• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.199-206
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• 2009

Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.225-232
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• 2000

Purpose : The use antimicrobial agents is one of the important strategies for the treatment and prophylaxis of microbial infections. But injudicious abuse and misuse of antimicrobial agents is problem to add an extra weight on medical fee, increase of resistant bacteria and side effects according to the antibiotic use. This study was performed to establish the pertinent use of antimicrobial agent in Chonbuk National University Hospital(CNUH). Characteristics of antibiotics use was analysis by reviewing the medical records of patients admitted to CNUH during the period of May 1998. Methods : One thousand eight hundred and thirty three patients were enrolled in this study(medical division 1,014 cases, surgical division 819 cases). Medical records were retrospectively reviewed to classify the rate of antibiotics use, name of antibiotics used, appropriateness of antibiotics use. Results : The overall rate of antibiotic usage in CNUH was 67.2%(1,231/1,833), showing higher rate in surgical division(89.6%) compare to that of medical division(49.0%). Among 1,231 patients to whom antimicrobial agents were given, only 125(10.2%) were treated with single antimicrobial agents. 311(25.3%) were treated with two antimicrobial agents, and 795(64.5%) patients received 3 or more antibiotics. ${\beta}$-lactams(56.4%) were most frequently used followed by aminoglycosides(35.3%), the others(4.9%) and quinolons(3.4%). Amoxicillin-clavulanate was the mostly commonly used antibiotics followed by amoxicillin and unasyn. Prophylactic use of antibiotics was carried in seven hundred six patients(57.4%), mostly in surgical division, which can be considered somewhat inappropriate in the initiation time and duration of antibiotic use. Conclusion : Importance of monotherapy and appropriate prophylactic antibiotic use should be emphasized. Strategies of antibiotics use, such as restriction of drug use, continuous monitoring system, flow sheet system should be considered to reduce antibiotics use and establish the appropriate use of antibiotics as well as inhibiting the occurrence of resistant strains.

• Journal of radiological science and technology
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• v.35 no.4
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• pp.299-308
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• 2012

To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.

• Asia pacific journal of information systems
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• v.18 no.4
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• pp.57-81
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• 2008

