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Acute Appendicitis -A Survey by the Korean Association of Pediatric Surgeons in 2006- (급성 충수염 - 2006년 대한소아외과학회회원 대상 전국조사 -)

  • Lee, Suk-Koo;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.G.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, J.T.;Lee, N.H.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Chang, S.I.;Jun, Y.S.;Chung, S.Y.;Chung, S.E.;Chung, U.S.;Jung, P.M.
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.203-211
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    • 2007
  • A nationwide survey on acute appendicitis (AAP) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the 6 months period from the $1^{st}$ October, 2005 to $31^{st}$ March, 2006. Questionnaires were collected from 23 members. Four hundred seventy six patients were registered from 21 hospitals where the members were working. The male to female ratio was 1.67:1. Average age was 9 years and 5 months (range 21 months-20 years). Operations were performed on average 10.4 hours (range 1-230 hours) from arrival at hospital. The average operation time was 59.1 minutes. The average admission days were 5.8 days (range 2-45 days). The most frequent symptoms were abdominal pain (95.1 %), vomiting (50.6 %) and fever (43.7%). The average duration of symptoms was 42.2 hours (range 1 hour-22 days). Leukocytosis (WBC count > 10,000) was found in 85.9%. The most popular diagnostic tools were ultrasonography and CT. Open surgery was performed in 72.1 % and laparoscopic surgery in 27.5 %. Two laparoscopic surgeries were converted to open surgery (0.4 %). Simple appendicitis was found in 54.5 % and complicated appendicitis such as abscess, gangrenous change and perforation in 45.5%. According to the questionnaires 12 hospitals were performing open surgery only in all patients. Four hospitals were performing laparoscopic surgery in all patients. Seven hospitals are performing both surgical methods according to surgeon or occasion. Regarding the use of antibiotics in acute appendicitis, three kinds of antibiotics were used in 40 % of total simple appendicitis patients. The results showed the trend of management in acute appendicitis in Korea. Especially it is necessary for the members to discuss the use of antibiotics for prophylaxis in the simple appendicitis.

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A Comparative Study of Air Law and Space Law in International Law (국제법상 항공법과 우주법의 비교연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.1
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    • pp.83-109
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    • 2008
  • According to 1944 Chicago Convention aircraft are classified into public aircraft(or state aircraft) and private aircraft(or civil aircraft). However even if public aircraft owned by government are used as commercial flights, those are classified into private aircraft. But as far as space activities are concerned in the 1967 Outer Space Treaty, those are related to all activities and all space objects, thus there being no differentiation between the public spacecraft and private spacecraft. As for the institutions of air law there are ICAO, IATA, ECAC, AFCAC, ACAC, LACAC in the world. However in the field of space law there is no International Civil Space Organization like ICAO. There is only COPUOS in the United Nations. The particular institutions such as INTELSAT, INMARSAT, ITU, WIPO, ESA, ARABSAT would be helpful to space law field. In the near future there is a need to establish International Civil Space Organization to cover problems rising from all space activities. According to article 1 of the 1944 Chicago Convention the contracting States recognize that every State has complete and exclusive sovereignty over the airspace above its territory. It means that absolute airspace sovereignty is recognized by not only the treaty law and but also customary law which regulates non-contracting States to the treaty. However as for the space law in the article n of the 1967 Space Treaty outer space, including the moon and other celestial bodies, is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means. It creates res extra commercium like the legal status of high seas in the law of the sea. However the 1979 Moon Agreement proclaimed Common Heritage of Mankind as far as the legal status of the outer space is concerned which is like the legal status of deep sea-bed in the 1982 United Nations Law of the Sea. As far as the liabilities of air transport system are concerned there are two kinds. One is the liabilities to passenger on board aircraft and the other is the liabilities to the third person or thing on the ground by the aircraft. The former is regulated by the Warsaw System, the latter by the Rome Convention. As for the liabilities of space law the 1972 Liability Convention applies. The Rome Convention and 1972 Liability Convention stipulate absolute liability. In the field of space transportation there would be new liability system to regulate the space passengers on board spacecraft like Warsaw System in the air transportation.

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Effect of Major Depressive Disorder and Insomnia on Somatization (주요 우울증과 불면증이 신체화 증상에 미치는 영향)

  • Jun, Jin Yong;Kim, Seog Ju;Lee, Yu-Jin;Cho, Seong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.19 no.2
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    • pp.84-88
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    • 2012
  • Introduction: The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively. Methods: A total of 181 participants (73 males and 108 females ; mean age $41.59{\pm}8.92$) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R). Results: There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08). Conclusion: In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.

