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Esophageal Atresia and Tracheoesophageal Fistula in Korea - A National Survey of Its Members by the Korean Association of Pediatric Surgeons - (선천성 식도 무공증 및 기관식도 누공 - 대한 소아외과학회 회원을 대상으로 한 전국 조사 -)

  • Park, W.H.;Kwon, S.I.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, H.H.;Park, K.W.;Park, Y.S.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Lee, S.K.;Lee, T.S.;Chang, S.I.
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.149-161
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    • 1995
  • The first national survey on esophageal atresia and tracheoesophageal fistula was conducted to access the current status of its incidence, clinical manifestation, preoperative diagnosis and management, type of its anomaly, associated anomalies, and surgical results and course. The 43 members of the Korea Association of Pediatric Surgeons received questionnaires and registration forms to be filled out on each patient who were born during the three years from January 1, 1992 through December 31, 1994. Questionnaires composed of six broad areas which include 1) preoperative diagnosis and management, 2) surgical technic, 3) long gap, 4) postoperative management, and 5) complications and courses. A total of 148 cases was returned by 28 members working at 23 institutions and 27 members returned questionnaires. We obtained the following results by analysis of the 148 cases of tracheoesophageal anomalies. The incidence of tracheoesophageal anomaly was about 1/10,000-11,000 in 1994, which is one third of that of anorectal malformations in Korea and the distribution of the patients was almost proportionate to the size of each province. Both sexes are about equally affected. Majority of the members make diagnosis of tracheoesophageal anomaly by taking a simple infantogram with a radiopaque tube in upper pouch and a little under half(46%) prefers to perform echocardiography as a part of preoperative management to identify congenital heart disease and lateralize the aorta. Esophageal atresia with distal TEF(87.5%) was by far the most common and there were pure esophageal atresia(5.6%), H-type TEF(2.1%), and so on. About half(49%) of the patients had one or more associated anomalies in addition to tracheoesophageal anomalies. Congenital heart disease was associated in 46 cases(31%), anorectral malfomations in 19 cases(13%), musculoskeletal anomalies in 15 cases(10%), genitourinary anomalies in 10 cases(7%) and gastrointestinal anomalies in 7 cases(5%). Postoperatively, parenteral nutrition and assisted ventilation were given in 66% and 52% of patients respectively. Ninety three(74%) of 126 cases who underwent sugical procedure, experienced one or more complications such as respiratory complication(65%), leak(22%), stricture(21%) and so on. The survival rates related to the Waterston risk categories were 90.2% in group A, 71.4-75% in $B_1$, $B_2$, and $C_1$, groups, and 28% in group $C_2$, and the overall survival rate was 71.4%. Thirty six(28.6%) of 126 cases died of pneumonia/sepsis(12 cases), respiratory failure(12 cases), and congenital heart disease(4 cases). With short term follow-up, 69% of patients have been excellent whereas remainders of the cases have suffered from some sort of morbidity related to gastroesophageal reflux, recurrent respiratory infection, and esophageal stricture.

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Juvenile-Mature Correlation of the Tree Growth (임목성장량(林木成長量)의 조기추정(早期推定)에 관(關)한 연구(硏究))

  • Yim, Kyong Bin;Lee, Yo Ha;Kwon, Ki Won;Kim, Zin Suh
    • Journal of Korean Society of Forest Science
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    • v.30 no.1
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    • pp.30-41
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    • 1976
  • The workers involved in breeding the growth of forest trees as well as in the efficiency of breeding work wish to find out the evidence that juvenile-mature correlations are high and that therefore early tests can be profitably employed in relation work. Juvenile-mature correlation denotes in general sense the interdependence between qualitative or quantitative data collected at different intervals during the life cycle. The correlation can also be obtained through the stem analysis if there is the possibility of cutting sample trees needed amount. In the present study, the juvenile-mature correlation coefficients are calculated from the stem analysis data. The every possible values of correlation coefficient between the 5-year age groups as to diameter, height, and volume growth of Pinus koraiensis S. et Z. and Larix leptolepis Gord. grown in the middle district of Korea were calculated. All the sample trees were cut from the man made plantation. The correlation coefficients are presented in tables and figures. In Pinus koraiensis S. et Z., the values of correlation coefficient between the successive age groups of heights growth are lower in general than those values pertaining to diameter growth. This tendencies are indifferent to site quality. In Larix leptolepis Gord., the values were lower thant these of Pinus koraiensis S.etZ. In any species and characteristics studied, the implications that at least 15 years growth character are related to 35 or 40 years size with reliability could be deduced. Through the relative ranking studies of diameter, height and volume growth of Larix leptolepis Gord., the large varieties among individual trees are appeared during 5-year to 35 year old.

