• Title/Summary/Keyword: Right turn

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Evaluation of Prognostic Factors in Corrected Transposition of the Great Arteries at Mid-term Follow-up (수정 대혈관 전위 환자에서 예후에 영향을 주는 인자들에 대한 중기적 고찰)

  • Song, Young-Hwan;Kwon, Hyok-Joo;Kim, Gi-Beom;Kang, Soo-Jung;Bae, Eun-Jung;Noh, Chung-Il;Yun, Yong-Soo;Lee, Jeong-Ryul;Kim, Yong-Jin;Rho, Joon-Ryang
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.154-161
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    • 2003
  • Purpose : The prognosis of patients with corrected transposition of the great arteries(C-TGA) is variably affected by associated intracardiac defects, systemic right ventricular function, tricuspid valve competence, and conduction disturbances. This study aims to evaluate the importance of those factors at mid-term follow-up. Methods : Medical records of 94 patients(males 58, females 36; mean age at last follow-up, $12{\pm}9$ years; mean follow-up duration, $9{\pm}6.4$ years) diagnosed between January 1980 and May 2002 at Seoul National University Children's Hospital were studied retrospectively. Results : Among 94 patients, operations were performed in 72 patients(classic operations in 55; double switch operations in 17). Among prognostic factors including associated intracardiac anomalies(at least moderately severe tricuspid insufficiency(TI), ventricular septal defect, pulmonary stenosis and pulmonary atresia), intracardiac operation and complete atrioventricular block, TI was the only significant factor for death(P=0.001), and in turn, Ebstein anomaly and high grade atrioventricular block predicted TI. 20-year survival without TI was 77%, but only 35% with TI(P=0.0002); excluding perioperative death, the 20-year survival rates with and without TI were 48% and 87% respectively(P=0.008). There was no statistical difference in 20-year survival rate or association with TI between classic and double switch operation. Conclusion : TI was the major prognostic factor for C-TGA and was associated with Ebstein anomaly and high grade atrioventricular block at mid-term follow-up. Long-term follow-up is required to evaluate other factors, including double switch operations and associated intracardiac defects more exactly.

Development and Evaluation of Traffic Conflict Criteria at an intersection (교차로 교통상충기준 개발 및 평가에 관한 연구)

  • 하태준;박형규;박제진;박찬모
    • Journal of Korean Society of Transportation
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    • v.20 no.2
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    • pp.105-115
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    • 2002
  • For many rears, traffic accident statistics are the most direct measure of safety for a signalized intersection. However it takes more than 2 or 3 yearn to collect certain accident data for adequate sample sizes. And the accident data itself is unreliable because of the difference between accident data recorded and accident that is actually occurred. Therefore, it is rather difficult to evaluate safety for a intersection by using accident data. For these reasons, traffic conflict technique(TCT) was developed as a buick and accurate counter-measure of safety for a intersection. However, the collected conflict data is not always reliable because there is absence of clear criteria for conflict. This study developed objective and accurate conflict criteria, which is shown below based on traffic engineering theory. Frist, the rear-end conflict is regarded, when the following vehicle takes evasive maneuver against the first vehicle within a certain distance, according to car-following theory. Second, lane-change conflict is regarded when the following vehicle takes evasive maneuver against first vehicle which is changing its lane within the minimum stopping distance of the following vehicle. Third, cross and opposing-left turn conflicts are regarded when the vehicle which receives green sign takes evasive maneuver against the vehicle which lost its right-of-way crossing a intersection. As a result of correlation analysis between conflict and accident, it is verified that the suggested conflict criteria in this study ave applicable. And it is proven that estimating safety evaluation for a intersection with conflict data is possible, according to the regression analysis preformed between accident and conflict, EPDO accident and conflict. Adopting the conflict criteria suggested in this study would be both quick and accurate method for diagnosing safety and operational deficiencies and for evaluation improvements at intersections. Further research is required to refine the suggested conflict criteria to extend its application. In addition, it is necessary to develope other types of conflict criteria, not included in this study, in later study.

On-line Quality Assurance of Linear Accelerator with Electronic Portal Imaging System (전자포탈영상장치(EPID)를 이용한 선형가속기의 기하학적 QC/QA System)

