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The Significance of the Early Electroencephalographic Findings in Severely Asphyxiated Newborn Infants (중증 주산기 가사 환아에서 시행한 초기 뇌파 검사의 임상적 의의)

  • Lee, Jong Uk;Choi, Won Joung;Kim, Chun Soo;Lee, Sang Lak;Kim, Jun Sik
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.784-788
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    • 2003
  • Purpose : Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. Methods : Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of ${\leq}3$ and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. Results : Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst-suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). Conclusion : Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.

Therapeutic response of cyclosporine and outcome in steroid resistant nephrotic syndrome (스테로이드 저항성 신증후군에서 cyclosporine 치료 반응 및 결과)

  • Choi, Hyung Soon;Lee, Joo Hoon;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.293-298
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    • 2008
  • Purpose : The aim of our study was to evaluate the therapeutic response to cyclosporine, time to remission and side effects in steroid resistant nephrotic syndrome (SRNS). Methods : This study included 22 children with idiopathic SRNS who were treated with cyclosporine between June 1989 and August 2006. Medical records were reviewed retrospectively. Results : The mean age of patients at diagnosis was $5.2{\pm}3.3\;years$. The male to female ratio was 1.2:1. Pre-treatment renal biopsies showed minimal change (MCD) in 12 (54.5%), focal segmental glomerulosclerosis (FSGS) in 8 (36.4%), membranous nephropathy (MGN) in one (4.5%) and mesangioproliferative glomerulonephritis in one (4.5%). 15 (68.2%) patients responded to cyclosporine, of whom 11 (91.6%) patients were MCD, 3 (37.5%) patients FSGS, and 1 patient MGN (MCD vs FSGS, P<0.05). The time to remission in patients who responded to cyclosporine was $31.5{\pm}15.2\;days$. Four of the 15 cyclosporine responders maintained complete remission even after cessation of the medication Seven still received cyclosporine, 2 were intermittently treated with steroids after discontinuation of cyclosporine, and two were treated with cyclosporine and steroids. The mean duration of cyclosporine therapy was $546.5{\pm}346.2$, $1,392.9{\pm}439.7$, $439.5{\pm}84.1$, and $433.5{\pm}74.2$ days, respectively. We performed post-treatment biopsies in 8 patients and partial interstitial fibrosis and tubular atrophy were found in two. Conclusion : The thrapeutic response of cyclosporine is good in steroid resistant nephrotic syndrome, especially in minimal change. But, there is a problem of long term cyclosporine dependency.

A study on the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis (알레르기성 직결장염의 임상상과 내시경 및 조직소견)

  • Lee, Joo Hee;Kim, Sung Shin;Park, Jae Ock
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.276-285
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    • 2008
  • Purpose : Allergic proctocolitis is a major cause of bloody stool in early infancy. This study was aimed at ascertaining the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis. We also analyzed the relationship between peripheral eosinophilia, the age at symptom onset, and sigmoidoscopic and histologic findings. Methods : We reviewed 25 infants retrospectively who had sigmoidoscopy and biopsy performed with a clinical diagnosis of allergic proctocolitis from April 2003 to April 2007. Results : The mean age at symptom onset was $15.2{\pm}13.2$ weeks. Fourteen infants (56.0%) were breast fed, one (4.0%) was formula fed, six (24.0%) were on combined formula, and four (16.0%) were on a weaning diet. Peripheral eosinophilia (${\geq}250/mm^3$) was seen in eighteen infants (75.0%), but total serum IgE was increased only in six (24.0%). Sigmoidoscopic findings were variable from normal (8.0%), erythema or edema (20.0%), lymphoid hyperplasia (8.0%), erosion (12.0%), hemorrhage and ulcer (4.0%) to lymphoid hyperplasia with erosion, hemorrhage, or ulcer (48.0%). Histologic findings showed focal infiltration of eosinophils in lamina propria (96.0%) and crypt epithelium (96.0%). In twenty four infants (96.0%), the number of eosinophils in mucosa was increased by a more than 60/10 high power field. There was a negative correlation between peripheral eosinophilia and the age at symptom onset. Among the twelve breast fed infants, bloody stool disappeared in ten (83.0%) with a maternal elimination diet of major food groups, but two improved spontaneously. Conclusion : Allergic proctocolitis should be considered as one of the major causes of bloody stool in healthy appearing infants. To confirm the diagnosis it is necessary to perform sigmoidoscopy and biopsy but histologic findings are more informative than sigmoidoscopic findings. Peripheral eosinophilia was prominent in the infants with an early onset of symptoms. Most infants experienced benign courses and recovered with the elimination of causative foods but did not need exclusive food restrictions.

