• Korean Journal of Community Nutrition
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• v.14 no.6
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• pp.817-830
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• 2009

The purpose of this study was to analysis the sanitary management performance based on HACCP system for school foodservice. This study was carried out from September 2008 until December 2008 and is targeted towards schools' dietitians that work at schools with school foodservice. The regional distribution of this research is as follows; 377 schools in Seoul, 648 schools in Gyeonggido, 160 schools in Kangwondo, 438 schools in Choongchungdo equaling 1,623 schools in total. When school foodservices were put through sanitation management achievement level analysis applied by the HACCP system, results displayed that management of temperature (3.96 points), time (4.08 points), and cross-contamination (4.07 points) were all below the average achievement level. HACCP system's achievement level based on the TQM showed that areas for strategy development, leadership, information and analysis had low achievement levels. Achievement levels for CCP are quality check, delivery/distribution process, sterilization/cleansing of food's contact surface. As a result of multiple regression analysis of the factors that influenced sanitation management achievement level of school foodservice HACCP system; sanitary job standard showed 35.6% and CCP achievement levels showed 26.8% explanatory rate. In particular, Kangwondo's number of foodservice provided to per cook was small. Also, the better the processing management was assessed, the higher the sanitary job standard achievement level became resulting to a explanatory rate of 39.5%. Elementary schools showed a higher explanatory rate of 37.0% than middle and high schools. CCP achievement levels in middle and high schools with self-operated foodservice had a 28.0% variable explanatory rate, which was the highest. The better the drainage system, leadership and assessments turned out to be, the higher the CCP achievement levels became. In summary, to revitalize HACCP system that is based on the TQM, it is considered that proper database of HACCP system for school foodservice's sanitation management be constructed and more emphasis should be put on strategy development to improve customers' satisfactory level. In addition, improvements in achievement levels of time, temperature, and cross-contamination for sanitary job standard and CCP achievement level are essential.

• Gut and Liver
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• v.12 no.6
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• pp.722-727
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• 2018

Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

• Journal of Korea Water Resources Association
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• v.52 no.4
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• pp.235-243
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• 2019

Recently, urban inundation was frequently occurred due to the intensive rainfall exceeding marginal capacity of the flood control facility. Furthermore, needs for the underground storage facilities to mitigate urban flood are increasing according to rapidly accelerating urbanization. Thus, in this study, drainage efficiency in drain tunnel connecting to underground storage was investigated from the air-core measurements in the drop shaft against two types of inlet structure. In case of the spiral inlet, the multi-stage structure is introduced at the bottom of the inlet to improve the vortex induction effect at low inflow discharge (multi-stage spiral inlet). The average cross-sectional area of the air-core in the multi-stage spiral inlet is 10% larger than the tangential inlet, and show the highly air emission effect and the highly inflow efficiency at the high inflow discharge. In case of the tangential inlets, the air emission effect decreased after exceeding the maximum inflow discharge, which is required to maintain the inherent performance of the tangential inlet. From the measurements, the empirical formula for the cross-sectional area of the air-core according to locations inside the drop shaft was proposed in order to provide the experimental data available for the inlet model used in experiments.

• Journal of KIISE:Information Networking
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• v.35 no.2
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• pp.99-111
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• 2008

