• Title/Summary/Keyword: case management

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Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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Dynamics of Technology Adoption in Markets Exhibiting Network Effects

  • Hur, Won-Chang
    • Asia pacific journal of information systems
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    • v.20 no.1
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    • pp.127-140
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    • 2010
  • The benefit that a consumer derives from the use of a good often depends on the number of other consumers purchasing the same goods or other compatible items. This property, which is known as network externality, is significant in many IT related industries. Over the past few decades, network externalities have been recognized in the context of physical networks such as the telephone and railroad industries. Today, as many products are provided as a form of system that consists of compatible components, the appreciation of network externality is becoming increasingly important. Network externalities have been extensively studied among economists who have been seeking to explain new phenomena resulting from rapid advancements in ICT (Information and Communication Technology). As a result of these efforts, a new body of theories for 'New Economy' has been proposed. The theoretical bottom-line argument of such theories is that technologies subject to network effects exhibit multiple equilibriums and will finally lock into a monopoly with one standard cornering the entire market. They emphasize that such "tippiness" is a typical characteristic in such networked markets, describing that multiple incompatible technologies rarely coexist and that the switch to a single, leading standard occurs suddenly. Moreover, it is argued that this standardization process is path dependent, and the ultimate outcome is unpredictable. With incomplete information about other actors' preferences, there can be excess inertia, as consumers only moderately favor the change, and hence are themselves insufficiently motivated to start the bandwagon rolling, but would get on it once it did start to roll. This startup problem can prevent the adoption of any standard at all, even if it is preferred by everyone. Conversely, excess momentum is another possible outcome, for example, if a sponsoring firm uses low prices during early periods of diffusion. The aim of this paper is to analyze the dynamics of the adoption process in markets exhibiting network effects by focusing on two factors; switching and agent heterogeneity. Switching is an important factor that should be considered in analyzing the adoption process. An agent's switching invokes switching by other adopters, which brings about a positive feedback process that can significantly complicate the adoption process. Agent heterogeneity also plays a important role in shaping the early development of the adoption process, which has a significant impact on the later development of the process. The effects of these two factors are analyzed by developing an agent-based simulation model. ABM is a computer-based simulation methodology that can offer many advantages over traditional analytical approaches. The model is designed such that agents have diverse preferences regarding technology and are allowed to switch their previous choice. The simulation results showed that the adoption processes in a market exhibiting networks effects are significantly affected by the distribution of agents and the occurrence of switching. In particular, it is found that both weak heterogeneity and strong network effects cause agents to start to switch early and this plays a role of expediting the emergence of 'lock-in.' When network effects are strong, agents are easily affected by changes in early market shares. This causes agents to switch earlier and in turn speeds up the market's tipping. The same effect is found in the case of highly homogeneous agents. When agents are highly homogeneous, the market starts to tip toward one technology rapidly, and its choice is not always consistent with the populations' initial inclination. Increased volatility and faster lock-in increase the possibility that the market will reach an unexpected outcome. The primary contribution of this study is the elucidation of the role of parameters characterizing the market in the development of the lock-in process, and identification of conditions where such unexpected outcomes happen.

Classification of submitted KSNMT dissertation (대한핵의학기술학회 투고 논문 분류)

