• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.169-176
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• 2010

Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.199-206
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• 2000

Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise $^{99m}Tc$-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. Materials and Methods: We evaluated 301 patients (mean age $52{\pm}10$ years, 166 males and 135 females) with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subject were evaluated for cardiac events and followed for 8-55 months (mean $19{\pm}10$ months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n=235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.57-64
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• 2007

Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.430-438
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• 2008

Background: All the patients with mechanical valves require warfarin therapy in order to prevent them from developing thromboembolic complications. According to the ACC/AHA practice guidelines, after AVR with bileaflet mechanical prostheses in patients with no risk factors, warfarin is indicated to achieve an INR of 2.0 to 3.0. After MVR with any mechanical valve, warfarin is indicated to achieve an INR of 2.5 to 3.5. But in our clinical experience, bleeding complications (epistaxis, hematuria, uterine bleeding, intracerebral hemorrhage etc.) frequently developed in patients who maintained their INR within this value. So, we retrospectively reviewed the patients with bileaflet mechanical heart valve prosthesis and we determined the optimal anticoagulation value. Material and Method: From January 1984 to February 2007, 311 patients have been followed up at a national medical center. We classified the AVR patients (n=60) into three groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II and an INR from 2.5 to 3.0 in Group III. We classified the MVR (n=171) and DVR (n=80) patients into four groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II, an INR from 2.5 to 3.0 in Group III and an INR from 3.0 to 3.5 in Group III. We compared the groups for their thromboembolic and bleeding complications by means of the Kaplan Meier method. Result: In the AVR patients, 2 thromboembolic complications and 4 bleeding complications occurred and the log rank test failed to identify any statistical significance between the groups for thethromboembolic complication rate, but groups I and II had lower bleeding complication rates than did group III. Thirteen thromboembolic complication and 15 bleeding complication occurred in the MVR and DVR patients, and the log rank test also failed to identify statistical significance between the groups for the thromboembolic complication rate, but groups I and II had lower bleeding complication rates that did groups III and IV. Conclusion: The thromboembolic complication rate was not statistically different between groups I and II and groups III and IV, but the bleeding complication rates of groups I and II were lower than those of groups III and IV. So this outcome encouraged us to continue using our low intensive anticoagulation regime, that is, an INR of 1.5 to 2.5.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.236-244
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• 2001

Background : Most current research using prognostic scoring systems in critically ill patients have focused on prediction using the first intensive care unit (ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. Methods : 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the $1^{st}$ and $7^{th}$ APACHE III scores and the mortality risk. Results : 1 )The mean length of stay in the ICU was $10.3{\pm}13.8$ days. 2)The mean $1^{st}$ and $7^{th}$ day APACHE III scores were $59.7{\pm}30.9$ and $37.9{\pm}27.7$. 3) The mean $1^{st}$ day APACHE III score was significantly lower in survivors than in non- survivors($49.9{\pm}23.8$ vs $86.3{\pm}32.3$, P<0.0001). 4)The mean $7^{th}$ day APACHE III score was significantly lower in survivors than in non- survivors($30.1{\pm}18.5$ vs $80.1{\pm}30.4$, P<0.0001). 5)The odds ratios among the $1^{st}$ and $7^{th}$ day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. Conclusion : These results suggest that the seventh day APACHE III score is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the $1^{st}$ and $7^{th}$ day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the $7^{th}$ day APACHE III score is useful for predicting the clinical outcome.

• Clean Technology
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• v.26 no.2
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• pp.151-157
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• 2020