Analysis on the association between EEG and 2-deoxy-2-[18F]-D-glucose (FDG)-PET findings in children with epilepsy (소아 간질 환아에서 뇌파와 PET과의 연관성에 대한 분석)

  • Hur, Yun Jung;Lee, Joon Soo;Lee, Jong Doo;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.286-292
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    • 2008
  • Purpose : We performed EEG and PET on children with epilepsy concomitantly in order to evaluate the effects of epileptiform and non-epileptiform discharge of EEG on glucose metabolism. Methods : Seventy three children with epilepsy who had PET and EEG simultaneously were included in our study. The subjects were classified in two ways: (1) based on the frequency of epileptiform discharge and (2) the severity of non-epileptiform discharge. We evaluated the clinical aspects of their seizures, the severity of focal slow waves during the interictal period with the frequency of spikes or sharp waves in order to compare with the PET results. Results : The subjects were divided by the frequency of epileptiform discharge, with 13 in the no/rare group, 7 in the occasional group, and 53 children in the frequent group. The concordant rates with PET in each group were 0%, 42.9%, and 67.9%, respectively, showing high correlations with the frequency of epileptiform discharge (P<0.05, r=0.491). The subjects as divided by the severity of non-epileptiform discharge were 15 in the no group, 25 in the infrequent group, 17 in the intermediate group, and 16 in the continuous group. The concurrence rates with PET for each group were 13.3%, 52.0%, 64.7%, and 68.8%, respectively, also showing a high correlation with the severity of non-epileptiform discharge (P<0.05, r= 0.365). Conclusion : Epileptiform discharge and non-epileptiform discharge in EEG showed a certain association with hypometabolism in PET. We recommend EEG to reduce false lateralization and to localize lesions in cases of high frequency and severity.

Magnetic resonance imagining findings of the white matter abnormalities in the brain of very-low-birth-weight infants (극소 저체중 출생아에서 뇌백질 병변의 MRI 소견)

  • Choi, Jae Hyuk;Chang, Young Pyo
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1127-1135
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    • 2009
  • Purpose : To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low- birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL). Methods : In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined. Results : MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15-2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82-0.99 P=0.036) for noncystic PVL were only significant independently. Conclusion : White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.

A Study on the Characteristics of Oddly Shaped Stone's Arrangement at Donggwoldo (동궐도(東闕圖)에 나타난 괴석(怪石)의 배치특성에 관한 연구)

  • Jung, Woo-Jin;Kim, Hwa-Ok;Park, Yool-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.2
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    • pp.12-26
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    • 2014
  • This study has researched the forms of arrangement and use of the oddly shaped stones which were used at palaces during Joseon Dynasty based on arrangements of stones as shown in Donggwoldo(東闕圖), and tried to identify its special features. The sorts of stone's arrangements which set formal patterns by assisting an axis in Donggwoldo can be classified as the single type using one stone, the symmetrical type using 2 stones symmetrically and the parallel type using 3 or more stones. The single type was used to endow a focal point and to accent centrality by arranging a stone on the axis performed from formal shaped buildings. The symmetrical type was used to show order and hierarchy by placing two odd-shaped stones on either side of a building. And the parallel type which is arranged three stones side by side, is put a middle stone on the central axis line to determine strong directional and frontality. Also similarity to method of arrangement of stones can be found from planting trees in a prominent way for scenery or planting trees symmetrically. Stones and trees can be chosen according to nature and scale of places and basically their effects of formation of axis and creating typical space is same. Based on these respect, the characteristics of arrangement of stones shown in Donggwoldo can be briefly summarized as follows. First, the oddly shaped stones were used by creating a centripetal space in order to show a grade of rank. Second, the distances among stones could be adjusted to the sizes of the architecture which was at the center. The aim was to provide stability through the balanced composition between the central axis and symmetrical structures. Third, the form of regularity was added by using stone vase in consideration of irregular shape of stone causing interference in forming regular symmetry. Fourth, a centrality was emphasized by adding change to central stones in the parallel type used 3 erect stones. Fifth, the sizes of stone were limited in order to make smooth for the mix and adjustment of its position with the types of other garden ornaments, so the oddly shaped stones in palace have portability. Sixth, the oddly shaped stones in palace which were appreciated as inspirational object basically were a sculpture of the same quality with suiseki (壽石), and the appreciative method, the composition and shape had developed in the same texture. Finally, the even number of stones by parallel type were arranged by equal partition. But odd number of stones followed the method with symmetrical arrangement on its center stone. These principles of stone arrangement are judged as distinguishing methods which oddly shaped stones was made and used in Joseon palaces.

