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Clinical Study of Children Using Home Mechanical Ventilation (가정용 인공 호흡기를 사용하는 소아의 임상적 고찰)

  • Ahn, Young Joon;Lee, Seung Hyeon;Kim, Hyo-Bin;Park, Seong Jong;Ko, Tae Sung;Hong, Soo Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.401-405
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    • 2005
  • Purpose : The use of mechanically-assisted ventilators at home reduces morbidity and improves the quality of life in children with chronic respiratory failure. But in Korea there is no clinical data of children with home mechanical ventilation. We investigated ventilator types, duration, the causes of failure or death, and the cost needed for care. Methods : We retrospectively analyzed the medical records of 21 children who were admitted and who applied for home mechanical ventilation at the Pediatric Intensive Care Unit in Asan Medical Center. Phone interviews took place after discharge. and interviewed by phone after discharge. Results : The median age was 31 months; the median duration with ventilator was 25 months. Underlying diseases were 16 neuromuscular diseases, one metabolic disease and four chronic respiratory diseases. The types of ventilator were pressure and volume type(16 and five patients, respectively). The frequency of ventilation failure was once per 19 months. Weaning could be performed in three cases. Frequencies of admission after receiving ventilators were 1.7 times per year; the most common cause was pneumonia. Nine patients(43%) died; four of them died because of endotracheal tube obstruction. The costs for medical care were about 1,110,000 won per month. Conclusion : There is an increment in the numbers of individuals who need mechanical ventilation support. The most common cause of death was endotracheal tube obstruction. The most important problem for the patients was medical cost. There needs to be more interest in patients with ventilator and social welfare systems to support their families need to be prepared.

Estimation of Optimal Size of the Treatment Facility for Nonpoint Source Pollution due to Watershed Development (비점오염원의 정량화방안에 따른 적정 설계용량결정)

  • Kim, Jin-Kwan
    • Journal of the Korean Society of Hazard Mitigation
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    • v.8 no.6
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    • pp.149-153
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    • 2008
  • The pollutant capacity occurred before and after the development of a watershed should be quantitatively estimated and controlled for the minimization of water contamination. The Ministry of Environment suggested a guideline for the legal management of nonpoint source from 2006. However, the rational method for the determination of treatment capacity from nonpoint source proposed in the guideline has the problem in the field application because it does not reflect the project based cases and overestimates the pollutant load to be reduced. So, we perform the standard rainfall analysis by analytical probabilistic method for the estimation of an additional pollutant load occurred by a project and suggest a methodology for the estimation of contaminant capacity instead of a simple rational method. The suggested methodology in this study could determine the reasonable capacity and efficiency of a treatment facility through the estimation of pollutant load from nonpoint source and from this we can manage the watershed appropriately. We applied a suggested methodology to the projects of housing land development and a dam construction in the watersheds. When we determine the treatment capacity by a rational method without consideration of the types of projects we should treat the 90% of pollutant capacity occurred by the development and to do so, about 30% of the total cost for the development should be invested for the treatment facility. This requires too big cost and is not realistic. If we use the suggested method the target pollutant capacity to be reduced will be 10 to 30% of the capacity occurred by the development and about 5 to 10% of the total cost can be used. The control of nonpoint source must be performed for the water resources management. However it is not possible to treat the 90% of pollutant load occurred by the development. The proper pollutant capacity from nonpoint source should be estimated and controlled based on various project types and in reality, this is very important for the watershed management. Therefore the results of this study might be more reasonable than the rational method proposed in the Ministry of Environment.

