• Journal of Trauma and Injury
• /
• v.25 no.2
• /
• pp.49-56
• /
• 2012

Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

• Investigative Magnetic Resonance Imaging
• /
• v.18 no.4
• /
• pp.314-322
• /
• 2014

Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

• Food Science and Preservation
• /
• v.16 no.5
• /
• pp.629-635
• /
• 2009

We investigated the prolongation of freshness and quality during storage of muskmelons harvested at different times and treated with 1-MCP. The weight loss rate increased in all samples as the storage period was extended, although the weight loss of 1-MCP-treated samples was lower than that of controls, regardless of the degree of maturation. Additionally, the hardness of 1-MCP-treated samples was higher than that of controls, again independent of maturation stage. Specifically, 1-MCP treatment delayed softening of muskmelons, as 1-MCP- treated samples showed a high hardness value after 22 days of storage, whereas hardness of control samples decreased rapidly after 10 days. The soluble solid level in muskmelons harvested 92 days after planting was $14.3^{\circ}$ Brix, whereas that of fruit harvested after 90 days was $12.7^{\circ}$ Brix. There was no significant difference in the acidity of 1-MCP-treated samples and controls after 7 days of storage, although the acidity of 1-MCP-treated fruit was greater than that of controls after 13 days, regardless of the degree of maturation. The L-values (lightness) of 1-MCP treated samples were higher than those of controls for the first 10 days of storage, but the reverse was true after 13 days of storage. The b-values (yellowness) were high in control fruits during the initial period of storage, but greater in 1-MCP treated samples after 19 days of storage. The respiration rate of 1-MCP treated samples was lower than that of controls, regardless of the degree of maturation. Sensory evaluation revealed that the texture of control fruit decreased as storage time rose, whereas that of 1-MCP-treated samples did not fall until 28 or 34 days of storage (p<0.05). Overall acceptability based on a marketable score of 5 points showed that 1-MCP-treated muskmelons scored higher than controls, and remained fresher on storage.

• Restorative Dentistry and Endodontics
• /
• v.24 no.2
• /
• pp.299-309
• /
• 1999

The composite resin, due to its esthetic qualities, is considered the material of choice for restoration of anterior teeth. With respect to shade control, the direct-placement resin composites offer some distinct advantages over indirect restorative procedures. Visible-light-cured (VLC) composites allow dentists to match existing tooth shades or to create new shades and to evaluate them immediately at the time of restoration placement. Optimal intraoral color control can be achieved if optical changes occurring during application are minimized. An ideal VLC composite, then, would be one which is optically stable throughout the polymerization process. The shade guides of the resin composites are generally made of plastic, rather than the actual composite material, and do not accurately depict the true shade, translucency, or opacity of the resin composite after polymerization. So the numerous problems associated with these shade guides lead to varied and sometimes unpredictable results. The aim of this study was to assess the color changes of current resin composite restorative materials which occur as a result of the polymerization process and to compare the color differences between the shade guides provided with the products and the actual resin composites before- and after-polymerization. The results obtained from this investigation should provide the clinician with information which may aid in improved color match of esthetic restoration. Five light activated, resin-based materials (${\AE}$litefil, Amelogen Universal, Spectrum TPH VeridonFil-Photo, and Z100) and shade guides were used in this study. Three specimens of each material and shade combination were made. Each material was condensed inside a 1.5mm thick metal mold with 10mm diameter and pressed between glass plates. Each material was measured immediately before polymerization, and polymerized with Curing Light XL 3000 (3M Dental products, USA) visible light-activation unit for 60 seconds at each side. The specimens were then polished sequentially on wet sandpaper. Shade guides were ground with polishing stones and rubber points (Shofu) to a thickness of approximately 1.5mm. Color characteristics were performed with a spectrophotometer (CM-3500d, Minolta Co., LTD). A computer-controlled spectrophotometer was used to determine CIELAB coordinates ($L^*$, $a^*$ and $b^*$) of each specimen and shade guide. The CIELAB measurements made it possible to evaluate the amount of the color difference values (${\Delta}E{^*}ab$) of resin composites before the polymerization process and shade guides using the post-polishing color of the composite as a control, CIE standard D65 was used as the light source. The results were as follows. 1. Each of the resin composites evaluated showed significant color changes during light-curing process. All the resin composites evaluated except all the tested shades of 2100 showed unacceptable level of color changes (${\Delta}E{^*}ab$ greater than 3.3) between pre-polymerization and post-polishing state. 2. Color differences between most of the resin composites tested and their corresponding shade guides were acceptable but those between C2 shade of ${\AE}$litefil and IE shade of Amelogen Universal and their respective shade guides exceeded what is acceptable. 3. Comparison of the mean ${\Delta}E{^*}ab$ values of materials revealed that Z100 showed the least overall color change between pre-polymerization and post-polishing state followed by ${\AE}$litefil, VeridonFil-Photo, Spectrum TPH, and Amelogen Universal in the order of increasing change and Amelogen Universal. Spectrum TPH, 2100, VeridonFil-Photo and ${\AE}$litefil for the color differences between actual resin and shade guide. 4. In the clinical environment, the shade guide is the better choice than the shade of the actual resin before polymerization when matching colors. But, it is recommended that custom shade guides be made from resin material itself for better color matching.

