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Immunization Practices in Children with Renal Disease : A Survey of the Members of Korean Society of Pediatric Nephrology (신질환 소아의 예방접종 현황 : 대한소아신장학회 회원들의 접종 방식에 대한 조사)

  • Park Seong-Shik;Ahn Sung-Ryou;Lee Ju-Suk;Kim Su-Yung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.198-208
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    • 2002
  • Purpose : There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists Methods : Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. Results : Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% us 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b ($54.3{\sim}77.1%$). Conclusion : Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.

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Exploration of Neurophysiological Mechanisms underlying Action Performance Changes caused by Semantic Congruency between Perceived Action Verbs and Current Actions (지각된 행위동사와 현재 행위의 의미 일치성에 따른 행위 수행 변화의 신경생리학적 기전 탐색)

  • Rha, Younghyoun;Jeong, Myung Yung;Kwak, Jarang;Lee, Donghoon
    • Korean Journal of Cognitive Science
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    • v.27 no.4
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    • pp.573-597
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    • 2016
  • Recent fMRI and EEG research for neural representations of action concepts insist that processing of action concepts evoke the simulation of sensory-motor information. Moreover, there are several behavioral studies showing that understanding of action verbs or sentences describing actions interfere or facilitate current action performance. However, it is unclear that online interaction between processing of action concepts and current action is based on the simulation of sensory-motor information, or other neural mechanisms. The present research aims to explore the underlying neural mechanism that how the perception of action language influence the performance of current action using high-spacial temporal resolution EEG and multiple source analysis techniques. For this, participants were asked to perform a cued-motor reaction task in which button-pressing hand action and pedal-stepping foot action were required according to the color of the cue, and we presented auditorily action verbs describing the responding actions (i.e., /press/, /step/, /stop/) just before the color cue and examined the interaction effect from the semantic congruency between the action verbs and the current action. Behavioral results revealed consistently a facilitatory effect when action verbs and responding actions were semantically congruent in both button-pressing and pedal-stepping actions, and an inhibitory effect when semantically incongruent in the button-pressing action condition. In the results of EEG source waveform analysis, the semantic congruency effects between action verbs and the responding actions were observed in the Wernicke's area during the perception of action verbs, in the anterior cingulate gyrus and the supplementary motor area (SMA) at the time when the motor-cue was presented, and in the SMA and primary motor cortex (M1) during action execution stage. Based on the current findings, we argue that perceived action verbs evoke the facilitation/inhibition effect by influencing the expectation and preparation stage of following actions rather than the directly activating the particular motor cortex. Finally we discussed the implication on the neural representation of action concepts and methodological limitations of the current research.

Development and Evaluation of a Nutritional Risk Screening Tool (NRST) for Hospitalized Patients (입원환자의 영양불량위험 검색도구의 개발 및 평가)

  • Han, Jin-Soon;Lee, Song-Mi;Chung, Hye-Kyung;Ahn, Hong-Seok;Lee, Seung-Min
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.119-127
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    • 2009
  • Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.

Assessment of Optimum Hydraulic Retention Time (HRT) for Maximum Biogas Production and Total Volatile Solid (TVS) Removal Efficiency of Semi-Continuously Fed and Mixed Reactor (SCFMR) Fed with Dairy Cow Manure (젖소분뇨로부터 최대 바이오가스 생산과 유기물 제거효율을 달성하기 위한 반건식 간헐주입 연속혼합 혐기성반응조의 최적 수리학적 체류시간 도출을 위한 연구)

  • Kang, Ho;Kim, Sun-Woo;Jeong, Ji-Hyun;Ahn, Hee-Kwon;Jung, Kwang-Hwa
    • Journal of Korean Society of Environmental Engineers
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    • v.37 no.12
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    • pp.696-704
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    • 2015
  • This study was carried out to evaluate the optimum operational condition of Semi-continuously Fed and Mixed Reactor (SCFMR) to treat the dairy cow manure and saw dust mixture. Step-wise increase in organic loading rates (OLRs) or decrease in hydraulic retention times (HRTs) were utilized until the biogas volume became significantly decreased at mesophilic temperature ($35^{\circ}C$). The optimum operating condition of the SCFMR fed with TS 13% dairy cow manure and saw dust mixture was found to be an HRTs of 25 days and its corresponding OLRs of $4.45kg\;VS/m^3-day$. At this condition the biogas and methane production rates were 1.44 v/v-d and 1.12 v/v-d (volume of biogas per volume of reactor per day), respectively and the TVS removal efficiency of 37% was achieved. The successful operation with such a high OLR was due to the high reactor alkalinity concentration of 14,500~15,600 mg/L as $CaCO_3$ as a result of the characteristic of the original substrate, dairy cow manure and saw dust mixture whose alkalinity was more than 8,000 mg/L as $CaCO_3$. The parameters for the reactor stability, the ratios of volatile acids and alkalinity concentrations (V/A) and the ratio of propionic acid and acetic acid concentrations (P/A) appeared to be 0.11 and 0.43, respectively, that were greatly stable in operation. Free ammonia toxicity was not experienced due to the long term acclimation by the reactor TS content ranged 7.2~10.4% during the entire operational period.