In recent years, the needs for WLANs(Wireless Local Area Networks) technology which can access to Internet anywhere have been dramatically increased particularly in SOHO(Small Office Home Office) and Hot Spot. However, unlike wired networks, there are some unique characteristics of wireless networks. These characteristics include the burst packet losses due to unreliable wireless channel. Note that burst packet losses, which occur when the distance between the wireless station and the AP(Access Point) increase or when obstacles move temporarily between the station and AP, are very frequent in 802.11 networks. Conversely, due to burst packet losses, the performance of 802.11 networks are not always as sufficient as the current application require, particularly when they use TCP at the transport layer. The high packet loss rate over wireless links can trigger unnecessary execution of TCP congestion control algorithm, resulting in performance degradation. In order to overcome the limitations of WLANs environment, MAC-layer LDA(Loss Differentiation Algorithm)has been proposed. MAC-layer LDA prevents TCP's timeout by increasing CRD(Consecutive Retry Duration) higher than burst packet loss duration. However, in the wireless channel with high packet loss rate, MAC-layer LDA does not work well because of two reason: (a) If the CRD is lower than burst packet loss duration due to the limited increase of retry limit, end-to-end performance is degraded. (b) energy of mobile device and bandwidth utilization in the wireless link are wasted unnecessarily by Reducing the drainage speed of the network buffer due to the increase of CRD. In this paper, we propose a new retransmission module based on Cross-layer approach, called BLD(Burst Loss Detection) module, to solve the limitation of previous link layer retransmission schemes. BLD module's algorithm is retransmission mechanism at IEEE 802.11 networks and performs retransmission based on the interaction between retransmission mechanisms of the MAC layer and TCP. From the simulation by using ns-2(Network Simulator), we could see more improved TCP throughput and energy efficiency with the proposed scheme than previous mechanisms.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.348-356
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• 2011

Objective : The safety and efficacy of various fusion substitutes in pyogenic osteomyelitis has not been investigated. We evaluated and compared the cadaveric allograft and titanium cages used to reconstruct, maintain alignment and achieve fusion in the management of pyogenic spinal infection. Methods : There were 33 patients with pyogenic osteomyelitis underwent fusion in this study. Fifteen of the 33 patients were operated on by fusion with allografts (cadaveric patella bones) and 18 of those were operated with titanium mesh cages filled with autologous cancellous iliac bone. After the affected disc and vertebral body resection with pus drainage, cadaveric allograft or titanium cages were inserted into the resected space. Posterior transpedicular screw fixation and rod compression in resected space, where cadaveric allograft or titanium cages were inserted, was performed to prevent the malposition in all patients except in 1 case. Recurrent infection was identified by serial erythrocyte sedimentation rate and cross reactive protein follow-up. Osseous union and recurred infection available at a minimum of 2 years following operation was identified. The amount of kyphosis correction and the subsidence were measured radiographically. Results : Spinal fusion was achieved in 29 of 33 patients. In the cadaveric allograft group, 93.3% of patient (14 of 15) showed the osseous union while 83.3% of patient (15 of 18) in the titanium cage group showed union. Subsidence was noted in 12 of the patients. Twelve patients (36.3%) showed unsettling amounts of subsidence postoperatively whereas 46.6% of patients in the cadaveric allograft group and 37.7% of patients in the titanium cage group showed similar subsidence, respectively. There were statistical difference in the fusion rate (p=0.397) and subsidence rate (p=0.276) between the two groups. There was significant statistical difference in the postoperative improvement of segmental kyphosis between the two groups (p=0.022), that is the improvement in sagittal alignment was greater in the titanium cage group than in the cadaveric allograft group. There was no case of recurred infection. Conclusion : The cadaveric allograft and titanium cages are effective and safe in restoring and maintaining sagittal plane alignment without increased incidence in infection recurrence in pyogenic osteomyelitis. The postoperative improvement of segmental kyphosis was better in the cage group.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.340-345
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• 2013