  • Han, Dong-Chan;Lee, Hyuk;Hong, Gun-Chul;Ahn, Byeong-Ho;Choi, Seong-Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.65-69
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    • 2017
  • Purpose KSNMT(Korea Society of Nuclear Medicine Technology) stepping first step in 1997, has published first journal related with nuclear medicine technology in 1985. With classifying In Vivo Session Dissertation reported in the entire journal, trend of the Dissertation will be studied. Materials and Methods Dissertations which published from 1985 to first half of 2016 in the journal are classified with presentation form and with scanner, And all the data is organized with Excel program. Through the data, the number of dissertations published in each year, the number of dissertation published in details, and keyword distributions in each period are analyzed. Results The number of In-vivo section dissertations was 1151 and the number of In-vivo section dissertations that have common subject with In-vitro section was 28. The number of In-vivo section dissertation in 1980s was 46, in 1990s was 149, in 2000 was 467 and from 2010 to the first half of 2016 was 517. The number of dissertation with original articles was 571, with abstract was 529, with symposium was 31, with special lecture was 25, with review was 11, with interesting image was 7, with poster was 3 and with case report was 2. With symposium and special lecture excluded, which count 56, the number of dissertation with PET was 319, with Planar was 302, with SPECT was 172, with radiopharmaceutical was 113, with guard and safety management 103, with BMD was 28, etc. was 86. The number of dissertation about oncology was 201, about scanner was 179, about cardiovascular and circulatory system was 102, about safe environment was 82, about musculoskeletal system was 76, about nervous nuclear medicine was 66, about quality assurance was 61, about genitourinary system was 56, about endocrine system was 49, about digestive system was 44, about Therapy, about industrial safety was 24, about molecular imaging was 15, infection and inflammation was 9, about respiratory system was 8 and etc. was 108. The mostly used keyword through 1999 to 2005 was PET and through 2006 to 2016 was PET/CT. Conclusion To encourage various dissertations to be submitted, Korea Society of Nuclear Medicine should analyze date about not only about dissertations that are already published, but also about various research materials. Moreover, Korea Society of Nuclear Medicine also have to provide technical support such as sharing big data from homepage and systematical support to its member to publish dissertation that has high impact factor. It is important each individual researcher to have continuing effort as well as each organization cooperation.

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Introduction of Kjeldahl Digestion Method for Nitrogen Stable Isotope Analysis (δ15N-NO3 and δ15NNH4) and Case Study for Tracing Nitrogen Source (Kjeldahl 증류법을 활용한 질산성-질소 및 암모니아성-질소 안정동위원소비 분석 및 질소오염원 추적 사례 연구)

  • Kim, Min-Seob;Park, Tae-Jin;Yoon, Suk-Hee;Lim, Bo-La;Shin, Kyung-Hoon;Kwon, Oh-Sang;Lee, Won-Seok
    • Korean Journal of Ecology and Environment
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    • v.48 no.3
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    • pp.147-152
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    • 2015
  • Nitrogen (N) loading from domestic, agricultural and industrial sources can lead to excessive growth of macrophytes or phytoplankton in aquatic environment. Many studies have used nitrogen stable isotope ratios to identify anthropogenic nitrogen in aquatic systems as a useful method for studying nitrogen cycle. In this study to evaluate the precision and accuracy of Kjeldahl processes, two reference materials (IAEA-NO-3, N-1) were analyzed repeatedly. Measured the ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ values of IAEA-NO-3 and IAEA-N-1 were $4.7{\pm}0.2$‰ and $0.4{\pm}0.3$‰, respectively, which are within recommended values of analytical uncertainties. Also, we investigated spatial patterns of ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ in effluent plumes from a waste water treatment plant in Han River, Korea. ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ values are enriched at downstream areas of water treatment plant suggesting that dissolved nitrogen in effluent plumes should be one of the main N sources in those areas. The current study clarifies the reliability of Kjeldahl analytical method and the usefulness of stable isotopic techniques to trace the contamination source of dissolved nitrogen such as nitrate and ammonia.

Investigation of Microbial Contamination in Oenanthe javanica at Postharvest Environments (미나리(Oenanthe javanica) 수확 후 처리 환경에서의 위생지표세균 및 병원성 미생물 오염도 조사)

