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Infantile Hypertrophic Pyloric Stenosis - Report of 35 cases - (영아 비후성 유문 협착증 - 35례 보고 -)

  • Huh, Young-Soo;Kim, Gyu-Rag;Shin, Son-Moon
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.199-210
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    • 1996
  • Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 6. Onset of symptoms was predominantly between 1week and 2 weeks in 11 cases(31.4%). 7. All had a history of nonbilious vomting, generally projectile in nature. 8. In the measured serum electrolytes, hypokalemia was noted in 9 cases(25.7%), hypochloremia was observed in 14 cases(40.0%). 9. In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.2mm, 12.1mm, and 17.9mm, respectively. 10. Among 35 cases, significant sonographic criteria of IHPS, muscle thickness of 5mm or more, were noted in 26 cases(83.9%). 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.

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The Comparison of ICSD and DSM-Ⅳ Diagnoses in Patients Referred for Sleep Disorders (정신과에 의뢰된 환자 중 수면장애에 대한 ICSD와 DSM-Ⅳ 진단 비교)

  • Lee, Bun-Hee;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.37-44
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    • 2001
  • Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

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CLINICAL EVALUATION OF CHILDREN WITH INATTENTION AND HYPERACTIVITY IN A PSYCHIATRIC CLINIC (주의산만과 과잉운동을 주소로 하는 정신과 내원 아동들의 임상 평가)

  • Kweon, Yong-Sil
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.93-103
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    • 2002
  • The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups:ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows:In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.

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Market Structure and Pricing Behavior in the Korean Transportation Fuel Market (국내 수송용 석유제품 시장의 시장구조와 가격행태)

  • Moon, Choon-Geol
    • Environmental and Resource Economics Review
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    • v.24 no.2
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    • pp.311-342
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    • 2015
  • We evaluate two main rationales of massive policy intervention of Lee Administration in the Korean transportation fuel market: high market share of domestic refineries, perceived by the Administration as the result of high market concentration, and asymmetry in price adjustment, perceived as the result of collusion. Domestic refineries, huge in capacity and located at seaports, maintain international competitiveness in price. Considering market openness offering preferential treatment to importers, they set domestic prices competitively on the basis of MOPS prices. Yet, the price competitiveness of domestic refineries is so high that they are able to sustain high market share. We confirm that the Korean before-tax consumer prices of gasoline and diesel are lower than Japan's and the weighted averages of 27 EU countries by as much as 159KRW and 21KRW per liter in the case of gasoline and 170KRW and 63KRW in the case of diesel. Price asymmetry is caused by diverse economic and managerial reasons and, as FTC (2005) states, price asymmetry does not immediately imply exercise of market power or collusion. We analyzed price asymmetry in Korea, Japan and 14 EU countries, and found asymmetry in Korea and 11 EU countries in the case of gasoline and in Korea and 8 EU countries in the case of diesel.

Diagnostic Significance of the Serologic Test Using Multiple Antigens of Mycobacterium Tuberculosis by ELISA (다양한 특이결핵항원을 이용한 결핵항체 검사(ELISA)의 진단적 유용성)