Analysis of Significance between SWMM Computer Simulation and Artificial Rainfall on Rainfall Runoff Delay Effects of Vegetation Unit-type LID System (식생유니트형 LID 시스템의 우수유출 지연효과에 대한 SWMM 전산모의와 인공강우 모니터링 간의 유의성 분석)

  • Kim, Tae-Han;Choi, Boo-Hun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.48 no.3
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    • pp.34-44
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    • 2020
  • In order to suggest performance analysis directions of ecological components based on a vegetation-based LID system model, this study seeks to analyze the statistical significance between monitoring results by using SWMM computer simulation and rainfall and run-off simulation devices and provide basic data required for a preliminary system design. Also, the study aims to comprehensively review a vegetation-based LID system's soil, a vegetation model, and analysis plans, which were less addressed in previous studies, and suggest a performance quantification direction that could act as a substitute device-type LID system. After monitoring artificial rainfall for 40 minutes, the test group zone and the control group zone recorded maximum rainfall intensity of 142.91mm/hr. (n=3, sd=0.34) and 142.24mm/hr. (n=3, sd=0.90), respectively. Compared to a hyetograph, low rainfall intensity was re-produced in 10-minute and 50-minute sections, and high rainfall intensity was confirmed in 20-minute, 30-minute, and 40-minute sections. As for rainwater run-off delay effects, run-off intensity in the test group zone was reduced by 79.8% as it recorded 0.46mm/min at the 50-minute point when the run-off intensity was highest in the control group zone. In the case of computer simulation, run-off intensity in the test group zone was reduced by 99.1% as it recorded 0.05mm/min at the 50-minute point when the run-off intensity was highest. The maximum rainfall run-off intensity in the test group zone (Dv=30.35, NSE=0.36) recorded 0.77mm/min and 1.06mm/min in artificial rainfall monitoring and SWMM computer simulation, respectively, at the 70-minute point in both cases. Likewise, the control group zone (Dv=17.27, NSE=0.78) recorded 2.26mm/min and 2.38mm/min, respectively, at the 50-minutes point. Through statistical assessing the significance between the rainfall & run-off simulating systems and the SWMM computer simulations, this study was able to suggest a preliminary design direction for the rainwater run-off reduction performance of the LID system applied with single vegetation. Also, by comprehensively examining the LID system's soil and vegetation models, and analysis methods, this study was able to compile parameter quantification plans for vegetation and soil sectors that can be aligned with a preliminary design. However, physical variables were caused by the use of a single vegetation-based LID system, and follow-up studies are required on algorithms for calibrating the statistical significance between monitoring and computer simulation results.

Prevalence and Risk Factors of Candida Sepsis in Neonatal Intensive Care Unit (신생아 중환자실에서 캔디다 패혈증의 발생 추이와 위험 인자)

  • Choi, Ic Sun;Lim, Suk Hwan;Cho, Chang Yee;Choi, Young Youn;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.836-846
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    • 2002
  • Purpose : With the development of neonatal intensive care and the increased use of systemic antibiotics, candida sepsis has become one of the most important causes of neonatal morbidity and mortality. The purpose of this study was to investigate the prevalence rate and its associated risk factors. Methods : We retrospectively reviewed medical records of 28 cases with candida sepsis who were admitted in the neonatal intensive care unit(NICU) of Chonnam University Hospital from July 1995 to June 2001. Twenty-nine patients without candida sepsis were enrolled for the control group to verify the risk factors. Results : The overall incidence of candida sepsis was 0.61% for all NICU admissions and 3.68% for all very low birth weight infants with the gradual increase of the annual prevalance rate over time. The endotracheal intubation, percutaneous central vein catheter(PCVC), umbilical vein catheter, total parenteral nutrition, intralipid and dopamine were more applied than the control group (P<0.01 for all). The durations of mechanical ventilator care, central catheter appliance, nothing per os, and admission were also significantly longer than the control group(P<0.01 for all). Ampicillin/ sulbactam, ceftazidime, amikacin, netilmicin, teicoplanin and imipenem/cilastatin were significantly more used than the control group(P<0.05). The durations of ampicillin/sulbactam, ceftazidime, netilmicin and imipenem/cilastatin administration were also proved to be significant as the risk factors(P<0.01). Conclusion : The average annual prevalence rate of candida sepsis in NICU for six years was 0.61% with gradual increasing tendency over time. The elimination of the above risk factors is important in decreasing neonatal morbidity and mortality associated with candida sepsis.