  • Kim, Yeon Rok;Lee, Kyoung Ah;Choi, In-Wook;Lee, Young-Ha;Kim, Se-Ri;Kim, Won-Il;Ryu, Song Hee;Lee, Hyo Sub;Ryu, Jae-Gee;Kim, Hwang-Yong
    • Journal of Food Hygiene and Safety
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    • v.29 no.4
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    • pp.268-277
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    • 2014
  • This study assessed microbiological hazards at postharvest stage of dropwort farms (A, B, C, D, E, F, G, H, I) located in 4 different areas in Korea. The samples were assessed for sanitary indication bacteria (total aerobic bacteria, coliform, and Escherichia coli) and pathogenic bacteria (Escherichia coli O157:H7, Listeria monocytogenes, Staphylococcus aureus and Bacillus cereus). Total aerobic bacteria and coliform in 9 dropwort farms were detected at the levels of 0~7.00 and 0~4.25 log CFU/g, mL, of $100cm^2$. In particular, microbial contamination in worker's hand showed higher than cultivation environment factors. Escherichia coli was detected in several farms of soil, irrigation water, washing water and worker's hand and also, dropwort in these farms was contaminated with E. coli (positive reaction). In case of pathogenic bacteria, B. cereus was detected at the highest levels in soil. S. aureus was detected qualitatively from only one sample of dropwort washed by water. E. coli O157:H7 and L. monocytogenes were not detected. Although dropwort pass through 2 process (trimming and washing), the microbial contamination was not differ significantly before and after which indicates that current washing system was not effect on reduction of microorganism. From these results, the postharvest environment and workers have been considered as cross-contamination factors. Thus, processing equipments and personal hygiene should be managed to reduce the microbial contamination of dropwort. Accordingly management system such as good agricultural practices (GAP) criteria is needed for the safety of dropwort

The Analysis of the Need Rate of Shunt and the Outcome in Hydrocephalus Following SAH - Relationship between the Outcome and the Duration, Daily and Total Amount of CSF Drainage at EVD - (자발성 지주막하출혈 후 발생하는 수두증에 대한 단락술의 필요성 및 예후에 관한 분석 - 뇌실외배액술의 기간, 일일배액량 및 총배액량과 예후관계 -)

  • Lee, Won Chang;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.99-107
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    • 2001
  • Objective : Hydrocephalus and vasospasm are the common complications following subarachnoid hemorrhage (SAH). In spite of development of perioperative management and operative technique, hydrocephalus cause neurological deficit and poor prognosis. Usually CSF drainage procedure(external ventricular drainage(EVD) or shunt) is needed in hydrocephalus following SAH. The aim of this study was to investigate whether the need for shunting and the outcome after shunting in hydrocephaus following SAH can be related to the duration, daily and total amount of cerebrospinal fluid(CSF) drainage at EVD. Material and Method : IVH is one of several factors which cause hydrocephalus. In this retrospective study, firstly we investigated the incidence of IVH in total cases and frequency of IVH according to aneurysmal site and then prognosis of IVH following SAH. Among 629 patients with SAH, hydrocephalus was diagnosed by CT scan and symptoms. And then those 102 hydrocephalus following SAH were divided into two groups which were hydrocephalus with IVH group and without IVH group. In these two groups, we investigated and compared the incidence of hydrocephalus in all case, frequency of hydrocephalus according to aneurysmal site, the outcome according to H-H grade on admission and the need rate of shunt, etc. Of those hydrocephalus, 100 EVD procedures were done. The duration, daily and total amount of CSF drainage at EVD were investigated. Fifty cases expired during EVD was excluded. We analyzed whether the need rate of shunt and the final outcome after shunting can be related to IVH, the duration and daily and total amount of CSF drainage. Result : The incidence of hydrocephalus following SAH was 20%(with IVH group ; 64%, without IVH group ; 11%). As H-H grade on admission was better, the outcome of hydrocephalus was also better. The mortality rate of hydrocephalus with IVH was 64% which was higher than 40% that of hydrocephalus without IVH. The need rate of shunt in all cases of hydrocephalus following SAH was 20%, but those with IVH group excluding expired patients before shunt was 40%. This was very similar to 41% of the need rate of shunt in hydrocephalus without IVH. The total amount of CSF drainage was statistically related to the need rate of shunt(total amount : need rate of shunt/<1000cc : 15%, 1000-2000cc : 40%, >2000cc : 50%). The duration and daily amount of CSF drainage were not statistically related to the need rate of shunt, but as daily amount of CSF drainage was more and duration was longer, the need rate of shunt was increased(daily amount : need rate of shunt /<100cc : 16%, 100-200cc : 25%, >200cc : 40%//duration : need rate of shunt/<1week : 8%, 1-2weeks : 30%, >2weeks : 47%), and also the final outcome after shunting was poor. Especially the total amount of CSF drainage was significant related to the final outcome after shunting(total amount : GOS/<1000cc : I&II(3/4), 1000-2000cc : II(2/4), III(2/4), >2000cc : III&IV(6/7)). Conclusion : This study revealed that the incidence and mortality rate of hydrocephalus following SAH were influenced by IVH. So SAH associated IVH has the higher incidence of hydrocephalus and poor outcome. As the CSF drainage amount was more and duration of drainage was longer, the need rate of shunt was increased and the final outcome after shunting was poor. Especially the total amount of CSF drainage were strongly related to the need rate of shunt and the outcome after shunting.

