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The ages and stages questionnaire: screening for developmental delay in the setting of a pediatric outpatient clinic (ASQ :소아과외래에서의 발달지연 선별검사)

  • Kim, Eun Young;Sung, In Kyung
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1061-1066
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    • 2007
  • Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.

Comparison of Mitral Valve Repair between a Minimally Invasive Approach and a Conventional Sternotomy Approach (승모판 성형술에 있어 최초 침습적 수술방식과 고전적 정중 흉골 절개술을 통한 접근방식의 비교)

  • Cho, Won-Chul;Je, Hyoung-Gon;Kim, Jeong-Won;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.825-830
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    • 2007
  • Background: Minimally invasive cardiac surgery appears to offer certain advantages such as earlier postoperative recovery and a greater cosmetic effect than that achieved through conventional sternotomy. However, this approach has not yet been widely adopted in Korea to replace complex open heart surgery such as mitral valve reconstruction. This study compared the results of robot assisted minimally invasive mitral valve repair with those results of conventional sternotomy. Material and Method: From December 1993 to December 2005, 520 consecutive patients underwent mitral valve reconstruction for mitral regurgitation in our institution. These patients were subdivided according to those whose surgery used the conventional sternotomy approach (Group S, n=432) and those who underwent minimally invasive right anterior thoracotomy (Group M, n=88); we then compared the clinical results of both groups. When we performed minimally invasive right thoracotomy, we used a robot (AESOP 3000) and made an incision less than 5 cm. Result: Our study patients in both groups were similar for their age, gender and preoperative ejection fraction. There were two hospital mortalities in group S. but there was no mortality in the group M patients. Significant reductions in the ICU stay and the postoperative hospital stay were observed in the group M patients compared with the group S patients. However, both the bypass time and the aortic cross-clamp time were significantly longer in the group M patients. In spite of the confined incision in the group M patients, there were no limitations on the mitral valve repair techniques. There was a similar frequency of postoperative significant residual mitral regurgitation in both groups. Conclusion: In this study, the minimally invasive mitral valve repair showed comparable early results with the conventional sternotomy patients. We will now need long-term follow-up of these patients who underwent minimally invasive mitral valve repair, but we anticipate that based on the results of this study, we will begin to routinely perform minimally invasive cardiac surgery as out primary approach for mitral valve reconstruction.

Temporal Variations of Ore Mineralogy and Sulfur Isotope Data from the Boguk Cobalt Mine, Korea: Implication for Genesis and Geochemistry of Co-bearing Hydrothermal System (보국 코발트 광상의 산출 광물종 및 황동위원소 조성의 시간적 변화: 함코발트 열수계의 성인과 지화학적 특성 고찰)

  • Yun, Seong-Taek;Youm, Seung-Jun
    • Economic and Environmental Geology
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    • v.30 no.4
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    • pp.289-301
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    • 1997
  • The Boguk cobalt mine is located within the Cretaceous Gyeongsang Sedimentary Basin. Major ore minerals including cobalt-bearing minerals (loellingite, cobaltite, and glaucodot) and Co-bearing arsenopyrite occur together with base-metal sulfides (pyrrhotite, chalcopyrite, pyrite, sphalerite, etc.) and minor amounts of oxides (magnetite and hematite) within fracture-filling $quartz{\pm}actinolite{\pm}carbonate$ veins. These veins are developed within an epicrustal micrographic granite stock which intrudes the Konchonri Formation (mainly of shale). Radiometric date of the granite (85.98 Ma) indicates a Late Cretaceous age for granite emplacement and associated cobalt mineralization. The vein mineralogy is relatively complex and changes with time: cobalt-bearing minerals with actinolite, carbonates, and quartz gangues (stages I and II) ${\rightarrow}$ base-metal sulfides, gold, and Fe oxides with quartz gangues (stage III) ${\rightarrow}$ barren carbonates (stages IV and V). The common occurrence of high-temperature minerals (cobalt-bearing minerals, molybdenite and actinolite) with low-temperature minerals (base-metal sulfides, gold and carbonates) in veins indicates a xenothermal condition of the hydrothermal mineralization. High enrichment of Co in the granite (avg. 50.90 ppm) indicates the magmatic hydrothermal derivation of cobalt from this cooling granite stock, whereas higher amounts of Cu and Zn in the Konchonri Formation shale suggest their derivations largely from shale. The decrease in temperature of hydrothermal fluids with a concomitant increase in fugacity of oxygen with time (for cobalt deposition in stages I and II, $T=560^{\circ}C-390^{\circ}C$ and log $fO_2=$ >-32.7 to -30.7 atm at $350^{\circ}C$; for base-metal sulfide deposition in stage III, $T=380^{\circ}-345^{\circ}C$ and log $fO_2={\geq}-30.7$ atm at $350^{\circ}C$) indicates a transition of the hydrothermal system from a magmatic-water domination toward a less-evolved meteoric-water domination. Sulfur isotope data of stage II sulfide minerals evidence that early, Co-bearing hydrothermal fluids derived originally from an igneous source with a ${\delta}^{34}S_{{\Sigma}S}$ value near 3 to 5‰. The remarkable increase in ${\delta}^{34}S_{H2S}$ values of hydrothermal fluids with time from cobalt deposition in stage II (3-5‰) to base-metal sulfide deposition in stage III (up to about 20‰) also indicates the change of the hydrothermal system toward the meteoric water domination, which resulted in the leaching-out and concentration of isotopically heavier sulfur (sedimentary sulfates), base metals (Cu, Zn, etc.) and gold from surrounding sedimentary rocks during the huge, meteoric water circulation. We suggest that without the formation of the later, meteoric water circulation extensively through surrounding sedimentary rocks the Boguk cobalt deposits would be simple veins only with actinolite + quartz + cobalt-bearing minerals. Furthermore, the formation of the meteoric water circulation after the culmination of a magmatic hydrothermal system resulted in the common occurrence of high-temperature minerals with later, lower-temperature minerals, resulting in a xenothermal feature of the mineralization.