• Journal of the Korean earth science society
• /
• v.42 no.5
• /
• pp.524-535
• /
• 2021

Rapid climate change and oceanic warming have increased the variability of oceanic wave heights over the past several decades. In addition, the extreme wave heights, such as the upper 1% (or 5%) wave heights, have increased more than the heights of the normal waves. This is true for waves both in global oceans as well as in local seas. Satellite altimeters have consistently observed significant wave heights (SWHs) since 1991, and sufficient SWH data have been accumulated to investigate 100-year return period SWH values based on statistical approaches. Satellite altimeter data were used to estimate the extreme SWHs at the Ieodo Ocean Research Station (IORS) for the period from 2005 to 2016. Two representative extreme value analysis (EVA) methods, the Initial Distribution Method (IDM) and Peak over Threshold (PoT) analysis, were applied for SWH measurements from satellite altimeter data and compared with the in situ measurements observed at the IORS. The 100-year return period SWH values estimated by IDM and PoT analysis using IORS measurements were 8.17 and 14.11 m, respectively, and those using satellite altimeter data were 9.21 and 16.49 m, respectively. When compared with the maximum value, the IDM method tended to underestimate the extreme SWH. This result suggests that the extreme SWHs could be reasonably estimated by the PoT method better than by the IDM method. The superiority of the PoT method was supported by the results of the in situ measurements at the IORS, which is affected by typhoons with extreme SWH events. It was also confirmed that the stability of the extreme SWH estimated using the PoT method may decline with a decrease in the quantity of the altimeter data used. Furthermore, this study discusses potential limitations in estimating extreme SWHs using satellite altimeter data, and emphasizes the importance of SWH measurements from the IORS as reference data in the East China Sea to verify satellite altimeter data.

• The Journal of Korean Philosophical History
• /
• no.23
• /
• pp.99-128
• /
• 2008