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The Satisfaction of Inpatient Families and Bereaved Families in the Hospice Service (호스피스 병동에 입원한 환자 가족과 사별 가족의 만족도)

  • Park, Theresia;Ra, Jeong-Ran;Seo, In-Ok;Cho, Young-Yee;Choi, Suk-Kyung;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.91-100
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    • 1999
  • Purpose : This study was performed to investigate the satisfaction in the hospice services provided for inpatient families and bereaved families whose members had been admitted to the hospice unit at Kangnam St. Mary's Hospital to improve the quality of care for the terminally ill patients and their families. Methods : This sample consisted of 33 families of hospice patients during the period of April to lune, 1998 and 30 bereaved families whose patients had died from March, 1993 to March, 1998. The data were collected through a self-report questionnaire and analyzed using t-test and ANOVA. Results : 1) The satisfaction level of inpatient families and bereaved families showed the mean value of 3.5 where the highest value is 5.0. 2) According to age, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management(P=0.0001). The level of satisfaction of bereaved families showed significant differences in the field of support for the family, medical management, nursing management, and facilities of the hospice unit(P=0.0001). 3) By family relationship, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management (P=0.0001). 4) According to religion, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family and nursing management (P=0.0001), but there was no significant difference for the bereaved families. Conclusions : The findings of this study showed that hospice services had positive influence on families with terminal disease such as cancer. To improve the level of satisfaction in the hospice services for families with hospice patients, we need to provide care by an interdisciplinary hospice team approach, and to assess needs of the families according to their socio-psychological characteristics. Further studies need to be conducted with large samples.

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A study on accuracy and application of the implant torque controller used in dental clinic (임상에서 사용하고 있는 임플란트 토크조절기의 정확도와 적용에 관한 사용실태)

  • Joo, Young-Hun;Lee, Jin-Han
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.3
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    • pp.197-205
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    • 2011
  • Purpose: This study was to evaluate the accuracy of the implant torque controller used in dental clinics and to investigate whether it was applied appropriately. Materials and methods: Fifty dentists who work in dental clinics were enrolled in this study. Dental (implant) practice career, experience frequency of implant screw loosening and fracture, education of implant torque controller application and infection control methods were included in the survey. 25 Ncm and 30 Ncm of the tightening torque applied to the implant screw were measured by 50 clinicians. After measuring the torque value by using the torque controller, the torque mean according to where education about the implant torque controller was received was analyzed with independent t-test at the significance level of 0.05. Results: The torque controller used in private dental clinics showed 4.78% error ratio. When 50 dentists applied 25 Ncm to the implant screw was $29.0{\pm}8.4$ Ncm, and that in 30 Ncm was $34.3{\pm}9.1$ Ncm. Statistical significance was found between the group that was educated about implant torque application and the group that was not educated. Conclusion: During the prosthodontic treatment with implant, there was difference between actual applied torsion force and the amount torque controller indicated. Clinicians have to not only be well-informed about the accurate usage method of the torque controller, but also keep and manage the torque controller so as to maintain continuous and accurate torque values. Through this, it is considered to achieve clinical results to minimize problems of screw loosening or fracture.

Limb Salvage in the Treatment of the Upper Extremity Bone Tumors (상지에 발생한 악성 및 침윤성 양성골종양에 대한 사지 구제술)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bum-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.154-163
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    • 1995
  • With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

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An Evaluation Model for Software Usability using Mental Model and Emotional factors (정신모형과 감성 요소를 이용한 소프트웨어 사용성 평가 모델 개발)

