden with the mean length of preoperative drug therapy, 5.0 months. Postoperative treatment was conducted for a mean period of 13.0 months with a mean number of postoperative specific drugs, 4.4. Postoperative treatment failures were confirmed in 8 among 69 patients(11.6%). 2 of these 8 patients were showed up in the preoperative 3 to 4 months medication group and each of the rest was occurred in the preoperative 2 to 3, 5 to 6, 6 to 7, 12 to 13, 17 to 18 months, less than one month medication group, respectively. 59 of 69 patients were available for evaluation of the relapse rate with the mean duration of the postoperative follow-up, 19.8 months. In 4 patients bacterial relapse was confirmed(6.8%). Each of these 4 was in the preoperative 1 to 2, 2 to 3, 3 to 4, 5 to 6 months medication group. Categorized into various groups according to the length of preoperative specific therapy, there were no statistical significances of the treatment failure rate, relapse rate and complication rate in the groups. There were seven treatment failures of 28 who were AFB culture positive until the time of operation(25%, p<0.01). Categorized the preoperative AFB culture positive group into various groups according to the length of preoperative drug therapy, there were no statistical significances, either. Conclusion: We believe that operation plays an important ancillary role in the treatment of pulmonary tuberculosis. Our results indicate that the timing of resection according to the length of preoperative drug therapy may not cause trouble.

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Ensemble of Nested Dichotomies for Activity Recognition Using Accelerometer Data on Smartphone (Ensemble of Nested Dichotomies 기법을 이용한 스마트폰 가속도 센서 데이터 기반의 동작 인지)

  • Ha, Eu Tteum;Kim, Jeongmin;Ryu, Kwang Ryel
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.123-132
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    • 2013
  • As the smartphones are equipped with various sensors such as the accelerometer, GPS, gravity sensor, gyros, ambient light sensor, proximity sensor, and so on, there have been many research works on making use of these sensors to create valuable applications. Human activity recognition is one such application that is motivated by various welfare applications such as the support for the elderly, measurement of calorie consumption, analysis of lifestyles, analysis of exercise patterns, and so on. One of the challenges faced when using the smartphone sensors for activity recognition is that the number of sensors used should be minimized to save the battery power. When the number of sensors used are restricted, it is difficult to realize a highly accurate activity recognizer or a classifier because it is hard to distinguish between subtly different activities relying on only limited information. The difficulty gets especially severe when the number of different activity classes to be distinguished is very large. In this paper, we show that a fairly accurate classifier can be built that can distinguish ten different activities by using only a single sensor data, i.e., the smartphone accelerometer data. The approach that we take to dealing with this ten-class problem is to use the ensemble of nested dichotomy (END) method that transforms a multi-class problem into multiple two-class problems. END builds a committee of binary classifiers in a nested fashion using a binary tree. At the root of the binary tree, the set of all the classes are split into two subsets of classes by using a binary classifier. At a child node of the tree, a subset of classes is again split into two smaller subsets by using another binary classifier. Continuing in this way, we can obtain a binary tree where each leaf node contains a single class. This binary tree can be viewed as a nested dichotomy that can make multi-class predictions. Depending on how a set of classes are split into two subsets at each node, the final tree that we obtain can be different. Since there can be some classes that are correlated, a particular tree may perform better than the others. However, we can hardly identify the best tree without deep domain knowledge. The END method copes with this problem by building multiple dichotomy trees randomly during learning, and then combining the predictions made by each tree during classification. The END method is generally known to perform well even when the base learner is unable to model complex decision boundaries As the base classifier at each node of the dichotomy, we have used another ensemble classifier called the random forest. A random forest is built by repeatedly generating a decision tree each time with a different random subset of features using a bootstrap sample. By combining bagging with random feature subset selection, a random forest enjoys the advantage of having more diverse ensemble members than a simple bagging. As an overall result, our ensemble of nested dichotomy can actually be seen as a committee of committees of decision trees that can deal with a multi-class problem with high accuracy. The ten classes of activities that we distinguish in this paper are 'Sitting', 'Standing', 'Walking', 'Running', 'Walking Uphill', 'Walking Downhill', 'Running Uphill', 'Running Downhill', 'Falling', and 'Hobbling'. The features used for classifying these activities include not only the magnitude of acceleration vector at each time point but also the maximum, the minimum, and the standard deviation of vector magnitude within a time window of the last 2 seconds, etc. For experiments to compare the performance of END with those of other methods, the accelerometer data has been collected at every 0.1 second for 2 minutes for each activity from 5 volunteers. Among these 5,900 ($=5{\times}(60{\times}2-2)/0.1$) data collected for each activity (the data for the first 2 seconds are trashed because they do not have time window data), 4,700 have been used for training and the rest for testing. Although 'Walking Uphill' is often confused with some other similar activities, END has been found to classify all of the ten activities with a fairly high accuracy of 98.4%. On the other hand, the accuracies achieved by a decision tree, a k-nearest neighbor, and a one-versus-rest support vector machine have been observed as 97.6%, 96.5%, and 97.6%, respectively.

