• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.94-99
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• 2008

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.41-48
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• 1995

Purpose : The adjuvant postoperative radiotherapy has been usually applied to the patients with unfavorable prognostic factors after radical operation in early cervical cancer. We focused on the evaluation of the survival status and failure patterns of the patients with postoperative radiotherapy. Materials and Methods : We retrospectively analyzed ninety patients with FIGO stage IB and IIA cervix cancer who received postoperative pelvic irradiation at Chonnam University Hospital between August 1985 and December 1988, Seventy-eight patients had adequate follow-up information for survival analysis. Median follow-up time of these patients was 64 months. Results : The 5 year overall and disease free survival rate of ninety patients was $80.0\%$ and $80.2\%$, respectively. The prognostic significance to the survival was determined by multivariate analysis. Adequacy of resection margin(p=0.005) and lymph node status(p=0.005) appeared to be independent prognostic factors. Recurrence occurred in 13 patients, 5 in the pelvis and 8 at distant sites. The median time to recurrence was 19 months(range:3-39 months). The pelvic recurrence was more prevalent in the group of patients with adenocarcinoma, depth of stromal invasion more than 10mm and use of chemotherapy. The distant failure was more prevalent in the group of positive resection margin or positive lymph node with statistical significance. Conclusion : Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group in this analysis and should be considered as candidates for some form of adjuvant therapy.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.137-145
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• 1997

From July 1983 to December 1993, total 112 consecutive mitral valve replacements in 107 patients were performed in patient with mitral valvular abnormalities. To estimate the risk factor related to operative death, all patient's perioperative data were reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age were $37.3\pm$ 13.1 years ranging from 13 to 72 years. Thirty-seven patients were male and fourty-eight patients were female. Mean follow-up durations were $51.1\pm33.8$ months ranging from 6 months t 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from $3.02\pm0.73$ to 1 $78\pm0.55,$ and also in cardiothoracic ratio, from 0.61 $\pm0.09$ to $0.58\pm0.08$ at 6 months follow-up after operation. Operative complications were detected in 23 patients(27.1 %) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases. Early mortality was 10.6%(n=9) and the most common cause of death was a congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period of our mitral surgery was high(5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985). Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this study were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation. Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.952-963
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• 1998

Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Journal of Biosystems Engineering
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• v.6 no.2
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• pp.9-19
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• 1982

The aim of this study was to improve the startability of the diesel engine at low temperature. The specific objective was to determine the optimum type of precombustion chamber. The eight different types of precombustion chamber and two different types of the cylinder head were designed and tested by $2^7$ factorial experiments with four replications. The lowest starting temperature for first operation, the maximum output, and the specific fuel consumption at full load and overload were checked and analyzed. The results of the study are summarized as follows; 1. The lowest starting temperature was lowered as much as $2.4^{\circ}C$ and the maximum output was increased as much as 0.3 ps with respect to the difference in the relative angle of the main passageway against the piston head from 20 degree to 18 degree. 2. The lowest starting temperature and the maximum out-put were lowered as much as $3.3^{\circ}C$ and 0.3 ps respectively with respect to the difference in the angle of the cylinder head groove from 20 degree to 18 degree. 3. The lowest starting temperature and the maximum out put were lowered as much as $2^{\circ}C$ and 0.2 ps respectively with respect to the difference in the length of the precombustion chamber from 17.5 mm to 15.5mm. 4. There was no significant difference in the startability but the maximum output was increased as much as 0.2 ps with respect to the difference in the diameter of the main passageway from 4.8mm to 4.5mm. 5. The lowest starting temperature was obtained under the condition at 47 degree in the angle of the main passageway and at 18 degree in the angle of the cylinder head groove. The maximum output and the minimum specific fuel consumption was obtained under the condition at 4.5mm in the diameter of the main passageway and at 17.5mm in the length of the precombustion chamber. 6. The angle of the cylinder head groove and the main passageway appeared to the major factors affecting the startability significantly. The interaction between the diameter of the main pass ageway and the length of the precombustion chamber had an significant influence on the maximum output. So it would be recommended to study further on the interaction between two factors mentioned above by expanding their levels. 7. The optimum condition suggested by this study could lower the starting temperature by $6^{\circ}C$ compared to the conventional precombustion chambers.

• Archives of design research
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• v.18 no.2 s.60
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• pp.155-164
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• 2005

Home-service robots need to have sufficient spatial information about the surroundings for interacting with human intelligently and performing services efficiently. It is very important to investigate the efficient interaction style that supports map building task through human-robot collaboration. We first analyzed map building task with a cleaning robot and drew 4 design factors and tentative solutions, including map building procedure (task-preferred procedure/space- preferred procedure), LCD display installation (robot/robot+remote control), navigation method (push type/pull type), feedback modality(GUI/GUI+TTS). The design factors and tentative solutions were defined as independent variables and levels. This research investigated how those variables affect to the human task performance and behavior in map building tast. 8 kinds of experiment prototypes were built and usability test among 16 house wives was conducted for acquiring empirical data. As the experiment result, in terms of map building procedure, space-preferred procedure indicated better task performance than task-proffered procedure as we expected. For the LCD display installation factor, remote control with LCD display indicated higher task performance and subjective satisfaction. In robot navigation method, it was very difficult to find a significant difference between push type and pull type which contrary to our expectation. In fact, push type indicated higher subjective satisfaction. Also in feedback modality, we have acquired negative feedback an additional TTS operation guidance. It seems that robot's autonomy before achieving spatial information is rudiment condition which means users are just interacting with a mobile appliance. Thus they prefer remote-control-based interaction style in robot map building process as they used in traditional appliance control.

