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A Study on the Expression of Connexin 43 in the Experimental Tooth Movement of Rat (백서의 실험적 치아이동시 connexin 43의 발현에 관한 연구)

  • Lim, Jeong-Hyeon;Kang, Kyung-Hwa;Lee, Jong-Jin;Kim, Eun-Cheol;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.525-534
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    • 2001
  • Bone remodeling in response to force requires coordinated actions of osteoblasts, osteoclasts, osteocytes, and periodontal ligament cells. Coordination among these cells may be mediated, in part, by cell-to-cell communication via gap junctions. This study was designed to evaluate the expression of gap junction, connection 43 In periodontal tissue during the experimental movement of rat's incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for connexin 43. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats), and 6 experimental groups(24 rats) where 75g of force was applied from helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 12 hours, 1, 4, 7, 14 and 28 days after force application, respectively. And the tissues of a control group and experimental groups were studied immunohistochemically. The results were as follows : 1. In control group, the expression of connexin 43 was rare in gingiva, dentin, cementum, periodontal ligament, and bone cells. 2. In experimental group, the expression of connexin 43 was increased in pulp, periodontal ligament, osteoblasts, and osteoclasts, comparing to that in control. And it was rare in gingiva, dentin, and odontoblasts regardless of the duration of force application, which was not different from that of control group. 3. The expression of connexin 43 in pulp of experimental group began to increase in 4-day after force application and got to the highest degree at 7-day. And it decreased after 14-day to be similar to that of control group at 28-day. 4. The expression of connexin 43 in periodontal ligament was noted in small capillaries adjacent to alveolar bone, showing higher intensity of immunolabelling after 4-day And it was stronger in the pressure side than in tension side of periodontal ligament. After 7-day, decrease in connexin 43 expression was observed. 5. The expression of connexin 43 in alveolar bone began to increase 1-day, reached to the highest degree at 4-day, and decreased at 7-day. And the expression in osteoclasts was more than that in osteoblasts or osteocyte at 7-day.

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A Study Meaning Analysis and Interpretation of Body Sign, Kiki Smith - On Pee Body - (키키 스미스 작품에서 신체기호의 의미 분석과 해석 - 를 중심으로 -)

  • Kim, Sung-Hee
    • Journal of Science of Art and Design
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    • v.10
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    • pp.5-50
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    • 2006
  • The terminology "human body" simply means a physical body but also more often, as an object in art works, carries symbolic concepts incorporating the whole history of human lives. Human body has been employed as an artistic object capturing physical body, delivering artist's idea expressing life indicators from different standpoints of times and places. This point of view about human body in art works has in fact rather short history since 1960's when modern thinking paradigm focusing upon rationality and reasoning has begun declining and on the contrary when the body used to be the servant of the mind and soul for a long time has begun attracting artist's attention as a real entity from the viewpoint of dichotomy. During the 1960's, frequent performances in Pop art and of Fluxus showed that the human body has been an important media for artistic communication after importance of body performances had been raised in Action painting in 1940's. The human body became a more determined media in body art works that had got into stride after Yves Kline's conceptual works applying body and its traces. These kinds of art works have continued and consolidated into the Feminism came into blossom in 1980's and into fragmentated and disembodied body art trend in 1990's. Through development of trends in body works, human body now might well be regarded as a clue provide from individual identity with implication over the world. This thesis is to analyse in semiotic way main works of Kiki Smith who is a representative artist devoting to Feminism and proposing extended significance of human body. In the analysis process of works done by two great artists with histrorical background of art trend in order to find and open an significance horizon of human body, semiotics and bodism are therefore perceived as pertinent and applied as basic tools. The first stage of analysis is to get the significances emerged in between expression part and contextual parts, which are separated structually from the most basic level. The study deals with body works furthermore in the way of structual cohesion of the expression and the context from the view of A J. Greimas' Structural Semantics and tried to build up a basic frame for the extended significances of human body. This thesis is, on the other hand, to attempt to contribute for extension of disembodied and fragmentated body discussed in the structural semantic frame earlier by Julia Kriesteva who delivers abjection concepts and phenomenology of Maurice Merleau-Ponty who enables to overview relationship between the body and the world from the viewpoint of Bodism, further into interpretation level. The other works are Kiki smith's that showed epics about death in mid-1980's, detailed humbleness of vulnerable human body exposed to dichotomy and fragmentation in 1990's and religion and mythology incorporating wouln healing in 2000's and henceforth. Through the analysis of Kiki Smith's representative work 'Pee body', it is verified and confirmed that fragmentated body showed beyond boundary gap of the human body and ultimately tends to imply human healing owing to divine maternity. Bodily symbols in Kiki Smith's are extended to the universal world to imply human life and death on the one hand and religion and mythology of human wound and divine healing one the other hand. This thesis through these process and results of analysis is in a broad context, to emphasize that human body as objectified text has a key indicator role to understand world as well as semiotic extension in art works in late 20th century so that we might confirm bodily symbol as a cultural context constitutes a section of contemporary visual arts.