The Comparison of Noise-induced Hearing Loss Evaluation Criteria for Management (소음성난청 관리를 위한 판정기준간의 비교)

  • 남궁원자;원정일
    • Journal of environmental and Sanitary engineering
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    • v.13 no.1
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    • pp.123-134
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    • 1998
  • The study was performed to investigate the differences among various evaluation criteria for noise-induced hearing loss(NIHL). The subjects were 100 workers who had received detailed audiometric examinations after the periodic annual examination for hearing loss. The evaluation criteria included were as follows: The criterion I was NIHL of 50dB or greater at 4,000Hz in either ear which is one of the legal requirements for determining occupational hearing loss in Korea. The criterion II was NIHL of 40dB or greater by 4-divided classification(a+b+c+d/4 at 500Hz(a), 1,000Hz(b), 2,000Hz(c), 4,000Hz(d)) which is also one of the legal requirements for determining occupational hearing loss in Korea. The criterion III was NIHL of 31dB of greater by 6-divided classification(a+2b+2c+d/6) which is the workers' compensation standard. The criterion IV was NIHL of 40dB or greater by 6-divided classification(a+2b+2c+d/6), the criterion used to prohibite workers to be employed in the noisy workplace. The criterion V was NIHL of 40dB or greater by 3-divided classification(a+b+c/3) which is the guideline of the Japanes Labour Department. The results were as follows; 1. The percentage of workers with NIHL by the criterion I was the highest(96%) and covered all workers with NIHL diagnosed by other criteria. Therefore, this criterion was the most sensitive one for early detection of NIHL among various evaluation criteria. 2. The percentage of workers with NIHL by the criterion II was 29% of the subjects, but all of them could be diagnosed as having NIHL by the criterion I and 33.1% of the NIHL by the criterion III could not be covered by the criterion II. Thus, this criterion was not considered suitable as an initial step for determining occupational hearing loss. 3. The percentage of workers with NIHL by the criterion III was 45% of the subjects. This percentage was 46.9% of the NIHL by the criterion I and was estimated to cover 3.6% of all noise exposed workers. 4. The percentage of workers with NIHL by the criterion IV was 28% of the subjects, but 37.8% of the NIHL by the criterion III and 70.8% of the NIHL by the criterion I were not covered by the criterion. Therefore, these workers could have been employed in the noisy workplaces. 5. Employed relocation which was one of the post management methods was an option in the criterion I in Korea and in the criterion V in Japan. The number of NIHL by the criterion I was 6.7times greater than that by the criterion V. Thus, although employee relocation was not used exclusively, many more workers with NIHL could have been relocated. In conclusion, this study revealed that the criteria being used for managing occupational hearing loss showed a lack uniformity among them. In addition, since these criteria are all relied on the total threshold shifts caused by the noise exposure at the time of hearing test with no consideration given to the past noise exposure history nor age, it can be said that they are not an effective tool for occupational hearing loss management. Since legal requirements are usually followed after being diagnosed as having NIHL, it is recommended that a uniform diagnostic criterion should be used to minimize confusion. Pre-employment hearing tests should also be utilized so as to managing occupational hearing loss after employment rather than being used as a legal roadblock of prohibiting workers with mild hearing loss from being employed. Thus, what is needed is an establishment of a rational criterion for occupational hearing loss management rather than for legal requirements.

