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The Clinical Efficacy of Uvulopalatopharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡 증후군 치료에서 구개수구개인두성형술의 임상적 유용성)

  • Moon, Hwa-Sik;Choi, Young-Mee;Park, Young-Hak;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1366-1381
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    • 1997
  • Background : Uvulopalatopharyngoplasty(UPPP) has become the most common surgical treatment for obstructive sleep apnea syndrome(OSAS). However, the results of this therapeutic modality have been quite variable with successful results by several authors and poor results by others. Until recently, in Korea, there is only a few reports about the clinical efficacy of UPPP. A prospective study was undertaken to evaluate the effectiveness and complications of UPPP. Method : Twenty-six OSAS patients who had undergone UPPP with preoperative and postoperative polysomnographic studies were included in this study. Two definitions of surgical success were used. The responder was defined, using a conventional criteria, as a 50% or more reduction in apnea index(AI) or apneahypopnea index(AHI) after UPPP, or a postoperative AI of <10 or AHI of <20. The initial cure was defined, using our own criteria, as a postoperative AI of <5 or AHI of <10. Complications were categorized in two groups : early(disorders during the first 10 postoperative days) and late. Results : Eighteen patients(69.2%) were responders, and ten patients(38.5%) were considered as initial cure. On the other hand, in five patients (19.2%), postoperative polysomnographic data demonstrated deterioration compared with preoperative data. Reduction rate of AI or AHI following UPPP was not significantly related to the preoperative body mass index, AI or AHI. There was no significant change of sleep architecture before and after UPPP in responder and initial cure groups. Early complications such as pain, dyspnea, bleeding, nasal reflux, dysphagia or wound disruption were observed in all patients. Late complications such as nasal reflux, voice change, dysphagia, loss of taste, pharyngeal dryness or foreign body sensation were discovered in 22 patients (84.6%). However, all early and late complications were of minor importance. Conclusion : The response to UPPP was favorable in approximately 70% of OSAS patient. However, the initial Cure rate of UPPP was relatively low. We suggest that selection of more appropriate surgical candidates and adequate surgical protocol is necessary to obtain a more successful result with UPPP.

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Various Possibilities of Dispositif Film (디스포지티프 영화의 다양한 가능성)

  • KIM, Chaehee
    • Trans-
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    • v.3
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    • pp.55-86
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    • 2017
  • This study begins with the necessity of the concept of reincarnation of film media and the inclusion of specific tendencies of contemporary films as post - cinema comes. Variable movements around recent films Challenging and experimental films show aesthetics that are difficult to approach with the analysis of classical mise en scene and montage. In this way, I review the dispositif proposed by Martin in films that are puzzling to criticize with the classical conceptual framework. This is because the concept of dispositive is a conceptual pile that extends more than a mise en scene and a montage. Dispositif films tend to be non-reproducible and non-narrative, but not all non-narrativef tendencies are dispositif films. Only the dispositif film is included in the flow. Dispositif movement has increased dramatically in the modern environment on which digital technology is based, but it is not a tendency to be found in any particular age. The movement has been detected in classical films, and the dispositif tendency has continued to exist in avant-garde films in the 1920s and some modernist films. First, for clear conceptualization of cinematic dispositif, this study examines the sources of dispositif debates that are being introduced into film theory today. In this process, the theory of Jean Louis Baudry, Michel Foucault, Agamben, Flusser, and Deleuze will help. The concept of dispositif was discussed by several scholars, including Baudry and Foucault, and today the notion of dispositif is defined across all these definitions. However, these various discussions are distinctly different from the cinematic dispositif or dispositif films that Martin advocates. Martin's proposed concept reminds us of the fundamentals of cinematic aesthetics that have distinguished between the mise-en-scene and the montage. And it will be able to reconsider those concepts and make it possible to view a thing a new light or create new films. The basic implications of dispositif are apparatus as devices, disposition and arrangement, the combination of heterogeneity. Thus, if you define a dispositif film in a word, it is a new 'constraint' consisting of rearrangement and arrangement of the heterogeneous elements that make up the conditions of the classical film. In order for something to become a new design, changes must be made in the arrangement and arrangement of the elements, forces, and forces that make up it. Naturally, the elements encompass both internal and external factors. These dispositif films have a variety of possibilities, such as reflection on the archival possibilities and the role of supervision, the reestablishment of active and creative audience, the reason for the film medium, and the ideological reflection. films can also 'network' quickly and easily with other media faster than any medium and create a new 'devised' aesthetic style. And the dispositif film that makes use of this will be a key keyword in reading the films that present the new trend of modern film. Because dispositif are so comprehensive and have a broad implication, there are certainly areas that are difficult to sophisticate. However this will have a positive effect on the future activation of dispositif studies end for end. Dispositif is difficult to elaborate the concept clearly, so it can be accessed from a wide range of dimensions and has theoretically infinite extensibility. At the beginning and end of the 21st century film, the concept of cinematic dispositif will become a decisive factor to dismantle old film aesthetics.