Knowledge is an essential strategic weapon for sustaining competitive advantage and is the key determinant for organizational growth. When knowledge is shared and disseminated throughout the organization, it increases an organization's value by providing the ability to respond to new and unusual situations. The growing importance of knowledge as a critical resource has forced executives to pay attention to their organizational knowledge. Organizations are increasingly undertaking knowledge management initiatives and making significant investments. Knowledge sourcing is considered as the first important step in effective knowledge management. Most firms continue to make an effort to realize the benefits of knowledge management by using various knowledge sources effectively. Appropriate knowledge sourcing strategies enable organizations to create, acquire, and access knowledge in a timely manner by reducing search and transfer costs, which result in better firm performance. In response, the knowledge management literature has devoted substantial attention to the analysis of knowledge sourcing strategies. Many studies have categorized knowledge sourcing strategies into intemal- and external-oriented. Internal-oriented sourcing strategy attempts to increase firm performance by integrating knowledge within the boundary of the firm. On the contrary, external-oriented strategy attempts to bring knowledge in from outside sources via either acquisition or imitation, and then to transfer that knowledge across to the organization. However, the extant literature on knowledge sourcing strategies focuses primarily on large organizations. Although many studies have clearly highlighted major differences between large and small firms and the need to adopt different strategies for different firm sizes, scant attention has been given to analyzing how knowledge sourcing strategies affect firm performance in small firms and what are the differences between small and large firms in the patterns of knowledge sourcing strategies adoption. This study attempts to advance the current literature by examining the impact of knowledge sourcing strategies on small firm performance from a holistic perspective. By drawing on knowledge based theory from organization science and complementarity theory from the economics literature, this paper is motivated by the following questions: (1) what are the adoption patterns of different knowledge sourcing strategies in small firms (i,e., what sourcing strategies should be adopted and which sourcing strategies work well together in small firms)?; and (2) what are the performance implications of these adoption patterns? In order to answer the questions, this study developed three hypotheses. First hypothesis based on knowledge based theory is that internal-oriented knowledge sourcing is positively associated with small firm performance. Second hypothesis developed on the basis of knowledge based theory is that external-oriented knowledge sourcing is positively associated with small firm performance. The third one based on complementarity theory is that pursuing both internal- and external-oriented knowledge sourcing simultaneously is negatively or less positively associated with small firm performance. As a sampling frame, 700 firms were identified from the Annual Corporation Report in Korea. Survey questionnaires were mailed to owners or executives who were most erudite about the firm s knowledge sourcing strategies and performance. A total of 188 companies replied, yielding a response rate of 26.8%. Due to incomplete data, 12 responses were eliminated, leaving 176 responses for the final analysis. Since all independent variables were measured using continuous variables, supermodularity function was used to test the hypotheses based on the cross partial derivative of payoff function. The results indicated no significant impact of internal-oriented sourcing strategies while positive impact of external-oriented sourcing strategy on small firm performance. This intriguing result could be explained on the basis of various resource and capital constraints of small firms. Small firms typically have restricted financial and human resources. They do not have enough assets to always develop knowledge internally. Another possible explanation is competency traps or core rigidities. Building up a knowledge base based on internal knowledge creates core competences, but at the same time, excessive internal focused knowledge exploration leads to behaviors blind to other knowledge. Interestingly, this study found that Internal- and external-oriented knowledge sourcing strategies had a substitutive relationship, which was inconsistent with previous studies that suggested complementary relationship between them. This result might be explained using organizational identification theory. Internal organizational members may perceive external knowledge as a threat, and tend to ignore knowledge from external sources because they prefer to maintain their own knowledge, legitimacy, and homogeneous attitudes. Therefore, integrating knowledge from internal and external sources might not be effective, resulting in failure of improvements of firm performance. Another possible explanation is small firms resource and capital constraints and lack of management expertise and absorptive capacity. Although the integration of different knowledge sources is critical, high levels of knowledge sourcing in many areas are quite expensive and so are often unrealistic for small enterprises. This study provides several implications for research as well as practice. First this study extends the existing knowledge by examining the substitutability (and complementarity) of knowledge sourcing strategies. Most prior studies have tended to investigate the independent effects of these strategies on performance without considering their combined impacts. Furthermore, this study tests complementarity based on the productivity approach that has been considered as a definitive test method for complementarity. Second, this study sheds new light on knowledge management research by identifying the relationship between knowledge sourcing strategies and small firm performance. Most current literature has insisted complementary relationship between knowledge sourcing strategies on the basis of data from large firms. Contrary to the conventional wisdom, this study identifies substitutive relationship between knowledge sourcing strategies using data from small firms. Third, implications for practice highlight that managers of small firms should focus on knowledge sourcing from external-oriented strategies. Moreover, adoption of both sourcing strategies simultaneousiy impedes small firm performance.

• Asia pacific journal of information systems
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• v.21 no.4
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• pp.45-62
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• 2011

