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A Case of Cavitary Lung Lesion as a Consequence of Smoke Inhalation Injury (흡입화상 치료과정에서 생긴 공동성 폐 병변)

  • Shin, Hyun Won;Kim, Cheol Hong;Eom, Kwang Seok;Park, Yong Bum;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Eil Seong
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.564-570
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    • 2006
  • Toxic gases and soot deposition as a consequence of smoke inhalation can cause direct injury to the upper and lower airways and even to the lung parenchyma. A delay in proper and prompt therapy can be detrimental to critically ill burn patients with an inhalation injury. Therefore, serial chest radiography is an important diagnostic tool for pulmonary complications during treatment. The radiographic findings of the chest include normal, consolidation, interstitial and alveolar infiltrates, peribronchial thickening, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, and a pneumothorax as acute complications of smoke inhalation. In addition, bronchiectasis, bronchiolitis obliterans and pulmonary fibrosis can occur as late complications. We encountered a case of 44-year-old male who presented with acute lung injury after an inhalation injury. He required endotracheal intubation and mechanical ventilation due to respiratory failure. He was managed successfully with conservative treatment. Later, a cavitary lesion of the left upper lobe was observed on the chest radiography and computed tomography, which was complicated by massive hemoptysis during the follow-up. However, the cavitary lesion disappeared spontaneously without any clinical consequences.

Teaching Methodology for Future Mathematics Classroom:Focusing on Students' Generative Question in Ill-Structured Problem (미래학교 수학교실의 교육 방법론에 대한 탐색:비구조화된 문제에서 학생들의 질문 만들기를 중심으로)

  • Na, Miyeong;Cho, Hyungmi;Kwon, Oh Nam
    • The Mathematical Education
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    • v.56 no.3
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    • pp.301-318
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    • 2017
  • This paper explores students' question generation process and their study in small group discussion. The research is based on Anthropological Theory of the Didactic developed by Chevallard. He argues that the savior (knowledge) we are dealing with at school is based on a paradigm that we prevail over whether we 'learn' or 'study' socially. In other words, we haven't provided students with autonomous research and learning opportunities under 'the dominant paradigm of visiting works'. As an alternative, he suggests that we should move on to a new didactic paradigm for 'questioning the world a question', and proposes the Study and Research Courses (SRC) as its pedagogical structure. This study explores the SRC structure of small group activities in solving ill-structured problems. In order to explore the SRC structure generated in the small group discussion, one middle school teacher and 7 middle school students participated in this study. The students were divided into two groups with 4 students and 3 students. The teacher conducted the lesson with ill-structured problems provided by researchers. We collected students' presentation materials and classroom video records, and then analyzed based on SRC structure. As a result, we have identified that students were able to focus on the valuable information they needed to explore. We found that the nature of the questions generated by students focused on details more than the whole of the problem. In the SRC course, we also found pattern of a small group discussion. In other words, they generated questions relatively personally, but sought answer cooperatively. This study identified the possibility of SRC as a tool to provide a holistic learning mode of small group discussions in small class, which bring about future mathematics classrooms. This study is meaningful to investigate how students develop their own mathematical inquiry process through self-directed learning, learner-specific curriculum are emphasized and the paradigm shift is required.

An Empirical Study of the Relationship between the 'Fit' of Task Characteristics and BSC System Characteristics and BSC System User Satisfaction (업무특성과 BSC 시스템 특성의 적합도가 BSC 시스템 사용자 만족도에 미치는 영향)