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A Study about the Direction and Responsibility of the National Intelligence Agency to the Cyber Security Issues (사이버 안보에 대한 국가정보기구의 책무와 방향성에 대한 고찰)

  • Han, Hee-Won
    • Korean Security Journal
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    • no.39
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    • pp.319-353
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    • 2014
  • Cyber-based technologies are now ubiquitous around the glob and are emerging as an "instrument of power" in societies, and are becoming more available to a country's opponents, who may use it to attack, degrade, and disrupt communications and the flow of information. The globe-spanning range of cyberspace and no national borders will challenge legal systems and complicate a nation's ability to deter threats and respond to contingencies. Through cyberspace, competitive powers will target industry, academia, government, as well as the military in the air, land, maritime, and space domains of our nations. Enemies in cyberspace will include both states and non-states and will range from the unsophisticated amateur to highly trained professional hackers. In much the same way that airpower transformed the battlefield of World War II, cyberspace has fractured the physical barriers that shield a nation from attacks on its commerce and communication. Cyberthreats to the infrastructure and other assets are a growing concern to policymakers. In 2013 Cyberwarfare was, for the first time, considered a larger threat than Al Qaeda or terrorism, by many U.S. intelligence officials. The new United States military strategy makes explicit that a cyberattack is casus belli just as a traditional act of war. The Economist describes cyberspace as "the fifth domain of warfare and writes that China, Russia, Israel and North Korea. Iran are boasting of having the world's second-largest cyber-army. Entities posing a significant threat to the cybersecurity of critical infrastructure assets include cyberterrorists, cyberspies, cyberthieves, cyberwarriors, and cyberhacktivists. These malefactors may access cyber-based technologies in order to deny service, steal or manipulate data, or use a device to launch an attack against itself or another piece of equipment. However because the Internet offers near-total anonymity, it is difficult to discern the identity, the motives, and the location of an intruder. The scope and enormity of the threats are not just focused to private industry but also to the country's heavily networked critical infrastructure. There are many ongoing efforts in government and industry that focus on making computers, the Internet, and related technologies more secure. As the national intelligence institution's effort, cyber counter-intelligence is measures to identify, penetrate, or neutralize foreign operations that use cyber means as the primary tradecraft methodology, as well as foreign intelligence service collection efforts that use traditional methods to gauge cyber capabilities and intentions. However one of the hardest issues in cyber counterintelligence is the problem of "Attribution". Unlike conventional warfare, figuring out who is behind an attack can be very difficult, even though the Defense Secretary Leon Panetta has claimed that the United States has the capability to trace attacks back to their sources and hold the attackers "accountable". Considering all these cyber security problems, this paper examines closely cyber security issues through the lessons from that of U.S experience. For that purpose I review the arising cyber security issues considering changing global security environments in the 21st century and their implications to the reshaping the government system. For that purpose this study mainly deals with and emphasis the cyber security issues as one of the growing national security threats. This article also reviews what our intelligence and security Agencies should do among the transforming cyber space. At any rate, despite of all hot debates about the various legality and human rights issues derived from the cyber space and intelligence service activity, the national security should be secured. Therefore, this paper suggests that one of the most important and immediate step is to understanding the legal ideology of national security and national intelligence.

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An Examination of Knowledge Sourcing Strategies Effects on Corporate Performance in Small Enterprises (소규모 기업에 있어서 지식소싱 전략이 기업성과에 미치는 영향 고찰)