Estimation of the Value of Road Traffic Noise within Apartment Housing Prices (아파트가격에 내재된 도로교통소음가치 추정)

  • 임영태;손의영
    • Journal of Korean Society of Transportation
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    • v.19 no.4
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    • pp.19-33
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    • 2001
  • In the developed countries, traffic noise is one of most serious problems faced by people's lives. So the importance of the traffic noise is quite well recognized by the infrastructure planners as well as the people. The traffic noise is valued in monetary terms in some countries and it is reflected in estimating the net present value or benefit/cost ratio. On the contrary, the effects of traffic noise are not reflected in the assessment of infrastructure in most cases in Korea. However, as the income level has been increasing, more people have been becoming to put more importance on their living conditions. The purpose of this paper is to estimate the value of traffic noise in the Seoul metropolitan area. The housing price were surveyed to use the quasi-hedonic price technique. By this way, two housing prices at the same floor level in different 128 complexes in the Seoul metropolitan area were surveyed. the actual traffic noise level was also measured. The differences of housing prices and noise levels were analyzed using the various types of regression models. The value is quite different by size of house. The value of large house is higher than that of small house. Since the income level of people in large house is higher than that in small house. it might be said that value of traffic noise for high income people is higher than that for low income people. Moreover, the increase of 1dB(A) noise affects the house price by about 0.3% in Seoul metropolitan area.

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Comparison of Landcover Map Accuracy Using High Resolution Satellite Imagery (고해상도 위성영상의 토지피복분류와 정확도 비교 연구)

  • Oh, Che-Young;Park, So-Young;Kim, Hyung-Seok;Lee, Yanng-Won;Choi, Chul-Uong
    • Journal of the Korean Association of Geographic Information Studies
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    • v.13 no.1
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    • pp.89-100
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    • 2010
  • The aim of this study is to produce land cover maps using satellite imagery with various degrees of high resolution and then compare the accuracy of the image types and categories. For the land cover map produced on a small-scale classification the estuary area around the Nakdong river, including an urban area, farming land and waters, was selected. The images were classified by analyzing the aerial photos taken from KOMPSAT2, Quickbird and IKONOS satellites, which all have a resolution of over 1m to the naked eye. Once all of the land cover maps with different images and land cover categories had been produced they were compared to each other. Results show that image accuracy from the aerial photos and Quickbird was relatively higher than with KOMPSAT2 and IKONOS. The agreement ratio for the large-scale classification across the classification methods ranged between 0.934 and 0.956 for most cases. The Kappa value ranged between 0.905 and 0.937; the agreement ratio for the middle-scale classification was 0.888~0.913 and the Kappa value was 0.872~0.901. The agreement ratio for the small-scale classification was 0.833~0.901 and the Kappa value was 0.813~0.888. In addition, in terms of the degree of confusion occurrence across the images, there was confusion on the urbanized arid areas and empty land in the large-scale classification. For the middle-scale classification, the confusion mainly occurred on the rice paddies, fields, house cultivating area and artificial grassland. For the small-scale classification, confusion mainly occurred on natural green fields, cultivating land with facilities, tideland and the surface of the sea. The findings of this study indicate that the classification of the high resolution images with the naked eye showed an agreement ratio of over 80%, which means that it can be used in practice. The findings also suggest that the use of higher resolution images can lead to increased accuracy in classification, indicating that the time when the images are taken is important in producing land cover maps.

How Can Non.Chaebol Companies Thrive in the Chaebol Economy? (비재벌공사여하재재벌경제중생존((非财阀公司如何在财阀经济中生存)? ‐공사층면영소전략적분석(公司层面营销战略的分析)‐)