  • Lee, Chang-Jin;Lee, Jung-Hoon;Lee, Choong-C.;Song, Joon-Woo
    • Journal of Information Technology Applications and Management
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    • v.16 no.2
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    • pp.1-21
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    • 2009
  • The balanced scorecard(BSC) framework is a tool for strategic decision making and task support that aims for efficiency in performance management and strategy execution. BSC evolved from an old performance management practice, which tended to be limited to a finance-only perspective, to a new system of corporate management looking at corporate tasks from a multi-dimensional, future-inclined value perspective. This form of BSC amounts to a framework capable of driving management innovation and renewing the ways in which companies conceive their strategy and perform their operations. Since BSC draws integrally on user participation, it can be expected that users' satisfaction with BSC systems is an important factor in systems' success or failure. However, previous studies of the BSC system have not yet considered it as a theoretical model, specifically examining BSC system and task characteristics. To date, only a few studies have put forward plans for the implementation and use of BSC systems, and these studies have the common limitation of failing to consider the circumstances or theoretical structure of the companies for which a BSC system is being proposed. This paper then begins to fill some of this gap by characterizing the BSC system from the perspective of contingency theories. Contingency theories can be particularly useful in the Korean context in exploring how different companies use the BSC system in ways determined by their unique environmental characteristics, which may also determine the performance factors behind the application of a company's particular BSC system. In order to provide concrete suggestions for implanting and using the BSC system from a contingency theory perspective, this study sets out to determine the relationships between the contingency variables affecting BSC system performance and BSC system property variables(in given cases) through an empirical analysis. The study takes into account the perspective from which contingency theory is to be applied in individual cases, sets contingency and BSC property variables with reference to the BSC system user's environment and BSC system's character, and frames initial hypotheses concerning corporate structure and environmental variables and BSC system performance variables with reference to previous studies. A survey was then conducted on users in Korean companies that have implemented the BSC system in order to verify the research model and understand results.

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The Relationship among Usage Situation of Customer's Reward Program, Negative Affect, Commitment, and Complaining Behavior - Focused on Equal Theory - (고객보상프로그램의 사용상황과 부정적 감정, 결속차원 및 불평행동의 관계에 관한 연구 - 공정성이론을 중심으로 -)

  • Lee, Eun-Mi;Jeon, Jung-Ok
    • CRM연구
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    • v.2 no.1
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    • pp.53-72
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    • 2009
  • Customer's reward program is a prevailing promotional technique. Recently, both management and marketing fields have been interested in the failure of customer's reward program. However, there are few empirical research regarding this. Therefore, this study examined a research model that employs justice in processing of customer's reward program perceived by customer to explain commitment(calculative commitment, affective commitment) and complaining behavior which is mediated by negative affect. Data was collected from the customers who dissatisfied with their reward programs. For the analysis, frequency, cronbach' α and path analysis were used as statistical test tool. Additionally, SPSS 12.0 and AMOS 4.0 were used for analyzing the hypotheses. As a result, proposed structural model largely supports the hypothesized framework and the major findings of this study are summarized as follows: First, distributive and interactional justice were negatively related to negative affect. But procedural justice didn't influence negative affect. Second, negative affect was negatively related to calculative commitment. But affective commitment wasn't influenced by negative affect. Third, negative affect was positively related to complaining behavior. Fourth, calculative commitment was negatively related to complaining behavior. But negative affect didn't influence complaining behavior. In conclusion, It can be posited that justice, negative affect, 2 forms of commitment and complaining behavior are important factors.

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A Case Study of Music Therapy with Song for the Improvement of Mentally Disable Children's Communications (정신지체아동의 의사소통 증진을 위한 노래활동 사례 분석)

  • Kang, Sung-Mi
    • Journal of Music and Human Behavior
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    • v.1 no.1
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    • pp.33-46
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    • 2004
  • Mentally disable children feel as failure because they have difficulty in restricted and undifferentiated communications with others. It also makes the counter-partner feel frustrated. Therefore, in the aspects of language acquirement and communication activities, it is essential to let the disable children learn and communicate voluntarily. Music provides the unthreatening and interesting stimulus as non-language communication vehicle. Musical experiences for mentally disable children's are multi-stimulating experiences that make a positive influence in speech and language development and development of variety of talents. There are many communication intervention and method to treat the mentally disable children. One of the most effective treatments for mentally disable children to acquire communication techniques by expressing the language more naturally and joyfully is the musical therapy. This study analyzes children's communication technique referring to response action and attempt action through video tape observation. Also, this study measured the receptive and expressive language by PRES(Preschool Receptive-Expressive Language Scale) as a test tool in order to examine the pre-post language ability for respective children as pre-post period of therapy activity. First result of this study showed that music therapy with song was effective for mentally disable children in enhancing the communication techniques centered with communication response and in attempt action by increasing the communication action incidence. Secondly, pre-post comparison test with PRES showed that the music therapy with song was effective on improvement the receptive and expressive language ability of 4 children.