  • Lee, Seok;Jang, Hye-Sook;Choi, Eun-Kyung;Kwon, Soo-Il;Lee, Byung-Yong
    • Progress in Medical Physics
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    • v.9 no.3
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    • pp.127-136
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    • 1998
  • On-line geometrical quality assurance system has been developed using electronic portal imaging system(OQuE). EPID system is networked into Pentium PC in order to transmit the acquisited images to analysis PC. Geometrical QA parameters, including light-radiation field congruence, collimator rotation axis, and gantry rotation axis can be easily analyzed with the help of graphic user interface(GUI) software. Equipped with the EPID (Portal Vision, Varian, USA), geometrical quality assurance of a linear accelerator (CL/2100/CD, Varian, USA), which is networked into OQuE, was performed to evaluate this system. Light-radiation field congruence tests by center of gravity analysis shows 0.2~0.3mm differences for various field sizes. Collimator (or Gantry) rotation axis for various angles could be obtained by superposing 4 shots of angles. The radius of collimator rotation axis is measured to 0.2mm for upper jaw collimator, and 0.1mm for lower jaw. Acquisited images for various gantry angles were rotated according to the gantry angle and actual center of image point obtained from collimator axis test. The rotated images are superpositioned and analyzed as the same method as collimator rotation axis. The radius of gantry rotation axis is calculated 0.3mm for anterior/posterior direction (gantry 0$^{\circ}$ and 170$^{\circ}$) and 0.7mm for right/left direction(gantry 90$^{\circ}$ and 260$^{\circ}$). Image acquisition for data analysis is faster than conventional method and the results turn out to be excellent for the development goal and accurate within a milimeter range. The OQuE system is proven to be a good tool for the geometrical quality assurance of linear accelerator using EPID.

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Counseling Case Study of a Child with Peer Confliction due to Lack of Social Skills and Impulsiveness (사회적 기술 부족과 충동성으로 인해 또래갈등이 심한 분교아동의 상담사례)

  • Lee, In-Sun
    • The Korean Journal of Elementary Counseling
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    • v.5 no.1
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    • pp.227-253
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    • 2006
  • It seems common for students living at a small county and islands to experience psychological conflicts and be unaccustomed in the peer society because they are not familiar with peer interaction and social skills. This is a case study of L (hereinafter called L) who was grown up in the sheltered school at a small county. L was psychologically disturbed because he couldn't get along well in the transferred school. It is the reason why he had lived in the sheltered school at a small county, so he had not enough exposure to interact with peer and social skills. Sometimes he was obstinate irrationally and when he had trouble with friends, he threw something out or went out of school and tricked juniors dangerously. The fact of disperse with families, parent's indifference, and hate of older brother made L to have ill feeling against family. He had low motivation and low self confident in learning because of short attention time and accumulated poor learning progress. In this study, he was evaluated at various area, such as, intelligent, affective, personal and inter-personal, before counselling. To evaluated the effect of the counselling, K-WISC-III, KPRC, sentence filling test, social adaptation ability test, etc, were administered right after the counselling was over and 8 weeks later. For specific information gathering and analysing, observation diary and deepen counselling were accomplished by homeroom teacher, his mother, and his peers. To correct his problematic behaviors, 13 counseling sessions were accomplished for 6 months and those counselling sessions were recorded and analysed definitely. Followings are the result of this case study. First, he was recovered from the anxiety of inter-personal interaction and he started to interact with peers. The result of sac scale score of KPRC profile was lower than before as much as average student after counseling and 8 weeks later. This reveals that the distress against interpersonal relation have settled. Especially, through the result of sentence filing test, he seemed to feel attachment to peers and be positive, active in the relation of peer. For instance, he was active in the open class lesson and interacted well with peers. It could be said that he overcame the psychological distress comparing with previous time. Second, he could apologize to his peer and juniors for his fault. His attitude were well shown in the letter from an old friend at the sheltered school, average KPRC profiling score comparing with previous counseling time, and remarkable decrease of attack scale score of teacher and peer. Third, his view toward family turn out positive. He recognized his situation that he lived apart from family and even worried about his parent's financial difficulty. Through solving the confliction with his older brother, he could acquire the feeling of family reunion. Fourth, his learning motivation and self-confidence were increased. He confirmed his future positively and he might be judged more attentive because his intelligence index was higher than before as much as average student. With the main goal of this study, verification for effectiveness of counseling. understanding and helping problematic students such as L who lives at a small county and island through investigation of their real situation and problems with the method of counseling and socio-cultural analysis is worthwhile. Identification of ideal relationship with peer is related with positive self-conception, harmonic social adaptation and development of child. It is time to investigate easy adaptive in classroom and well-organised program to acquire general social skills for sheltered school students at a small county and islands.

