• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.27-33
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• 2000

Objectives: The sensitivity and accuracy of thermistor airflow signal has been debated. The purposes of this study were to compare apnea-hypopnea index(AHI) detected from a conventional thermistor signal and a nasal pressure transducer of airflow(NPT), to evaluate the value of NPT for the diagnosis of upper airway resistance syndrome(UARS), and to measure airway pressure fluctuations which produced respiratory arousals in UARS by naso-oro-esophageal manometer catheter. The subjects were 30 patients with obstructive sleep apnea syndrome [mild(540), 10), and 6 UARS patients. Airway resistance arousal in this study was defined as arousals which were not associated with apnea or hypopnea of thermistor signal, but showed significant decrease of nasal airflow pressure just before arousal and a prompt recovery of nasal airflow pressure after arousal. The airway pressure fluctuations were measured during 260 airway resistance arousals observed in 10 patients with OSAS, 2 with UARS. Results: Mean AHIs of patients with OSAS were 33.4 by thermistor and 48.4 by NPT. The AHIs of mild, moderate and severe OSAS groups were 10.2, 32.1, 65.4 respectively by thermistor and 23.1, 45.9, 76.4 by NPT. The mean AHI of patients with UARS was 3.2 by thermistor and 10.8 by NPT. The mean AHI of patients with nonspecific arousals was 2.7 by thermistor and 4.4 by NPT. The mean airway pressure changes during respiratory arousals of different groups were $8.7\;cmH_2O$ in mild OSAS, $11.4\;cmH_2O$ in moderate OSAS, $24.7\;cmH_2O$ in severe OSAS and $6.6\;cmH_2O$ in UARS. Conclusion: The nasal pressure transducer of airflow was more sensitive and accurate for assessing respiratory disturbances of patients with OSAS and was extremely helpful for the diagnosis of UARS without esophageal pressure monitoring. From the results, we would like to propose carefully the NPT diagnostic criteria for sleep disordered breathing as follows: NPT-AHI 5-15 $\rightarrow$ UARS, 15-35 $\rightarrow$ mild OSAS, 35-55 $\rightarrow$ moderate OSAS and >55 $\rightarrow$ severe OSAS.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.2
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• pp.270-277
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• 2012

The purpose of this study was to evaluate the importance and satisfaction level foreigners place on human and physical evidence service in Korean restaurants based on nationality such as American/European, Japanese, Chinese, and Southeast Asian. The research was performed by using questionnaires conducted from August to September on 365 foreigners living in Busan. Total mean scores for the importance (3.96/5.00) and satisfaction (3.33/5.00) of Korean restaurant human and physical evidence service were significantly different (p<0.01), as the gap was -0.63. The mean scores of the gap were -1.03 for cleanliness of dining area, -1.01 for cleanliness of tableware, and -0.95 for easily understandable menu board. The mean scores of satisfaction for Southeast Asian individuals (3.77) were significantly (p<0.01) higher than those of American/European (3.40), Chinese (3.37), and Japanese (2.81). The importance and satisfaction grid showed that an easily understandable menu board and a brief description of the food or menu scored high for the importance and low for the satisfaction in American/European, Chinese, and Japanese individuals. Cleanliness of the dining area, cleanliness of tableware, cleanliness of staff appearance, kindness of employees, rapid resolution of complaints, and prompt and quick service scored high for importance and low for satisfaction in Japanese. However, Southeast Asians were satisfied with human and physical evidence service of Korean restaurants.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.11 no.5
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• pp.77-90
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• 2016

This study is to examine the importance of site selection and service quality in franchise business as food service franchise became one of the fastest-growing service industries today. The chief finding of this study is as follows: First, a survey in locational and service quality factors affecting food service franchise shows that responders are more concerned with hygiene and visibility of the store than proximity and transportation advantages which reflects low statistical significance, thus the distance did not seem to be a big problem for the responders in the context that they mostly visit nearby food franchise. Second, the examination of the influence by the service quality factors and customer satisfaction shows significant positive relation with customer response, speed and accuracy, and accuracy factors which reveals that the responders prefer prompt response and swift judgment toward the customer's needs and expectations, professional knowledge services to the credibility factors in which little correlation with the customer satisfaction were found. Third, the examination of the influence by the service quality factors, locational factors, and re-visit reveals that customer response and specialty showed statistically significant correlation with intention of WOM (Word of Mouth) and revisit, which suggests that swift judgment and response toward the customer's needs and expectations, professional knowledge services is of great importance to both customer satisfaction and revisit. The study on the aspects of locational and service quality factors affecting franchise industry's customer satisfaction was conducted as above, an investigation in both factors' influence on the customer satisfaction was made, and based on the results of the analysis, this research seeks an optimal operation strategy of a franchise business. Food service franchise are relatively very competent to business adminstration and reaction capability to consumption changes due to the already established market, and there are stores springing up everywhere inspired by the founders who are too confident of their success in the franchise business. However, it is necessary for the franchise beginners to figure out a zone oriented, regular customer oriented business strategy than just complying with the head office manual. Owing to an increasing trend of opening medium to large sized stores and investments in the wake of converting to multiple business type Korean food franchise, there is growing need to set up new concept of store development and operational management strategy in order to overcome the excessive competition and limited sales volume of the old-fashioned small sized, small capital franchise stores. Furthermore, as most business category of food service franchise serve very similar menus, from a product differentiation point of view, it is required to map out flexible sales concept including the adoption of competitive and low-price strategy. In conclusion, as is shown in the analytical research, the customers' optimal choice fluctuate over their preferences like customer convenience and circumstances rather than insisting on specific brand, thus it will be necessary for the franchise stores to draw up aggressive strategy and planning in running food service franchise to maximize their profits.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.11 no.5
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• pp.29-43
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• 2016