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A Theoretical Review of Basin Storage Coefficient and Concentration Time Using the Nash Model (Nash 모형을 이용한 유역 저류상수 및 집중시간의 이론적 검토)

  • Yoo, Chul-Sang
    • Journal of Korea Water Resources Association
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    • v.42 no.3
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    • pp.235-246
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    • 2009
  • This study theoretically reviews the basin storage coefficient and concentration time using the Nash model, a simple unit hydrograph theory. First, the storage coefficient and concentration time of Nash instantaneous unit hydrograph (IUH) are derived based on their definitions, whose characteristics as well as their relationship are also reviewed. Additionally, several empirical equations of storage coefficient and concentration time commonly used in Korea are evaluated by comparing them with those for the Nash IUH. Major results of this study are summarized as follows. (1) The concentration time of Nash IUH is approximately linearly proportional to the number of linear reservoirs, but the storage coefficient non-linearly to the square root. That is, if increasing the number of linear reservoirs by four times, the concentration time becomes also increased by about four times, but the storage coefficient only about two times. This result has a special meaning to understand the effect of basin subdivision on the concentration time and storage coefficient. (2) The storage coefficient and concentration time of Nash IUH are not independent each other, so their independent estimation does not make any physical sense. As the concentration time among the two is more sensitive to the number of linear reservoirs, which should be estimated first, then the storage coefficient considering the concentration time estimated. (3) Empirical equations of concentration time can be divided into two groups, one following the linear channel theory and the other not, whose equation forms are also found to be very similar. This result indicates that the characteristic factors dominating the concentration time are very similar, indicating the possibility of its regionalization over a basin with consistent equation forms. (4) Those for storage coefficient like the Russell formulae are found to consider the physical characteristics of a basin, so their unreasonable applications could sufficiently be excluded.

Assessments of Negotiation Options Regarding Post-2012 Rules for Land Use, Land-Use Change and Forestry (LULUCF) -With a Focus on the Forest Management Activities under the Kyoto Protocol - (Post-2012 LULUCF 협상 대안 평가 -산림경영 활동을 중심으로 -)

  • Bae, Jae-Soo
    • Journal of Korean Society of Forest Science
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    • v.98 no.1
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    • pp.55-65
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    • 2009
  • Annex I parties continued its consideration of how to address, the definitions, modalities, rules and guidelines for the treatment of Land Use, Land-use Change and Forestry (LULUCF) in the second commitment period of the Kyoto Protocol by the year of 2009. In the AWG-KP conference held in Accra, Ghana in 2008, four alternatives (gross-net carbon accounting, net-net with base year or base period accounting, net-net with forward looking baseline accounting, and land-based accounting method) for negotiations were decided in order to revise gross-net accounting method applied during the first commitment period of the Kyoto Protocol. In this study, alternative scenarios are set in consideration with reporting system (voluntary or compulsory), discount factors and cap about these three alternatives except for the method of net-net with forward looking baseline accounting, and then estimates the Removal Unit (RMU) among the countries. In the case that article 3.4 activities under the Kyoto Protocol revises from voluntary reporting to mandatory reporting, it is estimated that the loss of RMU would be huge in Russia, Australia, New Zealand, as well as Canada potentially. Net-net with base year or base period carbon accounting and land-based carbon accounting method have big difference of RMU in accordance with the base year or the base period. So the more unfavorable the country with a lot of old-age forests was, the closer the base year or period comes to the commitment period in the context of RMU. If it is getting lowered for the current rate of 85% in discount factors, RMU is getting higher to the whole countries. Therefore in Korea with little potential for afforestation and reforestation, there was the most sensitive response to the change of discount factors. Post-2012 LULUCF hereafter, it is strongly expected for the succession of current carbon accounting system which is voluntary reporting of gross-net carbon accounting and the activity for article 3.4. Other carbon accounting method is hard to accept in aspect that there is big differentiated interests among the countries and it is required enormous cost and time to develop reliable method. Provide for Post-2012 mandatory greenhouse gas reduction, Korea needs to have a competitive negotiation strategies differentiated from Annex I countries. The most reliable alternative would be to lower the discounting factors about the activities for forest management.

