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Making Differential Diagnosis of Biliary Atresia Using Endoscopy (내시경을 이용한 영아 담즙울체 질환의 감별진단에 대한 연구)

  • Beck, Nam-Seon;Kang, I-Seok;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.71-76
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    • 2001
  • Purpose: Many diagnostic modalities for neonatal cholestasis have shown features that are helpful, however until recently none of them are not pathognomonic of biliary atresia (BA). We carried out a prospective study of infants with cholestatic jaundice with the aim of establishing an efficient method of diagnosing BA. Methods: Twenty-seven consecutive infants with cholestatic jaundice were enrolled in this study and ranged from 7 to 152 days in age (mean; $51.2{\pm}34.2$ days). Gastroduodenoscopy was carried out using a fiberscope (Olympus N30). All the babies were fasted for at least 4 hours before the procedure and 20 ml of 10% dextrose solution was given at the time of endoscopy. The endoscopic examination focused on the 5 minutes observation of the evidence of biliary secretion. If there was lack of the evidence of the biliary secretion, endoscopy was removed and repeated the examination with some pause. Results: There are lack of the evidence of biliary secretion in all infants with BA. In non-BA group, 8 out of the 10 infants showed biliary secretion on the first trial, however one (Alagille syndrome) of the two infants without evidence of biliary secretion, finally exhibited biliary secretion on the second trial. The above observations resulted in the diagnostic accuracy of 96.3% with 100.0% sensitivity and 90.0% specificity. Conclusion: In light of the results from our relatively small study, endoscopy is a convenient, and relative inexpensive procedure. we strongly support the use of endoscopy for the diagnosis of BA in the screening and evaluation of infantile cholestasis.

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A Method for Determining the Sandstone Porosity by Using a Microwave Oven (마이크로웨이브 오븐을 이용한 사암의 공극률 산출 방법)

  • Woo, Seulgi;Kim, Jinhoo
    • Journal of the Korean earth science society
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    • v.38 no.2
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    • pp.150-160
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    • 2017
  • In order to determine the porosity of rock, the 'standard test method for porosity and density of rock' proposed by the Korean Society for Rock Mechanics is commonly used. However, the standard test method, which uses a drying oven, takes 8 to 24 hours to complete the test in taking samples out of the oven every four hours and measuring the weight of the specimen. To complement these disadvantages, we devised a method for measuring rock porosity by using a microwave oven. The devised method reduced the cause of errors and the inconvenience occurred in the process of weighing samples by constructing a weight monitoring system, which monitors the drying process. A suitable heating/pause time was set up to maintain the temperature of sample below $105{\pm}3^{\circ}C$ in drying process, and an alarm system was implemented in order to stop drying process when the weight change of the rock sample is within 0.1% of the initial weight. The porosity was determined from the dry weight of the sample, which was obtained by the curve fitting of weight monitoring data. Then, the porosities obtained by using the microwave oven were compared with those obtained by the standard test method. Test results using sandstone samples showed that the porosities obtained by a microwave oven was similar to those obtained by the standard method and the porosity difference between two methods was as large as 0.4%. In addition, repeated porosity measurement using the same specimen showed that the standard deviation of the porosity, which reflects the precision of the measurement was as good as 0.23%. Therefore, a microwave oven porosity measurement system can give the porosity of rock samples with high reliability.

Epic Theatre Reexamined from the Viewpoint of Cognitive Science (인지과학의 관점에서 본 서사극 이론)

