• The Journal of the Korean bone and joint tumor society
• /
• v.9 no.2
• /
• pp.148-154
• /
• 2003

Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

• Pediatric Infection and Vaccine
• /
• v.17 no.2
• /
• pp.148-155
• /
• 2010

Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.

• Neonatal Medicine
• /
• v.17 no.2
• /
• pp.224-231
• /
• 2010

Purpose: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. Methods: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. Results: The mean gestational age was $38^{+3}{\pm}1^{+4}$ weeks, and the mean age on admission was 8.8$\pm$4.0 days. The mean body weight (3,105$\pm$479 g) was decreased by 2.8$\pm$6.4 percent compared to the mean birth weight (3,174$\pm$406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. Conclusion: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.

• Pediatric Infection and Vaccine
• /
• v.15 no.1
• /
• pp.36-44
• /
• 2008

Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

• Radiation Oncology Journal
• /
• v.28 no.3
• /
• pp.177-183
• /
• 2010

Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.5
• /
• pp.519-528
• /
• 2002

Background : Steroid therapy has been shown to improve the clinical outcome in acute respiratory distress syndrome (ARDS) patients with histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. Because the histopathological features of acute interstitial pneumonia(AIP) are identical with that of ARDS, early steroid therapy was used in AIP patients who had histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. We analyzed seven years of our experience to evaluate the efficacy of early steroid therapy in AIP. Materials and Methods : A retrospective review was performed on AIP patients who received steroid therapy within 7 days of mechanical ventilatory support in Dankook university Hospital between May 1995 and May 2002. AIP was diagnosed clinically by ARDS without a known cause of the etiology and pathologically by a lung biopsy showing a fibroproliferative stage of diffuse alveolar damage. The clinical response and physiologic parameters were evaluated during steroid therapy. Results : Five AIP patients received intravenous methylprednisolone (1-2 mg/kg every 6 hours) after $0.6{\pm}1.7$ days of mechanical ventilatory support. Lung biopsies were performed after $1.8{\pm}1.4$ days of mechanical ventilatory support. Four patients(80%) survived and were extubated after $2.8{\pm}0.4$ days of steroid therapy with improvement in the $PaO_2/FiO_2$ ratio ($127.4{\pm}10.0$ at day 0 to $223.8{\pm}37.6$ at day 7) by steroid therapy. However, one patient(20%) died of respiratory failure after 15 days of steroid therapy. Conclusion : Early steroid therapy sppears to be beneficial in AIP patients without evidence of infection. However, as our study group was too small, further large scale studies to define the effectiveness of steroids are required.

• Korean Journal of Cognitive Science
• /
• v.19 no.4
• /
• pp.331-367
• /
• 2008

This study aims to validate a web-based neuropsychological testing tool developed by Kwak(2007) and to suggest solutions to potential problems that can deteriorate its validity. When it targets a wider range of subjects, a web-based neuropsychological testing tool is challenged by high drop-out rates, lack of motivation, lack of interactivity with the experimenter, fear of computer, etc. As a possible solution to these threats, this study aims to redesign the user interface of a web-based attention testing tool through three phases of study. In Study 1, an extensive analysis of Kwak's(2007) attention testing tool was conducted to identify potential usability problems. The Heuristic Walkthrough(HW) method was used by three usability experts to review various design features. As a result, many problems were found throughout the tool. The findings concluded that the design of instructions, user information survey forms, task screen, results screen, etc. did not conform to the needs of users and their tasks. In Study 2, 11 guidelines for the design of web-based attention testing tools were established based on the findings from Study 1. The guidelines were used to optimize the design and organization of the tool so that it fits to the user and task needs. The resulting new design alternative was then implemented as a working prototype using the JAVA programming language. In Study 3, a comparative study was conducted to demonstrate the excellence of the new design of attention testing tool(named graphic style tool) over the existing design(named text style tool). A total of 60 subjects participated in user testing sessions where their error frequency, error patterns, and subjective satisfaction were measured through performance observation and questionnaires. Through the task performance measurement, a number of user errors in various types were observed in the existing text style tool. The questionnaire results were also in support of the new graphic style tool, users rated the new graphic style tool higher than the existing text style tool in terms of overall satisfaction, screen design, terms and system information, ease of learning, and system performance.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.41 no.2
• /
• pp.11-26
• /
• 2013