The Lean Startup, a methodology for minimizing failure rate of startups, has been receiving attention since its publication in 2011. Although it has been receiving enormous attention as an effective methodology of startups' growth and the emergence of unicorn companies, it is undeniable that the theoretical research and cases on this topic have not been fully accumulated in Korea. Progress of management theory has been made when combining the theory and case studies. In this paper, we thus excavated the 'Cardoc' case, which has applied the lean startup concept to the entire process of service and customer development from the inception of its product design. The following are the findings of the case. First, for the successful application of lean startup, it is essential that all team members to understand the lean startup concept and are willing to apply it thoroughly to the business management. Second, the prompt launching of MVP(Minimum Viable Product) is more important than table discussion. Third, it is crucial to select the appropriate key metrics and analytic tools for effective learning. Fourth, startup must scale up promptly as soon as it verifies the product-market fit through the BML(Build-Measure-Learn) iteration cycle. Fifth, all new business expansion should be lean. Cardoc is currently testing new MVPs in order to move onto the next scale-up process with huge investments in newly added segments. This study is meaningful in that it elaborates the representative case of a Korean startup that has applied the lean startup strategy under the circumstance of insufficient discussion of Korean startup cases in comparison with growing attention both in concept development and case accumulation abroad. We hope that this paper can be a stepping stone for future relevant research on the implementation of lean startup methodology in Korea.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.964-970
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• 2008

Purpose : Methylmalonic aciduria (MMA) and propionic aciduria (PA) are inborn errors in the catabolism of branched-chain amino acids. The study was undertaken to investigate the genotypes and clinical features of Korean patients with MMA and PA. Methods : This study examined 12 patients with MMA and eight with PA. We analyzed various clinical features, laboratory findings, treatments, and neuro-developmental outcomes. Diagnoses were based on the presence of characteristic compounds detected by amino acid analysis in serum and organic acid analysis in urine. Mutation analysis was performed in the genes of MUT, MMAA, MMAB, and MMACHC for MMA and PCCA and PCCB for PA. Results : Among the 20 patients, six patients were diagnosed before one month of age and nine patients were diagnosed after the newborn period. Five patients were diagnosed via a neonatal screening test. Patients with early-onset forms had more severe illness at presentation and generally poor outcomes. A favorable outcome was obtained in 55% patients; most of them were of a late-onset type or diagnosed by neonatal mass screening test without symptoms. Genotypes were confirmed in all patients with MMA. We detected 11 different mutations by MUT gene analysis in 10 patients, and three different mutations in MMACHC genes in two patients. PCCA and PCCB gene mutations were identified in 14 of the 16 alleles, in eight patients with PA. Conclusion : Organic aciduria is a fatal disease; however, better outcomes are expected whenever early diagnosis and prompt management are made possible. Mutation analysis is useful for confirming diagnoses and planning management strategies.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.163-201
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• 2019

Doctor has the duty of an inter-hospital transfer, known as inter-facility or secondary transfer, when the diagnostic and therapeutic facilities required for a patient are not available at the given hospital. Also, the decision to transfer the patient to an another facility is rely on whether ill patient is the benefits of care, including clinical and non-clinical reasons, available at the another facility against the potential risks. Crucial point to note is that issues about 'inter-hospital transfer' is limited to questions occurred in the course of transfer between emergency medicals (facilities). 'emergency medical (facility)' is specified by Medical Law, article 3 and the duty of an inter-hospital transfer includes any possible adverse events, medical or technical, during the transfer. Because each medical facility has an different ability to care for a patient in an emergency condition, coordination between the referring and receiving hospitals' emergency medicals would be important to ensure prompt transfer to the definitive destination avoiding delay at an emergency. Simultaneously, transfer of documents about the transfer process, medical record and investigation reports are important materials for maintaining continuity of medical care. Although the duty of an inter-hospital transfer is recognized as one of duty of doctor and more often than not it occurs, there is constant legal conflict between a doctor and a patient related to the duty of the inter-hospital transfer. Therefore, we need clear and specific legal standard about the inter-hospital transfer. This paper attempts to review the Supreme Court's cases associated to the inter-hospital transfer and to compare opinion of the cases with guideline for an inter-hospital transfer already given. Furthermore, this article is intended to broaden our horizons of understanding the duty of an inter-hospital transfer and I wish this article helps to resolve the settlement and case dealt with the duty of inter-hospital transfer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.54-60
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• 2004

Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

• Korean Security Journal
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• no.46
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• pp.113-140
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• 2016

Right to counsel means a defendant has a right to have the assistance of counsel (i.e., lawyers), and if the defendant cannot afford a lawyer, requires that the government appoint one or pay the defendant's legal expenses. The right to counsel is generally regarded as a constituent of the right to a fair trial. Historically, however, not all countries have always recognized the right to counsel. The right is often included in criminal law and constitutional law etc. First, any person who is arrested or detained shall have the right to prompt assistance of counsel. When a criminal defendant is unable to secure counsel by his own efforts, the State shall assign counsel for the defendant as prescribed by act in article 12(4) of the constitutional law. Second, the defense counsel or a person who desires to be a defense counsel may have an interview with the defendant or the suspect who is placed under physical restraint, deliver or receive any documents or things and have any doctor examine and treat the defendant or the suspect in article 34 of the criminal law. Nonetheless, problems about guarantee of the rights to counsel to the national security violators like spy terrorist and etc will be important for Koreans to consider. That is because national security violators's cases are qualitatively different from general criminal offense's cases and historically, lawyer obstruct a investigation in the process of examination of a suspect for national security violators. Therefore, this study suggest a way that a restriction the rights to counsel with an attorney in cases of the national security violators. To this end, in this paper, I touch on restriction of right to counsel during interrogation in the England and Germany etc in comparison to that of Korea and review Korea's Supreme Court decision and Constitution Court decision to understand the prospective and trends for Korean investigation procedure improvement.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.826-830
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• 2002

Prosthetic valve thrombosis(PVT) may be a life-threatening complication requiring prompt intervention. This is a case report of thrombolytic therapy for thrombosis of prosthetic mitral valve. A 47 year-old male admitted to the emergency room for abrupt onset of dyspnea. He had undergone mitral valve replacement(On-Ⅹ valve, 29mm) for mitral stenosis 8 months ago. The patient's international normalized ratio(INR) on admission was 1.09. The mechanical clicks were muffled and rales were heard in both lung fields. A transesophageal echocardiography(TEE) revealed prosthetic valve thrombosis with increased transvalvular pressure gradient(34 mmHg). The patient's condition needed to intubation for mechanical ventilation due to hemodynamic compromise, however his wife and relatives refused the surgical intervention due to financial problems. The patient was transferred to the cardiac care unit and we decided to perform thrombolytic therapy. A bolus of 1,500,000 IU of urokinase was given, followed by a drip of 1,500,000 IU for 1 hour. The patient did not improved hemodynamically; therefore, we gave 100 mg of tissue plasminogen activator(t-PA) for over 2 hours. During that time mechanical clicks were audible and hemodynamics of the patient improved progressively. A TEE showed disappearance of thrombus and decreased pressure gradient(1.7 mmHg) after 6 hours of thrombolytic therapy. The patient was recovered without any neurologic sequale and was discharged with administration of warfarin.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.495-500
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• 1993

Background: For the relief of the occlusion of major bronchi, laser therapy, radiation therapy or combined therapy is generally used. But the effect of radiation therapy is very slow and not consistent and laser therapy requires expensive equipments and technical expertise with occasional serious side effects. Direct ethanol injection has been widely used for the control of bleeding in gastrointestinal lesion, esophageal varices or renal cell carcinoma with good results. So we tried direct injection of ethanol into the tumor to relieve the obstruction of major bronchus in 11 patients. Method: All procedures were done under the fiberoptic bronchoscopy with continuous oxygen supplement and aliquoted 0.5-1.0 ml of absolute ethanol directly into the tumor through the endobronchial aspiration needle. The tumor was endoscopically removed with a biopsy forceps immediately after ethanol injection. The whole procedure was repeated 3-4 days interval until the lumen opens. Usually after 2-3 trials of ethanol injection, the lumen opened up. Results: The immediate effect of ethanol injection was whitening of the mucosa and prompt cessation of bleeding. The late effect was necrosis of the tumor. The final results of this procedure were improvement of symptoms and reexpnasion of the lung in all patients. $FEV_{1.0}$ and FVC were improved and $PaO_2$ was increased from $68.1{\pm}9.2$ mmHg to $83.9{\pm}8.1$ mmHg, $SaO_2$: from $94{\pm}8.5%$ to $96.6{\pm}1.1%$, and $AaDO_2$ was reduced from $26.5{\pm}8.5$ mmHg to $10.9{\pm}9.1$ mmHg. Conclusion: Direct ethanol injection into the tumor tissue is a rapid, cheap and relatively safe method of relieving the complete occlusion of major bronchus.