Preoperative Staging in Non-Small Cell Lung Cancer without Lymphadenopathy on Computed Tomogram (흉부 전산화 단층촬영상 임파절종대가 없는 비소세포암 환자에 있어서 술전 병기판정)

  • Cha, Seung-Ick;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Chang, Bong-Hyun;Kang, Duk-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.616-623
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    • 1994
  • Objectives: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. Methods & Results: 1) Records of a total of 41 patients with preoperative $T_{1-3}N_0M_0$ non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative $T_2$, 2 cases were identified postoperatively as $T_3$ with invasion of chest wall and among 6 cases with preoperative $T_3$, 1 case was identified postoperatively as $T_4$ with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with $T_{1-2}$, 5 cases were $N_1$ and 3 cases were $N_2$ postoperatively. After the operation of 6 cases with $T_3$, 2 cases were $N_1$ and 3 cases were $N_2$ postoperatively. Preoperative $T_3$ showed more intrathoracic lymph node metastases and higher $N_2/N_1$ involvement ratio than preoperative $T_{1-2}$. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative $N_2$ tumors. Conclusion: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative $T_3$ non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.

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The effect of 8 French catheter and chest tube on the treatment of spontaneous pneumothorax (자연기흉에 있어서 8 French 도관과 흉관의 삽입 치료 효과)

  • Kang, Yoon-Jeong;Koh, Hyoung-Gee;Shin, Jong-Wook;Lim, Seong-Yong;Choi, Jae-Sun;Yu, Ji-Hoon;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho;Seo, Seung-Cheon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.410-419
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    • 1996
  • Background : Spontaneous pneumothorax have been managed with a variety of methods. The technique most frequently used is chest tube drainage. Small caliber catheters were first used in the management of pneumothorax complicating the percutaneous needle aspiration lung biopsy, and the try to treat spontaneous pneumothorax also has been reported. However, the value of small caliber catheters in spontaneous pneumothorax has not been fully evaluated. So, we tried to elucidate the efficacy of 8 French catheter in the management of spontaneous pneumothorax. Method : From January, 1990, to April, 1994, 44 patients with spontaneous pneumothorax treated at Chung-Ang university hospital were reviewed. The patients were sub-divide into 8 French catheter insertion group (n=21) and chest tube insertion group (n=23). We compared the presence of underlying lung disease, the extent of the collapse, the duration of indwelling catheter and complication between two groups. Results : 1) The duration of indwelling showed no significant difference between 8 French catheter group and chest tube. But, complication after insertion as subcutaneous emphysema was developed in only chest tube group. (p<0.05) 2) In the primary spontaneous pneumothorax, all case of the pneumothorax of which size was less than 50% showed complete healing with 8 French catheter insertion. Whereas the success rate in patients with large pneumothorax (more than 50%) was tended to be dependent on the age. 3) In the patients with secondary spontaneous pneumothorax who were managed with 8 French catheter, the success rate was trended to be high if the underlying disease of pneumothorax was not COPD and if the patient was young. Conclusion : These results show that 8 French catheter insertion probably was effective in the pneumothorax less than 50%, the primary spontaneous pneumothorax, young age or secondary pneumothorax not associated with COPD.

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Differential Diagnosis of Pleural Mesothelioma and Metastatic Adenocarcinoma by Immunohistochemistry (면역조직화학염색법을 이용한 흉막의 악성중피종과 전이성 선암의 감별진단)

  • Ko, Kyung-Haeng;Park, Chang-Min;Rim, Myung-Soo;Kim, Yoo-Il;Jang, Il-Gweon;Hwang, Joon-Hwa;Lim, Sung-Chul;Kim, Young-Chul;Park, Kyung-Ok;Park, Chang-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.478-487
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    • 1999
  • Background : Differential diagnosis of pleural malignant mesothelioma from secondary metastatic adenocarcinoma is often difficult. A variety of pathologic techniques have been developed to make a differential diagnosis of carcinoma from mesothelioma. Immunohistochemistry detecting diverse antigenic substances such as CEA, Leu-M1, Bn-3, S-100 protein, vimentin, CK and EMA has been claimed to be of value as a panel in the differential diagnosis of adenocarcinoma from mesothelioma. The aim of this study was to investigate the suitable antibodies to distinguish mesothelioma from metastatic adenocarcinoma and establish candidate markers in a panel. Methods : Complete, one-hour immunohistochemical staining using antibodies against cytokeratin (CK), epithelial membrane antigen(EMA), S-100 protein, vimentin, B72-3, Leu-M1, and carcino-embryonic antigen(CEA) was applied to cell blocks from 7 mesotheliomas and 7 adenocarcinomas which were confirmed by electron microscopic and histpathologic methods. Results : All adenocarcinomas and 71.4% of mesotheliomas expressed the cytokeratin and EMA. S-100 protein and vimentin were expressed in 57.1% and 42.9% of mesotheliomas and 14.3% and 28.5% of adenocarcinomas, respectively. B72-3 was expressed in all adenocarcinomas, but in none of mesotheliomas. Leu-M1 was positive in 71.4% of the adenocarcinoma and 14.3% of the mesotheliomas. CEA was positive in all adenocarcinomas and 42.9% of mesotheliomas. Leu-M1 and B72-3 were coexpressed in 71.4% of adenocarcinomas but in none of mesothelioma. B72-3 and CEA were coexpressed in all adenocarcinomas, but in none of mesotheliomas. Conclusion : We concluded that B72-3 immunohistochemistry or panel staining of B72-3 and CEA could be recommanded for the differential diagnosis of pleural mesothelioma from metastatic adenocarcinoma.