A Study on Design of Agent based Nursing Records System in Attending System (에이전트기반 개방병원 간호기록시스템 설계에 관한 연구)

  • Kim, Kyoung-Hwan
    • Journal of Intelligence and Information Systems
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    • v.16 no.2
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    • pp.73-94
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    • 2010
  • The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.

Exploring the level of nature of science and its degree of revising curriculums: The case of the 7th and 2009 revised curriculums (교육과정 개정에 따른 과학의 본성 수준 및 반영정도 탐색 : 7차 및 2009 개정교육과정사례 분석)

  • Lee, Jeong-Won;Park, Young-Shin;Jeong, Da-Hye
    • Journal of the Korean Society of Earth Science Education
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    • v.9 no.2
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    • pp.217-232
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    • 2016
  • In line with the emphasis on the importance of nature of science recently, this paper examines the degree and level at which the 2009-revised convergence science textbook, developed from the common science under the 7th curriculum in South Korea, reflected nature of science according to the development of curriculum. 'Nature of science' was classified according to scientific view - which represents scientists' view - and naive view - which represents general thinking and scientific error concepts. Also, 'Nature of science' was classified according to the explicit method and implicit method in terms of teaching method. The level of nature of science was defined using the four occasions of scientific view, naive view, explicit teaching and implicit teaching. In order to identify the components and level of nature of science reflected in the textbook, using the 10 items which refer to Lederman(2001)'s 7 definitions, NOSAT (Nature of Science Analyzing Tool) was developed and used. The results are that, since the educational curriculum is changed from common science under 7th curriculum to 2009-revised convergence science, the degree of reflection was rather a withdrawal. On parts of theories of 7th common science curriculum except research parts, it was difficult to find explicit nature of science. Also on 2009-revised curriculum, nature of science, which is seen on 2007 curriculum, disappeared. It is suggested that the future curriculum emphasizes the importance of nature of science, and bolster the reflection of nature of science according to the changing curriculum. Nature of science should not be expressed limitedly, but instead, should be more positively reflected, and the reflection method should be not implicit but explicit, allowing direct teaching. Towards that end, writers of the textbook should have an accurate understanding of nature of science. And, for the right teaching, teachers' capabilities are important and it is necessary to train teachers to understand and act for nature of science.

Critiques of 'The Endangered and Protected Wild Species List in Korea' Proposed by Korea Ministry of Environment and Listing Process - Is This the Best Process for the Current National Management of Endangered Wildlife and Plants in Korea? - (2011년 환경부 멸종위기종 등록절차 및 대상 멸종위기종 식물 목록 재고-과연 현재 국가 멸종위기종 관리가 최선의 방안인가? -)

