• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.15-26
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• 2019

The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

• Parasites, Hosts and Diseases
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• 제59권3호
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• pp.273-280
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• 2021

Biting midges (Culicoides: Ceratopogonidae) were collected using New Jersey light traps at Yongsan US Army Garrison (USAG;urban), Seoul Metropolitan city and Camp Humphreys USAG (rural), Pyeongtaek, Gyeonggi-do (province), Republic of Korea , from May-October 2010-2013 and 2015-2017, to determine species composition and seasonal distribution patterns in urban and rural habitats. A total of 9,958 female (53.85%) and 8,533 male (46.15%) Culicoides comprising 16 species were collected. Overall, the most commonly collected species was Culicoides arakawae (74.3%), followed by C. circumscriptus (16.2%), C. kibunensis (2.5%), C. nasuensis (2.2%), C. clavipalpis (1.4%), and C. pallidulus (1.3%), while the remaining 10 species accounted for <2.1% of all Culicoides spp. collected. The 2 predominant species collected were C. circumscriptus (47.4%) and C. arakawae (33.4%) at Yongsan, and C. arakawae (90.4%) and C. circumscriptus (3.9%) at Camp Humphreys. The seasonal abundance of these 2 species varied between years and between sites but on average peaked in August-September for C. arakawae and June-July for C. circumscriptus. Annual variations in abundance were observed for most species collected during this study. Unusually high proportions of male specimens were observed for most species at both sites which may be due to the use of the New Jersey trap.

• 영미문화
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• 제9권1호
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• pp.185-219
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• 2009

This article aims to illuminate the comic characters and their humor in Dickens's novel David Copperfield in Bakhtinian point, and to clarify what the humorous characteristics are, and how they contribute to his reinforcement of socially critical messages in this novel. So far this novel has been called the only one of Dickens's comic novels, even though it includes lots of social critical meanings. But it is true that Dickensian critics couldn't make sure of the clear reasons why it is both very interesting and critical. Furthermore, it is also true that this novel has been criticized as a clumsy one in the realistic, psycho-analytic, dramatic angle. This approach to Dickensian comic characters through Bakhtinian fool, clown, and rogue concepts here could make up for or correct such criticisms, and reevaluate Dickens's humor and social criticisms in the context of general public culture. Bakhtin believes oppression by social ideologies prevent us from having good mutual relationships and divides our society. He thinks laughter liberates us from such oppression and restores our good relationships. As he applied his concepts based on the laughter of Middle Ages to Rabelais's novels, and examined what the authentically liberating power in Rabelais's laughter is, this article could clarify the liberating power of laughter by Dickens's comic characters, such as Mr and Mrs Micawber, Dick, Miss Betsey Trotwood and Miss Mowcher. In this novel, they often lead comic happenings, and such happenings are very similar to carnival-amusements including burning the dummy of the czar who has oppressed his or her citizenry. Especially, Dickens's comic characters's social criticisms, in the case of this novel, contain many complaints of social marginers, even though he has been labelled as being conservative politically. They always criticize the ideological absurdities in their society through the humorous words and behaviors in their comic happenings, like those of a carnival fool or clown in his or her amusements. This shows Dickens achieves both laughter and social criticism in David Copperfield by using Rabelaisian characterization-devices based on his general public culture. Like Bakhtin and Rabelais, Dickens seems to have believed that when we all truly liberate ourselves from the oppression of social ideologies, we can have desirable relationships between ourselves, and also solve social problems positively.

• 영어영문학
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• 제55권6호
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• pp.1163-1191
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• 2009

As many critics do, this article starts from the premise that Charles Waddell Chesnutt wrote The Conjure Woman with a distinct socio-ethical view to ameliorating white readers' racism. For this purpose of social activism, first, the author uses a racially submissive genre and narrator- antebellum plantation-dialect fiction and an old ex-slave Julius-in order to win the attention of white racists, who constituted the majority of the reading public of postbellum America. Chesnutt then allows this seemingly submissive ex-slave consecutively to wage narrative battles against a Northern white capitalist, John. This fiction's structure is thus based on interracial narrative conflict. Granted, the result of these narrative battles is Julius's defeat. Even though he sometimes has narrative success through his manipulation of either his white female auditor's sentimentalism or the white capitalist's racial prejudice, it does not lead to any fundamental change in the white audience members' awareness: John still regards Julius's tacitly reformoriented tales merely as nonsensical ghost stories invented by the absurd imagination of a subservient, entertaining, and exploitable black coachman. Admitting his defeat, Julius relinquishes his original goal of deterring John's capitalist exploitation of both racial Others and the natural environment of the South and finally decides to serve the economic power of white capitalism. This self-defeating conclusion, however, should not be identified with Chesnutt's failure as an author. Rather, it should be understood as an interim result of the black author's earnest experiment with literary media best suited to his reform project. In fact, this narrative failure reveals Chesnutt's accurate diagnosis of the postbellum literary world: a black voice is still feebly heard and even easily buried by the whites' capitalist ambition and consequently intensifying racism. Conclusively, Julius's narrative failure should be positively evaluated as Chesnutt's one step further in his gradual and lifelong progress to a narrative goopher effectively to engage whites' imagination and sympathy for a vision of equal interracial coexistence.