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Texture Characteristics of Seokibyung as affected by ingredients (석이병의 재료배합비에 따른 Texture특성)

  • 황미경;이효지
    • Korean journal of food and cookery science
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    • v.9 no.3
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    • pp.198-203
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    • 1993
  • The objective of this study was to evaluate the effect the Seokibyung, when the ingrdients were changed in a variety aspects ; the amount of Seoki flour to rice flour, and several kinds of sweeteners such as sugar, honey and syrup and condition of water. The evaluation of these result were as followings ; 1. According to sensory evaluation, the, flavor, grain, softness, moistness, chewiness, sweetness, overalquality of Seokibyung were the most excellent the mixture of 60g sugar, 280g rice flour, 70g glutious rice flour and 10.5g seoki flour mixed in 90$m\ell$ boiled water. 2. According to Instron evaluation that the higer level resulted to the left to the right treatment that Hardness : syrup, honey, sugar Cohesiveness : honey, syrup, sugar, Adhesiveness : syrup, honey, sugar Gumminess : honey, syrup, sugar Springness : honey, sugar, syrup, Chewiness : honey, syrup, sugar. there was no significant difference among the three treatment groups in each experimental group. 3. The Color & color difference evaluation_that Overall color difference was sugar, honey, syrup in turn. 4. percentages of moisture of honey-added, sugar-added and syrup-added Seokibyung were 42.49%, 41.45% and 36.73% respectively.

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Middle School Students' Perception of Body Image and Allowance for Plastic Surgery (중학생의 신체상 지각수준과 성형수술 허용도)

  • Bae, Jin-Ju;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.5
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    • pp.25-42
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    • 2004
  • This study set out to investigate the relations between middle school students' perception of body image and their allowance for plastic surgery, to understand their perception of body image and desire for plastic surgery, and provide some data needed to warn against reckless plastic surgery and guide the students effectively. For those purposes, an examination was conducted of the relationships between the individual characteristics and perception levels of body image, the individual characteristics and allowance for plastic surgery, and perception levels of body image and allowance for plastic surgery. The subjects were drawn from sour middle schools located in two regions of Gyeonggi Province. Total 922 boys and girls were surveyed on a questionnaire, which was developed based on the pretest of previous literature, reviewed for appropriateness, and tested for reliability and reasonableness. The body image on the five scale was greater as the perception level was higher. The allowance for plastic surgery was also greater as the scores were more. The findings were as follows: First, the relationships between individual characteristics and perception levels of body image were examined. The third graders showed the highest perception level, being followed by the first and second graders. The girls were more perceptive than the boys, and those who were extrovert were more perceptive than those who were introvert. Those students whose parents earned 2 million won or more a month and who adapted themselves to the environmental changes had a higher perception level. In a word, the girls from the middle class that were well adapted, felt happy, and were extrovert had a higher perception level of body image. Second, the connections between individual characteristics and allowance for plastic surgery were investigated. The third graders were the most admissive of plastic surgery, followed by the second and first graders. That is, the upper graders were more admissive of plastic surgery. In addition, the girls were more admissive than the boys, and those who were extrovert were more than those who were introvert. There were no significant differences according to the monthly income of the parents, grades, adaptability to surroundings, and happiness, which results almost resembled the findings of a study conducted on adults. Third, there were negative correlations found between the perception levels of body image and the allowance for plastic surgery. To elaborate, the higher the perception levels were, the lower the allowance was, and vice versa. As for the items, the subjects showed more allowance for plastic surgery when they scored less in the item of caring about appearance, importance of looking pretty to others, and efforts to improve appearance. When they had a low value of body and easily felt tired, they were highly acceptive of plastic surgery. The allowance for plastic surgery was also great when their perception was much of how healthy they felt, how important they felt about their bodies, how they were satisfied with their current appearances, how they evaluated the appearance of others, how much they were satisfied physically, and how much demanding they were for physical changes. Meanwhile, there were no correlations between the allowance and physical attraction, the degree for one's activities to be hindered, and sickness. In short, the demand for plastic surgery was 41% for the girls and 20.2% for the boys. Just as the study on adults reported, those who had a low or negative perception of body image were more acceptive of plastic surgery. The middle school students were generally positive about their bodies with the lowest perception level at 2.91 and the highest at 3.21. Their individual allowance for plastic surgery was related to their individual body images, which were in turn affected by the mass communication, surrounding environments, and social values. Thus it's necessary for the entire society to try to improve or change the overall perception. Helping measures should be taken so that the students can form right sense of values about their bodies, avoid the obsession with appearance and appearance-based evaluation, and exercise righteous criteria against humans beings and things. In conclusions, the following suggestions were made: they need to develop such questionnaires or tools as can measure the body image of teens and fit the reality. Moreover, body image improvement programs should be more diverse and more applicable to teens. Despite the consistent reports that prove the correlations between body image and plastic surgery, there has been little effort to apply such factors as experience of the life of the disabled, volunteer activities for the disabled and at the hospitals, and others that can induce changes to body image to the body image improvement programs. In the future, comparative research should be carried out on body image and plastic surgery.