Assessment of Positioning Accuracy of UAV Photogrammetry based on RTK-GPS (RTK-GPS 무인항공사진측량의 위치결정 정확도 평가)

  • Lee, Jae-One;Sung, Sang-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.63-68
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    • 2018
  • The establishment of Ground Control Points (GCPs) in UAV-Photogrammetry is a working process that requires the most time and expenditure. Recently, the rapid developments of navigation sensors and communication technologies have enabled Unmanned Aerial Vehicles (UAVs) to conduct photogrammetric mapping without using GCP because of the availability of new methods such as RTK (Real Time Kinematic) and PPK (Post Processed Kinematic) technology. In this study, an experiment was conducted to evaluate the potential of RTK-UAV mapping with no GCPs compared to that of non RTK-UAV mapping. The positioning accuracy results produced by images obtained simultaneously from the two different types of UAVs were compared and analyzed. One was a RTK-UAV without GCPs and the other was a non RTK-UAV with different numbers of GCPs. The images were taken with a Canon IXUS 127 camera (focal length 4.3mm, pixel size $1.3{\mu}m$) at a flying height of approximately 160m, corresponding to a nominal GSD of approximately 4.7cm. As a result, the RMSE (planimetric/vertical) of positional accuracy according to the number of GCPs by the non-RTK method was 4.8cm/8.2cm with 5 GCPs, 5.4cm/10.3cm with 4 GCPs, and 6.2cm/12.0cm with 3 GCPs. In the case of non RTK-UAV photogrammetry with no GCP, the positioning accuracy was decreased greatly to approximately 112.9 cm and 204.6 cm in the horizontal and vertical coordinates, respectively. On the other hand, in the case of the RTK method with no ground control point, the errors in the planimetric and vertical position coordinates were reduced remarkably to 13.1cm and 15.7cm, respectively, compared to the non-RTK method. Overall, UAV photogrammetry supported by RTK-GPS technology, enabling precise positioning without a control point, is expected to be useful in the field of spatial information in the future.

Anisotropy of Magnetic Susceptibility (AMS) of the Quaternary Faults, SE Korea: Application to the Determination of Fault Slip Sense and Paleo-stress Field (한반도 남동부 제4기 단층의 대자율이방성(AMS): 단층의 운동감각과 고응력장 해석)

  • Cho, Hyeongseong;Kim, Min-Cheol;Kim, Hyeonjeong;Son, Moon
    • The Journal of the Petrological Society of Korea
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    • v.23 no.2
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    • pp.75-103
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    • 2014
  • The Quaternary faults are extensively observed along major inherited fault zones (i.e. Yangsan Fault System, Ulsan Fault, Yeonil Tectonic Line, Ocheon Fault System) in SE Korea. Their geometry and kinematics provide a very useful piece of information about the Quaternary crustal deformation and stress field in and around Korean Peninsula. Using magnetic fabrics (AMS), we attempted to determine the slip senses of Jinti, Mohwa, Suseongji2, and Wangsan faults and then interpreted the fabric development process of fault gouge and the characteristics of stress field during the Quaternary. All the magnetic fabrics of the faults, except the Wangsan Fault, consistently indicate a dominant reverse-slip sense with weak strike-slip component. Most of the oblate fabrics are nearly parallel to the fault surface and the anisotropy degrees generally increase in proportion to the oblatenesses. These results suggest that the fabrics of the fault gouges resulted from a progressive deformation due to continuous simple shear during the last reactivation stage as reverse faulting. It is also interpreted that the pre-existing fabrics were overwhelmed and obliterated by the re-activated faulting. Paleostress field calculated from the fault slip data indicates an ENE-WNW compressive stress, which is in accord with those determined from previous fault tectonic analysis, focal mechanism solution, and hydraulic fracturing test in and around Korean Peninsula.

The Effect of Hotel Employee's Service Orientation on Service Performance, Job Satisfaction, and Organizational Commitment (호텔기업 종업원의 서비스지향성이 서비스 성과, 직무만족과 조직몰입에 미치는 영향)