Rapid urbanization has elevated the risk of urban flooding due to the increase in the impervious surface, causing environmental disasters and environmental pollution problems, such as lowering the groundwater level and increasing water pollution. In Korea, low impact development (LID) techniques have been introduced to minimize these environmental impacts and maintain the water cycle soundness. However, most small-scale development projects are in blind spots because there is no legal basis for rainfall runoff management. Small-scale development projects that increase the surface runoff of rainwater are required to mandate the application of LID facilities in accordance with the polluters' responsibility principle. Therefore, it is necessary to implement a preliminary consultation system for water cycle recovery. This study focuses on the cost-benefit analysis on the application of LID techniques for small-scale development projects. The scale of nationwide small-scale development projects used for cost-benefit analysis were defined as buildings with a land area of more than 1,000 ㎡ or a total floor area of 1,500 ㎡. As a result of analyzing the cost-benefits from the installation of LID facilities, they were found to be much lower than the economic standard value of 1. This might be due to the high cost of facilities compared to the scale of the project. However, considering the overall environmental value of improving the water environment and air quality by the installation of LID facilities and the publicity of reducing the operating cost of sewage treatment facilities, the introduction of a prior consultation for small-scale development projects is inevitable. In the future, institutional and financial support from local governments is required to improve the cost-benefits with the introduction of a prior consultation for small-scale development projects.

• Journal of Korean Society of societal Security
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• v.4 no.2
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• pp.73-78
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• 2011

In order to resolve the problem of change in global climate which is worsening as days go by and to preemptively cope with strengthened restriction on carbon emission, the government enacted 'Framework Act on Low Carbon Green Growth' in 2010 and selected green technology and green industry as new national growth engines. For this reason, the necessity to use the un-utilized waste heat across the whole industrial system has become an issue, and studies on and applications of recycling in the agricultural and fishery fields such as cultivation of tropical crops and flatfishes by utilizing the waste heat and thermal effluent generated by large industrial complexes including power plants are being actively carried out. In this study, we looked into the domestic and overseas examples of having utilized waste heat abandoned in the form of power plant thermal effluent, and carried out economic efficiency evaluation of sturgeon aquaculture utilizing thermal effluent of Yeongwol LNG Combined Cycle Power Plant in Gangwon-do. In this analysis, we analyzed the economic efficiency of a model business plan divided into three steps, starting from a small scale in order to minimize the investment risk and financial burden, which is then gradually expanded. The business operation period was assumed to be 10 years (2012~2021), and the NVP (Net Present Value) and economic efficiency (B/C) for the operation period (10 years) were estimated for different loan size by dividing the size of external loan by stage into 80% and 40% based on the basic statistics secured through a site survey. Through the result of analysis, we can see that reducing the size of the external loan is an important factor in securing greater economic efficiency as, while the B/C is 1.79 in the case the external loan is 80% of the total investment, it is presumed to be improved to 1.81 when the loan is 40%. As the findings of this study showed that the economic efficiency of sturgeon aquaculture utilizing thermal effluent of power plant can be secured, it is presumed that regional development project items with high added value can be derived though this, and, in addition, this study will greatly contribute to reinforcement of the capability of local governments to cope with climate change.

• Journal of Intelligence and Information Systems
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• v.16 no.4
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• pp.1-19
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• 2010

In offline environment, unlike traditional advertising model through TV, newspaper, and radio, online advertising model draws instantaneous responses from potential consumers and it is convenient to assess. This kind of characteristics of Internet advertising model has driven the growth of advertising model among various Internet business models. There are, conventionally classified, CPM (Cost Per Mile), CPC (Cost Per Click), and CPS (Cost Per Sales) models as Internet advertising expenditure model. These can be examined in manners regarding risks that stakeholders should stand and degree of responsibility. CPM model that is based on number of advertisement exposure is mechanically exposed to users but not actually recognized by users resulting in risk of wasted expenditure by advertisers without any advertising effect. While on aspect of media, CPS model that is based on conversion action is the most risky model because of the conversion action such as product purchase is determined by capability of advertisers not that of media. In this regard, while there are issue of CPM and CPS models disadvantageously affecting only one side of Internet advertising business model value network, CPC model has been evaluated as reasonable both to advertisers and media, and occupied the largest segment of Internet advertising market. However, CPC model also can cause fraudulent behavior such as click fraud because of the competition or dishonest amount of advertising expenditure. On the user aspect, unintentionally accessed advertisements can lead to more inappropriate expenditure from advertisers. In this paper, we suggest "CPCD"(Cost Per Coupon Download) model. This goes beyond simple clicking of advertisements and advertising expenditure is exerted when users download a coupon from advertisers, which is a concept in between CPC and CPS models. To achieve the purpose, we describe the scenario of advertiser perspective, processes, participants and their benefits of CPCD model. Especially, we suggest the new value in online coupon; "possibility of storage" and "complement for delivery to the target group". We also analyze the working condition for advertiser by a comparison of CPC and CPCD models through advertising expenditure simulation. The result of simulation implies that the CPCD model suits more properly to advertisers with medium-low price products rather than that of high priced goods. This denotes that since most of advertisers in CPC model are dealing with medium-low priced products, the result is very interesting. At last, we contemplate applicability of CPCD model in ubiquitous environment.