Evaluation on the Radiation Exposure of Radiation Workers in Proton Therapy (양성자 치료 시 방사선 작업 종사자에게 미치는 방사선 피폭에 대한 평가)

  • Lee, Seung-Hyun;Jang, Yo-Jong;Kim, Tae-Yoon;Jeong, Do-Hyung;Choi, Gye-Suk
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.107-114
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    • 2012
  • Purpose: Unlike the existing linear accelerator with photon, proton therapy produces a number of second radiation due to the kinds of nuclide including neutron that is produced from the interaction with matter, and more attention must be paid on the exposure level of radiation workers for this reason. Therefore, thermoluminescence dosimeter (TLD) that is being widely used to measure radiation was utilized to analyze the exposure level of the radiation workers and propose a basic data about the radiation exposure level during the proton therapy. Materials and Methods: The subjects were radiation workers who worked at the proton therapy center of National Cancer Center and TLD Badge was used to compare the measured data of exposure level. In order to check the dispersion of exposure dose on body parts from the second radiation coming out surrounding the beam line of proton, TLD (width and length: 3 mm each) was attached to on the body spots (lateral canthi, neck, nipples, umbilicus, back, wrists) and retained them for 8 working hours, and the average data was obtained after measuring them for 80 hours. Moreover, in order to look into the dispersion of spatial exposure in the treatment room, TLD was attached on the snout, PPS (Patient Positioning System), Pendant, block closet, DIPS (Digital Image Positioning System), Console, doors and measured its exposure dose level during the working hours per day. Results: As a result of measuring exposure level of TLD Badge of radiation workers, quarterly average was 0.174 mSv, yearly average was 0.543 mSv, and after measuring the exposure level of body spots, it showed that the highest exposed body spot was neck and the lowest exposed body spot was back (the middle point of a line connecting both scapula superior angles). Investigation into the spatial exposure according to the workers' movement revealed that the exposure level was highest near the snout and as the distance becomes distant, it went lower. Conclusion: Even a small amount of exposure will eventually increase cumulative dose and exposure dose on a specific body part can bring health risks if one works in a same location for a long period. Therefore, radiation workers must thoroughly manage exposure dose and try their best to minimize it according to ALARA (As Low As Reasonably Achievable) as the International Commission on Radiological Protection (ICRP) recommends.

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The Study on Risk Factors Analysis and Improvement of VDT Syndrome in Nuclear Medicine (핵의학과 Video Display Terminals Syndrome 유해 요인 조사 및 개선에 관한 연구)