  • Kim, Yongsoo
    • Journal of Korean Theatre Studies Association
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    • no.49
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    • pp.133-169
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    • 2013
  • Reexamining Brecht's theoretical hypotheses in terms of cognitive science, this essay arrived at several temporary interpretations. Cognitive science implies that empathy can precede the rational understanding in Verfremdungseffekt. The spectator tends to simulate the unfamiliar incident and character and feels the consequential embodied emotion that leads to the cognitive understanding. The similar situation can be found in social gestus. According to cognitive science, gesture(social gestus) is simulated in the mirror-neuron of spectator, arousing consequently the embodied emotion that triggers the succeeding understanding. The spectator apts to experience and feel physically the moving gesture before decoding it as a social signification. Brecht's intention that attempts to reveal the duality of actor and character by eliminating the fourth wall is negated by cognitive science. According to the theory of conceptual blending, the spectator under the eliminated fourth wall mixes actor and character, and simulates this blending image so that he experiences it imaginatively. As such, another kind of illusion can be formed when a fourth wall is collapsed. Meanwhile, the critical thinking of spectator Brecht wanted can be hard to occur during the performance. It is necessary for the spectator to recollect the bygone dialogue and action in terms of social context as if he presses the pause, stopping the playback while watching a play in video. In this respect the social meaning Brecht intended can be achieved more effectively by the stop motion like tableau. It would not only give the time for the spectator to consider the implied social signification, but also make him possible to decode a semiotic meaning as if interpreting a still picture. Or it can be delivered by the dialogue that expresses the playwright's critical judgement. In this case, the subject of critical thinking is not the spectator but the author. The alternative explanation that the cognitive science suggests illuminates theoretically the reasons why Brecht's theory fails to be realized in practice. In a sense, Brecht's theory is nothing but a theoretical hypothesis. It takes the premise that the emotion hinders the rational thinking, understanding emotion and reason oppositively like Plato. This assumption is negated easily by the recent cognitive science that sees the reason as a by-product of physical experience including emotion. The rational understanding, in this sense, begins from the embodied emotion. As such the cognitive science denies the dichotomy of emotion and reason that Brecht adopted. The theoretical hypothesis of cognitive science makes us recognize again the importance of bodily experience in theatre. In theatre the spectator tends to experience physically before decoding the intellectual meaning. The spectator Brecht wanted, therefore, is far from the reality. The spectator usually experiences and reacts physically before decoding the meaning critically. Thus Brecht's intention can be realized by the embodied emotion resulted from simulation. This tentative interpretation suggests that we need to pay more attention to the empirical study of spectatorship, not remaining in a speculative study.

The Macroeconomic Impacts of Korean Elections and Their Future Consequences (선거(選擧)의 거시경제적(巨視經濟的) 충격(衝擊)과 파급효과(波及效果))

  • Shim, Sang-dal;Lee, Hang-yong
    • KDI Journal of Economic Policy
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    • v.14 no.1
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    • pp.147-165
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    • 1992
  • This paper analyzes the macroeconomic effects of elections on the Korean economy and their future ramifications. It measures the shocks to the Korean economy caused by elections by taking the average of sample forecast errors from four major elections held in the 1980s. The seven variables' Bayesian Vector Autoregression Model which includes the Monetary Base, Industrial Production, Consumption, Consumer Price, Exports, and Investment is based on the quarterly time series data starting from 1970 and is updated every quarter before forecasts are made for the next quarter. Because of this updating of coefficients, which reflects in part the rapid structural changes of the Korean economy, this study can capture the shock effect of elections, which is not possible when using election dummies with a fixed coefficient model. In past elections, especially the elections held in the 1980s, $M_2$ did not show any particular movement, but the currency and base money increased during the quarter of the election was held and the increment was partly recalled in the next quarter. The liquidity of interest rates as measured by corporate bond yields fell during the quarter the election and then rose in the following quarter, which is somewhat contrary to the general concern that interest rates will increase during election periods. Manufacturing employment fell in the quarter of the election because workers turned into campaigners. This decline in employment combined with voting holiday produce a sizeable decline in industrial production during the quarter in which elections are held, but production catches up in the next quarter and sometimes more than offsets the disruption caused during the election quarter. The major shocks to price occur in the previous quarter, reflecting the expectational effect and the relaxation of government price control before the election when we simulate the impulse responses of the VAR model, imposing the same shocks that was measured in the past elections for each election to be held in 1992 and assuming that the elections in 1992 will affect the economy in the same manner as in the 1980s elections, 1992 is expected to see a sizeable increase in monetary base due to election and prices increase pressure will be amplified substantially. On the other hand, the consumption increase due to election is expected to be relatively small and the production will not decrease. Despite increased liquidity, a large portion of liquidity in circulation being used as election funds will distort the flow of funds and aggravate the fund shortage causing investments in plant and equipment and construction activities to stagnate. These effects will be greatly amplified if elections for the head of local government are going to be held this year. If mayoral and gubernatorial elections are held after National Assembly elections, their effect on prices and investment will be approximately double what they normally will have been have only congressional and presidential elections been held. Even when mayoral and gubernatorial elections are held at the same time as congressional elections, the elections of local government heads are shown to add substantial effects to the economy for the year. The above results are based on the assumption that this year's elections will shock the economy in the same manner as in past elections. However, elections in consecutive quarters do not give the economy a chance to pause and recuperate from past elections. This year's elections may have greater effects on prices and production than shown in the model's simulations because campaigners' return to industry may be delayed. Therefore, we may not see a rapid recall of money after elections. In view of the surge in the monetary base and price escalation in the periods before and after elections, economic management in 1992 should place its first priority on controlling the monetary aggregate, in particular, stabilizing the growth of the monetary base.