  • Kim, Hui;Lee, Byong Cheon;Kim, Yong Shik;Chang, Chin-Sung
    • Journal of Korean Society of Forest Science
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    • v.101 no.1
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    • pp.7-19
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    • 2012
  • After having announced legislation for threatened or endangered species on the List of Endangered and Threatened Wildlife and Plants in 2005, the Korea Ministry of Environment proposed (in June 2011) amending the list, thereby delisting or reclassifying endangered species using new quantitative criteria for two levels (I and II), as well as status reviews. The new legislation included 40 species remained in their original endangered status, but 19 species were delisted, 5 species were proposed as candidates for delisting, 29 species were given a new endangered listing, and 3 species were proposed for an endangered listing in Korea. We assessed the threatened status of 98 plants using the IUCN Red List Criteria (version 3.1) at the global level, and compared the Ministry's revised criteria with the IUCN Red List Criteria and ESA criteria used in the USA. Most species proposed by the Ministry do not qualify as threatened and one of the major difficulties found in applying IUCN Red List Criteria at the global scale was a lack of knowledge on the status of species at broader geographic scales and the perceived difficulty this causes. Under the current classification process, many endangered species, such as Abeliophyllum distichum, Leontice microrhyncha, Echinosophora koreensis, Leontopodium coreanum, Iris odaesanensis, and Corylopsis coreana at global level were excluded here. Knowledge gaps and uncertainties mean that the number of taxa at high risk of extinction may be substantially greater than is currently understood. Due to a lack of information on its taxonomic status, currently there is controversy over the Red List status of Physocarpus insularis. Also, Caragana koreana, which was an invalidly published name, should be excluded here. Although the Korea Ministry of Environment insisted this procedure was conducted by applying the modified IUCN threat categories and definitions, this evaluation has been carried out based only on subjective views and misapplication of the IUCN Red List Criteria. The current listings by the Korea Ministry of Environment should be challenged. We suggest that broad species concepts on endemic species are applied and also criteria that adequately address the proper quantitative knowledge should be used. It is suggested that the highest priorities for the Red List should be given to endemic species at least in the Korean peninsula first at global scale.

The Significance of VEGF Expression in Stage II Carcinoma of Uterine Cervix Treated with Definitive Radiotherapy (자궁경부암 환자의 근치적 방사선치료 시 VEGF 발현의 임상적 의의)

  • Park Won;Choi Yoon-La;Huh Seung-Jae;Yoon Sang-Min;Park Young-Je;Nam Hee-Rim;Ahn Yong-Chan;Lim Do-Hoon;Park Hee-Chul
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.37-43
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    • 2006
  • Purpose: We wanted to determine the clinical characteristics and prognosis according to the VEGF expression in stage II cervical carcinoma patients treated with definitive radiotherapy. Materials and Methods: We enrolled 31 patients who were diagnosed with cervical cancer from 1995 to 2003 at Samsung Medical Center and their paraffin block tissue samples were available for study. The median age of the patients was 65 years. The mean tumor size was 4.1 cm $(range:\;1.2{\sim}8.2cm)$. Seven patients (22.6%) were suspected of having pelvic lymph node metastasis. An external beam irradiation dose of 45-56.4 Gy was administered to the whole pelvis with a 15 MV linear accelerator, and an additional 24 Gy was given to point A by HDR intracavitary brachytherapy. VEGF staining was defined as positive when more than 10% of the tumor cells were stained. The median follow-up duration was 58 months. Results: A positive VEGF expression was observed in 21 patients (67.7%), There was no significant correlation between the VEGF expression and pelvic lymph node metastasis, tumor size and the response of radiotherapy. During follow-up, 7 patients had recurrence. The complete response rate was not significant between the VEGF(-) and VEGF(+) tumors. However, the VEGF(+) tumors showed a significantly higher recurrence rate in comparison with the VEGF(-) tumors (p=0.040), The three year disease-free survival rates were 100% and 66.7%, respectively, for patients with VEGF(-) or VEGF(+) tumor (p=0.047), Conclusion: The VEGF expression was a significant factor for recurrence and disease-free survival. However, the significance of the VEGF expression is still controversial because of the various definitions of VEGF expression and the mismatches of the clinical data in the previous studies.

Definition of Child and Youth Welfare and Proposals for the Reform of Legal System (아동·청소년 복지의 개념과 법체계의 개선방안)