  • Kim, Jung-Soo;Kim, Seung-Jeong;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyun-Joo;Han, In-Im;Joo, Yung-Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.61-66
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    • 2010
  • Purpose: Recently, Department of Nuclear Medicine have an interest in Video Display Terminals (VDT) syndrome including musculoskeletal disorders, ophthalmologic disorders, trouble of electromagnetic waves and stress disorders occur to VDT workers as the growing number of users and rapid pace of service period supply in large amount. This study research on the actual condition for VDT syndrome in Nuclear Medicine, Seoul National University Hospital (SNUH), discover the problem and draw a plan of upcoming improvement. The aim of this study establish awareness about VDT syndrome and is to prevent for it in the long run. Materials and Methods: Department of Nuclear Medicine, SNUH is composed Principle part, Pediatric part and PET center. We estimated risk factors visit in each part directly. Estimation method use "Check list for VDT work" of Wonjin working environment health laboratory and check list is condition of VDT work, condition of work tables, condition of chairs, condition of keyboards, condition of monitors, working position, character of health management and other working environment. Analysis result is verified in Department of Occupational and Environment, Hallym University Sacred Heard Hospital. Results: As a result of analysis, VDT condition of Department of Nuclear Medicine, SNUH is rule good. In case of work tables, recent of things are suitable to users upon the ergonomical planning, but 15% of existing work tables are below the standard value. In case of chairs are suitable, but 5% of theirs lost optimum capacity become superannuated. The keyboards are suitable for 98% of standard value. In case of monitors, angle control of screen is possible of all, but positioning control is impossible for 38%. In case of working position, 10% is fixed positioning for long time and some of the items researched unsuitable things for standard. At health management point, needed capable of improvement. Also, other working condition as lighting, temperature, noise and ventilation, discovered the problem, but is sufficient to advice value. Conclusion: VDT syndrome is occurrences of possibility continuously, come economical expensive about improvement, is inherent in various causes and originate without your knowledge. So, there is need systematic management system. In Nuclear Medicine, VDT syndrome make it better that constant interest and effort as improvement of ergonomical working environment, improvement of working procedure, regular exercise and steady stretching, and can be prevented fairly. This promote physical and mental condition of worker in top form in comfortable working environment, so this is judged by enlargement of operations efficiency and rising of satisfaction ratings of the inside client.

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Palliative Care Practitioners' Perception toward Pediatric Palliative Care in the Republic of Korea (소아완화의료에 대한 호스피스 완화의료 전문기관 종사자의 인식)

  • Moon, Yi Ji;Shin, Hee Young;Kim, Min Sun;Song, In Gyu;Kim, Cho Hee;Yu, Juyoun;Park, Hye Yoon
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.39-47
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    • 2019
  • Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.

A Study on the Characteristics of Oddly Shaped Stone's Arrangement at Donggwoldo (동궐도(東闕圖)에 나타난 괴석(怪石)의 배치특성에 관한 연구)

  • Jung, Woo-Jin;Kim, Hwa-Ok;Park, Yool-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.2
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    • pp.12-26
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    • 2014
  • This study has researched the forms of arrangement and use of the oddly shaped stones which were used at palaces during Joseon Dynasty based on arrangements of stones as shown in Donggwoldo(東闕圖), and tried to identify its special features. The sorts of stone's arrangements which set formal patterns by assisting an axis in Donggwoldo can be classified as the single type using one stone, the symmetrical type using 2 stones symmetrically and the parallel type using 3 or more stones. The single type was used to endow a focal point and to accent centrality by arranging a stone on the axis performed from formal shaped buildings. The symmetrical type was used to show order and hierarchy by placing two odd-shaped stones on either side of a building. And the parallel type which is arranged three stones side by side, is put a middle stone on the central axis line to determine strong directional and frontality. Also similarity to method of arrangement of stones can be found from planting trees in a prominent way for scenery or planting trees symmetrically. Stones and trees can be chosen according to nature and scale of places and basically their effects of formation of axis and creating typical space is same. Based on these respect, the characteristics of arrangement of stones shown in Donggwoldo can be briefly summarized as follows. First, the oddly shaped stones were used by creating a centripetal space in order to show a grade of rank. Second, the distances among stones could be adjusted to the sizes of the architecture which was at the center. The aim was to provide stability through the balanced composition between the central axis and symmetrical structures. Third, the form of regularity was added by using stone vase in consideration of irregular shape of stone causing interference in forming regular symmetry. Fourth, a centrality was emphasized by adding change to central stones in the parallel type used 3 erect stones. Fifth, the sizes of stone were limited in order to make smooth for the mix and adjustment of its position with the types of other garden ornaments, so the oddly shaped stones in palace have portability. Sixth, the oddly shaped stones in palace which were appreciated as inspirational object basically were a sculpture of the same quality with suiseki (壽石), and the appreciative method, the composition and shape had developed in the same texture. Finally, the even number of stones by parallel type were arranged by equal partition. But odd number of stones followed the method with symmetrical arrangement on its center stone. These principles of stone arrangement are judged as distinguishing methods which oddly shaped stones was made and used in Joseon palaces.