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Improvement of Heat Pump Heating Performance by Selective Heat Storage Using Air Heat of Inside and Outside Greenhouse (온실 내외부 공기열의 선택적 축열에 의한 히트펌프 난방성능 개선)

  • Kwon, Jin Kyung;Kim, Seung Hee;Jeon, Jong Gil;Kang, Youn Koo;Jang, Kab Yeol
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.353-360
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    • 2017
  • In this study, the design and performance test of the air to water heat pump capable of producing hot water for greenhouse heating by using the surplus solar heat inside the greenhouse and the air heat outside greenhouse as the selective heat source were conducted. The heat storage operations using the surplus solar heat and the outside air heat were designed to be switched according to the setting temperature of the greenhouse in consideration of the optimum temperature range of the crop. In the developed system, it was possible to automatically control the switching of heat storage operation, heating and ventilation by setting 12 reference temperatures on the control panel. In the selective heat storage operation with the surplus solar heat and outside air heat, the temperature of thermal storage tank was controlled variably from $35^{\circ}C$ to $52^{\circ}C$ according to the heat storage rate and heating load. The heat storage operation times using the surplus solar heat and outside air heat were 23.1% and 30.7% of the experimental time respectively and the heat pump pause time was 46.2%. COP(coefficient of performance) of the heat pump of the heat storage operation using the surplus solar heat and outside air heat were 3.83 and 2.77 respectively and was 3.24 for whole selective heat storage operation. For the comparative experiment, the heat storage operation using the outside air heat only was performed under the condition that the temperature of the thermal storage tank was controlled constantly from 50 to $52^{\circ}C$, and COP was analyzed to be 2.33. As a result, it was confirmed that the COP of the heat storage operation using the surplus solar heat and outside air heat as selective heat source and the variable temperature control of the thermal storage tank was 39% higher than that of the general heat storage operation using the outside air heat only and the constant temperature control of the thermal storage tank.

Evaluation on Thermal Performance Along with Constructability and Economic Feasibility of Large-diameter Cast-in-place Energy Pile (대구경 현장타설 에너지파일의 열교환 성능과 시공성 및 경제성 분석)

  • Park, Sangwoo;Sung, Chihun;Lee, Dongseop;Jung, Kyoungsik;Choi, Hangseok
    • Journal of the Korean Geotechnical Society
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    • v.31 no.5
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    • pp.5-21
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    • 2015
  • An energy pile is a novel type of ground heat exchangers (GHEX's) which sets up heat exchange pipes inside a pile foundation, and allows to circulate a working fluid through the pipe for exchanging thermal energy with the surrounding ground stratum. Using existing foundation structure, the energy pile can function not only as a structural foundation but also as a GHEX. In this paper, six full-scale energy piles were constructed in a test bed with various configurations of the heat exchange pipe inside large-diameter cast-in-place piles, that is, three parallel U-type heat exchangers (5, 8 and 10 pairs), two coil type heat exchangers (with a 500 mm and 200 mm pitch), and one S-type heat exchanger. During constructing the energy piles, the constructability of each energy pile was evaluated with consideration of the installation time, the number of workers and any difficulty for installing. In order to evaluate the thermal performance of energy piles, the thermal performance tests were carried out by applying intermittent (8 hours operating-16 hours pause) artificial cooling operation to simulate a cooling load for commercial buildings. Through the thermal performance tests, the heat exchange rates of the six energy piles were evaluated in terms of the heat exchange amount normalized with the length of energy pile and/or the length of heat exchange pipe. Finally, the economic feasibility of energy pile was evaluated according to the various types of heat exchange pipe by calculating demanded expenses per 1 W/m based on the thermal performance test results along with the market value of heat exchange pipes and labor cost.