  • 김한샘;김효영;한혁수
    • Journal of KIISE:Software and Applications
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    • v.30 no.1_2
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    • pp.117-128
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    • 2003
  • Software usability is a characteristic of the software that is decided based on learnability, effectiveness, and satisfaction when it is evaluated. The usability is a main factor of the software quality. A software has to be continuously improved by taking guidelines that comes from the usability evaluation. Usability factors may vary among the different software products and even for the same factor, the users may have different opinions according to their experience and knowledge. Therefore, a usability evaluation process must be developed with the consideration of many factors like various applications and users. Existing systems such as satisfaction evaluation and performance evaluation only evaluate the result and do not perform cause analysis. And also unified evaluation items and contents do not reflect the characteristics of the products. To address these problems, this paper presents a evaluation model that is based on the mental model of user and the problems, this paper presents a evaluation model that is based on the mental model of user and the emotion of users. This model uses evaluation factors of the user task which are extracted by analyzing usage of the target product. In the mental model approach, the conceptual model of designer and the mental model of the user are compared and the differences are taken as a gap also reported as a part to be improved in the future. In the emotional factor approach, the emotional factors are extracted for the target products and evaluated in terms of the emotional factors. With this proposed method, we can evaluate the software products with customized attributes of the products and deduce the guidelines for the future improvements. We also takes the GUI framework as a sample case and extracts the directions for improvement. As this model analyzes tasks of users and uses evaluation factors for each task, it is capable of not only reflecting the characteristics of the product, but exactly identifying the items that should be modified and improved.

Improvement of infrared channel emissivity data in COMS observation area from recent MODIS data(2009-2012) (최근 MODIS 자료(2009-2012)를 이용한 천리안 관측 지역의 적외채널 방출률 자료 개선)

  • Park, Ki-Hong;Suh, Myoung-Seok
    • Korean Journal of Remote Sensing
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    • v.30 no.1
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    • pp.109-126
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    • 2014
  • We improved the Land Surface Emissivity (LSE) data (Kongju National University LSE v.2: KNULSE_v2) over the Communication, Ocean and Meteorological Satellite (COMS) observation region using recent(2009-2012) Moderate Resolution Imaging Spectroradiometer (MODIS) data. The surface emissivity was derived using the Vegetation Cover Method (VCM) based on the assumption that the pixel is only composed of ground and vegetation. The main issues addressed in this study are as follows: 1) the impacts of snow cover are included using Normalized Difference Snow Index (NDSI) data, 2) the number of channels is extended from two (11, 12 ${\mu}m$) to four channels (3.7, 8.7, 11, 12 ${\mu}m$), 3) the land cover map data is also updated using the optimized remapping of the five state-of-the-art land cover maps, and 4) the latest look-up table for the emissivity of land surface according to the land cover is used. The updated emissivity data showed a strong seasonal variation with high and low values for the summer and winter, respectively. However, the surface emissivity over the desert or evergreen tree areas showed a relatively weak seasonal variation irrespective of the channels. The snow cover generally increases the emissivity of 3.7, 8.7, and 11 ${\mu}m$ but decreases that of 12 ${\mu}m$. As the results show, the pattern correlation between the updated emissivity data and the MODIS LSE data is clearly increased for the winter season, in particular, the 11 ${\mu}m$. However, the differences between the two emissivity data are slightly increased with a maximum increase in the 3.7 ${\mu}m$. The emissivity data updated in this study can be used for the improvement of accuracy of land surface temperature derived from the infrared channel data of COMS.

Factors Influencing Workers' Perception and Attitude Toward Special Periodic Health Screening Test (특수건강진단에 대한 근로자의 인식과 태도에 영향을 미치는 요인)

  • Nam, Si-Hyun;Kam, Sin;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.334-346
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    • 1995
  • To investigate the factors influencing workers' perception and attitude toward special periodic health screening test for workers, a survey with self-administered questionnaires was performed on 779 workers who had special periodic health screening test from September 1 to October 15, 1994. A study model was developed by modifying the health belief model. The end and intermediate response variables of the model were the voluntary participation and necessity perception on the special screening for workers. The result of analysis was consistent with the study model. Rates for the necessity perception and voluntary participation on the special screening for workers were 77.2%, 79.2%, respectively. Factors influencing on the voluntary participation were necessity perception, benefit of special screening for workers, and cue to action. And on the necessity perception were susceptibility and severity to occupational disease, knowledge to special screening for workers, and support of company. General and occupational characteristics influencing on the susceptibility and severity to occupational disease were sex, age, educational level, work duration, and health education. On the knowledge to special screening for workers were age, educational level, work duration, and locus-of-control. On the benefit of special screening for workers were age, locus-of-control, pride on health, and health education. Therefore, to increase the voluntary participation and necessity perception on the special periodic health screening for workers, 1) if a worker is judged as occupational disease, the judgment should be widely known in his workplace, 2) the screening result forms should be directly sent to the workers themselves, 3) for the positivity of employers, the campaign and education program subjected to them should be planned, 4) health education should give the first consideration to the younger, lower educational level, and newly employed women, and its frequency should be increased and it should be more frequently dealt with occupation-related subjects, and 5) the employers should have a careful concern in not being disadvantageous to workers due to result of screening.