This research analyzes some Korean historical figures and presents the core values of their leaderships so that we can bring up the theory of leadership which would be compatible with the current circumstances around Korea. Through this work, we expected that we would not only find out typical examples among historical leaders but also reaffirm our identities in our history. As a result of the research, it was possible to classify some figures in history into several patterns and discover their archetypal qualities. Those qualities were 'transform(實事)', 'challenge(決死)', 'energize(風流)', 'create(創案)', and 'envision(開新)' respectively. Among the qualities, this research concentrated on the quality of 'challenge', exclusively 'death-defying spirit'. This spirit is the one with which historical leaders could sacrifice their lives for their great causes. This research selected twelve figures as incarnations of death-defying spirit, who are Gyebaek(階伯), Ganggamchan(姜邯贊), Euljimundeok(乙支文德), Choeyoung(崔瑩),ChungMongju(鄭夢周), Seongsammun (成三問), Yisunsin(李舜臣), Gwakjaewoo(郭再祐), Choeikhyeon(崔益鉉), Anjunggeun(安重根), Yunbonggil(尹奉吉), Yijun(李儁). Through analyzing their core values and abilities and categorizing some historical cases into four spheres such as a private sphere, relations sphere, a community sphere, and a society sphere, we came to find a certain element in common among those figures. It was that they eventually took the lead by showing the goal and the ideal to their people at all times. Moreover, their goals were always not only obvious but also unwavering. In the second chapter, I described the core value in a private sphere, so called '志靑靑'. It implies that a leader should set his ultimate goal and then try to attain it with an unyielding will. Obvious self-confidence and unfailing self-creed are core values in a private sphere. In the third chapter, I described the core value in a relative sphere, the relationship between one and others. It is '守信結義'. It indicates that a leader should win confidence from others by discharging his duties in the relation with others. Confidence is the highest leveled affection to others. Thus, mutual reliance should be based on truthful sincerity and affection toward others. Stubbornness and strictness are needed not to be prompted by pity simultaneously. In the fourth chapter, I described the core value in a community sphere. It is '丹心合力'. For this value, what are required to a leader are both his community spirit and his loyalty to one's community. Moreover, the strong sense of responsibility and the attitude of taking an initiative among others are also required. Thus, it can be said that the great power to conduct the community is so called fine teamwork. What's more, the attitude of the leader can exert a great influence on his community. In the fifth chapter, I described the core value of death defying spirit in the society sphere. This value might be more definite and explicit than other ones described above. A leader should prepare willingly for one's death to fulfill his great duties. 'What to do' is more important for a leader than 'how to do'. That is to say, a leader should always do righteous things. Efficiency is nothing but one of his interests. A leader must be the one who behaves himself always according to righteousness. Unless a leader's behaviors are based on righteousness, it is absolutely impossible that a leader exerts his leadership toward people very efficiently. Thus, it can be said that a true leader is the one not only who is of morality and but also who tries to fulfill his duties.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.6
• /
• pp.486-491
• /
• 2004

Purpose: factor analysis and independent component analysis (ICA) has been used for handling dynamic image sequences. Theoretical advantages of a newly suggested ICA method, ensemble ICA, leaded us to consider applying this method to the analysis of dynamic myocardial $H_2^{15}O$ PET data. In this study, we quantified patients' blood flow using the ensemble ICA method. Materials and Methods: Twenty subjects underwent $H_2^{15}O$ PET scans using ECAT EXACT 47 scanner and myocardial perfusion SPECT using Vertex scanner. After transmission scanning, dynamic emission scans were initiated simultaneously with the injection of $555{\sim}740$ MBq $H_2^{15}O$. Hidden independent components can be extracted from the observed mixed data (PET image) by means of ICA algorithms. Ensemble learning is a variational Bayesian method that provides an analytical approximation to the parameter posterior using a tractable distribution. Variational approximation forms a lower bound on the ensemble likelihood and the maximization of the lower bound is achieved through minimizing the Kullback-Leibler divergence between the true posterior and the variational posterior. In this study, posterior pdf was approximated by a rectified Gaussian distribution to incorporate non-negativity constraint, which is suitable to dynamic images in nuclear medicine. Blood flow was measured in 9 regions - apex, four areas in mid wall, and four areas in base wall. Myocardial perfusion SPECT score and angiography results were compared with the regional blood flow. Results: Major cardiac components were separated successfully by the ensemble ICA method and blood flow could be estimated in 15 among 20 patients. Mean myocardial blood flow was $1.2{\pm}0.40$ ml/min/g in rest, $1.85{\pm}1.12$ ml/min/g in stress state. Blood flow values obtained by an operator in two different occasion were highly correlated (r=0.99). In myocardium component image, the image contrast between left ventricle and myocardium was 1:2.7 in average. Perfusion reserve was significantly different between the regions with and without stenosis detected by the coronary angiography (P<0.01). In 66 segment with stenosis confirmed by angiography, the segments with reversible perfusion decrease in perfusion SPECT showed lower perfusion reserve values in $H_2^{15}O$ PET. Conclusions: Myocardial blood flow could be estimated using an ICA method with ensemble learning. We suggest that the ensemble ICA incorporating non-negative constraint is a feasible method to handle dynamic image sequence obtained by the nuclear medicine techniques.