The notion of information systems (IS) continuance has recently emerged as one of the most important research issues in the field of IS. A great deal of research has been conducted thus far on the basis of theories adapted from various disciplines including consumer behaviors and social psychology, in addition to theories regarding information technology (IT) acceptance. This previous body of knowledge provides a robust research framework that can already account for the determination of IS continuance; however, this research points to other, thus-far-unelucidated determinant factors such as habit, which were not included in traditional IT acceptance frameworks, and also re-emphasizes the importance of emotion-related constructs such as satisfaction in addition to conscious intention with rational beliefs such as usefulness. Experiences should also be considered one of the most important factors determining the characteristics of information system (IS) continuance and the features distinct from those determining IS acceptance, because more experienced users may have more opportunities for IS use, which would allow them more frequent use than would be available to less experienced or non-experienced users. Interestingly, experience has dual features that may contradictorily influence IS use. On one hand, attitudes predicated on direct experience have been shown to predict behavior better than attitudes from indirect experience or without experience; as more information is available, direct experience may render IS use a more salient behavior, and may also make IS use more accessible via memory. Therefore, experience may serve to intensify the relationship between IS use and conscious intention with evaluations, On the other hand, experience may culminate in the formation of habits: greater experience may also imply more frequent performance of the behavior, which may lead to the formation of habits, Hence, like experience, users' activation of an IS may be more dependent on habit-that is, unconscious automatic use without deliberation regarding the IS-and less dependent on conscious intentions, Furthermore, experiences can provide basic information necessary for satisfaction with the use of a specific IS, thus spurring the formation of both conscious intentions and unconscious habits, Whereas IT adoption Is a one-time decision, IS continuance may be a series of users' decisions and evaluations based on satisfaction with IS use. Moreover. habits also cannot be formed without satisfaction, even when a behavior is carried out repeatedly. Thus, experiences also play a critical role in satisfaction, as satisfaction is the consequence of direct experiences of actual behaviors. In particular, emotional experiences such as enjoyment can become as influential on IS use as are utilitarian experiences such as usefulness; this is especially true in light of the modern increase in membership-based hedonic systems - including online games, web-based social network services (SNS), blogs, and portals-all of which attempt to provide users with self-fulfilling value. Therefore, in order to understand more clearly the role of experiences in IS continuance, analysis must be conducted under a research framework that includes intentions, habits, and satisfaction, as experience may not only have duration-based moderating effects on the relationship between both intention and habit and the activation of IS use, but may also have content-based positive effects on satisfaction. This is consistent with the basic assumptions regarding the determining factors in IS continuance as suggested by Oritz de Guinea and Markus: consciousness, emotion, and habit. The principal objective of this study was to explore and assess the effects of experiences in IS continuance, with special consideration given to conscious intentions and unconscious habits, as well as satisfaction. IN service of this goal, along with a review of the relevant literature regarding the effects of experiences and habit on continuous IS use, this study suggested a research model that represents the roles of experience: its moderating role in the relationships of IS continuance with both conscious intention and unconscious habit, and its antecedent role in the development of satisfaction. For the validation of this research model. Korean university student users of 'Cyworld', one of the most influential social network services in South Korea, were surveyed, and the data were analyzed via partial least square (PLS) analysis to assess the implications of this study. In result most hypotheses in our research model were statistically supported with the exception of one. Although one hypothesis was not supported, the study's findings provide us with some important implications. First the role of experience in IS continuance differs from its role in IS acceptance. Second, the use of IS was explained by the dynamic balance between habit and intention. Third, the importance of satisfaction was confirmed from the perspective of IS continuance with experience.

• Korean Journal of Food Science and Technology
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• v.45 no.3
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• pp.376-381
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• 2013

In this study, we monitored total mercury and methylmercury concentrations in tuna, billfish, and deep-sea fish distributed in Seoul city. With the acquired data, we carried out statistical analysis and an exposure assessment for intake. The mean concentrations (mg/kg) of total mercury and methylmercury were $0.32{\pm}0.31/0.20{\pm}0.20$ for tuna, $0.43{\pm}0.48/0.20{\pm}0.17$ for patagonian toothfish, $0.99{\pm}0.72/0.51{\pm}0.40$ for billfish and $1.20{\pm}0.70/0.95{\pm}0.51$ for sharks, respectively. We found that sharks, billfish, patagonian toothfish, and tuna were more contaminated with total mercury and methylmercury, in sequence, and that 66% of the total mercury concentration consisted of methylmercury, on average. Although the estimated weekly intakes of methylmercury from commercial deep-sea fish were lower than the weekly intakes recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), we identified that the total mercury and methylmercury concentrations in tuna, billfish, and deep-sea fish continued to increase with the passage of time. Therefore, we confirmed the necessity of continuous monitoring and comprehensive analysis for general safety.