  • Kim, Nam-Kuk;Sengupta, Sanjit;Kim, Dong-Jae
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.28-36
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    • 2009
  • While existing literature has focused extensively on the strengths and weaknesses of the Chaebol and their ownership and governance, there have been few studies of Korean non-Chaebol firms. However, Lee, Lee and Pennings (2001) did not specifically investigate the competitive strategies that non-Chaebol firms use to survive against the Chaebol in the domestic Korean market. The motivation of this paper is to document, through four exploratory case studies, the successful competitive strategies of non-Chaebol Korean companies against the Chaebol and then offer some propositions that may be useful to other entrepreneurial firms as well as public policy makers. Competition and cooperation as conceptualized by product similarity and cooperative inter.firm relationship respectively, are major dimensions of firm.level marketing strategy. From these two dimensions, we develop the following $2{\times}2$ matrix, with 4 types of competitive strategies for non-Chaebol companies against the Chaebol (Fig. 1.). The non-Chaebol firm in Cell 1 has a "me-too" product for the low-end market while conceding the high-end market to a Chaebol. In Cell 2, the non-Chaebol firm partners with a Chaebol company, either as a supplier or complementor. In Cell 3, the non-Chaebol firm engages in direct competition with a Chaebol. In Cell 4, the non-Chaebol firm targets an unserved part of the market with an innovative product or service. The four selected cases such as E.Rae Electronics Industry Company (Co-exister), Intops (Supplier), Pantech (Competitor) and Humax (Niche Player) are analyzed to provide each strategy with richer insights. Following propositions are generated based upon our conceptual framework: Proposition 1: Non-Chaebol firms that have a cooperative relationship with a Chaebol will perform better than firms that do not. Proposition 1a; Co-existers will perform better than Competitors. Proposition 1b: Partners (suppliers or complementors) will perform better than Niche players. Proposition 2: Firms that have no product similarity with a Chaebol will perform better than firms that have product similarity. Proposition 2a: Partners (suppliers or complementors) will perform better than Co.existers. Proposition 2b: Niche players will perform better than Competitors. Proposition 3: Niche players should perform better than Co-existers. Proposition 4: Performance can be rank.ordered in descending order as Partners, Niche Players, Co.existers, Competitors. A team of experts was constituted to categorize each of these 216 non-Chaebol companies into one of the 4 cells in our typology. Simple Analysis of Variance (ANOVA) in SPSS statistical software was used to test our propositions. Overall findings are that it is better to have a cooperative relationship with a Chaebol and to offer products or services differentiated from a Chaebol. It is clear that the only profitable strategy, on average, to compete against the Chaebol is to be a partner (supplier or complementor). Competing head on with a Chaebol company is a costly strategy not likely to pay off for a non-Chaebol firm. Strategies to avoid head on competition with the Chaebol by serving niche markets with differentiated products or by serving the low-end of the market ignored by the Chaebol are better survival strategies. This paper illustrates that there are ways in which small and medium Korean non-Chaebol firms can thrive in a Chaebol environment, though not without risks. Using different combinations of competition and cooperation firms may choose particular positions along the product similarity and cooperative relationship dimensions to develop their competitive strategies-co-exister, competitor, partner, niche player. Based on our exploratory case-study analysis, partner seems to be the best strategy for non-Chaebol firms while competitor appears to be the most risky one. Niche players and co-existers have intermediate performance, though the former do better than the latter. It is often the case with managers of small and medium size companies that they tend to view market leaders, typically the Chaebol, with rather simplistic assumptions of either competition or collaboration. Consequently, many non-Chaebol firms turn out to be either passive collaborators or overwhelmed competitors of the Chaebol. In fact, competition and collaboration are not mutually exclusive, and can be pursued at the same time. As suggested in this paper, non-Chaebol firms can actively choose to compete and collaborate, depending on their environment, internal resources and capabilities.

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A Study on Titanium Miniscrew as Orthodontic Anchorage : An experimental investigation in dogs (성견에서 교정적 고정원으로서의 티타늄 미니스크류에 대한 연구)

  • Yoon, Byung-Soo;Choi, Byung-Ho;Lee, Won-You;Kim, Kyoung-Nam;Shim, Hyung-Bo;Park, Jin-Hyung
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.517-523
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    • 2001
  • Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.