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Clinical Course of Untreated Sarcoidosis (스테로이드 치료를 받지 않은 유육종증 환자의 임상경과)

  • Koh, Young-Min;Chung, Kyeong-Jae;Park, Sang-Joon;Kang, Kyeong-Woo;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.807-816
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    • 1999
  • Background: Sarcoidosis, uncommon in Korea, has variable clinical course, ranging from benign self-limited recovery to life-long disability regardless of corticosteroid therapy. The purpose of this study is to observe the clinical course of untreated sarcoidosis. Methods: Twenty four patients who were confirmed as sarcoidosis by tissue diagnosis were included. For average 12month follow-up periods, subjective symptoms, radiologic findings, and parameters of pulmonary function test(FVC, $FEV_1$, DLco) were evaluated every 3mooths compared between corticosteroid treated(n=5) and non-treated(n=19) patients. 'Deterioration' was defined if patients met more than one of followings (1) decrement in any parameters of pulmonary function test(2) worsening in the degree of dyspnea(3) increase in radiologic extents, and (4) newly developed extrapulmonary sarcoidosis. 'Stable' was defined as no significant interval changes in every parameters. 'Improvement' was defined as decrement of extension of the radiologic lesions without deterioration. Results: Among 19 untreated sarcoidosis patient, one deteriorated, 14 improved(13 of them showed complete resolution in radiology), and 4 were remained stable. On the other hand, five corticosteroid treated patients, uveitis was developed in one, 2 improved, and 2 remained stable. Conclusion : These findings suggest that patient with sarcoidosis, especially those without serious extrapulmonary disease, has stable clinical course and would not need corticosteroid therapy.

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Study of Rat Mammary Epithelial Stem Cells In Vivo and In Vitro (생체 및 시험관에서 유선 상피 모세포의 분리와 동정)

  • Nam Deuk Kim;Kee-Joo Paik
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.3
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    • pp.470-486
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    • 1995
  • Mammary epithelial cells contain a subpopulation of cells with a large proliferativ potential which are responsible for the maintenance of glandular cellularity and are the progenitor cells of mammary cancer. These clonogens give rise to multicellular clonal alveolar or ductal units(AU or DU) on transplantation and hormonal stimulation. To isolate putative mammary clonogens, enzymatically monodispersed rat mammary epithelial cells from organoid cultures and from intact glands are sorted by flow cytometry according to their affinity for FITC labeled peanut lectin(PNA) and PE labeled anti-Thy-1.1 antibody(Thy-1.1) into four subpopulations : cells negative to both PNA and Thy-1.1(B-), PNA+cells, Thy-1.1+cells, and cells positive to both reagents(B+). The in vivo transplantation assays indicate that the clonogenic fractions of PNA+cells from out-growths of organoids in primary cultures for three days in complete hormone medium(CHM) are significantly higher than those of cells from other subpopulations derived from cultrues or from intact glands. Extracellular matrix(ECM) is a complex of several proteins that regulated cell function ; its role in cell growth and differentiation and tissue-specific gene expression. It can act as a positive as well as a negative regulator of cellular differentiation depending on the cell type and the genes studied. Regulation by ECM is closely interrelated with the action of other regulators of cellular function, such as growth factors and hormones. Matrigel supports the growth and development of several different multicellular colonies from mammary organoids and from monodispersed epithelial cells in culture. Several types of colonies are observed including stellate colonies, duct-like structures, two- and three-dimensional web structures, squamous organoids, and lobulo-duct colonies. Organoids have the greatest proliferative potential and formation of multi-cellular structures. Phase contrast micrographs demonstrate extensive intracellular lipid accumulation within the web structures and some of duct-like colonies. At the immunocytochemical and electron micrograph level, casein proteins are predominantly localized near the apical surface of the cells or in the lumen of duct-like or lobulo-duct colonies. Squamous colonies are comprised of several layers of squamous epithelium surrounding keratin pearls as is typical fo squamous metaplasia(SM). All-trans retinoic acid(RA) inhibits the growth of SM. The frequency of lobulo-ductal colony formation increased with the augmentation of RA concentration in these culture conditions. The current study models could provide powerful tools not only for understanding cell growth and differentiation of epithelial cells, but also for the isolation and characterization of mammary clonogenic stem cells.