• The Journal of Engineering Geology
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• v.14 no.1
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• pp.1-20
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• 2004

This study focuses on the hydrochemical characteristics in goundwater affected by reclamation at 2000 Sydney Olympic Games site, Sydney, Australia. The Olympic Games site can be divided into three areas, i.e. reclaimed areas; landfill areas and non-infilled areas. In the current work, 'reclaimed areas' were previously estuarine, and were filled with waste materials and are now above present high tide level, whereas 'landfill areas' are areas where deposition of waste materials occurred above sea level. No deposition of waste took place in 'non-infilled areas'. This study was also evaluated by three different types such as deep boreholes, shallow boreholes and standpipes. The hydrochemishy of groundwaters in reclaimed and non-in-filled areas is characterized by Mg- and Ca-enrichment, whereas groundwaters in landfill areas are elevated in K and NO₃. Na, K and Mg are the dominant cations in groundwater from reclaimed areas and Na and K are the dominant cations in groundwater in landfill areas. Na and Mg are the dominant cations in groundwater in deep boreholes, whereas Na and K are the dominant cations in groundwater in shallow boreholes and standpipes. There is no distinct trend in heavy metals with electrical conductivity in the groundwater between the re-claimed, landfill and non-infilled areas. Fe and Mn in landfill areas with respect to reclaimed areas and non-infilled areas show a distinct increase in concentration with declining pH. Mean electrical conductivity values in the deep and shallow boreholes are higher than that of standpipes, but the minimum and maximum value of electrical conductivity in groundwater in standpipes shows remarkably different value, probably due to perched pond. There is no correlation between Cu, Pb, Zn, Cr concentrations in groundwater with pH, from deep boreholes, shallow boreholes and standpipes, except for Fe and Mn, which demonstrate increasing concentrations with declining pH. The results revealed a close association between elevated concentrations in groundwater and the presence of fill materials at the site. Trace metals teachability from re-claimed soils adjacent to estuary plays a significant role in determining their potential environmental risk to surrounding environment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.1 no.1
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• pp.73-82
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• 2000

Conventional funding system for the university research projects is limited to a grant or subsidy type funding method which does not require an obligation of refund. Such a funding system is known as ideal one for the university research activities which in general is not a profit oriented activities. It is considered ideal in a sense that nonprofit oriented research activities gives more emphasis on creativity than on efficiency or practical value. A venture- business-start-up research activity can not be considered as a pure nonprofit oriented activities. It clearly gives more emphasis on efficiency and practical value than on creativity Recently a large portion of the venture-business-start-up research activities are carried out in the universities. When a conventional research funding system is applied to such a new type of research activities, it turned out that the success rate is much lower than expectancy. This is why a new and differentiated funding system is sought for such a new type of research activities. A funding system of loan type for a venture-business-start-up research activities is proposed herewith. A loan system naturally requires a pay back after the successful start up of the venture business. This loan system nay be considered that a business concept is grafted on a conventional funding system for the university research activities. This means that a rather loose or generous terms and conditions of the money loan case is introduced into this funding system to remedy the short comings of the intrinsic nonprofit nature of the university research activities. The point is how to improve the success rate and how to reduce the undesirable aspect of the conventional university research activities when it is practiced with the new type of research activities. After one and half year of practicing with the new funding system. it can not be asserted that a definitely positive results could be obtained. but a trend of desirable aspects could be observed such as low drop out rate. project selection efficiency, higher sense of responsibility. etc.