  • Cho, Sung-Hae
    • Journal of Legislation Research
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    • no.41
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    • pp.43-85
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    • 2011
  • Child and youth welfare law in Korea is vague and complex. In a narrow sense it means the research on the provisions of the Child Welfare Act. In a broad sense it embraces all of the social welfare system regarding to the protection for children and youth. Regardless of the scope of child and youth welfare law it should be cleared what the term of child and youth means in Korean legal regulation. Historically, child protection in Korea was based on the good intentions of individuals to protect war orphan children from poverty or danger after the end of the Korean War. It is the story of the evolving status of children from being viewed as dependant of the parents to becoming rights-based citizens, even not in Constitution. In Korea neither parents nor children have constitutionally recognized right. According to Korean Constitution the parents have only the obligation to educate their children. And the state ist obliged to improve the welfare of the youth(section 34). In compliance with this article there are lots of statutes regulating youth welfare. This article reviews the legal definition of child and youth to test the uncertain definition of child and youth welfare in relation to the treatment of children's and youth's legal status in Korea. According to the Child Welfare Act child is the person under age of 18, while the legal definition of youth oscillates between the person under the age of 19 and the person over the age 9 to the age of 23. As a result child welfare is often used as the synonym of youth welfare, and vice versa. The lack of the arrangement of the legal definition of child and youth is based on the historical reasons that the legal definitions of youth (under the age of 19 or over the age 9 to the age of 23) newly appeared in the statutes regulating youth welfare, whereas the Child Welfare Act still maintained the definition of child under the age of 18. In order to get rid of the confusion of the definition of the child and youth, a part of certain statues should combine with another Act according to the purpose of the individual amended statutes. And the definition of child and youth should be subdivided into 3 or 4 classes, namely infant(0-6), child(7-13), youth(14-18) and young adult(19-26). Furthermore this article proposes a reform of the existing legal system pursuant to the nature of the law, i.g. whether the issued or amended Act takes on a selective(residual) or universal character.

Recognition and Narrative Aspects of the History of Korean Classic Literature from Two Korean Literature History Works Written in China (중국 한국문학사 2종의 한국고전문학사 인식과 서술 양상: 남북한문학사와 자국문학사의 수용과 변용을 중심으로)

  • Lee, Deung-yearn
    • Cross-Cultural Studies
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    • v.48
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    • pp.67-106
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    • 2017
  • This study focuses on two specific history of Korean literature in Chinese: the outline of The History of Joseon Literature (2010) by Li Yan and The History of Joseon Literature (1988, 2008) by Wei Xu-sheng; it was conducted to compare narrative viewpoints to the history of South and North Korean literature and therefore identify distinguishable characteristics. As a result, the following was concluded. First, The History of Korean Literature by Cho Dong-il and The History of Korean Literature in North Korea (15 volumes) include thorough discussions on division of historical eras, concept of genres as well as individual literary works and applied such discussions on writing literary history. However, Wei Xu-sheng and Li Yan's The History of Korean Literature did not illuminate theoretical discussion of South and North Korea. Li Yan's outline of The History of Joseon Literature was published in 2010 and the first edition of Wei Xu-sheng's The History of Joseon Literature was published in 1986 and later was published as revised editions in 2000 and 2008. Regarding published dates, it is a matter of course to reference Cho Dong-il's The History of Korean Literature, published in the 1980s, or The History of Korean Literature in North Korea (15 volumes), published in the 1990s; nevertheless, neither Wei Xu-sheng nor Li Yan used those texts in their works. Their works were heavily influenced by the narrative tradition of the history of national literature and therefore, entailed unsophisticated discussion on the division of historical eras or the concept of genres. Second, those two texts also emphasized external factors such as politics, society, economy and culture and explicitly mention these factors in historical overview of each chapter. Such an approach is commonly used in narratives of literary history under socialist regimes, including The History of Korean Literature in North Korea (15 volumes). Accordingly, evaluations based on 'political standards' - stress of people, nationality, practicality and so forth - in main texts are particularly accentuated, akin to narratives of literary history under socialist regimes. Finally, since those two Korean literature history works are written by Chinese scholars, they focus on correlation between Chinese literature history and Korean literature history. However, several genre-related terminologies such as Xiaopin (a kind of essay), Yuefu (a kind of popular song/poem), Yuyan (fable), Shuochang (telling of popular stories with the interspersal songs), Shizhuan (biography or/and memoirs in history) were adopted directly from Chinese literature. In analyzing Korean literature using terminologies introduced from Chinese literature, differences between original and alternative definitions were not examined in detail. While some terminologies and concepts were adopted directly without further consideration as to state of the two nations, it is also interesting to note that dichotomy, mainly used in Korean literature history, was used to discuss the genre of Cheonki (romance tale), relevant to Suyichon and Keumosinhua, rather than follow traditions of Chinese literature history.