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Comparison of Service Quality between Local and Global Coffee Brand Shops (국내와 국외브랜드 커피전문점의 서비스품질 비교)

  • Ryu, Si-Hyun;Lee, Ju-Young;Kim, Dong-Gun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.8
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    • pp.1164-1171
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    • 2011
  • The purpose of this study was to compare service quality between local and global coffee brand shops and to investigate improvement. Of 350 questionnaires distributed to customers of six brand coffee shops (three local brands, three global brands) located in Daejeon, 330 complete questionnaires (94.3%) were analyzed. The questionnaire included a seven-point multiple-item scale for measuring service quality. The 21 items measuring service quality were grouped into four factors, and the mean scores for the levels of "representativeness", "coffee sensory and beverage features", "employee attitude" and "physical environment" were 5.42, 4.77, 4.74, and 4.13, respectively. The levels of "coffee sensory and beverage features" and "employee attitude" of the high income customers were significantly lower than those of the low income customers. The results showed that the levels of "employee attitude" of local coffee brand shops was significantly higher (p=0.050) than that of global coffee brand shops. Whereas, the levels of "representativeness" of global coffee brand shops was significantly higher (p=0.003) than that of local coffee brand shops. Based on the results, the global coffee brand shops should pay attention to internal marketing and the local coffee brand shops must strive to improve service quality through strategies such as improving brand awareness and developing representative beverages and foods.

Development of Intelligent ATP System Using Genetic Algorithm (유전 알고리듬을 적용한 지능형 ATP 시스템 개발)

  • Kim, Tai-Young
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.131-145
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    • 2010
  • The framework for making a coordinated decision for large-scale facilities has become an important issue in supply chain(SC) management research. The competitive business environment requires companies to continuously search for the ways to achieve high efficiency and lower operational costs. In the areas of production/distribution planning, many researchers and practitioners have developedand evaluated the deterministic models to coordinate important and interrelated logistic decisions such as capacity management, inventory allocation, and vehicle routing. They initially have investigated the various process of SC separately and later become more interested in such problems encompassing the whole SC system. The accurate quotation of ATP(Available-To-Promise) plays a very important role in enhancing customer satisfaction and fill rate maximization. The complexity for intelligent manufacturing system, which includes all the linkages among procurement, production, and distribution, makes the accurate quotation of ATP be a quite difficult job. In addition to, many researchers assumed ATP model with integer time. However, in industry practices, integer times are very rare and the model developed using integer times is therefore approximating the real system. Various alternative models for an ATP system with time lags have been developed and evaluated. In most cases, these models have assumed that the time lags are integer multiples of a unit time grid. However, integer time lags are very rare in practices, and therefore models developed using integer time lags only approximate real systems. The differences occurring by this approximation frequently result in significant accuracy degradations. To introduce the ATP model with time lags, we first introduce the dynamic production function. Hackman and Leachman's dynamic production function in initiated research directly related to the topic of this paper. They propose a modeling framework for a system with non-integer time lags and show how to apply the framework to a variety of systems including continues time series, manufacturing resource planning and critical path method. Their formulation requires no additional variables or constraints and is capable of representing real world systems more accurately. Previously, to cope with non-integer time lags, they usually model a concerned system either by rounding lags to the nearest integers or by subdividing the time grid to make the lags become integer multiples of the grid. But each approach has a critical weakness: the first approach underestimates, potentially leading to infeasibilities or overestimates lead times, potentially resulting in excessive work-inprocesses. The second approach drastically inflates the problem size. We consider an optimized ATP system with non-integer time lag in supply chain management. We focus on a worldwide headquarter, distribution centers, and manufacturing facilities are globally networked. We develop a mixed integer programming(MIP) model for ATP process, which has the definition of required data flow. The illustrative ATP module shows the proposed system is largely affected inSCM. The system we are concerned is composed of a multiple production facility with multiple products, multiple distribution centers and multiple customers. For the system, we consider an ATP scheduling and capacity allocationproblem. In this study, we proposed the model for the ATP system in SCM using the dynamic production function considering the non-integer time lags. The model is developed under the framework suitable for the non-integer lags and, therefore, is more accurate than the models we usually encounter. We developed intelligent ATP System for this model using genetic algorithm. We focus on a capacitated production planning and capacity allocation problem, develop a mixed integer programming model, and propose an efficient heuristic procedure using an evolutionary system to solve it efficiently. This method makes it possible for the population to reach the approximate solution easily. Moreover, we designed and utilized a representation scheme that allows the proposed models to represent real variables. The proposed regeneration procedures, which evaluate each infeasible chromosome, makes the solutions converge to the optimum quickly.