  • Kim, Dae-Yun;Choi, In-Hwan;Park, Seung-Kyu;Cho, Shang-Rae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.757-767
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    • 1999
  • Background: Diagnosis by smear and/or cultures of the Mycobacterium tuberculosis from body fluid or biopsy specimen is "Gold standard". However the sensitivity of the direct microscopy is relatively low and culture of mycobacteria is time consuming. Despite an explosion in the techniques of rapid identification of mycobacteria by molecular genetic means, it is laborious and expensive and then rapid, inexpensive serodiagnosis is interested in diagnosis of tuberculosis. But sensitivity and specificity of known serologic antigen is not full sufficient level and then new antigen develop and combination cocktails of new developed antigens by ELISA are needed. Method: To compare the efficacy of different mycobacterial specific antigen and to assess the applicability of the combination of several different antigens in the diagnosis of tuberculosis, five ELISA tests derived 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were evaluated in 57 active pulmonary patient and 24 inactive post-therapy follow up patient and 48 normal control. Results: The optical densities of ELISA test with 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were significantly higher in active tuberculosis cases than in normal control(P<0.001, P<0.001, P<0.027, P<0.001, P<0.001) and those with 16KDa, 38KDa were significant higher in active tuberculosis cases than in inactive post-therapy follow up cases(P<0.01. P<0.001) and those of 14KDa, 16KDa, 23KDa, 38KDa were significant higher in inactive post-therapy follow up cases than in normal control(P<0.008. P<0.01. P<0.006. P<0.001). The sensitivity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 42.1%, 43.9%, 15.8%, 28.0%, 70.2%, respectively and the specificity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 95.8%, 95.8%, 91.7%, 89.6%, 93.8%, respectively. The sensitivity and specificity of combination 38KDa with 16KDa was 87% and 93.7%. Conclusion: The sensitivity and specificity of new antigens for serodiagnosis of the tuberculosis still remains limited at around 70%, which makes its a poor diagnostic tool for disease confirmation. A combination of cocktail antigens provided by cut-off value adjustment for serodiagnosis of tuberculosis some improved diagnostic yield than single antigen serologic test.

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The Influence of Online Social Networking on Individual Virtual Competence and Task Performance in Organizations (온라인 네트워킹 활동이 가상협업 역량 및 업무성과에 미치는 영향)

  • Suh, A-Young;Shin, Kyung-Shik
    • Asia pacific journal of information systems
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    • v.22 no.2
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    • pp.39-69
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    • 2012
  • With the advent of communication technologies including electronic collaborative tools and conferencing systems provided over the Internet, virtual collaboration is becoming increasingly common in organizations. Virtual collaboration refers to an environment in which the people working together are interdependent in their tasks, share responsibility for outcomes, are geographically dispersed, and rely on mediated rather than face-to face, communication to produce an outcome. Research suggests that new sets of individual skill, knowledge, and ability (SKAs) are required to perform effectively in today's virtualized workplace, which is labeled as individual virtual competence. It is also argued that use of online social networking sites may influence not only individuals' daily lives but also their capability to manage their work-related relationships in organizations, which in turn leads to better performance. The existing research regarding (1) the relationship between virtual competence and task performance and (2) the relationship between online networking and task performance has been conducted based on different theoretical perspectives so that little is known about how online social networking and virtual competence interplay to predict individuals' task performance. To fill this gap, this study raises the following research questions: (1) What is the individual virtual competence required for better adjustment to the virtual collaboration environment? (2) How does online networking via diverse social network service sites influence individuals' task performance in organizations? (3) How do the joint effects of individual virtual competence and online networking influence task performance? To address these research questions, we first draw on the prior literature and derive four dimensions of individual virtual competence that are related with an individual's self-concept, knowledge and ability. Computer self-efficacy is defined as the extent to which an individual beliefs in his or her ability to use computer technology broadly. Remotework self-efficacy is defined as the extent to which an individual beliefs in his or her ability to work and perform joint tasks with others in virtual settings. Virtual media skill is defined as the degree of confidence of individuals to function in their work role without face-to-face interactions. Virtual social skill is an individual's skill level in using technologies to communicate in virtual settings to their full potential. It should be noted that the concept of virtual social skill is different from the self-efficacy and captures an individual's cognition-based ability to build social relationships with others in virtual settings. Next, we discuss how online networking influences both individual virtual competence and task performance based on the social network theory and the social learning theory. We argue that online networking may enhance individuals' capability in expanding their social networks with low costs. We also argue that online networking may enable individuals to learn the necessary skills regarding how they use technological functions, communicate with others, and share information and make social relations using the technical functions provided by electronic media, consequently increasing individual virtual competence. To examine the relationships among online networking, virtual competence, and task performance, we developed research models (the mediation, interaction, and additive models, respectively) by integrating the social network theory and the social learning theory. Using data from 112 employees of a virtualized company, we tested the proposed research models. The results of analysis partly support the mediation model in that online social networking positively influences individuals' computer self-efficacy, virtual social skill, and virtual media skill, which are key predictors of individuals' task performance. Furthermore, the results of the analysis partly support the interaction model in that the level of remotework self-efficacy moderates the relationship between online social networking and task performance. The results paint a picture of people adjusting to virtual collaboration that constrains and enables their task performance. This study contributes to research and practice. First, we suggest a shift of research focus to the individual level when examining virtual phenomena and theorize that online social networking can enhance individual virtual competence in some aspects. Second, we replicate and advance the prior competence literature by linking each component of virtual competence and objective task performance. The results of this study provide useful insights into how human resource responsibilities assess employees' weakness and strength when they organize virtualized groups or projects. Furthermore, it provides managers with insights into the kinds of development or training programs that they can engage in with their employees to advance their ability to undertake virtual work.