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Stress analysis of Multiloop Edgewise Arch Wire with various degree of tip back bend : a study using the finite element method (Multiloop Edgewise Arch Wire의 tip back 정도에 따른 응력 분포에 관한 유한요소법적 연구)

  • Lee, Young-Il;Cha, Kyung-Suk;Ju, Jin-Won;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.127-142
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    • 2000
  • This study have been carried out to find out the mechnical effect of Multiloop Edgewise Arch Wire(MEAW) making use of the finite element method. The tip back bend of MEAW taken in this analysis is $5^{\circ},\;10{\circ}\;and\;15{\circ}$. In addition, Class II or up & down elastic is applied to find out stress distribution and their values in PDL. A adult male of normal occlusion was selected to create the models of teeth and PDL. And the model of MEAW was also created using commercial finite element code (ANSYS version 5.2). The MEAW is forcibly engaged with a class II or up & down elastic, to determine the initial stress generated in PDL. Comparing the compressive and tensile stress at each reference-planes, following results are obtained. 1. When a MEAW of $5^{\circ},\;10{\circ}\;15{\circ}$ tip back bend was engaged with Class II or up & down elastic, the distribution of compressive, tensile stress in entire PDL is similar in each case. 2. The values of compressive and tensile stress in PDL is higher in $15{\circ}$ tip back bend case than in $10{\circ}\;or\;15{\circ}$ tip back bend case. 3. In the distal PDL of 1st and 2nd molar, compressive stress appears. The compressive area is more wide and its values is higher in PDL of 2nd molar than those in 1st molar. The compressive area and its values become more wide and higher according to the increase of the tip back bend. 4. The values of compressive stress are comparatively smaIIer in PDL of molars than those in premolars. 5. Comparing class II and up & down elastic case, tensile stress values in anterior teeth PDL are smaller md their distribution is more wide in up & down elastic case than class If elastic case. On another hand, there is no difference in distribution and stress values in PDL of posterior teeth between two cases. 6. Comparing the tensile area in PDL of anterior teeth, tensile stress values are maximum in PDL of canine.

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Perception of Local Community on Forest Partnership in Indonesia: Expectation and Challenges - A Case of Forest Partnership between Forest Management Unit and local community in Lombok - (인도네시아의 산림 파트너십에 대한 지역주민의 인식: 기대와 도전 - 롬복 산림 파트너십 사례를 중심으로 -)

  • Bae, Jae Soo
    • Journal of Korean Society of Forest Science
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    • v.105 no.3
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    • pp.366-376
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    • 2016
  • The "Forest Partnership" mechanism in Indonesia allows those with authority to manage forests, including Forest Management Units (KPH) and concession holders, to partner with local communities for forest management and profit sharing. The objective of this study is to identify the challenges that this new mechanism is facing and develop practical policy recommendations for its successful implementation. "Lombok Forest Partnership" is the first of its kind in Indonesia between Forest Management Unit (KPH) and a local community. The local community members participating in this partnership were surveyed for their expected outcomes, degree of their satisfaction about the process and profits sharing, as well as other factors affecting their participation. Respondents reported that they have obtained the information on Forest Partnership completely from KPH and NGO. Local peoples participated in Lombok Forest Partnership to improve their incomes, and recognized timber production as the most important income source with high possibility of success. However, timber production will require sizable initial capital investment for establishing nursery and other supporting activities, which cannot come from local communities lacking economic means. Thus, Forest Partnership would be difficult to succeed if KPH does not take the initiative to permit and promote local community to use special area and generate profits in their jurisdiction. KPH, in turn, can share the profits with local peoples. In this regard, KPH's leadership is the key factor in the success of Forest Partnership. However, KPH will need to cultivate their capacity to develop and implement income-generating business with local community. Although profit sharing ratio of timber and non-timber forest products among local community who participated in Lombok Forest Partnership was very high at 75%, and 90%, the level of satisfaction on profit sharing ratio was only average. The cooperative organized by the local community is also dealing with sensitive nature of allocating forest area internally among their members. Thus, keeping the principle of fairness, equity and transparency is the key for successful implementation of Forest Partnership mechanism. This first case of Forest Partnership can serve as a model for the future cases and provide the early lessons.