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.2
• /
• pp.363-368
• /
• 2014

Purpose : The aim of this study was to appraise properties for radiation therapy techniques and effectiveness of time and economy to a patient in the case of applying flattening filter-free (3F) and flattening filter (2F) beam to the radiation therapy. Materials and Methods : Alderson rando phantom was scanned for computed tomography image. Treatment plans for intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and stereotactic body radiation therapy (SBRT) with 3F and 2F beam were designed for prostate cancer. To evaluate the differences between the 3F and 2F beam, total monitor units (MUs), beam on time (BOT) and gantry rotation time (GRT) were used and measured with $TrueBeam^{TM}$ STx and Surveillance And Measurement (SAM) 940 detector was used for photoneutron emitted by using 3F and 2F. To assess temporal and economical aspect for a patient, total treatment periods and medical fees were estimated. Results : In using 3F beam, total MUs in IMRT plan increased the highest up to 34.0% and in the test of BOT, GRT and photoneutron, the values in SBRT plan decreased the lowest 39.8, 38.6 and 48.1%, respectively. In the temporal and economical aspect, there were no differences between 3F and 2F beam in all of plans and the results showed that 10 days and 169,560 won was lowest in SBRT plan. Conclusion : According as the results, total MUs increased by using 3F beam than 2F beam but BOT, GRT and photoneutron decreased. From above the results, using 3F beam can decrease intra-fraction setup error and risk of radiation-induced secondary malignancy. But, using 3F beam did not make the benefits of temporal and economical aspect for a patient with the radiation therapy.

• Archives of design research
• /
• v.17 no.2
• /
• pp.335-350
• /
• 2004

Design takes concrete form from the things which are not yet exist to the molded reality. Creation of value which is accompanied by the rational value could be possible only through the searching examination of the basic concept. All designs are under circumstances because the results and the character of the problems are different under the given conditions and circumstances which are the characteristic of the design. The aim of this study is searching for the differential design conce- pt which is the most appropriate and reasonable in the basic design process in which the phase of the analysis, synthesis and evaluation of the problem. First of all the pursuit value of the times and the change of the view point of value of the product design. How the pursuit value of times were searched and analyzed. Analyze the successful product design realization of the typical trend of the modern design which are 3-2. function-focused design, 3-3. emotion-centered design, 3-4. image communicative design through the metaphor, 3-5. environmental affinity design. On the base of the case analysis how to apply the differential design concept which is coming as a trend in the future society which are sustainable developing society was examined closely. The outcome through the analysis of the success cases are as follows, \circled1 the value of the spirit of the times should be emphasized as the design image, \circled2 environmental appropriateness should be taken into consideration as the first primary factor, \circled3 the realization of value of the fulfillment of differential consumer's needs, \circled4 lead to prolong the life cycle of the product, \circled5 promote the sustaining growth of enterprise, \circled6 user-centered product value should be the first consideration. \circled7 It is necessary to overcome the cultural andinguistic barriers and to reflect the metaphor which people remember well. \circled8 The application of human's true character should be decided beforehand. It is the commonness of values of times and customs. \circled9 The differentiated design concept which meets our mental satisfaction, not material one, will be required. In addition to this the creative and differentiated design concepts which are accompanied by the good design factor under the base of product could achieve the emotional consensus from the consumers. That is, the value of all designs should be estimated by the base of the humanism ' The human beings are the barometer of all things".ngs".uot;.

• Korean Journal of Poultry Science
• /
• v.37 no.4
• /
• pp.361-372
• /
• 2010

Serological evaluation for the poultry is important for various reasons, such as designing and assessing the vaccination program and diagnosing diseases and for this reason, serologic tests for the layer flocks have been conducted on a regular basis. Moreover, the nationwide serological survey and analysis are essential to understand the epidemiological status of national poultry industry. In this sense, the study was conducted to evaluate the immune status of the layer flocks with the sera submitted to Avian Disease Laboratory, Chungbuk National University in 2009, and several important viral diseases were selected for evaluation including low pathogenic avian influenza (LPAI), Newcastle disease (ND), infectious bronchitis (IB) and avian metapneumovirus (aMPV). For LPAI and ND, the age-related patterns of geometric mean titer (GMT) changes were similar but there were differences in the flock positive rate and the level of GMT due to the different vaccination policy. In the case of IB, the values of GMT showed that the field infection was more prevalent than expected. For aMPV, positive birds in a flock increased as the layers got older, which reflected the course of field infection because vaccination against aMPV was not allowed in 2009. From this study, the immune status for the main viral diseases in layers became more clarified but this information was limited because of only one year study. Therefore, serological survey needs to be conducted on a yearly basis and furthermore include broilers and breeders for a better understanding of the health status in the national poultry industry.