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Experimental Study on Helical Turbine Efficiency for Tidal Current Power Plant (조류 발전용 헬리컬 수차의 효율에 대한 실험적 연구)

  • Han, Sang-Hun;Lee, Kwang-Soo;Yum, Ki-Dai;Park, Woo-Sun;Park, Jin-Soon;Yi, Jin-Hak
    • Proceedings of the Korea Water Resources Association Conference
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    • 2006.05a
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    • pp.530-534
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    • 2006
  • 조류발전은 조류 유속이 빠른 곳에 수차발전기를 설치하여 해수의 운동에너지로부터 전기를 생산하는 발전방식이다. 2001년부터 해양연구원에서는 울돌목의 우수한 조류발전 개발 여건을 바탕으로 조류에너지 실용화 기술을 개발하고 있다. 본 연구에서는 조류발전 시스템에 사용되는 헬리컬 수차의 효율을 현장실험을 바탕으로 판단하고자 하였다. 현장실험을 위하여 지름 2.2 m, 높이 2.5 m의 수차를 제작하고, 울돌목 협수로의 한 쪽 면에 쟈켓구조물을 설치하여 수차를 거치한다. 수차가 회전함에 따라 회전봉에 일정 마찰을 주어 토크와 RPM을 측정하고, 함께 측정된 유속자료를 이용하여 수차를 효율을 산정한다. 유속-수차효율, TSR(수차의 날개속도와 유속의 비)-수차효율의 상관관계로 실험결과를 고찰하였다. 1중 날개 수차인 경우에 유속 1.4에서 2.6 m/s 사이에서 최대효율이 30 - 35 % 정도였고, 2중 날개 수차에 대한 실험에서는 유속 1.4에서 2.6 m/s 사이에서 최대수차효율이 25 - 35 % 사이임을 알 수 있었다. TSR과 최대수차효율의 상관관계는 실험 case별로 조금씩 다르다. 전체적으로 1중 날개의 경우가 최대수차효율에서 2중 날개보다 TSR 값이 조금 큰 경향을 나타냄을 알 수 있다. 이것은 1중 날개가 2중 날개보다 가벼워 좀 더 큰 RPM을 발생시켜서 나타난 현상으로 생각된다. 현재의 실험결과들을 이용하여 TSR과 최대수차효율을 상관관계를 나타내는 모델식을 도출하였다. 현장시험결과를 종합하면, 현장조류발전 시설이 최소 600 kW의 전력이 생산되기 위해서는 지름 3 m, 높이 3.6 m 인 수차 3개가 하나의 축에 설치되어야하는 것으로 계산되었다. 정격유속이 4.8 m/s이고 수차의 지름이 3m 라면, 최적 전력발생시의 RPM은 1중 날개의 경우 79이고 2중 날개의 경우는 63정도임을 추정할 수 있었다.촬영하여 실시간으로 전송하기 때문에 홍수시 하천 상황에 대한 모니터링 목적으로 사용될 수 있다. 영상수위계는 우물통 등을 이용하는 기존 방법과 비교하여 구조물이 필요 없어 설치 비용이 저렴하고, 영상에 의한 하천 모니터링 기능을 자체적으로 가지고 있기 때문에 효율적이라고 할 수 있다.따른 4개의 평가기준과 26개의 평가속성으로 이루어진 2단계 기술가치평가 모형을 구축하였으며 2개의 개별기술에 대한 시범적용을 실행하였다.하는 것으로 추정되었다.면으로의 월류량을 산정하고 유입된 지표유량에 대해서 배수시스템에서의 흐름해석을 수행하였다. 그리고, 침수해석을 위해서는 2차원 침수해석을 위한 DEM기반 침수해석모형을 개발하였고, 건물의 영향을 고려할 수 있도록 구성하였다. 본 연구결과 지표류 유출 해석의 물리적 특성을 잘 반영하며, 도시지역의 복잡한 배수시스템 해석모형과 지표범람 모형을 통합한 모형 개발로 인해 더욱 정교한 도시지역에서의 홍수 범람 해석을 실시할 수 있을 것으로 판단된다. 본 모형의 개발로 침수상황의 시간별 진행과정을 분석함으로써 도시홍수에 대한 침수위험 지점 파악 및 주민대피지도 구축 등에 활용될 수 있을 것으로 판단된다. 있을 것으로 판단되었다.4일간의 기상변화가 자발성 기흉 발생에 영향을 미친다고 추론할 수 있었다. 향후 본 연구에서 추론된 기상변화와 기흉 발생과의 인과관계를 확인하고 좀 더 구체화하기 위한 연구가 필요할 것이다.게 이루어질 수 있을 것으로 기대된다.는 초과수익률이 상승하지만, 이후로는 감소하므로, 반전거래전략을 활용하는 경우 주식투자기간은 24개월이하의 중단기가 적합함을 발견하였다. 이상의 행태적 측면과 투자성과측면의 실증결과를 통하여 한국주식시장에 있어서 시장수익률을 평균적으로 초과할 수 있는 거래전략은 존재하므로 이러한 전략을 개발 및 활용할 수 있으며, 특히, 한국주식시장에 적합한 거래전략은 반전거래전