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Productivity and Density Control of Stands of Japanese Larch (일본잎갈나무 임분(林分)의 생산력(生產力)과 밀도관리(密度管理)에 관(關)한 연구(硏究))

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
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    • v.34 no.1
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    • pp.21-30
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    • 1977
  • Japanese larch (Larix leptolepis) is one of main timber species in Korea that could find much plantation and growing stands on all over the country. It is thought to be in meaningful that a guiding diagram for density control of Japanese larch stands is made to estimate easily the density conditions in the quantitaive, ecological and economic viewpoint. Sample plots for this study are selected from the stands that have not been thinned in recent years, and mean height, mean diameter, dominant height, tree numbers per hectare and stem volume of mean tree are calculated from the each sample plots among total 165 plots In this study, especially, the theory of slenderness of mean tree are applied, that have been identified through the results of the spacing trial. Relative growth characteristics of this species are calculated from the general logistic curve and its formula is $Y=ax^b$. Relatwion between the measured items are found out as follows: 1. Relation between the mean height and tree numbers per hectare by slender class is showing the high correlation as table 1 and fig. 2, and between mean diameter and tree numbers per hectare is also high correlation as table 1 and fig 3. 2. The stem volume can be correctly estimated from height in case that slender class may be known, as showing in table 3 and fig. 4. 3. The stem volume can be more correctly estimated from the relation with $D^2H$ as formula, $Log_e\;V=0.9569\;Log_eD^2H-9.8431$, and relation between stem volume of single tree or volume per hectare and tree numbers per hectare are as following formulas: $Log_e$ stem volume=9.5026-1.6800 $Log_e$ tree numbers per hectare $Log_e$ stem volume per hectare=9.4911-0.6784 $Log_e$ tree numbers per hectare. Stem volume of mean tree, tree numbers per hectare and stem volume per hectare correspond to the mean tree height are calculated to slender class as table 5, 6, 7. Through the above steps, the diagram for density control of Japanese larch are produced as fig. 9. It is thought that this diagram could be applied to control the density of Japanese larch stands.

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A Study on Clinical Features and Pharmacologic Treatment Outcomes of Patients with Trigeminal Neuralgia (삼차신경통의 임상 소견과 약물 치료에 관한 연구)

  • Ko, Yu-Jeong;Kim, Kyun-Yo;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.207-216
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    • 2009
  • Trigeminal neuralgia is defined "a sudden, usually unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve". The initial treatment of choice for trigeminal neuralgia is medical therapy. In patients with medically intractable pain or intolerable medication side effects, invasive therapeutic approaches are often necessary. Based on the amount of evidence and estimated efficacy, carbamazepine is the drug of choice in the management of trigeminal neuralgia. In case of insufficient or no response to carbamazepine, second-line drugs can be added. In this study, the author tried to review and analyzed the cases of 90 patients whom had visited for treatment of trigeminal neuralgia at the Department of Oral Medicine, Kyungpook National University Hospital from 2003 to 2008. The results were as follows: 1. Trigeminal neuralgia was significantly more common with advancing age, and nearly twice as common in women than men (ratio of 2.1:1) 2. The maxillary branch of the trigeminal nerve involved most often (51.1%), and the right side of the face is affected more commonly than the left (ratio of 2.9:1). 3. 85(94.4%) patients had experiences visiting medical or dental specialties before being referred to the Department of Oral Medicine. 4. 40(44.4%) patients with trigeminal neuralgia had systemic diseases. 5. Treatment with carbamazepine monotherapy was satisfactory initially in 69(76.7%) the patients, and the mean daily dose of carbamazepine was 402.9mg. On the other hand, 16(17.8%) patients expressed effectiveness after combination therapy of carbamazepine and other drugs. 6. Of the 69 patients who had a good initial response to carbamazepine monotherapy, 18 patients became resistant, so that combination therapy of carbamazepine and other drugs were necessary. 7. 54(60%) patients developed side effects such as dizziness, drowsiness, nausea, vomiting, blood dyscrasias, skin rash and constipation, and 11 of the patients decided to stop tmedicaion due to side effects.