  • Park, Dae-Hwan
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.1-22
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    • 2007
  • Customer satisfaction is important in an increasingly competitive and global marketplace. This implies that customer service is a critical factor for many organizations. In service encounter context, customer satisfaction is affected by employees' attitudes and behaviors. Accordingly, service firms have been focusing on selecting high quality of service employees, which resulted the ability to identify and select quality service- or customer- oriented employees to become critical for an organization's success. It was suggested that customer service orientation links to performance and subsequent organizational revenue. Moreover, it was found that service encounter failures were among the major reasons for customers' service switch. Therefore, the selection of customer service oriented employees is a key factor in establishing customer service - a potential source of sustained competitive advantage. However, the measurement of employee service orientation is more confusing than that of definitive answers. The difficulty of measuring service orientation is attributed to the use of broad versus narrow measures of personality. Advocates for the broad perspective prefer using basic personality constructs, such as the Big Five personality traits. On the contrary, the latter prefer a construct-oriented approach of personality research that provides a better measure of job performance because it requires the specification of the relationship of the personality traits with multiple dimensions of job performance. The customer service orientation was defined as "a set of basic individual predispositions and an inclination to provide service, to be courteous and to be helpful in dealing with customers and associates." Similarly, it is a fact that the Big five personality traits are predictors of customer orientation, and employee's self- and supervisor performance. They propose that basic personality traits may be too far removed from focal service behaviors to be able to predict specific service behaviors (customer orientation) and service worker performance. Also, customer orientation is defined as "an employee's tendency or predisposition to meet customer needs in an on-the-job context." This means that people who have job-relevant personality traits such as concern, empathy, and conscientiousness will be more adept at customer service than people who do not possess these traits. However, little attention has been given to the exploration of the service orientation of customer-contact employees who play a key role in creating satisfactory service encounters in the hospitality industry except for Kim, McCahon, & Miller (2003)'s study, especially in family restaurants context. Thus, the purposes of this study are to examine and validate the customer service orientation of customer-contact employees using the instrument developed by Donavan (1999) in Korean family restaurants, because the scale was developed to measure the personality traits related job behaviors. And this study explores the relationships between customer service orientation, job satisfaction, organizational commitment, and self service performance using structural equation modeling (SEM). And this study explores the relationships between customer service orientation, job satisfaction, organizational commitment, and self service performance using structural equation modeling (SEM). For these purposes the author developed several hypotheses as follows: H1: Employee's service orientation is associated with service performance. H2: Employee's service orientation is positively associated with job satisfaction. H3: Employee's service orientation is positively associated with organizational commitment. H4: Service performance is positively associated with job satisfaction. H5: Service performance is positively associated with organizational commitment. H6: Job satisfaction is negatively associated with organizational commitment. The data were collected from 278 employees in 5 deluxe hotels located in Pusan, Korea. The researcher contacted the manager of the restaurants, and managers consented to administer surveys to their employees. The survey was executed during one month period in the October of 2007. The data were analyzed with structural equation modeling with LISREL 8.7 W. The result of the overall model analysis appeared as follows: $X^2$=122.638 (p = 0.00), df=59, GFI=.936, AGFI=.901, NFI=.948, CFI=.971, RMSEA=.0625. Since the result of the overall model analysis demonstrated a good fit, we could further analyze our data. The findings can be summarized as follows: First, the greater the employee service orientation, the greater the service performance. Second, the greater the employee service orientation, the greater the job satisfaction. Third, the greater the employee service orientation, the greater the organizational commitment. Fourth, the greater the service performance, the greater the job satisfaction. Fifth, the greater the service performance, the greater the organizational commitment. Finally, the greater the job satisfaction, the greater the organizational commitment. Seventh, the greater the customer satisfaction, the greater the customer loyalty.

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Neuropsychological Mechanism of Delusion (망상의 신경심리학적 기전)

  • Lee, Sung-Hoon;Kim, Dong-Wha;Park, Yun-Zo;Park, Hae-Jung;Shin, Yoon-Sik
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.60-66
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    • 2000
  • Objectives: The Psychopathology of schizophrenia was expected to be related with focal dysfunction of brain while schizophrenia is recognized and studied as the brain disease. Authors studied correlation between neuropsychological tests and delusion which is representative symptom of schizophrenia in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in delusional symptom. Methods: Halstead Reitan Neuropsychological Test Battery and Korean Weschler Intelligent Scale and Minnesota Multiphasic Personality Inventory(MMPI) were administered to one hundred ninteen patients consisted of sixty nine psychiatric patients and fifty patients with brain damage. We tested correlation between results of neuropsychological tests and delusional scale made from twenty four items related with delusion in MMPI. T-test between eighteen higher delusion scorers and twenty one lower scorers was examed in psychiatric group. Results: In brain damage group, signigicant correlations were found in the tests related with function of frontal lobe such as category test, trail making AB test, tactual performance test, digit symbol test and fingertip number writing test, and significant correlations were also noted in the tests related with function of left temporal and parietal lobes such as information, comprehension, vocabulary, similarities and speech sound perception test. The tests related with the function of right hemisphere such as tactual performance test location, picture completion and performance, and the tests related with subcortical function such as arithmetic, digit span, attention, digit symbol test, digit symbol and trail making AB test were signigicantly corelated with delusional scale too. In psychiatric group there were significant difference of delusional score in the tests related with function of left hemisphere such as vocabulary, vocable IQ, comprehension and language, and in the tests related with subcortical function such as N 120 voltage, digit symbol and arithmetic. Conclusions: Delusion seems to be related with function of frontal lobe, left hemisphere and subcortex in both groups. Right hemisphere may be also partially related with delusion.

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