• Journal of the Korean Society for Library and Information Science
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• v.10
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• pp.39-70
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• 1983

The concept of the public library defined by the Korean Library Association does not describe the current state of the Korean public library but describes the public libraries in the western society. Korean public library was formed after the western public library but it was modified and reconciled with the tradition of Korea. The difference between the concepts occured in the acculturation process of the Korean public library. According to the International Encyclopeadia of the Social Sciences, acculturation comprehends those phenomena which result when groups of individuals having different cultures come into continuous firsthand contact, with subsequent changes in the original cultural patterns of either of both groups. Korea opened its door to western world in 1876, and it began to contact with the western world. As the consequence, the concept of the public library of the West diffused to Lee Dynasty which were characterized by the confucianism and the extended family system. These two characteristics were against the public library concept and it could not function as it was and it had to be modified to fit to Korean society. The American public library was formed by the diffusion of English public library. The concept fitted in the colonial American society which was characterized by the Christianity and nuclear family system. Religion and family life were closely knitted together and they contributed much to the formation of the American public library. Also the society needed various information to form their new nation. The need of the public library grew and the public library repidly developed as the American society was urbanized and industrialized. The changes of Korean public library has passed the following process of acculturation. 1. The Korean culture contacted with Western world. 2. The public library concept diffused to Korea, but the people were illiterate and the need of the public library was for the preservation of the old books. The collection was not for people. 3. The function of the public library in Korea was altered slightly as several intellectuals who formed the first modern public library tried to literate Koreans as a means of liberation :from Japan through the library service. 4. The traditional libraries such as sodandg and hyangyo disorganized and finally disappeared as the traditional elements of the culture disappeared and the new cultural elements prevailed in Korea. 5. When the traditional elements of culture were disorganized, a reinterpretation of the diffused culture appeared. With the appearance of the vouth group which was not existed in the traditional society, cultural facilities for them were needed. They began to use public library as their reading rooms. This pattern has been institutionalized ever since in Korean public library. 6. When the new element of the culture spread, the traditional cultural elements react against this element. As the new public libraries sprung out, there were movements to restore the old Korean tradition of the family libraries and Hyangyo to counteract to the new libraries. This movements were not successful and they all disappeared as they could not keep up the rapid social change occurred in the Korean society. 7. In the process of the cultral change, cultural lag occurred between the public library and the users who could not adopt to the new library. This has been continued to the present time. 8. This diffused concept of the public library was modified and became native to Korean society. However, the acculturation of the public library concept has not changed the traditional ideas of Korean people and their behavior. The Korean society recently has been changing rapidly and the function of the Korean public library is improving accordingly; 1. The extended Korean family system is disorganizing. As the consequence, the public library could substitute the family system offering information and recreation service, etc. 2. The growth of educated population is requiring a variety of library materials. An individual library can not meet the needs of them and cooperative library service will be needed to share resources. The public library will become the center of the cooperative service. 3. The Koreans are watching TV more hours than they read printed materials. For them, the public library needs to collect audiovisual materials. Especially the teaching materials should be all audiovisualized for the effective teaching. 4. Technology is developing rapidly in Korea, especially computer technology is applied in many parts of the society. This will also influence library service. The public library will be developing as the centralized library computer system. When the Korean public library functions as the extended family system and the center of the cooperative library system, the Korean public library will be functioning as the public library defined by the Korean Library Association.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.75-84
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• 1994

The need for assessment of ureteric function in the patient with an obviousely dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydrone-phrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during $^{99m}Tc$-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Kt1/2) and ureteral (Ut1/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Kt1/2 (>20 min), no patient with an abnormal ureter underwent therapy at the ureteropelvic junction because the hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

• Journal of Korean society of Dental Hygiene
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• v.8 no.4
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• pp.19-30
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• 2008