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The way to make training data for deep learning model to recognize keywords in product catalog image at E-commerce (온라인 쇼핑몰에서 상품 설명 이미지 내의 키워드 인식을 위한 딥러닝 훈련 데이터 자동 생성 방안)

  • Kim, Kitae;Oh, Wonseok;Lim, Geunwon;Cha, Eunwoo;Shin, Minyoung;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.1-23
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    • 2018
  • From the 21st century, various high-quality services have come up with the growth of the internet or 'Information and Communication Technologies'. Especially, the scale of E-commerce industry in which Amazon and E-bay are standing out is exploding in a large way. As E-commerce grows, Customers could get what they want to buy easily while comparing various products because more products have been registered at online shopping malls. However, a problem has arisen with the growth of E-commerce. As too many products have been registered, it has become difficult for customers to search what they really need in the flood of products. When customers search for desired products with a generalized keyword, too many products have come out as a result. On the contrary, few products have been searched if customers type in details of products because concrete product-attributes have been registered rarely. In this situation, recognizing texts in images automatically with a machine can be a solution. Because bulk of product details are written in catalogs as image format, most of product information are not searched with text inputs in the current text-based searching system. It means if information in images can be converted to text format, customers can search products with product-details, which make them shop more conveniently. There are various existing OCR(Optical Character Recognition) programs which can recognize texts in images. But existing OCR programs are hard to be applied to catalog because they have problems in recognizing texts in certain circumstances, like texts are not big enough or fonts are not consistent. Therefore, this research suggests the way to recognize keywords in catalog with the Deep Learning algorithm which is state of the art in image-recognition area from 2010s. Single Shot Multibox Detector(SSD), which is a credited model for object-detection performance, can be used with structures re-designed to take into account the difference of text from object. But there is an issue that SSD model needs a lot of labeled-train data to be trained, because of the characteristic of deep learning algorithms, that it should be trained by supervised-learning. To collect data, we can try labelling location and classification information to texts in catalog manually. But if data are collected manually, many problems would come up. Some keywords would be missed because human can make mistakes while labelling train data. And it becomes too time-consuming to collect train data considering the scale of data needed or costly if a lot of workers are hired to shorten the time. Furthermore, if some specific keywords are needed to be trained, searching images that have the words would be difficult, as well. To solve the data issue, this research developed a program which create train data automatically. This program can make images which have various keywords and pictures like catalog and save location-information of keywords at the same time. With this program, not only data can be collected efficiently, but also the performance of SSD model becomes better. The SSD model recorded 81.99% of recognition rate with 20,000 data created by the program. Moreover, this research had an efficiency test of SSD model according to data differences to analyze what feature of data exert influence upon the performance of recognizing texts in images. As a result, it is figured out that the number of labeled keywords, the addition of overlapped keyword label, the existence of keywords that is not labeled, the spaces among keywords and the differences of background images are related to the performance of SSD model. This test can lead performance improvement of SSD model or other text-recognizing machine based on deep learning algorithm with high-quality data. SSD model which is re-designed to recognize texts in images and the program developed for creating train data are expected to contribute to improvement of searching system in E-commerce. Suppliers can put less time to register keywords for products and customers can search products with product-details which is written on the catalog.