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EXPRESSION OF PROLIFERATING CELL NUCLEAR ANTIGEN AND TYPE I COLLAGEN IN THE ELONGATED BONE IN THE MANDIBLE OF ADULT MONGREL DOGS (성견 하악 골체부 신장시 신장부위의 증식세포핵항원과 제 1형 교원질 발현에 관한 연구)

  • Lim, Sun-Mo;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.385-396
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    • 2001
  • The purpose of this experiment was to examine the histological changes and the pattern of expression of proliferating cell nuclear antigen(PCNA) and type I collagen in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. Seven adult male mongrel dogs weighing over 20kg were used for this experiment. The author excluded 3 animals because they died before the planned time of sacrifice. The custom-made linear extraoral device and 4 bicortical fixation screws 2.3mm in diameter, 50mm in total length, 15mm in screw length were used in each animal. The distal part of the distractor produced a 0.75mm gap between proximal and distal bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side from each animal was experimental side and the left side was left intact and served as control. At the experimental side, the mandibular body was osteotomized. After 5-day latency period, the segments were distracted with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were sacrificed at the 4th. 17th, and 32th day after the end of the distraction. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with Masson trichrome and examined under the light microscope. The immunohistochemical examinations using anti-PCNA antibody and anti-type-I collagen antibody were performed to examine the pattern of the expression of PCNA and type I collagen, respectively. Results : 1. The mean increment of the distance between the proximal and distal screw-holding parts of the distractor was 6.8mm. The average elongation of the mandible in the experimental side was 5.3mm. The loss of elongation was 1.5mm in average. 2. New bone was already observed at the 4th. day after the end of distraction. But, bony union was not completed in the distraction gap at the 32th. day after the end of distraction by radiographic and microscopic examinations. 3. The expression rate of PCNA positive cells in the distraction gap had a tendency of decrease from 35.1-68.8% initially, to 49.1%, and finally to 17.6-27.2%. But at the final period, the tissue of the elongated gap still had the ability of cell proliferation. On the other hand, the expression of PCNA positive cells in the control side were negligible through the experimental period. 4. PCNA positive cells were observed primarily both at the central fibrous zone and at the region of just adjacent to CFZ which initiated new bone formation. 5. The expression pattern of the type I collagen was not zone-specific. They were observed diffusely throughout the elongation gap. 6. The predominant mechanism of new bone formation in the distraction gap was intramembranous. But, some of the regenerated bone was formed by endochondral ossification.

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HISTOLOGICAL CHANGES IN THE ELONGATED BONE AFFECTED BY OSTEODISTRACTION OF THE MANDIBLE IN THE DOG (성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화)

  • Baek, Sun-Ho;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.404-416
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    • 2001
  • Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

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Perineal Skin Toxicity according to Irradiation Technique in Radiotherapy of Anal Cancer (항문암의 방사선치료 시 방사선 조사 기법에 따른 회음부 피부 독성)

  • You, Sei-Hwan;Seong, Jin-Sil;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.222-228
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    • 2008
  • Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.

A Study on Solutions to the Problems of the Current Tax Appeal System (조세심판청구제도의 문제점에 관한 개선방안)

  • Park, Sang-Bong
    • Management & Information Systems Review
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    • v.35 no.2
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    • pp.67-81
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    • 2016
  • The purpose of this study was to investigate lots of problems that the current tax appeal system has, which are becoming serious issues as tax appeal cases are recently increasing. Those problems include the unreasonable procedure and period of deliberation on tax appeal cases, permission of a same tax appeal by more than one governmental agencies and the compulsory transposition system of tax appeal cases. All of these problems should be rectified in order to ensure that the currently tax appeal system protect taxpayers' rights and interests effectively. According to the current tax appeal system, the period from the receipt of tax appeal cases to ruling on them is up to 90 days. This is unrealistic, so that period should be allowed to be extended if those cases about more complicated taxation or if they are even harder to be treated for any reason. At present, chief of Tax Tribunal has to unconditionally accept resolution from the meeting of tax judges and make a ruling accordingly because he has no right to reject that resolution. But now, it's time to establish legal grounds based on which the chief suggests the tax judges to reconsider their resolution if it is undoubtedly wrong. Currently, there's a relatively little acceptance of tax appeals from people who can't financially afford to designate a proxy for them. To solve this problem, lots of efforts to make socially recognized the necessity to relive those people's rights and interests and make widely known the Public Proxy of Tax Appeal System. The current tax appeal system allows the Board of Audit and Inspection to be an appealer. This means taxation may be deliberated on by more than one governmental agencies. It is so inefficient. Therefore, tax appeal by the board should be only about taxation that they found unacceptable by audit and inspection. Except for this, it is not allowed that the Board of Audit and Inspection file tax appeals that are, in turn, necessarily transported to the National Taxation. Esecially, the transposition should be a procedure that is occasionally taken. In sum, this study investigated problems with the current tax appeal system, and made suggestions about solutions that are not theoretical but practical.

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