Designing large parks such as Yongsan Park requires the open-ended process-oriented design approach in complex layers rather than the conventional self-completed master plan method. This study aims to examine the characteristics of process-oriented design in the eight invited entries of "International Competition for the Master Plan of the Yongsan Park, Korea"(2012). For this purpose, it analyzed each entry according to three criteria: objects of process-oriented approach, time factor and its features of phasing plan, and presentation method of the process. This analysis can not only critically review the current level of the process-centered design methodology but also suggest strategic future directions for Yongsan Park. The objects of process-oriented design in the eight works were order of physical space development, restoration process of ecosystem, recovering process of publicity, and economic operation and management. Main considerations in the objects were connections to adjacent urban fabrics, links to regional green and water system, reuse of existing buildings and infrastructures in the site. The temporal criteria of the phasing plan had two aspects. One was planning a certain time and period, and the other was just establishing an order of phases. Most of the presentation method of process was the phasing plan, but some of the entries suggested a scenario plan. The eight works of "International Competition for the Master Plan of Yongsan Park" did not attempt process-oriented designs entirely and completely. Rather, they tried to introduce the phasing plan as part of a process-centered design. Also, they took an eclectic approach between master plan and process-oriented design instead of rejecting the conventional master plan approach.

• Clinical and Experimental Pediatrics
• /
• v.48 no.2
• /
• pp.191-196
• /
• 2005

Purpose : Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. Methods : The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. Results : Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was $0.8{\pm}0.2IU/kg/wk$ in GH treated group. Mean growth velocity was $5.6{\pm}2.0cm/yr$, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were $12.2{\pm}2.7yr$ $10.3{\pm}2.5yr$ $127.5{\pm}10.1cm$ and $-3.1{\pm}1.1$, respectively. In the GH treated group, the mean FAH and SD score of FAH were $146.9{\pm}5.8cm$ and $-2.7{\pm}1.2$, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. Conclusion : GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
• /
• v.78
• /
• pp.93-117
• /
• 2018

In all countries of the world, the development of trade is an important factor for the survival of the national economy. Increased export will lead to national economic growth. Export is directly linked to employment, and the industrial structure will be developed in the direction to produce products of comparative advantages. Therefore, every country around the world is trying to promote export regardless of the size of its economy. Accordingly, this paper focused on the promotion of export of domestic companies. It proposed to cultivate trade experts to promote export of domestic companies. The following five methods were proposed to materialize the proposal. First, it is important to foster trade experts to expand and foster the one-person creative companies. In particular, it is important to develop a professional education curriculum. It is necessary to design and conduct a systematic curriculum throughout the process including follow-up after education such as teaching detailed procedures for establishing a trade business, identification of relevant regulations and related organizations, understanding of special features of each exporting country, and details of exporting procedures through specialist training for the individual industries, helping themto keep their network steady so that they can easily get help from consultants. Second, it is necessary to educate traders working in the field to make them trade experts and utilize themin on-the-job training and consulting. To do this, it is necessary to introduce systematic consultant selection process, and to introduce a systemto educate and manage them. It is because, we must select the most appropriate candidates, educate themto be lecturers and consultants, and dispatch themto the field, in order to make the best achievement in export. Nurturing trading professionals utilizing the current trading workers to activate export of domestic companies can be more efficient through cooperation of trading education agencies and related agencies in various industries. Third, it is also proposed to cultivate female trade experts by educating female trade workers whose career has been disrupted. It is to provide career disrupted women with opportunities to work after training them as trade professionals and to give manpower pool to domestic companies that are preparing for export. Fourth, it is also proposed to educate foreign students living in Korea to be trading experts and to utilize them as trading infra. They can be trading professionals who will contribute to the promotion of export. In the short term, they will be provided with opportunities for employment and start-upin the field of trade, and in the mid- to long-term, they may develop a business network between Korea and their own countries. To this end, we need to improve the visa system, expand free trade education opportunities, and support them so that they can establish small but strong enterprises. Fifth, it is proposed to proactively expand trade education to specialized high school students. Considering that most of domestic companies pursuing activation of export are small but strong companies or small and mediumsized companies, they may prefer high school graduates rather than university graduates because of financial limitations. Besides, the specialized high school students may occupy better position in the job market if they are equipped with expertise in trading. This study can be meaningful, in that it is the first research that focuses on cultivating trading experts to contribute to the export activation of domestic companies. However, it also has a limitation that it has failed to reflect the more specific field voices. It is hoped that detailed plans will be derived from the opinions of the employees of domestic companies making efforts to become an export company in the related researches in the future.