Synaptic Organization of Vibrissa Afferent Terminals in the Trigeminal Interpolar Nucleus (삼차신경중간핵에서 저역치기계자극수용기 유래 들신경섬유 종말의 연접양상)

  • Ahn, Hyoung-Joon;Paik, Sang-Kyoo;Bae, Yong-Chul;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.87-106
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    • 2005
  • In order to evaluate the mechanism of transmission as well as processing of sensory information originating from low-threshold mechanoreceptor in oral and maxillofacial region at primary synaptic region of trigeminal nervous system, vibrissa afferent fibers of adult cat were labeled with intra-axonal HRP injection. Serial sections containing labeled boutons were obtained from the piece of trigeminal interpolar nucleus. Under electron microscope, total 30 labeled boutons were observed, and ultrastructural characteristics, frequency of occurence, synaptic organizations of vibrissa afferent terminals were analysed. The results were as follows: 1. Labeled boutons contained clear, spherical synaptic vesicles with diameter of 45$\sim$55nm. They formed asymmetrical synapse with dendrites showing definite postsynaptic density, larger synaptic cleft, multiple synaptic structures at various regions. With unlabeled axon terminals(p-ending) containing polymorphic synaptic vesicles, they formed symmetrical synapse showing indefinite postsynaptic density and narrower synaptic area. 2. Each labeled bouton formed 1 to 15 synapses, the average of 4.77$\pm$3.37 contacts per labeled bouton, with adjacent neuronal profiles. Relatively complex synaptic organization, which formed synapses with more than 5 neuronal profiles, was observed in a large number(46.7%, n=14) of labeled boutons. 3. Axo-somatic synapse was not observed. The number of axo-dendritic synapse was 1.83$\pm$1.37 per labeled bouton. Majority(85.0%) of axo-dendritic synapses were formed with dendritic shafts, nonprimary dendrites(n=47, 1.57$\pm$1.38/1 bouton), however, synapses formed with primary dendrites(n=6, 0.20$\pm$0.41/1 bouton) or dendritic spines(n=2, 0.07$\pm$0.25/1 bouton) were rare. 4. 76.7%(n=23) of labeled boutons formed axo-axonic synapse (2.93$\pm$2.36/1 bouton) with p-endings containing pleomorphic vesicles. Synaptic triad, in which p-endings formed synapses with labeled boutons and dendrites adjacent to the labeled boutons simultaneoulsy, were also observed in 60.0%(n=18) of labeled boutons. From the above results, vibrissa afferent terminals of adult cat showed distinctive synaptic organization in the trigeminal interpolar nucleus, thus, suggests their correlation with the function of the trigeminal interpolaris nucleus, which participates in processing of complex sensory information such as two-point discrimination and motivational-affective action. Further studies on physiologic functions such as quantitative analysis on ultrastructures of afferent terminals and nerve transmitters participating in presynaptic inhibition are required.

A Study on the Multi-Layer of Religious Inertia Represented in Sense of Place and Cultural Remains at Mt. Bak-wha (장소성과 문화경관으로 해석한 태안 백화산의 다층적 종교 관성)

  • Rho, Jae-Hyun;Park, Joo-Sung;Goh, Yeo-Bin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.4
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    • pp.36-48
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    • 2010
  • The objectives of this study are to research and analyze the positioning of Mt. Back Hwa(白華山) and the characteristics of its neighboring cultural scenery based on the Two Seated Buddah Temple, a small Buddhist temple of Taeul in Taean and to view both landscape geographic codes and religious attractions over Mt. Back Hwa by discussing its expression and meaning for the scenery scattered or nested over this districts. The panoramic view of west shows the character of Mt. Back Hwa as a magnanimity of Buddhist Goddess of Mercy which is viewed as a view point field no less than its location as a landscape target and its singularity as a rocky mountain. The ancient castle, signal beacon post and the small Buddhist temple of Taeul to be read importantly in the old map and SinjeungDongkukyeojiseungram(新增東國輿地勝覽) form the core of place identity, and a number of carve(engrave) letters such as Eopungdae(御風臺), Youngsadae(永思臺), etc. show the prospect of this mountain and monumentality derived from place characteristics. In addition removing of Taeiljeon, a portrait scroll of Dangun, national ancestor makes possible to guess the national status hold by Mt. Back Hwa in advance and to know that it has symbiotic relationship with indigenous religion and shares with the universal locality which have been continued for a long time through a portrait scroll of Dangun enshrined in Samsunggak. More than anything else, however the Rock-carved Buddha Triad in Taean, Giant Buddha of Baekjae era enshrined in the small Buddhist temple of Taeul is not only why Mt. Back Hwa, magnanimity of Buddhist Goddess of Mercy exists but also a signifier. In spite of such a placity, the union ideas of confucianism, buddhism and doctrinism of buddhism prevailed in the Late Joseon Dynasty allows the cultural phenomenon of taoism to be read in the same weight through Ilsogae(一笑溪) and Gammodae(感慕臺) which are mountain stream and pond area respectively centered in the carve letter, 'Taeeuldongcheon(太乙洞天)' constructed in front of the small Buddhist temple of Taeul, the Baduk board type of rock carvings engraved over them and a number of traces of carve letters made by confucian scholars since the Middle of Joseon Dynasty. The reason such various cultural sceneries are mixed in Mt. Back Hwa is in the results of inheritance of religious places and fusion of sprit of the times, and the various type of cultural scenery elements scattered in Mt. Back Hwa are deemed as unique geographic code to understand the multi-layered placity and the characteristics of scenery of Mt. Back Hwa in Taean.