• 영어영문학
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• 제54권4호
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• pp.483-509
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• 2008

For the last decades, criticism on Frankenstein has tried to make a link between Victor's Creature and Rousseaurean "man in a state of nature." Like the Rousseaurean savage in a state of animal, the monster has only basic instincts least needed for his survival, i.e. self-preservation, but turns into a civilized man after learning language. Most critics argue that, despite the monster's acquisition of language, his failure in entry into a cultural and linguistic community is the outcome of a lack of sympathy for him by others, which displays the stark existence of epistemological barriers between them. That is to say, the monster imagines his being the same as others in the pre-linguistic stage but, in the linguistic stage, he realizes that he is different from others. Interpreting the Rousseaurean idea of language, which appears in his writings, as much more focused on emotion than many critics think, I read the dispute between Victor and his Creature as a variation of parent-offspring conflict. Shelley criticizes Rousseau's parental negligence in putting his children into a foundling hospital and leaving them dying there. The monster's revenge on uncaring Victor parallels the likely retaliation Rousseau's displaced children would perform against Rousseau, which Shelley imaginatively reproduces in her novel. The conflict between the monster and Victor is due to a disrupted attachment between parent and child in terms of Darwinian developmental psychology. Affective asynchrony between parent and child, which refers to a state of lack of mutual favorable feelings, accounts for numerous dysfunctional families. This paper shifts a focus from a semiotics-oriented perspective on the monster's social isolation to a Darwinian perspective, drawing attention to emotional problems transpiring in familial interactions. In doing so, it finds that language is a means of communicating one's internal emotions to others along with other means such as facial expressions and body movements. It also demonstrates that how to promote emotional well-being in either familial or social relationships entirely depends on the way in which one employs language that can entail either pleasure or anger on hearers' part.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.633-641
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• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.549-558
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• 2022

Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design. Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali. Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

• 패션비즈니스
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• 제25권5호
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• pp.114-130
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• 2021

The purpose of this study is to analysis BTS's image based on Peirce's semiotics. Methodologies of this study are literature study to analyze the structure of idol image based on Peirce's theory of signs, case study and FGI analyzing the semiotic characteristics of BTS images. The research results of analyzing the semiotic features of BTS images by period of the BTS album are as follows. First, in the early days of their debut, they emphasized the image of hip-hop and expressed their will to resist and rebel against the older generation with a challenging and strong image. Second, during the 'The most beautiful day of life' period, image of wandering, rebellion, growth, and youth of teenagers was expressed. Third, in the 'Love Yourself' period, BTS showed various image changes between natural and pure image to splendid image by expressing the process of finding confidence during chaotic moment of growing. Fourth, during the 'Map of the Soul' period, the exploration and reflection on themselves were expressed in an outwardly splendid and bright manner, while at the same time expressing the inner darkness in a contrasting manner. Fifth, in the 'pandemic period', they expressed hopeful energy and willness with the image of mature and attractive man and bright and casual image. Their growth and change have been directly linked to the change of their image, and their image showed a successful signification with complementary combination of icons, indexes, and symbols.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.729-739
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• 2022

Cranioplasties are common procedures in plastic surgery. The use of tissue expansion (TE) in staged cranioplasties is less common. We present two cases of cranioplasties with TE and systematically review literature describing the use of TE in staged cranioplasties and postoperative outcomes. A systematic review was performed by querying multiple databases. Eligible articles include published case series, retrospective reviews, and systematic reviews that described use of TE for staged bony cranioplasty. Data regarding study size, patient demographics, preoperative characteristics, staged procedure characteristics, and postoperative outcomes were collected. Of 755 identified publications, 26 met inclusion criteria. 85 patients underwent a staged cranioplasty with TE. Average defect size was 122 cm², and 30.9% of patients received a previous reconstruction. Average expansion period was 14.2 weeks. The most common soft tissue closures were performed with skin expansion only (75.3%), free/pedicled flap (20.1%), and skin graft (4.7%). The mean postoperative follow-up time was 23.9 months. Overall infection and local complication rates were 3.53 and 9.41%, respectively. The most common complications were cerebrospinal fluid leak (7.1%), hematoma (7.1%), implant exposure (3.5%), and infection (3.5%). Factors associated with higher complication rates include the following: use of alloplastic calvarial implants and defects of congenital etiology (p = 0.023 and 0.035, respectively). This is the first comprehensive review to describe current practices and outcomes in staged cranioplasty with TE. Adequate soft tissue coverage contributes to successful cranioplasties and TE can play a safe and effective role in selected cases.

• 천문학회보
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• 제46권1호
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• pp.39.1-39.1
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• 2021

The Local Volume Mapper(LVM) project in the fifth iteration of the Sloan Digital Sky Survey (SDSS-V) will produce large integral-field spectroscopic survey data to understand the physical conditions of the interstellar medium in the Milky Way, the Magellanic Clouds, and other local-volume galaxies. We are developing the LVM Instrument control software. The architecture design of the software follows a hierarchical structure in which the high-level software packages interact with the low-level and mid-level software and hardware components. We adopt the spiral software development model in which the software evolves by iteration of sequential processes, i.e., software requirement analysis, design, code generation, and testing. This spiral model ensures that even after being commissioned, the software can be revised according to new operational requirements. We designed the software by using the Unified Modeling Language, which can visualize functional interactions in structure diagrams. We plan to use the SDSS software framework CLU for the interaction between components, based on the RabbitMQ that implemented the Advanced Message Queuing Protocol (AMQP).