Construction of Event Networks from Large News Data Using Text Mining Techniques (텍스트 마이닝 기법을 적용한 뉴스 데이터에서의 사건 네트워크 구축)

  • Lee, Minchul;Kim, Hea-Jin
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.183-203
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    • 2018
  • News articles are the most suitable medium for examining the events occurring at home and abroad. Especially, as the development of information and communication technology has brought various kinds of online news media, the news about the events occurring in society has increased greatly. So automatically summarizing key events from massive amounts of news data will help users to look at many of the events at a glance. In addition, if we build and provide an event network based on the relevance of events, it will be able to greatly help the reader in understanding the current events. In this study, we propose a method for extracting event networks from large news text data. To this end, we first collected Korean political and social articles from March 2016 to March 2017, and integrated the synonyms by leaving only meaningful words through preprocessing using NPMI and Word2Vec. Latent Dirichlet allocation (LDA) topic modeling was used to calculate the subject distribution by date and to find the peak of the subject distribution and to detect the event. A total of 32 topics were extracted from the topic modeling, and the point of occurrence of the event was deduced by looking at the point at which each subject distribution surged. As a result, a total of 85 events were detected, but the final 16 events were filtered and presented using the Gaussian smoothing technique. We also calculated the relevance score between events detected to construct the event network. Using the cosine coefficient between the co-occurred events, we calculated the relevance between the events and connected the events to construct the event network. Finally, we set up the event network by setting each event to each vertex and the relevance score between events to the vertices connecting the vertices. The event network constructed in our methods helped us to sort out major events in the political and social fields in Korea that occurred in the last one year in chronological order and at the same time identify which events are related to certain events. Our approach differs from existing event detection methods in that LDA topic modeling makes it possible to easily analyze large amounts of data and to identify the relevance of events that were difficult to detect in existing event detection. We applied various text mining techniques and Word2vec technique in the text preprocessing to improve the accuracy of the extraction of proper nouns and synthetic nouns, which have been difficult in analyzing existing Korean texts, can be found. In this study, the detection and network configuration techniques of the event have the following advantages in practical application. First, LDA topic modeling, which is unsupervised learning, can easily analyze subject and topic words and distribution from huge amount of data. Also, by using the date information of the collected news articles, it is possible to express the distribution by topic in a time series. Second, we can find out the connection of events in the form of present and summarized form by calculating relevance score and constructing event network by using simultaneous occurrence of topics that are difficult to grasp in existing event detection. It can be seen from the fact that the inter-event relevance-based event network proposed in this study was actually constructed in order of occurrence time. It is also possible to identify what happened as a starting point for a series of events through the event network. The limitation of this study is that the characteristics of LDA topic modeling have different results according to the initial parameters and the number of subjects, and the subject and event name of the analysis result should be given by the subjective judgment of the researcher. Also, since each topic is assumed to be exclusive and independent, it does not take into account the relevance between themes. Subsequent studies need to calculate the relevance between events that are not covered in this study or those that belong to the same subject.

Organizational Buying Behavior in an Interdependent World (상호의존세계중적조직구매행위(相互依存世界中的组织购买行为))

