Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.
Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
Asian Pacific Journal of Cancer Prevention
/
v.14
no.6
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pp.3941-3944
/
2013
Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.
Journal of the Korean BIBLIA Society for library and Information Science
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v.27
no.3
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pp.51-73
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2016
This study analyzes on the perception of public librarians about lifelong education tasks in public library using Mann Whitney U-test, Spearman rank-order correlation coefficient, Multiple regression analysis. At the same time, analysis about re-education needs using Analytic Hierarchy Process is conducted. As result, at first, 87% of respondents feel moderate or difficult about lifelong education tasks, especially on planning task. At second, librarians who have qualification about lifelong educator feel easier (P=0.04) than others, in detail, task about lecturer liaison (P=0.04) and planning (P=0.05). Adding that, the career experience and the job difficulty of librarians has negative relationship (R=-0.217). Especially scheduling (R=-0.33) and progressing (R=-0.22) tasks show statistically meaningful. At third, as the result of Multiple regression analysis, tasks about planning (P=0.04) and library marketing (P=0.05) are selected as meaningful elements which effect overall difficulty of life long education job. As final, 91% of librarian need retraining for life long education function, as result of spearman (R=-0.210), the more librarians feels difficult about life long education jobs, the more they need retraining. Anyway, as the result of priority of retraining subjects through AHP technique, user communication (CU P=0.310), planning (PL P=0.246), library marketing (LM P=0.173) are in weight order. CR ratio shows 0.146 with permissible degree.
KSCE Journal of Civil and Environmental Engineering Research
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v.35
no.6
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pp.1405-1412
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2015
In Korea, public infrastructure projects employ "long term continuation (LTC) contracts," which require budgets to be reevaluated and re-appropriated annually throughout the multi-year life of the project. However, such contracts also make it susceptible to frequently changing government policies, in which budgets required for existing projects are allocated to new projects and thus does not provide a consistent stream of capital to multi-year projects. Each year, the KEC needs to attain government funds for construction of its multiple highway construction sites. Because it is difficult to know the amount that may be actually appropriated to KEC in a given year, it is in turn difficult to anticipate and provide sufficient funds necessary for construction to run smoothly and continuously. The lack of a good logic for appropriation has resulted in projects having a skewed distribution of capital. To get better budget appropriations from the central government, the KEC first needs a systemized approach that rationalizes the annual construction capital optimally required for its individual sites. The goal of this research was to devise a way that allows the KEC to determine and calculate the optimal construction costs that would be required for its individual construction sites on an annual basis. Both the optimal progress rate and the essential work types were assessed through a workshop with 24 professionals (KEC employees and contractors) who had extensive experience in KEC projects and also were currently working in these projects.
The aims of this study concerning tourists travelling in the island of Jeju include: to identify and assess the promotional efforts for traditional Jeju cuisine; and to identify the impacts of those efforts on customers and tourists. The analyses revealed that continuous promotion efforts, along with changes in the cooking methods and the development of new menus, are needed for the items of traditional Jeju cuisine that are relatively unknown to tourists and that fail to satisfy customers. Customers seeking Jeju food reported high satisfaction with such items as grilled meat and fish, steamed meat and fish, and raw fish(hoe), so those cooking methods must also be continually improved. Promotional efforts had impacts on the satisfaction and revisit rates of customers while the recognizability of foods offered had impacts on all areas, including the satisfaction and revisit rates of customers as well as word-of-mouth advertising among them. There needs to be an experience-oriented or educational program that introduces customers to traditional Jeju cuisine. Since customers and tourists gain information on traditional Jeju cuisine from the recommendations and word-of-mouth advertising from the locals they meet on the island, traditional Jeju cuisine should also be advertised to the local residents. The commercial merchandising of Jeju culinary culture and making festivals based on it must, therefore, be preceded by studies on how to increase the locals' awareness of local traditional cuisine.
Recent progress in Martian exploration identified hematite as the major candidate for the strong magnetic anomalies observed in Martian lithosphere. In the present study, grain-size dependence of thermoremanent magnetization and low-temperature stability of room-temperature saturation isothermal remanent magnetization (RTSIRM) were monitored using synthetic hematites. For hematite, the antiferromagnetic spin configuration is re-arranged from being perpendicular to the c-axis to be parallel to the c-axis below the Morin transition ($=T_M$). A large fraction of RTSIRM is demagnetized at $T_M$ (= 260 K) during zero-field cooling from 300 K to 10 K. About 37% of the initial RTSIRM is recovered on warming from 10 K to 300 K. Shallow Martian subsurface at 1~2 km depth would experience low-temperature cooling-warming of $T_M$ because average Martian surficial temperature is about 220 K. However in most Martian lithosphere whose temperatures are higher than 260 K, the very stable magnetic memory of hematite could be a contributor to Martian magnetic anomalies.