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A study of Brachytherapy for Intraocular Tumor (안구내 악성종양에 대한 저준위 방사선요법에 관한 연구)

  • Ji, Gwang-Su;Yu, Dae-Heon;Lee, Seong-Gu;Kim, Jae-Hyu;Ji, Yeong-Hun
    • The Journal of Korean Society for Radiation Therapy
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    • v.8 no.1
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    • pp.19-27
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    • 1996
  • I. Project Title A Study of Brachytherapy for intraocular tumor II. Objective and Importance of the project The eye enucleation or external-beam radiation therapy that has been commonly used for the treatment of intraocular tumor have demerits of visual loss and in deficiency of effective tumor dose. Recently, brachytherapy using the plaques containing radioisotope-now treatment method that decrease the demerits of the above mentioned treatment methods and increase the treatment effect-is introduced and performed in the countries, Our purpose of this research is to design suitable shape of plaque for the ophthalmic brachytherapy, and to measure absorbed doses of Ir-192 ophthalmic plaque and thereby calculate the exact radiation dose of tumor and it's adjacent normal tissue. III. Scope and Contents of the project In order to brachytherapy for intraocular tumor, 1. to determine the eye model and selected suitable radioisotope 2. to design the suitable shape of plaque 3. to measure transmission factor and dose distribution for custom made plaques 4. to compare with the these data and results of computer dose calculation models IV. Results and Proposal for Applications The result were as followed. 1. Eye model was determined as a 25mm diameter sphere, Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15mm, 17mm and 20mm in diameter, and 1.5mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within ${\pm}10\%$ and distance deviations are within 0.4mm Maximum error is $-11.3\%$ and 0.8mm, respectively. As a result of it, we can treat the intraocular tumor more effectively by using custom made gold plaque and Ir-192 seeds.

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Analysis of Radiation Treatment Planning by Dose Calculation and Optimization Algorithm (선량계산 및 최적화 알고리즘에 따른 치료계획의 영향 분석)

  • Kim, Dae-Sup;Yoon, In-Ha;Lee, Woo-Seok;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.137-147
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    • 2012
  • Purpose: Analyze the Effectiveness of Radiation Treatment Planning by dose calculation and optimization algorithm, apply consideration of actual treatment planning, and then suggest the best way to treatment planning protocol. Materials and Methods: The treatment planning system use Eclipse 10.0. (Varian, USA). PBC (Pencil Beam Convolution) and AAA (Anisotropic Analytical Algorithm) Apply to Dose calculation, DVO (Dose Volume Optimizer 10.0.28) used for optimized algorithm of Intensity Modulated Radiation Therapy (IMRT), PRO II (Progressive Resolution Optimizer V 8.9.17) and PRO III (Progressive Resolution Optimizer V 10.0.28) used for optimized algorithm of VAMT. A phantom for experiment virtually created at treatment planning system, $30{\times}30{\times}30$ cm sized, homogeneous density (HU: 0) and heterogeneous density that inserted air assumed material (HU: -1,000). Apply to clinical treatment planning on the basis of general treatment planning feature analyzed with Phantom planning. Results: In homogeneous density phantom, PBC and AAA show 65.2% PDD (6 MV, 10 cm) both, In heterogeneous density phantom, also show similar PDD value before meet with low density material, but they show different dose curve in air territory, PDD 10 cm showed 75%, 73% each after penetrate phantom. 3D treatment plan in same MU, AAA treatment planning shows low dose at Lung included area. 2D POP treatment plan with 15 MV of cervical vertebral region include trachea and lung area, Conformity Index (ICRU 62) is 0.95 in PBC calculation and 0.93 in AAA. DVO DVH and Dose calculation DVH are showed equal value in IMRT treatment plan. But AAA calculation shows lack of dose compared with DVO result which is satisfactory condition. Optimizing VMAT treatment plans using PRO II obtained results were satisfactory, but lower density area showed lack of dose in dose calculations. PRO III, but optimizing the dose calculation results were similar with optimized the same conditions once more. Conclusion: In this study, do not judge the rightness of the dose calculation algorithm. However, analyzing the characteristics of the dose distribution represented by each algorithm, especially, a method for the optimal treatment plan can be presented when make a treatment plan. by considering optimized algorithm factors of the IMRT or VMAT that needs to optimization make a treatment plan.

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