Background: This study aims to evaluate whether or not the method of right vertical axillary minithoracotomy (RVAM) is preferable to and as reliable as conventional sternotomy surgery, and also assesses its cosmetic results. Methods: Thirty-three patients (7 males, 26 females) with atrial septal defect were admitted to the Cardiovascular Surgery Clinic of Cukurova University from December 2005 until January 2010. The patients' ages ranged from 3 to 22. Patients who underwent vertical axillary minithracotomy were assigned to group I, and those undergoing conventional sternotomy, to group II. Group I and group II were compared with regard to the preoperative, perioperative and postoperative variables. Group I included 12 females and 4 males with an average age of $16.5{\pm}9.7$. Group II comprised 14 female and 3 male patients with an average age of $18.5{\pm}9.8$ showing similar features and pathologies. The cases were in Class I-II according to the New York Heart Association (NYHA) Classification, and patients with other cardiac and systemic problems were not included in the study. The ratio of the systemic blood flow to the pulmonary blood flow (Qp/Qs) was $1.8{\pm}0.2$. The average pulmonary artery pressure was $35{\pm}10$ mmHg. Following the diagnosis, performing elective surgery was planned. Results: No significant difference was detected in the average time of the patients' extraportal circulation, cross-clamp and surgery (p>0.05). In the early postoperative period of the cases, the duration of mechanical ventilator support, the drainage volume in the first 24 hours, and the hospitalization time in the intensive care unit were similar (p>0.05). Postoperative pains were evaluated together with narcotic analgesics taken intravenously or orally. While 7 cases (43.7%) in group I needed postoperative analgesics, 12 cases (70.6%) in group II needed them. No mortality or major morbidity has occurred in the patients. The incision style and sizes in all of the patients undergoing RVAM were preserved as they were at the beginning. Furthermore, the patients of group I were mobilized more quickly than the patients of group II. The patients of group I were quite pleased with the psychological and cosmetic results. No residual defects have been found in the early postoperative period and after the end of the follow-up periods. All of the patients achieved functional capacity per NYHA. No deformation of breast growth has been detected during 18 months of follow-up for the group I patients, who underwent RVAM. Conclusion: To conclude, the repair of atrial septal defect by RVAM, apart from the limited working zone for the surgeon in these pathologies as compared to sternotomymay be considered in terms of the outcomes, and early and late complications. And this has accounted for less need of analgesics and better cosmetic results in recent years.

• Korean Journal of Remote Sensing
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• v.14 no.4
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• pp.325-342
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• 1998

Two RADARSAT SAR images with different modes acquired by Canadian Space Agency to test the effectiveness of geological lineament extraction and spring water detection over the Cheju Island. Geological lineaments are poorly developed this basalt dominant volcanic island, but more linear features can be extracted when SAR and TM images are simultaneously analyzed than when TM image alone is used. This results mainly owe to the facts that RADARSAT SAR systems are able to provide data with different frequencies, azimuth, and incidence angles. Distribution of spring water along coast is poorly correlated with geological lineaments or drainage pattern, but those in middle range of mountain region are developed along geological lineaments. Detection of spring water using remotely sensed images are turned out to be very difficult to achieve. Radial shaped sea surface temperature anomaly derived from TM thermal band should be the best candidate for spring water, but the resolution is not high enough. We also investigate the normalized radar cross section (or sigma naught) converted from RADARSAT and ERS-1 SAR data but to discriminate the spring water effectively except where relatively large water mass is observed on land side. Speckle noise and irregularity in physical sea surface condition are the serious obstacles for this application. ERS-1 SAR image acquired in low incidence angle was more useful for geological lineament estimation and water body study than RADARSAT SAR images with high incidence angles. Therefore the selection of incidence angle is critical in geological and spring water applications of SAR images, and low incidence angles less than about 30$^{\circ}$ are recommended to monitor the Cheju volcanic island.

• Journal of the Korean Society of Food Culture
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• v.23 no.5
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• pp.582-594
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• 2008