Hazard Analysis for the Cultivation Stage of Strawberry Farms for Securing Preliminary Data to Establish the Good Agricultural Practices (농산물우수관리제도 확립의 기초자료 확보를 위한 딸기농장 재배단계의 위해요소 분석)

  • Lee, Chi-Yeop;Lee, Won-Gyeong;Song, Jeong-Eon;Kim, Kyeong-Yeol;Shim, Won-Bo;Yoon, Yo-Han;Kim, Yun-Shik;Chung, Duck-Hwa
    • Journal of agriculture & life science
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    • v.46 no.3
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    • pp.97-108
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    • 2012
  • Physical, chemical and biological hazards of strawberry farms at the cultivation stage were analyzed to establish the GAP(Good Agricultural Practice) system. Samples were collected from the plants, cultivation environments(water, soil and air), and personal hygiene (hand, glove, and clothes) of three strawberry farms(A, B, and C) and were tested to analyze physical, chemical (heavy metals and pesticide residues), and biological(sanitary indications and foodborne pathogens) hazards. Physical hazards such as insects and pieces of metal and glass were found in the strawberry farms and can be potential bow for strawberry products. Heavy metal and pesticide residue as chemical hazards were detected at levels lower than the regulation limit. In case of biological hazards, total bacteria and coliform were detected at the levels of 1.6~7.3 and 1.3~5.6 log CFU/g, leaf, mL, hand or $100cm^2$. However, Escherichia coli was not detected in all samples. Bacillus cereus and Staphylococuus aureus were detected at levels of ${\leq}$ 1.1~6.1 log CFU and 4.7~5.4 log CFU/g, mL, hand or $100cm^2$, whereas Listeria monocytogenes, E. coli O157 and Salmonella spp. were not detected in all samples. This study demonstrates that various harzards were in strawberry farms at the growing stage. Therefore proper management such as GAP is needed to prevent the occurrence of food poisoning associated with the hazards revealed in this study.

Risk Analysis for the Harvesting Stage of Tomato Farms to Establish the Good Agriculture Practices(GAP) (GAP 모델 확립을 위한 토마토 농장 수확단계의 위해요소 조사 및 분석)

  • Lee, Chae-Won;Lee, Chi-Yeop;Heo, Rok-Won;Kim, Kyeong-Yeol;Shim, Won-Bo;Shim, Sang-In;Chung, Duck-Hwa
    • Journal of agriculture & life science
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    • v.46 no.4
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    • pp.141-153
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    • 2012
  • Samples collected from six tomato farms(A, B, C : soil culture, D, E, F : Nutriculture) located in Gyeongsangnam-do were tested for the analyses of biological(sanitary indications, major foodborne pathogens, fungi), chemical(heavy metals, pesticides) and physical hazards. The highest levels of total bacteria(7.5 log CFU/g) and coliforms(5.0 log CFU/g) in soil culture farms were higher than those of nutriculture farms(total bacteria: 2.5 log CFU/mL, coliforms: 0.6 log CFU/mL). In crops and personal hygiene soil culture farms showed a slightly higher contamination levels. From all farms, the levels of fungi in soil farms were higher than those of nutrient solution. In case of major pathogens, Bacillus cereus and Staphylococcus aureus were detected in all sample with the exception of nutrient solution. Meantime, Escherichia coli, Listeria monocytogenes, E.coli O157 and Salmonella spp. were not detected. For airborne bacteria, soilculture farms showed less contamination than nutriculture farms. A piece of glass and can was confirmed asphysical hazards. Heavy metal(Cd, Pb, Cu, Cr, Hg, Zn, Ni and As) and pesticide residues as chemical hazards were detected, but their levels were lower than the regulation limit. These results demonstrate that potential hazards on harvesting stage of tomato fam were exposed. Therefore, proper management is needed to prevent biological hazards due to cross-contamination, while physical and chemical hazards were in appropriate levels based on GAP criteria.