This study reached the following conclusions as a result of carrying out the questionnaire survey of self-descriptions for the satisfaction after the citizens of Daejon uses the dental clinics, in order to identify the factors of satisfaction to the medical services of such dental clinics to be utilized in the patient management by dental hygienists, provide the basic data to provide the medical services desired by patients. 1. 43.9% men responded to the facilities and 56.1% women to the atmosphere for the standards of selection of dental clinics by general characteristic, and the college graduates or more to the kindness (38.2%), high-school graduates (43.2%) and middle-school graduates (25.9%) or less to the close distance for the level of educational attainment (p=0.009), which was meant to have a statistical significance. 2. The execution of reservation system for the dental clinics showed 54.7%, the reserved time was observed upon the execution of such reservation system, the dental clinics where they practice such system were 40.6%, and the confirmation methods was done through the telephone with 62.5%. 3. The experience of fear upon the dental treatment showed 74.6%. The type of fear showed the machine sound (48.7%) for men and cry of others for women (70.8%) at the highest. 70% of those under 30 at the age responded to the sharp instruments at the highest. 83.3% of Yousung-gu showed the highest by responding to the cry of others for the residential areas. The statistically significant difference was shown in both the age and residential area (p=0.000). 4. Women showed higher in the distribution of gender for the sterilization of instruments for the external satisfaction of dental clinics(p=0.000) and those under 30 at the age showed the highest with 2.98${\pm}$0.95(p=0.001). Seo-gu (3.48${\pm}$0.77) was the highest for the residential area (p=0.000), and there was statistically significant differences in the gender, age and residential area. 5. Men showed higher satisfaction than women in the clean state and the statistically significant differences were shown (p=0.000) at the age as the high satisfaction was shown for those under 30 at the age (2.35${\pm}$0.79), those having the income not less than 10 million won and not more than 20 million won (2.43${\pm}$0.78), and Seo-gu (2.63 ${\pm}$0.69) for the residential area. 6. For the internal satisfaction of dental clinic by users for the medical services in the dental clinics, 61.1% women responded to no in the ability of solving the inconvenience in the service process, and showed low ability of solving the inconvenience from 30 at the age (26.2%) and by responding to Dong-gu (22.1%) for the residential area, showing statically significant differences(p=0.000). For the re-use of dental clinics, 46.6% men (p=0.043) for the gender, 24.3% under 30 at the age and 22.9% of Dong-gu for the residential area responded to the re-use, showing statistically significant differences for the gender and residential area (p=0.000). 7. The dissatisfaction showed a high rate of 69.5% for the satisfaction to the medical services of dental clinics. 46.2% men responded to the pain and women to the feeling of foreign substance for the reason of dissatisfaction while those under 30 at the age showed 55.6% for others, those between 50 and 59 41.7% for the feeling of foreign substance. 86.3% carried out the education for cautions after the treatments and most people turned out that they do not carry out the continuous health management of mouth as 20.5% responded to that they carry out such health management.

• Korean Journal of Food Science and Technology
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• v.41 no.2
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• pp.173-178
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• 2009

Epidemiological studies showed that high trans-fat consumption is closely associated with getting the risks of cardiovascular disease. The objective of this study was to produce trans-free fat through lipase-catalyzed interesterification, as a substitute for the cream margarine commonly used in industry. Optimum conditions for interesterification in a packed bed enzyme bioreactor (PBEB) were determined using response surface methodology (RSM) based on central composite design. Three kinds of reaction variables were chosen, such as substrate flow rate (0.4-1.2 mL/min), reaction temperature (60-70$^{\circ}C$), and ratio of fully hydrogenated canola oil (FHCO, 35-45%) to evaluate their effects on the degree of interesterification. Optimum conditions from the standpoint of solid fat content (SFC) were found to be as follows: 0.4 mL/min flow rate, 64.7$^{\circ}C$ reaction temperate, and 42.8% (w/w) ratio of FHCO, respectively. The half-life of immobilized lipase in PBEB with two stages at 60$^{\circ}C$ ($1^{st}$ stage) and 55$^{\circ}C$ ($2^{nd}$ stage) was about more than 30 days as estimated by extrapolating the incubation time course of tristearoyl glycerol (TS) conversion, whereas the half-life of the enzyme in PBEB with single stage at 65$^{\circ}C$ was only about 15 days. Finally, the results from SFC analysis suggest that trans-free fat produced in this study seems to be a suitable substitute for the cream margarine commonly used in industry.