• Proceedings of the Korean Operations and Management Science Society Conference
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• 1996.04a
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• pp.525-529
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• 1996

Decision environments involve a high degree of uncertainty as well as multiple, conflicting goals. Although traditional goal programming offers a means of considering multiple, conflicting goals and arrives at a satisficing solution in a deterministic manner, its major drawback is that decision makers often specify aspiration level of each goal as a single number. To overcome the problem of setting aspiration levels, chance constrained programming can be incorporated into goal programming formulation so that sampling information can be utilized to describe uncertainty distribution. Another drawback of goal programming is that it does not provide a systematic approach to set priorities and trade-offs among conflicting goals. To overcome this weekness, the analytic hierarchy process(AHP) is used in the model. Also, most goal programming models in the literature are of a linear form, although some nonlinear models have been presented. Consideration of risk in technological coefficients and right hand sides, however, leads to nonlinear goal programming models, which require a linear approximation to be solved. In this paper, chance constrained reformulation with linear approximation is presented for a 0-1 goal programming problem whose technological coefficients and right hand sides are stochastic. The model is presented with a numerical example for the purpose of demonstration.

• Korean Journal of Adult Nursing
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• v.25 no.2
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• pp.113-124
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• 2013

Purpose: Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. Methods: The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. Results: A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. Conclusion: We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.

• Journal of Korean Neurosurgical Society
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• v.63 no.3
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• pp.380-385
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• 2020

Objective : A consensus regarding the ideal regimen for urokinase (UK) thrombolysis subsequent to stereotactic spontaneous intracerebral hemorrhage aspiration has yet to be established. The purpose of this study is to evaluate the efficacy of UK thrombolysis relative to when the regimen is changed. Methods : Venous blood from 30 heathy volunteers was obtained for this in-vitro study. Various concentrations of UK solution were added to microcentrifuge tubes containing the clotted blood. The efficacy of UK thrombolysis was identified by checking the weight of lysed hematoma following various time intervals with different concentrations of UK solution. Group one, the "3×4" group involved four administrations every 3 hours over 12 hours, and group two, the "6×2" group involved two administrations every 6 hours over 12 hours. Results : More hematoma was lysed in the 3×4 group than the 6×2 group across all concentration levels (however, the differences were only significant between groups at the 500 and 1000 IU concentration levels, p<0.05). There were no significant differences of lysed hematoma among the various UK solution concentrations within groups. Conclusion : This study suggests that frequent administrations of UK thrombolysis may result in a greater degree of lysed hematoma in comparison to a higher concentration of UK.

• Journal of Engineering Education Research
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• v.15 no.2
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• pp.20-29
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• 2012

The purpose of this study was to explore the academic achievements, learning attitudes, and career compromising processes for successful undergraduate students in the College of Engineering. To achieve this goal, research was conducted to analyze whether there was a strong major-career connection among Engineering students of Seoul National University. Afterwards, differences in levels of academic achievement, learning attitude, and academic aspiration were analyzed between students who had achieved a major-career match and students who had not. As a result, it was found that the level of major-career connection was highly correlated to the level of academic achievement; furthermore, learning attitudes were strongly related to the level of motivation towards a high academic achievement, and influenced future learning attitudes as well. These findings suggest that further academic support, career guidance, and major switching policies are needed for undergraduate students in Colleges of Engineering.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.83-87
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• 2003

Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.521-526
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• 2014

The authors report a case of symptomatic epidural gas accumulation 2 weeks after the multi-level lumbar surgery, causing postoperative recurrent radiculopathy. The accumulation of epidural gas compressing the dural sac and nerve root was demonstrated by CT and MRI at the distant two levels, L3-4 and L5-S1, where vacuum in disc space was observed preoperatively and both laminectomy and discectomy had been done. However, postoperative air was not identified at L4-5 level where only laminectomy had been done in same surgical field, which suggested the relationship between postoperative epidural gas and the manipulation of disc structure. Conservative treatment and needle aspiration was performed, but not effective to relieve patient's symptoms. The patient underwent revision surgery to remove the gaseous cyst. Her leg pain was improved after the second operation.

• Journal of Global Scholars of Marketing Science
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• v.19 no.3
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• pp.49-61
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• 2009

This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1050-1057
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• 2018

Thyroglobulin antibody (TgAb) is a class G immunoglobulin and a conventional marker for thyroid autoimmunity. From a clinical perspective, TgAb is less useful than thyroid peroxidase antibodies for predicting thyroid dysfunction. However, TgAb is found more frequently in differentiated thyroid cancer (DTC) and can interfere with thyroglobulin (Tg) measurements, which are used to monitor the recurrence or persistence of DTC. Recent studies suggested a small but consistent role for preoperative TgAb in predicting DTC in thyroid nodules, and in reflecting adverse tumor characteristics or prognosis, including lymph node metastasis, but this is still controversial. Postoperative TgAb can serve as a biomarker for remnant thyroid tissue, so follow-up measures of TgAb are useful for predicting cancer recurrence in DTC patients. Since high serum TgAb levels may also affect the fine needle aspiration washout Tg levels from suspicious lymph nodes of DTC patients, it is important to use caution when interpreting the washout Tg levels in patients who are positive for TgAb.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.40-44
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• 2016

Background and Objectives : Surgery is considered the primary treatment for intracordal cyst. However, patients who had undergone surgery are still subject to recurrence and continued voice changes. Intracordal cysts naturally disappear in some patient population. Cyst does not always recur in patients who had received partial surgical removal, too. Contradicting results raises a question whether complete surgical removal of intracordal cyst is necessary and demonstrate need for better treatment. Herein, the author proposes novel surgical method technique intralaryngeal needle technique (INT), a technique using surgical needle for not only injection but also for aspiration and excision of cyst. This study aims to examine the potential of intralaryngeal needle technique in treating intracordal cysts. Materials and Methods : Surgical procedures were done on in-patients diagnosed with intracordal cyst. 23 patients received follow-up screening after the surgery for one year. Patients' subjective satisfaction levels, acoustic measures, aerodynamic measures, laryngeal stroboscopic results were compared before and after the treatment. Results : Overall patients were satisfied with novel surgical excision method. In terms of aerodynamic measures, maximum phonation time, mean air flow rate improved after the surgery. In terms of acoustic measures, Jitter, Shimmer, NHR, and voice pitch changes after the treatment showed statistically significant differences. Laryngeal stroboscopy results showed significant decreases in cyst sizes. Post-surgery patients had improved mucosal waves and amplitudes values. Conclusion : The results show the validity of intralaryngeal needle technique in reducing intracordal cyst size by excision, aspiration, and injection. The author believes this novel technique can be used as an alternative surgical method for intracordal cysts.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.17-21
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• 2011

Purpose: Percutaneous endoscopic gastrostomy (PEG) can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6) months. Results: Mean patient age was 9.4 (4.5) years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD). The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87%) had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.