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A Study on the Determination of Applicable law to Liability for the compensation of Damage in a plane accident (항공기사고 손해배상청구에 있어서 준거법의 결정에 관한 소고)

  • So, Jae-Seon
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.2
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    • pp.3-42
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    • 2010
  • This study shows that the Warsaw Convention in Article 1 is not an international transport, origin, destination and all the Contracting Parties is not a purely domestic shipping does not apply to this Treaty. Therefore, in this case, liability and damages for the governing law is selected according to international law should be. In addition, in the case of international shipping and passenger air carrier of this treaty to govern the relationship, not all of which aim is the unification of certain rules. Product liability is the most important thing of all. As for the aircraft manufacturer's responsibility according to international law also does not select the applicable law is not. The Warsaw Convention Article 17 apply for the passenger's personal damages Article 2 Section 2 leads to the most prestigious type of damages, and subjective and objective with regard to the scope of international law are being committed. In this regard, Governing Law-related aircraft accidents leading to serious accidents in China of an aircraft crash in Nagoya, Japan, the airport can be. China Airlines accident of the aircraft are operated for the unification of the rules for international air transport on the Warsaw Convention as amended by Article 17, Article 18 of damages by the tort claims and claims based on damages caused by, or this cause of aircraft accidents air bus maker by the Corporation for damages in tort claims for damages claimed on the basis of solidarity is the case. In the case of these grand scale claim responsibility for the airline, air transport agreements to determine the applicable law of the contract is very complex. There for the contracts based on individual circumstances or origin, and by considering because each must be determined.

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The relation between Movement working as a Grouping clue in Moving Picture and Semantic structure forming (동영상에서 그룹핑(grouping) 단서로 작용하는 움직임(Movement)과 의미구조 형성의 관계)