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Relationship between Blood Pressure and Impairment of Cognitive Function In Some Rural Residents Aged 60-64 (일부 60-64세 농촌 거주자에서 혈압과 인지기능 장애와의 관계)

  • Lee, Moo-Sik;Chun, Jong-Chan;Lee, Choong-Won
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.2
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    • pp.208-214
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    • 2000
  • Objectives : Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 Methods : Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Results : By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95% confidence interval CI; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95% CI; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% CI; 0.37-0.89). Conclusions : These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.

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A Study on the Effects of After-purchase Feedback About Customer Service Quality on Purchase Process - Focusing on Internet Shopping Mall - (고객 서비스 품질에 대한 구매 후기 댓글이 구매과정에 미치는 영향 - 인터넷 쇼핑몰을 중심으로 -)

  • Shin, Chang-Nag;Kim, Young-Ei;Park, Young-Kyun
    • Journal of Distribution Research
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    • v.14 no.1
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    • pp.27-44
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    • 2009
  • This research classified the customer service factor of on-line shopping mall into tangibility, reliability, responsiveness, and empathy and analyzed the effect that the factors affect to consumer's purchase and re-purchase. If we present suggestions on the basis of these results of study, we would provide next two points: First, purchasers have utilized online shopping mall who pursued free from hard sell that being done in off-line and convenience of purchase affected more by reliability and responsiveness such as the fame of shopping mall that visit, reliability of security, and quick product search than the Customer of After-purchase Feedback influence for online purchasers decision factor out of consumer's purchase and re-purchase by on-line shopping mall customer service factor. Second, This study analyzed that online re-purchaser recognized the Customer of After-purchase Feedback factor high and built their loyalty through friendly emotion of on-line shopping mall and satisfaction of shopping mall service, and recommendation. In addition, they behave themselves as an affirmative messenger that is role of the Customer of After-purchase Feedback that make active opinion presentation and participation through community by important adjustment impact that empathy factor of on-line shopping mall customer service.

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Conception of Self in Korea: Indigenous, Cultural and Psychological Analysis (한국인의 자기 인식에 나타난 토착문화심리 분석)

  • Uichol Kim;Youngshin Park
    • Korean Journal of Culture and Social Issue
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    • v.12 no.4
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    • pp.1-36
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    • 2006
  • This study examines the conception of the self using indigenous, cultural and psychological analysis. The self is viewed from four aspects: (1) conception of the self as an entity (the self in general, the self as an unique entity and the self when alone), (2) conception of self in the context of family (the self when with mother, father, children and spouse), (3) the self with the context of close and working relationships (the self when with friends, teachers, work superior and work subordinate), and (4) the self in context of the larger society (the self when with strangers and foreigners). A total of 1,465 respondents (623 elementary, middle, high and university students and their parents = 842) completed an open-ended questionnaire developed by the present authors. The results reveal two patterns of results. First, the conception of self in Korea is influence by one's role. Second, the conception of self in influenced by relationship and context and there is an emphasis on the flexibility and adjustment of the self to relationship and context. Implications of the conception of the self in context of relationships, roles, and contexts are discussed, along with the importance of indigenous, cultural and psychological analysis.

Nasal Continuous Positive Airway Pressure Titration and Time to Reach Optima1 Pressure in Sleep Apnea Syndrome (수면 무호흡 증후군에서 지속적 양압 치료시의 최적압 및 그 도달기간)

  • Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.84-92
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    • 1995
  • Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

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