• Journal of Distribution Science
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• v.9 no.2
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• pp.49-59
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• 2011

A franchise can be said to be the main method of distribution and marketing. It appears to be the future of the retail industry and is one of the world's fastest growing businesses sectors, as many policy reports and research results have acknowledged. Korea's franchise industry began in the 1970s, spread out into many areas (including food services, retail, and the service industry), and has grown by over 10% each year ever since. The industry's influence on the national economy becomes ever greater. Although the size of the franchise industry is expected to grow as it spreads and as the government expands its support, it has not yet attracted much academic interest. Research has so far been very fragmented. The main interest has been the relationship and conflicts between the head offices and the affiliates. No study has yet occurred on whether the concepts of satisfaction and intent to conclude a contract directly affect the success or failure of the affiliates. Few studies have empirically inquired into the demographic characteristics and abilities of the affiliates that significantly affect their results. Domestic franchise industries must prepare to leap from quantitative to qualitative growth. Most important is the need for affiliate headquarters and affiliates to build confidence between them. A friendly and reliable relationship between affiliate headquarters and affiliates will eliminate distrust from the franchise and maintain a healthy franchise system. This study suggests that current and prospective heads of affiliation should concentrate not on attracting affiliates but on investment and techniques of affiliate support. They should work on the reinforcement of brand power, the appropriate affiliate business environment, systematic education/training, taking burdens off the affiliate business persons, consolidating the relationship with the affiliate business persons, marketing mix factors (e.g. products, price conditions, logistics and shipping services, promotion, supervising and supervisor, operation procedures/processes, and material evidence); these all greatly affect the success or failure of the affiliate business. Supporting the affiliates is an important factor that enhances their results and satisfaction and consequently increases the positive recommendations to others and the ratio of recurrent conclusions of contracts, which ultimately generate the growth of the franchises. In addition, it is suggested that prospective franchise founders should make every effort to choose a good head office since the characteristics of the head office greatly influence the success of the affiliates. This study is significant in that it grasps the characteristics of the head office of affiliation and of the affiliates that influence affiliate results in ways not yet academically attempted.

• Korean Chemical Engineering Research
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• v.52 no.4
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• pp.467-474
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• 2014

Preliminary design in chemical process furnishes economic feasibility through calculation of both mass balance and energy balance and makes it possible to produce a desired product under the given conditions. Through this design stage, the process possesses unchangeable characteristics, since the materials, reactions, unit configuration, and operating conditions were determined. Unique characteristics could be very economic, but it also implies various potential risk factors as well. Therefore, it becomes extremely important to design process considering both economics and safety by integrating process simulation and quantitative risk analysis during preliminary design stage. The target of this study is LNG liquefaction process. By the simulation using Aspen HYSYS and quantitative risk analysis, the design variables of the process were determined in the way to minimize the inherent explosion risks and operating cost. Instead of the optimization tool of Aspen HYSYS, the optimization was performed by using stochastic optimization algorithm (Covariance Matrix Adaptation-Evolution Strategy, CMA-ES) which was implemented through automation between Aspen HYSYS and Matlab. The research obtained that the important variable to enhance inherent safety was the operation pressure of mixed refrigerant. The inherent risk was able to be reduced about 4~18% by increasing the operating cost about 0.5~10%. As the operating cost increases, the absolute value of risk was decreased as expected, but cost-effectiveness of risk reduction had decreased. Integration of process simulation and quantitative risk analysis made it possible to design inherently safe process, and it is expected to be useful in designing the less risky process since risk factors in the process can be numerically monitored during preliminary process design stage.

• Journal of Sasang Constitutional Medicine
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• v.9 no.1
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• pp.303-313
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• 1997

Disease depends on the three factors, agent, host and environment. According to history of disease, by early 1900s the case of deaths is infectious disease, in late 1900s care of infectious diseases and tremendous scale of chronic disease, i.e., heart disease, diabetes, cancers and etc, makes care of chronic diseases be a most important theme. Now, life-style of diet is being westernized and in high industry-oriented society, obesity makes attack fate remarkably increase and life-expectancy become short, so that it causes severe problem of health. Chronic disease, such as obesity, is not affected by specific agent, but depends of interaction between host and environmental factors. There is the theory of constitutional medicine in Korean Medicine. According to it, all the people have constitutional specificity and disease. Because obesity is a kind of disease, there is the corresponding constituent being apt to be fat. Oriental Medicine utilizes herb-medication, acupuncture, and massage-therapy in treating obesity. Therefore study on relationship between constituent and obesity for OPD patients of Sangji-Oriental Medicine Hospital is carried out. The results are summarized as followings. 1. 70.2% of obesity patients are Taeumin(太陰人), 26.9% of those are Soyangin(少陽人), 2.9% of thoese are Soeumin(少陰人). 2. Most cases, high value of Free Fat Acid and Triglyceride not that of Total Cholesterol and Low Density Lipoprptein is meaningful in obesity patient blood. The corelationship between lipid test and Constitution is meaningful in Triglyceride and Free Fatty Acid. 3. Obesity is not related with gene. 4. Obesity is not related with Boyak(Herb-Med : 補藥). 5. Obesity mostly happens after delivery, contraception and operation. 6. Obese Patients are apt to eat between meals, especially food of wheat flour such as a snack. 7. The aim of treating obesity is not persuit of beauty but of keeping healthy. 8. 2.2Kg of body weight is lost after 4 week-treatment. 9. Common cause of obesity is overeating of carbohydrate and lipid than meat.