The purpose of this study was to analyze the effect of single-fraction stereotactic radiosurgery (SRS) for the treatment of 15 cases of cerebral arteriovenous malformations (AVMs). Between 2002 and 2009, of the 25 patients who had SRS for the treatment of cerebral AVM, 15 patients (6 men, 9 women) taken a digital subtraction angiography (DSA) over 12 months after SRS were included. We retrospectively evaluated the size, location, hemorrhage of nidus, angiographic changes on follow-up on the MR angiography and DSA, and clinical complications during follow-up periods. At a median follow-up of 24 months (range 12-89), complete obliteration of nidus was observed in all patients (100%) while residual draining veins was observed in 3 patients (20%). There was no clinical complication during the follow-up period except seizure in 1 patient. The mean nidus volume was 4.7cc (0.5~11.7 cc, SD 3.7 cc). The locations of nidus were in cerebral hemisphere in 11 patients, cerebellum in 2 patients, basal ganglia in 1 patient, and pons in 1 patient respectively. 9 cases were hemorrhagic, and 6 cases were non-hemorrhagic AVMs. The SRS with LINAC is a safe and effective treatment for cerebral AVMs when the follow up period is over 4 years. However, it is recommended to continue to follow up until the draining vein on arterial phase of follow up DSA disappears completely.
Corticotropin-releasing factor(CRF) and neuropeptide Y(NPY) are known to play important roles in mediating stress responses and stress-related behavior. To elucidate the role of neuropeptides in response to the condition that had paired with traumatic event, we observed the changes of CRF and NPY by immunohistochemistry using a conditioned footshock paradigm. Male Sprague-Dawley rats were placed in a shuttle box and exposed to 20 pairings of a tone(< 70dB, 5sec) followed by a footshock(FS, 0.8mA, 1sec) over 60min. A second group was exposed to the tone-footshock pairings, returned to the homecage for 2days, and then reexposed to the test chamber and 20tones alone for 60min, prior to sacrifice. Control groups were : a) sacrificed without exposure to FS ; b) exposed to the tone-footshock pairings and then sacrificed two days later ; or c) exposed to the chamber and tones alone, returned to the homecage for 2days and then reexposed to the chamber and 20tones over 60min prior to sacrifice. CRF was increased in animals exposed to FS or the aversive condition(context and tone) that had paired to FS in bed nucleus of the stria terminalis (BNST) compared to the control. NPY was increased by FS in amygdala and PVN, but the condition previously associated with FS results in slight increase only in amygdala area. These results suggest that the BNST appears to be the mostly involved neural circuit in response to explicit cues previously paired with footshock. Moreover, this study raise the possibility that increased CRF peptide in the BNST in response to re-exposure to the aversive condition may underlie, in part, the experience of conditioned fear-related anxiety behavior.
Game production education in a university is very important because it is the stage for completing a game education course as well as for determining a future of game industry. In order to perform various experience and creative learning, it should be able to effectively use a computer infrastructure representing the knowledge and information society for the purpose of obtaining and re-processing information necessary for game production through prediction of directions of game industry as well information technology. This research is focused on an effective game engine education for students whom want to become game graphics designers. The purpose of this study is to draw a lesson of game production utilizing game engines and it enables practice-focused class for game production. It also allows the class participant to manufacture prototypes without support from game programmers for their outcomes of works planned during the game production class. The theoretical background of game production compared and analyzed exemplary game engines. Based on the result, the study selected Unity 3D engine and conducted the research on the background where the Unity engine has been selected and its characteristics. In addition, this study provided an example of game production utilizing a game engine, and also described the details of actual realization. This study selected Torque3D with the Unity in order to identify the purpose of this study and efficiency of learning. Thus, the previous situation is that the class remained in making a game plan during the course of game production project and, students whose major is not game programming. Now, it is necessary for students to make many efforts to make a game in an active and positive attitude by utilizing a game engine beyond the previous method of class.
With the upcoming Digital age, it is time to develop digitalized contents based on cultural basis. in this respect, Kimchi is one of the most primal cultural content signifying Korean culture. It's no doubt the time to initiate the movement to digitalize the contents concerning Kimchi by gathering materials on the origin of Kimchi culturally and a great value to revive digital contents regarding Kimchi. Therefore, in this research, it is regarded that Kimchi is one of the most prominent cultural value that is possible to inherit from generations and should be stratified on the database. A method explaning Korean Kimchi culture is sought in this paper. And It is focused on the culture of Korean Kimchi profoundly and focus on detailed context and varied styles of he digital contents. It is organized on the basis of various aged volumes regarding Kimchi classified by seasons, ingredients, Jonga Kimchi (Kimchi inherited from the oldest family by generations), 24 seasonal divisions of the year, and 8 regional divisions of the nation. It is planned to set up digitally-focused library regarding cultural origin of contents and to present solidity and a feeling of being dynamic The results could be used in a variety of Industries in tourism, education, Kimchi and building basic infrastructure in entertainment industry. It is also applied to specialized industry by providing cultural contents and it could contribute to activation of Kimchi industry with e-Market and portal site regarding Kimchi. Moreover, it may re-establish the cultural value of Kimchi and provide the infrastructure in Kimchi-related industry such as Kimchi cyber museum, Kimchi Expo, Kimchi town by using educational materials in Education industry fields (regular curriculum and experience tour).
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