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The Role of Pectoralis Major Myocutaneous Flap in the Era of Free Flap (유리피판 시대의 대흉근피판의 역할)

  • Choi Eun-Chang;Kim Chul-Ho;Kim Se-Heon;Kim Young-Ho;Kim Kwang-Moon
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.190-193
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    • 2001
  • Background and Objectives: Reliable and versatile free flap has become a mainstay in reconstruction of the head and neck. But until now pectoralis major myocutaneous flap (PMMCF) as workhorse is useful and has some advantages such as good viability, one-stage reconstruction and carotid protection. The objective of this study was to review the role and indication of PMMCF in this era of potent free flaps for head and neck reconstruction. Patients and Methods: Sixty one PMMCF and one hundred forty six free flaps used for head and neck reconstruction between 1991 and 2001 were reviewed retrospectively. We compared the applied sites of flap, the flap failure rate and complications. Results: Contrary to the free flap, use of PMMCF has gradually decreased after the middle of 1990s. PMMCF were mainly used for mucosal defect(33cases, 54.1%) and cervical skin defect(22cases, 36.1%) and free flap were mainly used for mucosal defect(129cases, 88.4%). In point of use of PMMCF according to years, from 1991 to 1997, 30cases(70%) are used to reconstruct mucosal defect and 12cases(29%) are used to reconstruct skin defect. But from 1998 to 2001, only 2cases(10.5%) are used to reconstruct mucosal defect and 13cases(68.4%) are used to reconstruct neck skin defect. In case of free flap, from 1991 to 1997, 41cases (87%) are used to reconstruct mucosal defect and from 1998 to 2001 88cases(89%) are used as same purpose. Three major necrosis (more than 50%) deveolped in 61 PMMCF (4.9%) and three major necrosis developed in 146 free flaps(2.1%). Conclusion: PMMCF is no longer flap of choice for primary reconstruction but it is a still one of a good tool in some head and neck reconstruction such as covering single wide defect of face or neck skin, back-up procedure of free flap, postoperative status, treatment of pharyngocutaneous fistula and covering vital structure.

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Case Study on the Firing Pin Fatigue Destruction of the Korean Rifle by Repeated Impact (반복충격에 의한 한국형 소총의 공이 피로파괴 사례 연구)

  • Lee, Ho-Jun;Choi, Si-Young;Shin, Tae-Sung;Seo, Hyun-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.648-655
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    • 2020
  • The firing pin of modern automatic rifles detonates the primer of loaded ammunition via a hammer. During this process, the firing pin receives an impact load and repetitive force throughout the life of the rifle. An endurance test of a rifle showed that the firing pin breaks prematurely at 96.26% of life. Accordingly, a case study was conducted through cause analysis and a reconstruction test. Optical microscopy and scanning electron microscopy of the broken surface of the firing pin showed that a crack began in the circumferential direction of the surface, resulting in a fatigue crack to the core after repeated impact. Crack growth and fatigue destruction occurred at the end due to the repetitive impact and was estimated using a notch. For verification, a sample that produced a 0.03mm circumferential notch was broken at 64.25% of life in the reconstruction test. A test of breakage according to the notch types showed that a 0.3mm and a 0.5mm one-side notch were broken at 66.53% and 50.76%, respectively, and a 0.03mm six-point notch was broken at 85.65%. The endurance life of a sample firing pin with a rough surface and tool mark was examined, but an approximately 381 ㎛ internal crack formed. Through this study, failure for each notch type was considered. These results show that quality control of the notch and surface roughness is essential for ensuring the reliability of a component subjected to repeated impact.