The Respiratory and Hemodynamic Effects of Prone Position According to the Level of PEEP in a Dog Acute Lung Injury Model (잡종견 급성폐손상 모델에서 Prone position 시행시 PEEP 수준에 따른 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Chin, Jae-Yong;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.140-152
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    • 1998
  • Background: Prone position improves oxygenation in patients with ARDS probably by reducing shunt Reduction of shunt in prone position is thought to be effected by lowering of the critical opening pressure (COP) of the dorsal lung because the pleural pressure becomes less positive in prone position compared to supine position. It can then be assumed that prone position would bring about greater improvement in oxygenation when PEEP applied in supine position is just beneath COP than when PEEP is above COP. Hemodynamically, prone position is expected to attenuate the lifting of cardiac fossa induced by PEEP. Based on these backgrounds, we investigated whether the effect of prone position on oxygenation differs in magnitude according to the level of PEEP applied in supine position, and whether impaired cardiac output in supine position by PEEP can be restored in prone position. Methods: In seven mongrel dogs, $PaO_2/F_1O_2$(P/F) was measured in supine position and at prone position 30 min. Cardiac output (CO), stroke volume (SV), pulse rate (PR), and pulmonary artery occlusion pressure (PAOP) were measured in supine position, at prone position 5 min, and at prone position 30 min. After ARDS was established with warmed saline lavage(P/F ratio $134{\pm}72$ mm Hg), inflection point was measured by constant flow method($6.6{\pm}1.4cm$ $H_2O$), and the above variables were measured in supine and prone positions under the application of Low PEEP($5.0{\pm}1.2cm$ $H_2O$), and Optimal PEEP($9.0{\pm}1.2cm$ $H_2O$)(2 cm $H_2O$ below and above the inflection point, respectively) consecutively. Results : P/F ratio in supine position was $195{\pm}112$ mm Hg at Low PEEP and $466{\pm}63$ mm Hg at Optimal PEEP(p=0.003). Net increase of P/F ratio at prone position 30 min, however, was far greater at Low PEEP($205{\pm}90$ mm Hg) than at Optimal PEEP($33{\pm}33$ mm Hg)(p=0.009). Compared to CO in supine position at Optimal PEEP($2.4{\pm}0.5$ L/min), CO in prone improved to $3.4{\pm}0.6$ L/min at prone position 5 min (p=0.0180) and $3.6{\pm}0.7$ L/min at prone position 30 min (p=0.0180). Improvement in CO was attributable to the increase in SV: $14{\pm}2$ ml in supine position, $20{\pm}2$ ml at prone position 5 min (p=0.0180), and $21{\pm}2$ ml at prone position 30 min (p=0.0180), but not to change in PR or PAOP. When the dogs were turned to supine position again, MAP ($92{\pm}23$ mm Hg, p=0.009), CO ($2.4{\pm}0.5$ L/min, p=0.0277) and SV ($14{\pm}1$ ml, p=0.0277) were all decreased compared to prone position 30 min. Conclusion: Prone position in a dog with saline-lavaged acute lung injury appeared to augment the effect of relatively low PEEP on oxygenation, and also attenuate the adverse hemodynamic effect of relatively high PEEP. These findings suggest that a PEEP lower than Optimal PEEP can be adopted in prone position to achieve the goal of alveolar recruitment in ARDS avoiding the hemodynamic complications of a higher PEEP at the same time.

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