Morphological Traits of Selected Chestnut Races and its Propagation Studies (밤나무 우량품종(優良品種)의 형태학적(形態學的) 특징(特徵)과 증식(增殖)에 관(關)한 연구(硏究))

  • Yim, Kyong-Bin;Kwon, Ki-Won
    • Journal of Korean Society of Forest Science
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    • v.22 no.1
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    • pp.49-62
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    • 1974
  • 1. In the comparison of survival ratio among three different methods(bark graft, veneer graft, root graft), bark graft showed the highest survival ratio and root graft was the lowest. It was shown to be significant at the level of 5% in the analysis of variance for the results. It was able to be supposed that one of the main causes for the results was the different amounts of ferric tannic acid which was formated owing to the reaction of grafting knife with tannic acid oozing from cutting faces of the tree. In juvenile tissue graft, the survival ratio of inverted radicle graft was a little higher than that of juvenile stem graft, but there was no significant difference between two methods in analysis of variance. 2. The most hairs of chestnut tree leaves were recognized as stellates on the most part of leaves except for venation. The number of rays in the stellates was ranged from 4 to 8 generally. It was shown to be highly significant differences at the level of 1% among the each race growing at the similar environmental condition in the length of ray and the distributed ratio of the stellates having different ray number. 3. Excepting for the basal width of serration there were no significant differences between $Imakita_1$, $Imakita_2$ as well as between $Teteuchi_1$, $Teteuchi_2$ at the each point of experimental items in this study. Such results made this study more useful. 4. Among the races that were growing in the similar environmental condition, there were highly significant differences at the level of 1% in the length and the width of serration. 5. The rolling of hair, the angle of serration from the leaf margin, the existence of lateral vein in the serration, the intrusion of main vein into the serration and the width of main vein were observed to be somewhat useful as the subsidiary methods for the identification of chestnut races.

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The Performance Analysis of CCA Adaptive Equalization Algorithm for 16-QAM Signal (16-QAM 신호에 대한 CCA 적응 등화 알고리즘 성능 분석)

  • Lim, Seung-Gag
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.13 no.1
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    • pp.27-34
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    • 2013
  • This paper deals with the performance anlysis of CCA adaptive equalization algorithm, that is used for reduction of intersymbol interference at the receiving side which occurs in the time dispersive communication channel. Basically, this algorithm is borned for the solving phase unrecovery problem in the CMA equalizer, and the comines the concept of DDA (Decision Directed Algorithm) and RCA (Reduce Constellation Algorithm). The DDA has a stable convergence characteristics in unilevel signal, but not in the number of levels in multilevel signal such as QAM, so it has unstable problem. The RCA does not provide reliable initial convergence. And even after convergence, the equalization noise due to the steady state misadjustment exhibited by it is very high as compared to DDA. For the solving the abovemensioned point, the CCA adaptive eualization alogorithm has borned. In order to performance analysis of CCA algorithm, the recovered signal constellation that is the output of the equalizer, the convergence characteristic by the residual isi and MD (maximum distortion), the SER characteristic are used by computer simulation and it was compared with the DDA, RCA respectively. As a result of simulation, the DDA has superior performance than other algoithm, but it has a convergence unguarantee and unstability in the multilevel signal. In order to solving this problem, the CCA has more good performance than RCA in every performance index.