  • Wind, Yoram;Thomas, Robert J.
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.110-122
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    • 2010
  • The emergence of the field of organizational buying behavior in the mid-1960’s with the publication of Industrial Buying and Creative Marketing (1967) set the stage for a new paradigm of thinking about how business was conducted in markets other than those serving ultimate consumers. Whether it is "industrial marketing" or "business-to-business marketing" (B-to-B), organizational buying behavior remains the core differentiating characteristic of this domain of marketing. This paper explores the impact of several dynamic factors that have influenced how organizations relate to one another in a rapidly increasing interdependence, which in turn can impact organizational buying behavior. The paper also raises the question of whether or not the major conceptual models of organizational buying behavior in an interdependent world are still relevant to guide research and managerial thinking, in this dynamic business environment. The paper is structured to explore three questions related to organizational interdependencies: 1. What are the factors and trends driving the emergence of organizational interdependencies? 2. Will the major conceptual models of organizational buying behavior that have developed over the past half century be applicable in a world of interdependent organizations? 3. What are the implications of organizational interdependencies on the research and practice of organizational buying behavior? Consideration of the factors and trends driving organizational interdependencies revealed five critical drivers in the relationships among organizations that can impact their purchasing behavior: Accelerating Globalization, Flattening Networks of Organizations, Disrupting Value Chains, Intensifying Government Involvement, and Continuously Fragmenting Customer Needs. These five interlinked drivers of interdependency and their underlying technological advances can alter the relationships within and among organizations that buy products and services to remain competitive in their markets. Viewed in the context of a customer driven marketing strategy, these forces affect three levels of strategy development: (1) evolving customer needs, (2) the resulting product/service/solution offerings to meet these needs, and (3) the organization competencies and processes required to develop and implement the offerings to meet needs. The five drivers of interdependency among organizations do not necessarily operate independently in their impact on how organizations buy. They can interact with each other and become even more potent in their impact on organizational buying behavior. For example, accelerating globalization may influence the emergence of additional networks that further disrupt traditional value chain relationships, thereby changing how organizations purchase products and services. Increased government involvement in business operations in one country may increase costs of doing business and therefore drive firms to seek low cost sources in emerging markets in other countries. This can reduce employment opportunitiesn one country and increase them in another, further accelerating the pace of globalization. The second major question in the paper is what impact these drivers of interdependencies have had on the core conceptual models of organizational buying behavior. Consider the three enduring conceptual models developed in the Industrial Buying and Creative Marketing and Organizational Buying Behavior books: the organizational buying process, the buying center, and the buying situation. A review of these core models of organizational buying behavior, as originally conceptualized, shows they are still valid and not likely to change with the increasingly intense drivers of interdependency among organizations. What will change however is the way in which buyers and sellers interact under conditions of interdependency. For example, increased interdependencies can lead to increased opportunities for collaboration as well as conflict between buying and selling organizations, thereby changing aspects of the buying process. In addition, the importance of communication processes between and among organizations will increase as the role of trust becomes an important criterion for a successful buying relationship. The third question in the paper explored consequences and implications of these interdependencies on organizational buying behavior for practice and research. The following are considered in the paper: the need to increase understanding of network influences on organizational buying behavior, the need to increase understanding of the role of trust and value among organizational participants, the need to improve understanding of how to manage organizational buying in networked environments, the need to increase understanding of customer needs in the value network, and the need to increase understanding of the impact of emerging new business models on organizational buying behavior. In many ways, these needs deriving from increased organizational interdependencies are an extension of the conceptual tradition in organizational buying behavior. In 1977, Nicosia and Wind suggested a focus on inter-organizational over intra-organizational perspectives, a trend that has received considerable momentum since the 1990's. Likewise for managers to survive in an increasingly interdependent world, they will need to better understand the complexities of how organizations relate to one another. The transition from an inter-organizational to an interdependent perspective has begun, and must continue so as to develop an improved understanding of these important relationships. A shift to such an interdependent network perspective may require many academicians and practitioners to fundamentally challenge and change the mental models underlying their business and organizational buying behavior models. The focus can no longer be only on the dyadic relations of the buying organization and the selling organization but should involve all the related members of the network, including the network of customers, developers, and other suppliers and intermediaries. Consider for example the numerous partner networks initiated by SAP which involves over 9000 companies and over a million participants. This evolving, complex, and uncertain reality of interdependencies and dynamic networks requires reconsideration of how purchase decisions are made; as a result they should be the focus of the next phase of research and theory building among academics and the focus of practical models and experiments undertaken by practitioners. The hope is that such research will take place, not in the isolation of the ivory tower, nor in the confines of the business world, but rather, by increased collaboration of academics and practitioners. In conclusion, the consideration of increased interdependence among organizations revealed the continued relevance of the fundamental models of organizational buying behavior. However to increase the value of these models in an interdependent world, academics and practitioners should improve their understanding of (1) network influences, (2) how to better manage these influences, (3) the role of trust and value among organizational participants, (4) the evolution of customer needs in the value network, and (5) the impact of emerging new business models on organizational buying behavior. To accomplish this, greater collaboration between industry and academia is needed to advance our understanding of organizational buying behavior in an interdependent world.

Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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An Analysis of the Specialist's Preference for the Model of Park-Based Mixed-Use Districts in Securing Urban Parks and Green Spaces Via Private Development (민간개발 주도형 도시공원.녹지 확보를 위한 공원복합용도지구 모형에 대한 전문가 선호도 분석)

  • Lee, Jeung-Eun;Cho, Se-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.6
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    • pp.1-11
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    • 2011
  • The research was aimed to verify the feasibility of the model of Park-Based Mixed-Use Districts(PBMUD) around urban large park to secure private-based urban parks through the revision of the urban zoning system. The PBMUD is a type of urban zoning district in which park-oriented land use is mixed with the urban land uses of residents, advertising, business, culture, education and research. The PBMUD, delineated from and based on a new paradigm of landscape urbanism, is a new urban strategy to secure urban parks and to cultivate urban regeneration around parks and green spaces to enhance the quality of the urban landscape and to ameliorate urban environmental disasters like climate change. This study performed a questionnaire survey and analysis after a review of literature related to PBMUD. The study looked for specialists in the fields of urban planning and landscape architecture such as officials, researchers and engineers to respond to the questionnaire, which asked about degree of preference. The conclusions of this study were as follows. Firstly, specialists prefer the PBMUD at 79.3% for to 20.7% against ratio, indicating the feasibility of the model of PBMUD. The second, the most preferable reasons for the model, were the possibility of securing park space around urban parks and green spaces that assures access to park and communication with each area. The third, the main reason for non-preference for the model, was a lack of understanding of PBMUD added to the problems of unprofitable laws and regulations related to urban planning and development. These proposed a revision of the related laws and regulations such as the laws for planning and use of national land, laws for architecture etc. The fourth, the most preferred type of PBMUD, was cultural use mixed with park use in every kind of mix of land use. The degree of preference was lower in the order of use of commercial, residential, business, and education(research) when mixed with park use. The number of mixed-use amenities with in the park was found to be an indicator determining preference. The greater the number, the lower was preference frequencies, especially when related to research and business use. The fifth, the preference frequencies of the more than 70% among the respondents to the mixed-use ratio between park use and the others, was in a ratio of 60% park use and 40% other urban use. These research results will help to launch new future research subjects on the revision of zoning regulations in the laws for the planning and uses of national land and architectural law as well as criteria and indicators of subdivision planning as related to a PBMUD model.

Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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Clinical Observations of Gastrointestinal Cow Milk Allergy in Children According to a New Classification (새로운 분류법에 따른 소아 위장관 우유 알레르기 질환에 관한 임상적 고찰)

  • Hwang, Jin Bok;Choi, Seon Yun;Kwon, Tae Chan;Oh, Hoon Kyu;Kam, Sin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.40-47
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    • 2004
  • Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.

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An Empirical Study on the Determinants of Supply Chain Management Systems Success from Vendor's Perspective (참여자관점에서 공급사슬관리 시스템의 성공에 영향을 미치는 요인에 관한 실증연구)