  • Lee, Soo-Jin
    • Archives of design research
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    • v.19 no.5 s.67
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    • pp.119-128
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    • 2006
  • The scale of visual expression has expanded from freeze frame to motion picture as media have developed. Moving pictures such as animation, movies, TV CM and GUI become formative elements whose movement is necessary compared to freeze frame as apparent movement phenomenon and unit structure such as short and scene appear. Therefore, of formative elements such as a shape, color, space, size and movement, movement is importantly distinguished in the moving image. The expression and form of image as a relationship between the signified and signifier explained by Saussure are accepted as a sign by mutual complement even though they limit the content. This makes it possible to infer that the formal feature of movement participates in the message content. To verify this, the result of moving picture visual perception experiment based on the gestalt grouping principle result shows that 70-80 percent of subjects think that 'movement' is the important grouping clue in perception. Movement affects the maintenance of the context of message content in the communication process when the meaning structure of moving picture is analyzed based on the structural feature. The identity can be maintained with if there is a movement with similar directive point even if the color and shape of people, things and background are changed. Second, the clarity of the content is elevated by a distinguished object as a figure by movement. Third, it acts as a knowledge representation which can predict similar movement process of next information processing. Forth, movement gives the content consistency even though more than two scenes have fast switch and complicated editing structure like cross-cutting. Movement becomes a clue which can make grouping information input by visual perception reaction. Also, it gives the order to the visual expression which can be used improperly by formation of structural frame of image message and has the effectiveness which elevates the clarity of signification. Moving picture has discourse with several mixed unit structures because it fundamentally contains time and the common and distinguished expression is needed by media-mix circumstances. Therefore, by the application of gestalt grouping principle to moving picture field, movement becomes the more distinguished than other formative elements and affects the formation of meaning structure. This study propose a viewpoint that develops structural formative beauty and new image expression in the media image field.

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Review on Usefulness of EPID (Electronic Portal Imaging Device) (EPID (Electronic Portal Imaging Device)의 유용성에 관한 고찰)

  • Lee, Choong Won;Park, Do Keun;Choi, A Hyun;Ahn, Jong Ho;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.57-67
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    • 2013
  • Purpose: Replacing the film which used to be used for checking the set-up of the patient and dosimetry during radiation therapy, more and more EPID equipped devices are in use at present. Accordingly, this article tried to evaluated the accuracy of the position check-up and the usefulness of dosimetry during the use of an electronic portal imaging device. Materials and Methods: On 50 materials acquired with the search of Korea Society Radiotherapeutic Technology, The Korean Society for Radiation Oncology, and Pubmed using "EPID", "Portal dosimetry", "Portal image", "Dose verification", "Quality control", "Cine mode", "Quality - assurance", and "In vivo dosimetry" as indexes, the usefulness of EPID was analyzed by classifying them as history of EPID and dosimetry, set-up verification and characteristics of EPID. Results: EPID is developed from the first generation of Liquid-filled ionization chamber, through the second generation of Camera-based fluoroscopy, and to the third generation of Amorphous-silicon EPID imaging modes can be divided into EPID mode, Cine mode and Integrated mode. When evaluating absolute dose accuracy of films and EPID, it was found that EPID showed within 1% and EDR2 film showed within 3% errors. It was confirmed that EPID is better in error measurement accuracy than film. When gamma analyzing the dose distribution of the base exposure plane which was calculated from therapy planning system, and planes calculated by EDR2 film and EPID, both film and EPID showed less than 2% of pixels which exceeded 1 at gamma values (r%>1) with in the thresholds such as 3%/3 mm and 2%/2 mm respectively. For the time needed for full course QA in IMRT to compare loads, EDR2 film recorded approximately 110 minutes, and EPID recorded approximately 55 minutes. Conclusion: EPID could easily replace conventional complicated and troublesome film and ionization chamber which used to be used for dosimetry and set-up verification, and it was proved to be very efficient and accurate dosimetry device in quality assurance of IMRT (intensity modulated radiation therapy). As cine mode imaging using EPID allows locating tumors in real-time without additional dose in lung and liver which are mobile according to movements of diaphragm and in rectal cancer patients who have unstable position, it may help to implement the most optimal radiotherapy for patients.

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Evaluation of Set-up Accuracy for Frame-based and Frameless Lung Stereotactic Body Radiation Therapy (폐암 정위체부방사선치료 시 고정기구(frame) 사용 유무에 따른 셋업 정확성 평가)