  • Choi, Byoung-Gu
    • Asia pacific journal of information systems
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    • v.18 no.4
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    • pp.57-81
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    • 2008
  • Knowledge is an essential strategic weapon for sustaining competitive advantage and is the key determinant for organizational growth. When knowledge is shared and disseminated throughout the organization, it increases an organization's value by providing the ability to respond to new and unusual situations. The growing importance of knowledge as a critical resource has forced executives to pay attention to their organizational knowledge. Organizations are increasingly undertaking knowledge management initiatives and making significant investments. Knowledge sourcing is considered as the first important step in effective knowledge management. Most firms continue to make an effort to realize the benefits of knowledge management by using various knowledge sources effectively. Appropriate knowledge sourcing strategies enable organizations to create, acquire, and access knowledge in a timely manner by reducing search and transfer costs, which result in better firm performance. In response, the knowledge management literature has devoted substantial attention to the analysis of knowledge sourcing strategies. Many studies have categorized knowledge sourcing strategies into intemal- and external-oriented. Internal-oriented sourcing strategy attempts to increase firm performance by integrating knowledge within the boundary of the firm. On the contrary, external-oriented strategy attempts to bring knowledge in from outside sources via either acquisition or imitation, and then to transfer that knowledge across to the organization. However, the extant literature on knowledge sourcing strategies focuses primarily on large organizations. Although many studies have clearly highlighted major differences between large and small firms and the need to adopt different strategies for different firm sizes, scant attention has been given to analyzing how knowledge sourcing strategies affect firm performance in small firms and what are the differences between small and large firms in the patterns of knowledge sourcing strategies adoption. This study attempts to advance the current literature by examining the impact of knowledge sourcing strategies on small firm performance from a holistic perspective. By drawing on knowledge based theory from organization science and complementarity theory from the economics literature, this paper is motivated by the following questions: (1) what are the adoption patterns of different knowledge sourcing strategies in small firms (i,e., what sourcing strategies should be adopted and which sourcing strategies work well together in small firms)?; and (2) what are the performance implications of these adoption patterns? In order to answer the questions, this study developed three hypotheses. First hypothesis based on knowledge based theory is that internal-oriented knowledge sourcing is positively associated with small firm performance. Second hypothesis developed on the basis of knowledge based theory is that external-oriented knowledge sourcing is positively associated with small firm performance. The third one based on complementarity theory is that pursuing both internal- and external-oriented knowledge sourcing simultaneously is negatively or less positively associated with small firm performance. As a sampling frame, 700 firms were identified from the Annual Corporation Report in Korea. Survey questionnaires were mailed to owners or executives who were most erudite about the firm s knowledge sourcing strategies and performance. A total of 188 companies replied, yielding a response rate of 26.8%. Due to incomplete data, 12 responses were eliminated, leaving 176 responses for the final analysis. Since all independent variables were measured using continuous variables, supermodularity function was used to test the hypotheses based on the cross partial derivative of payoff function. The results indicated no significant impact of internal-oriented sourcing strategies while positive impact of external-oriented sourcing strategy on small firm performance. This intriguing result could be explained on the basis of various resource and capital constraints of small firms. Small firms typically have restricted financial and human resources. They do not have enough assets to always develop knowledge internally. Another possible explanation is competency traps or core rigidities. Building up a knowledge base based on internal knowledge creates core competences, but at the same time, excessive internal focused knowledge exploration leads to behaviors blind to other knowledge. Interestingly, this study found that Internal- and external-oriented knowledge sourcing strategies had a substitutive relationship, which was inconsistent with previous studies that suggested complementary relationship between them. This result might be explained using organizational identification theory. Internal organizational members may perceive external knowledge as a threat, and tend to ignore knowledge from external sources because they prefer to maintain their own knowledge, legitimacy, and homogeneous attitudes. Therefore, integrating knowledge from internal and external sources might not be effective, resulting in failure of improvements of firm performance. Another possible explanation is small firms resource and capital constraints and lack of management expertise and absorptive capacity. Although the integration of different knowledge sources is critical, high levels of knowledge sourcing in many areas are quite expensive and so are often unrealistic for small enterprises. This study provides several implications for research as well as practice. First this study extends the existing knowledge by examining the substitutability (and complementarity) of knowledge sourcing strategies. Most prior studies have tended to investigate the independent effects of these strategies on performance without considering their combined impacts. Furthermore, this study tests complementarity based on the productivity approach that has been considered as a definitive test method for complementarity. Second, this study sheds new light on knowledge management research by identifying the relationship between knowledge sourcing strategies and small firm performance. Most current literature has insisted complementary relationship between knowledge sourcing strategies on the basis of data from large firms. Contrary to the conventional wisdom, this study identifies substitutive relationship between knowledge sourcing strategies using data from small firms. Third, implications for practice highlight that managers of small firms should focus on knowledge sourcing from external-oriented strategies. Moreover, adoption of both sourcing strategies simultaneousiy impedes small firm performance.