Missed Skeletal Trauma Detected by Whole Body Bone Scan in Patients with Traumatic Brain Injury

  • Seo, Yongsik;Whang, Kum;Pyen, Jinsu;Choi, Jongwook;Kim, Joneyeon;Oh, Jiwoong
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.649-656
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    • 2020
  • Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

A Study of Political Use of Naval Power in Solving International Conflicts (설득이론을 통한 해군력의 정치적 사용에 관한 고찰)

  • Yang, Jung-Seung
    • Strategy21
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    • s.30
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    • pp.236-262
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    • 2012
  • Morgenthau claims that in international relations, there are the economic, political, and military powers that enable a nation to achieve its political and diplomatic goals. This paper explores the possibility of resolving international conflicts with naval power. First, the theoretical and historical perspective, naval power was used as a final resort to force a nation's political or diplomatic objective on an enemy nation when negotiations failed, and this was done through the physical and psychological destruction of the enemy by naval power. But as the use of military power has decreased because of the invention of the nuclear weapon, the existence of a large and capable navy deterrent has become one of the most useful military options among a nation's diplomatic measures. In other words, he focused on the political usefulness of naval power as a deterrent and coercive diplomatic tool for persuading other nations to acquiesce, rather than using naval power and actual military action as a final resort. The reason for this is that compared to army and air force, navy's flexibility, continuity, and the ability to deter are greater. The navy provides excellent accessibility through its wide mobility on the sea, and it has been shown through research that the navy possesses a political usefulness that facilitates the solution of conflicts through presence, naval intervention, and naval blockade. On the other hand, among the factors that could improve the influence of the navy are alliance relations, a reliable and powerful navy, carrots and sticks that it would have to deal with in the case of successful or unsuccessful negotiations, and support from international opinion. On this paper I introduce E.N.Luttwak's naval suasion theory. By the his theory, there are two mode of naval suasion. One is latent naval suasion the other is active suasion. Latent suasion there are deterrent mode and supportive mode. Active naval suasion there are coercive mode and supportive mode. Coercive mode has positive and negative. The limitations of naval suasion have been identified as follows. First, because the objective of the use of naval power is persuading enemy nations, the results are unpredictable. Second, the leaders of all countries possess limited understanding on the complexities of naval power and therefore lack understanding of the usefulness of naval power when choosing options. Third, in case of failure through naval suasion, prestige and reputation of a nation can be damaged. Finally, the following are additional possible research topic. First, a research on the decision making process of choosing naval power as a measure to resolve conflicts is needed. Lastly, research on the size of the navy and types of ships required for efficient naval suasion is needed. Today's world requires cooperative security regime so that middle class navy also requires political use of naval power in solving international conflicts. Therefore, additional research on this topic is needed.

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Analysis of the Optimal Separation Distance between Multiple Thermal Energy Storage (TES) Caverns Based on Probabilistic Analysis (확률론적 해석에 기반한 다중 열저장공동의 적정 이격거리 분석)

  • Park, Dohyun;Kim, Hyunwoo;Park, Jung-Wook;Park, Eui-Seob;Sunwoo, Choon
    • Tunnel and Underground Space
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    • v.24 no.2
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    • pp.155-165
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    • 2014
  • Multiple thermal energy storage (TES) caverns can be used for storing thermal energy on a large scale and for a high-aspect-ratio heat storage design to provide good thermal performance. It may also be necessary to consider the use of multiple caverns with a reduced length when a single, long tunnel-shaped cavern is not suitable for connection to aboveground heat production and injection equipments. When using multiple TES caverns, the separation distance between the caverns is one of the significant factors that should be considered in the design of storage space, and the optimal separation distance should be determined based on a quantitative stability criterion. In this paper, we described a numerical approach for determining the optimal separation distance between multiple caverns for large-scale TES utilization. For reliable stability evaluation of multiple caverns, we employed a probabilistic method which can quantitatively take into account the uncertainty of input parameters by probability distributions, unlike conventional deterministic approaches. The present approach was applied to the design of a conceptual TES model to store hot water for district heating. The probabilistic stability results of this application demonstrated that the approach in our work can be effectively used as a decision-making tool to determine the optimal separation distance between multiple caverns. In addition, the probabilistic results were compared to those obtained through a deterministic analysis, and the comparison results suggested that care should taken in selecting the acceptable level of stability when using deterministic approaches.