This study aimed at evaluating current sanitation management performances in Korean-Food restaurants by their operation types and to develop sanitary training posters based on the risk factors, in an attempt to improve the level of sanitation management in Korean food service facilities. Eighteen Korean-food restaurants that are managed by franchisor, franchisees as well as self-managed with large-scale and small-scale restaurants in Seoul and Gyeonggi-Do, were evaluated by on-the-spot inspectors with an auditing tool consisting of three dimensions, nine categories and thirty four items. Data were analyzed using SPSS. The total score of each group showed that restaurants managed by franchisees ranked the highest (59 out of 100 points), while self-managed, small-scale restaurants ranked the lowest (44 out of 100 points). In the categorization of sanitation management compliance, the dimensions of food hygiene during production recorded the lowest compliance rate of 47.7% (22.89/48.0 points) followed by the dimension of environmental hygiene 59.3% (20.17/34.0 points) and personal hygiene 60.5% (10.89/18.0 points). This indicated the need for urgent improvement. The items which showed the lowest compliance rates were 'proper thawing of frozen foods' (0%), 'notifying and observing heating/reheating temperature' (6%), 'using of hand-washing facility and proper hand-washing' (33%), 'monitoring temperature of frozen-foods and cold-foods' (35%), and 'prevention of cross-contamination' (36%) among thirty four items. Self-managed, small-scale restaurants, in particular, needed to improve sanitary practices such as 'sanitation education for employee', 'verifying the employee health inspection reports', 'storing food on the shelves 15 cm distance away from the wall', 'suitability of ventilation capacity of hoods' and 'cleanliness of drainage'. On the basis of the findings of this study, we developed sanitary training posters, especially for small-scale restaurant operators. This could be an effective tool to educate food service employees on sanitary knowledge and principles and could be used to improve the existing sanitary conditions in Korean food service facilities.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.42-47
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• 2024

Backgrounds/Aims: Hepatolithiasis and choledocholithiasis are frequent pathologies and unfortunately, with the current treatment strategies, the recurrence incidence is still high. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis in Vietnamese patients. Methods: A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at the Department of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020. Results: A total of 84 patients were analyzed. Most patients were females (56.0%) with a median age of 55.56 years. Among them, 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) had both intrahepatic and extrahepatic stones. The rate of stones ≥ 10 mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. Intraoperative complications were encountered in two patients, but there was no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes. The early postoperative complication rate was 9.6%, and all patients were managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%. Conclusions: Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube is a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with a previous choledochotomy.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.1-6
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• 2003

Currently, atrial septal defect repair has been considered low risk operation duo to the development of open heart surgery Not only the operation itself, but also the cosmetic aspect is now focused. Though many methods exist as minimally invasive cardiac surgery in atrial septal defect repair, some surgeons advocate that right anterolateral thoracotomy is better than the others in the cosmetic aspect and we compared right anterolateral thoracotomy with median sternotomy. Material and Method: From January 1999 to August 2002, 43 patient underwent atrial septal defect repair by one operator, including 15 patients through right anterolateral thoracotomy(group A) and 15 patients through median sternotomy(group B) in Hanyang university Hospital. The data were randomized and operation outcomes were analyzed between these two groups. Result: The mean weight of group A was 38.77$\pm$15.57kg and 38.21$\pm$21.82kg in group B. In group A, mean operation (OP) time was 197.6$\pm$61.40min, mean cardiopulmonary bypass(CPB) time was 48.66$\pm$13.02min and mean fibrillation time or aortic cross clamp(ACC) time was 30$\pm$11.64min. In group B, mean OP time was 212.33$\pm$31.95min, mean CPB time was 55$\pm$12.10min, and mean fibrillation or ACC time was 29.33$\pm$9.04min. There was no significant differences in these two groups. In group A, mean mechanical ventilation time was 3.78$\pm$0.78 hours, mean postoperative ICU stay was 1.2$\pm$0.47 days and mean postoperative hospital stay was 10.20 41.08 days. In group B, mean mechanical ventilation time was 5.95$\pm$3.73 hours, mean post operative ICU stay was 1.41$\pm$0.61 days, and mean postoperative hospital stay was 12.20$\pm$3.55 days. There was no any significant difference in two groups. Group A had significantly lower mean thoracic and pleuropericardial drainage than group B (175.33$\pm$90.54cc vs 352.33$\pm$239.43cc, p<0.05). Complication was seen in one case in group B, transient 2nd degree A-V block. Conclusion: Right anterolateral thoracotomy was better than median sternotomy not only in cosmetic aspect but also in postoperative thoracic and pleuropericardial drainage, using the same instrument(p.0.05). But, right anterolateral thoracotomy was more technically difficult due to narrow operative field and we should be careful of aortic cannulation.