  • Ji, Yunseo;Chang, Kyung Hwan;Cho, Byungchul;Kwak, Jungwon;Song, Si Yeol;Choi, Eun Kyung;Lee, Sang-wook
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.286-293
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    • 2015
  • The purpose of this study was to evaluate the set up accuracy using stereotactic body frame and frameless immobilizer for lung stereotactic body radiation therapy (SBRT). For total 40 lung cancer patients treated by SBRT, 20 patients using stereotactic body frame and other 20 patients using frameless immobilizer were separately enrolled in each group. The setup errors of each group depending on the immobilization methods were compared and analyzed. All patients received the dose of 48~60 Gy for 4 or 5 fractions. Before each treatment, a patient was first localized to the treatment isocenter using room lasers, and further aligned with a series of image guidance procedures; orthogonal kV radiographs, cone-beam CT, orthogonal fluoroscopy. The couch shifts during these procedures were recorded and analyzed for systematic and random errors of each group. Student t-test was performed to evaluate significant difference depending on the immobilization methods. The setup reproducibility was further analyzed using F-test with the random errors excluding the systematic setup errors. In addition, the ITV-PTV margin for each group was calculated. The setup errors for SBF were $0.05{\pm}0.25cm$ in vertical direction, $0.20{\pm}0.38cm$ in longitudinal direction, and $0.02{\pm}0.30cm$ in lateral direction, respectively. However the setup errors for frameless immobilizer showed a significant increase of $-0.24{\pm}0.25cm$ in vertical direction while similar results of $0.06{\pm}0.34cm$, $-0.02{\pm}0.25cm$ in longitudinal and lateral directions. ITV-PTV margins for SBF were 0.67 cm (vertical), 0.99 cm (longitudinal), and 0.83 cm (lateral), respectively. On the other hand, ITV-PTV margins for Frameless immobilizer were 0.75 cm (vertical), 0.96 cm (longitudinal), and 0.72 cm (lateral), indicating less than 1 mm difference for all directions. In conclusion, stereotactic body frame improves reproducibility of patient setup, resulted in 0.1~0.2 cm in both vertical and longitudinal directions. However the improvements are not substantial in clinic considering the effort and time consumption required for SBF setup.

A Study on the Retransmission Consent and Arbitration for the Retransmission of Terrestrial Broadcasting Signal in Japan (지상파채널의 재전송 동의와 중재 기준에 관한 연구 - 일본의 사례분석을 중심으로)

  • Kim, Kyung-Hwan
    • Korean journal of communication and information
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    • v.48
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    • pp.46-62
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    • 2009
  • The current study attempted to review the standards of retransmisison consent and arbitration for the terrestrial broadcasting signal. The standards are based upon the principles encouraged by the MIAC(Ministry of Internal Affairs and Communications). It has been criticized that the standards of judgement for the retransimission consent and arbitration are ambiguous and arbitrary in Japan. In 2009, MIAC announced five decisions regarding the retransmission of over-the-air. The result of the current study found that the regulations of compulsory over-the-air signal retransmission have been sustained until now. The retransmission policy of the Japan government based upon three principles; localism, proper cause and copyright act. The judgment is dependent on the intrepretation of MIAC's standard about these three principles.

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Analyzing animation techniques used in webtoons and their potential issues (웹툰 연출의 애니메이션 기법활용과 문제점 분석)

  • Kim, Yu-mi
    • Cartoon and Animation Studies
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    • s.46
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    • pp.85-106
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    • 2017
  • With the media's shift into the digital era in the 2000s, comic book publishers attempted a transition into the new medium by establishing a distribution structure using internet networks. But that effort shied from escaping the parallel-page reading structure of traditional comics. On the other hand, webtoons are showing divers changes by redesigning the structure of traditional sequential art media; they tend to separate and allot spaces according to the vertical scroll reading method of the internet browser and include animations, sound effects and background music. This trend is also in accordance with the preferences of modern readers. Modern society has complicated social structures with the development of various media; the public is therefore exposed to different stimuli and shows characteristics of differentiated perceptions. In other words, webtoons display more relevant and entertaining characteristics by inserting sounds and using moving texts and characters in specific frames, while traditional comics require an appreciation of withdrawal and immersion like other published media. Motions in webtoons are partially applied for dramatic tension or to create an effective expression of action. For example, hand-drawn animation is adopted to express motions by dividing motion images into many layers. Sounds are also utilized, such as background music with episode-related lyrics, melodies, ambient sounds and motion-related sound effects. In addition, webtoons provide readers with new amusement by giving tactile stimuli via the vibration of a smart phone. As stated above, the vertical direction, time-based nature of animation motions and tactile stimuli used in webtoons are differentiated from published comics. However, webtoons' utilization of innovative techniques hasn't yet reached its full potential. In addition to the fact that the software used for webtoon effects is operationally complex, this is a transitional phenomenon since there is still a lack of technical understanding of animation and sound application amongst the general public. For example, a sound might be programmed to play when a specific frame scrolls into view on the monitor, but the frame may be scrolled faster or slower than the author intended; in this case, sound can end before or after a reader sees the whole image. The motion of each frame is also programmed to start in a similar fashion. Therefore, a reader's scroll speed is related to the motion's speed. For this reason, motions might miss the intended timing and be unnatural because they are played out of context. Also, finished sound effects can disturb the concentration of readers. These problems come from a shortage of continuity; to solve these, naturally activated consecutive sounds or animations, like the simple rotation of joints when a character moves, is required.