The Evaluation of Images with Various Filters in I-131 SPECT/CT (I-131 SPECT/CT에서 Ringing Artifact 감소를 위한 다양한 Filter값의 적용)

  • Kim, Ha Gyun;Kim, Soo Mee;Woo, Jae Ryong;Oh, So Won;Lee, Jae Sung;Kim, Yu Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.62-68
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    • 2014
  • Purpose: After I-131 therapy, SPECT/CT is useful in identifying location of thyroid remnants and metastasis of thyroid cancers. An excessive uptake of thyroid leads to a ringing artifact in the SPECT images. The aim of this study is to investigate and suggest a proper post filters to remove ringing artifact and produce better image quality. Materials and Methods: A low-cost, customized thyroid-mimicking phantom, consisting of an acrylic bottle and a hollow sphere was used for SPECT/CT Discovery (GE Healthcare, USA). It was filled with I-131 solution. The ratio of hollow sphere to background were varied as 50:1, 200:1, 1000:1 and 4000:1. Acquired images were reconstructed by OSEM (2 iterations, 10 subsets) with and without Evolution (resolution recovery correction, GE). Three different post-filters were applied; Butterworth (cut off: 0.38 to 0.58 with intervals of 0.05), Hanning (cut off: 0.8 to 1 with intervals of 0.05) and Gaussian (FWHM: 3 to 5 with intervals of 0.5) filters. Contrast, background variability, air area variability, and full width half maximum (FWHM) were compared. Results: Higher contrasts were obtained from the SPECT images with Evolution than without Evolution. In the case of images without Evolution, image distortion such as star artifact was generated. For all sphere-to-background ratio, the Butterworth filter showed better constrasts and FWHMs than other two filters, but the ringing artifact was still generated in all studies except 50:1 and it was decreased as cutoff value was increased. The ringing artifact didn't appear with Hanning and Gaussian filters at all studies, however constrats and FWHMs with Gaussian was worse than Hanning filter. For the images having ringing artifacts, the background variability and air area variability were increased. Conclusion: In this study, we suggested that it is desirable to use Hanning filter when the ringing artifact is generated and to use Butterworth filter when ringing artifact is not generated in I-131 SPECT.

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Survey on the Awareness of Guardians of Young Infants on the Weaning of Food in Pohang and Gyeongju Area (두 종합 병원을 방문한 영유아 양육자의 이유식에 대한 인지도 조사)

  • We, Hyun Woo;Seo, Yu Kyung;Kim, Ae Suk;Lee, Sun Ju;Cho, Sung Min;Lee, Dong Seok;Kim, Doo Kwun;Choi, Sung Min
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.233-241
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    • 2006
  • Purpose: This study was carried out to investigate the awareness of the weaning of food using questionnaires, and the relationship with the weight gain in young infants. Methods: From September 2005 to December 2005, we performed a survey on 141 guardians of young infants aged from 6 to 18 months, who visited the pediatric out-patient department at Dongguk University Medical Center. We calculated the total score for each responder from ten questions on the weaning of food and assessed the body weight percentile of each of the young infants. Results: The most commonly reported information source for weaning food was 'the friends around' by 62 respondents (44.0%); 54 (38.3%) responded that the definition of weaning food was the preparatory step before starting a solid diet. Most used a spoon (90.8%) to feed when weaning food with a thin gruel of rice (78.7%). The time for weaning of food was before breast or infant formula feeding (55.3%). Addition of cow's milk was around 12 months (77.3%). The mean score was 6.21; however this did not show a statistically significant correlation with weight gain in young infants. Conclusion: The overall awareness of weaning of food has improved; however, information from doctors has decreased. Although the relationship between the awareness of weaning of food and the growth of young infants was not statistically significant, further studies on weaning of food, with larger and controlled sample sizes may provide important information.

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Ni/Au Electroless Plating for Solder Bump Formation in Flip Chip (Flip Chip의 Solder Bump 형성을 위한 Ni/Au 무전해 도금 공정 연구)

  • Jo, Min-Gyo;O, Mu-Hyeong;Lee, Won-Hae;Park, Jong-Wan
    • Korean Journal of Materials Research
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    • v.6 no.7
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    • pp.700-708
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    • 1996
  • Electroless plating technique was utilized to flip chip bonding to improve surface mount characteristics. Each step of plating procedure was studied in terms pf pH, plating temperature and plating time. Al patterned 4 inch Si wafers were used as substrstes and zincate was used as an activation solution. Heat treatment was carried out for all the specimens in the temperature range from room temperature to $400^{\circ}C$ for $30^{\circ}C$ minutes in a vacuum furnace. Homogeneous distribution of Zn particles of size was obtained by the zincate treatment with pH 13 ~ 13.5, solution concentration of 15 ~ 25% at room temperature. The plating rates for both Ni-P and Au electroless plating steps increased with increasing the plating temperature and pH. The main crystallization planes of the plated Au were found to be (111) a pH 7 and (200) and (111) at pH 9 independent of the annealing temperature.

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