  • Kang, Sung-Bae;Moon, Tae-Soo;Chung, Yoon
    • Asia pacific journal of information systems
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    • v.20 no.3
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    • pp.139-166
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    • 2010
  • The supply chain management (SCM) systems have emerged as strong managerial tools for manufacturing firms in enhancing competitive strength. Despite of large investments in the SCM systems, many companies are not fully realizing the promised benefits from the systems. A review of literature on adoption, implementation and success factor of IOS (inter-organization systems), EDI (electronic data interchange) systems, shows that this issue has been examined from multiple theoretic perspectives. And many researchers have attempted to identify the factors which influence the success of system implementation. However, the existing studies have two drawbacks in revealing the determinants of systems implementation success. First, previous researches raise questions as to the appropriateness of research subjects selected. Most SCM systems are operating in the form of private industrial networks, where the participants of the systems consist of two distinct groups: focus companies and vendors. The focus companies are the primary actors in developing and operating the systems, while vendors are passive participants which are connected to the system in order to supply raw materials and parts to the focus companies. Under the circumstance, there are three ways in selecting the research subjects; focus companies only, vendors only, or two parties grouped together. It is hard to find researches that use the focus companies exclusively as the subjects probably due to the insufficient sample size for statistic analysis. Most researches have been conducted using the data collected from both groups. We argue that the SCM success factors cannot be correctly indentified in this case. The focus companies and the vendors are in different positions in many areas regarding the system implementation: firm size, managerial resources, bargaining power, organizational maturity, and etc. There are no obvious reasons to believe that the success factors of the two groups are identical. Grouping the two groups also raises questions on measuring the system success. The benefits from utilizing the systems may not be commonly distributed to the two groups. One group's benefits might be realized at the expenses of the other group considering the situation where vendors participating in SCM systems are under continuous pressures from the focus companies with respect to prices, quality, and delivery time. Therefore, by combining the system outcomes of both groups we cannot measure the system benefits obtained by each group correctly. Second, the measures of system success adopted in the previous researches have shortcoming in measuring the SCM success. User satisfaction, system utilization, and user attitudes toward the systems are most commonly used success measures in the existing studies. These measures have been developed as proxy variables in the studies of decision support systems (DSS) where the contribution of the systems to the organization performance is very difficult to measure. Unlike the DSS, the SCM systems have more specific goals, such as cost saving, inventory reduction, quality improvement, rapid time, and higher customer service. We maintain that more specific measures can be developed instead of proxy variables in order to measure the system benefits correctly. The purpose of this study is to find the determinants of SCM systems success in the perspective of vendor companies. In developing the research model, we have focused on selecting the success factors appropriate for the vendors through reviewing past researches and on developing more accurate success measures. The variables can be classified into following: technological, organizational, and environmental factors on the basis of TOE (Technology-Organization-Environment) framework. The model consists of three independent variables (competition intensity, top management support, and information system maturity), one mediating variable (collaboration), one moderating variable (government support), and a dependent variable (system success). The systems success measures have been developed to reflect the operational benefits of the SCM systems; improvement in planning and analysis capabilities, faster throughput, cost reduction, task integration, and improved product and customer service. The model has been validated using the survey data collected from 122 vendors participating in the SCM systems in Korea. To test for mediation, one should estimate the hierarchical regression analysis on the collaboration. And moderating effect analysis should estimate the moderated multiple regression, examines the effect of the government support. The result shows that information system maturity and top management support are the most important determinants of SCM system success. Supply chain technologies that standardize data formats and enhance information sharing may be adopted by supply chain leader organization because of the influence of focal company in the private industrial networks in order to streamline transactions and improve inter-organization communication. Specially, the need to develop and sustain an information system maturity will provide the focus and purpose to successfully overcome information system obstacles and resistance to innovation diffusion within the supply chain network organization. The support of top management will help focus efforts toward the realization of inter-organizational benefits and lend credibility to functional managers responsible for its implementation. The active involvement, vision, and direction of high level executives provide the impetus needed to sustain the implementation of SCM. The quality of collaboration relationships also is positively related to outcome variable. Collaboration variable is found to have a mediation effect between on influencing factors and implementation success. Higher levels of inter-organizational collaboration behaviors such as shared planning and flexibility in coordinating activities were found to be strongly linked to the vendors trust in the supply chain network. Government support moderates the effect of the IS maturity, competitive intensity, top management support on collaboration and implementation success of SCM. In general, the vendor companies face substantially greater risks in SCM implementation than the larger companies do because of severe constraints on financial and human resources and limited education on SCM systems. Besides resources, Vendors generally lack computer experience and do not have sufficient internal SCM expertise. For these reasons, government supports may establish requirements for firms doing business with the government or provide incentives to adopt, implementation SCM or practices. Government support provides significant improvements in implementation success of SCM when IS maturity, competitive intensity, top management support and collaboration are low. The environmental characteristic of competition intensity has no direct effect on vendor perspective of SCM system success. But, vendors facing above average competition intensity will have a greater need for changing technology. This suggests that companies trying to implement SCM systems should set up compatible supply chain networks and a high-quality collaboration relationship for implementation and performance.