• Korean Circulation Journal
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• v.52 no.4
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• pp.304-319
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• 2022

Background and Objectives: De-escalation of dual-antiplatelet therapy through dose reduction of prasugrel improved net adverse clinical events (NACEs) after acute coronary syndrome (ACS), mainly through the reduction of bleeding without an increase in ischemic outcomes. Whether the benefits of de-escalation are sustained in highly thrombotic conditions such as ST-elevation myocardial infarction (STEMI) is unknown. We aimed to assess the efficacy and safety of de-escalation therapy in patients with STEMI or non-ST-segment elevation ACS (NSTE-ACS). Methods: This is a pre-specified subgroup analysis of the HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomized to prasugrel de-escalation (5 mg daily) or conventional dose (10 mg daily) at 1-month post-percutaneous coronary intervention. The primary endpoint was a NACE, defined as a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, clinically driven revascularization, stroke, and bleeding events of grade ≥2 Bleeding Academic Research Consortium (BARC) criteria at 1 year. Results: Among 2,338 patients included in the randomization, 326 patients were diagnosed with STEMI. In patients with NSTE-ACS, the risk of the primary endpoint was significantly reduced with de-escalation (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.48-0.89; p=0.006 for de-escalation vs. conventional), mainly driven by a reduced bleeding. However, in those with STEMI, there was no difference in the occurrence of the primary outcome (HR, 1.04; 95% CI, 0.48-2.26; p=0.915; p for interaction=0.271). Conclusions: Prasugrel dose de-escalation reduced the rate of NACE and bleeding, without increasing the rate of ischemic events in NSTE-ACS patients but not in STEMI patients.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.50-61
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• 2023

Objective: To describe the roadmapping technique and our three-year experience in the management of intracranial aneurysms in the hybrid operating room. Methods: We analyzed all patients who underwent surgical clipping for cerebral aneurysms with the roadmapping technique from January 2017 to September 2019. We report demographic, clinical, and morphological variables, as well as clinical and radiological outcomes. We further describe three illustrative cases of the technique. Results: A total of 13 patients were included, 9 of which (69.2%) presented with subarachnoid hemorrhage, with a total of 23 treated aneurysms. All patients were female, with a mean age of 47.7 years (range 31-63). All cases were anterior circulation aneurysms, the most frequent location being the ophthalmic segment of the internal carotid artery (ICA) in 11 cases (48%), followed by posterior communicating in 8 (36%), and ICA bifurcation in 2 (8%). Intraoperative clip repositioning was required in 9 aneurysms (36%) as a result of the roadmapping technique in the hybrid operating room. There were no residual aneurysms in our series, nor reported mortality. Conclusions: The roadmapping technique in the hybrid operating room offers a complementary tool for the adequate occlusion of complex intracranial aneurysms, as it provides a real time fluoroscopic-guided clipping technique, and clip repositioning is possible in a single surgical stage, whenever a residual portion of the aneurysm is identified. This technique also provides some advantages, such as immediate vasospasm identification and treatment with intra-arterial vasodilators, balloon proximal control for certain paraclinoid aneurysms, and simultaneous endovascular treatment in selected cases during a single stage.

• Journal of Korean Home Economics Education Association
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• v.18 no.1 s.39
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• pp.65-76
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• 2006

The purposes of this study were to segment adolescents into groups by Satir's communication and self-esteem and to investigate the differences among the groups regarding impulse buying of clothing and clothing behavior. The study distributed the questionnaires to the adolescents who were high school students in seoul. The total respondents were 596. The data were analyzed by factor analysis, k-means cluster analysis, ANOVA, Duncan test, regression and ${\chi}2-test$. Factor analysis showed that impulse buying of clothing had three dimensions: sensitive aspects of products stimulation, marketing situation stimulation and non-Plan stimulation. K-means cluster analysis showed that adolescents were segmented into four groups(blame-high self esteem, placate-high self esteem, blame-low self esteem, placate-low self esteem). The four groups were significantly different in regard to three dimensions of sensitive aspects of products stimulation, marketing situation stimulation and non-plan stimulation. For example, placate-high and low self esteem groups were influenced by sensitive aspects of products stimulation and marketing situation stimulation(-). And blame-high and low self esteem groups were influenced by marketing situation stimulation.

• Proceedings of the Korean Geotechical Society Conference
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• 1991.10a
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• pp.87-102
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• 1991

It has been reported that the failure of Carsington Dam in Eng1and occured due to the existence of a thin yellow clay layer which was not identified during the design work, and due to pre-existing shears of the clay layer. The slope stability analyses during the design work, which utilized traditional circular arc type failure method and neglected the existence of the clay layer, showed a safety factor of 1.4. However, the post-failure analyses which utilized translational failure mode considering the clay layer and the pre-existing shear deformation revealed the reduction of safety factor to unity. The post-failure analysis assumed 10。 inclination of the horizontal forces onto each slice based on the results of finite element analyses. In this paper, Bishop's simplified method, Janbu method, and Morgenstern-Price method were used for the comparison of both circular and translational failure analysis methods. The effects of the pre-existing shears and subsquent movement were also considered by varying the soil strength parameters and the pore pressure ratio according to the given soi1 parameters. The results showed factor of safefy 1.387 by Bishop's simplified method(STABL) which assumed circular arc failure surface and disregarding yellow clay layer and pre-failure material properties. Also the results showed factor of safety 1.093 by Janbu method(STABL) and 0.969 by Morgenstern-Price method(MALE) which assumed wedge failure surface and considerd yellow clay layer using post failure material properties. In addition, dam behavior was simulated by Cam-Clay model FEM program. The effects of pore pressure changes with loading and consolidation, and strength reduction near or at failure were also considered based on properly assumed stress-strain relationship and pore pressure characteristics. The results showed that the failure was initiated at the yellow clay layer and propagated through other zones by showing that stress and displacement were concentrated at the yel1ow clay layer.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.2
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• pp.114-120
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• 2017

There have been many studies to develop methods for predicting diabetes and to prevent diabetes. The validity of glycated hemoglobin (HbA1c), one of the commonly known tools in predicting diabetes, has been verified by many previous studies. In this study, we examined the cutoff value of HbA1c for diabetes and impaired fasting glucose (IFG). Based on this study, we proposed a proper clinical guideline and evaluated the validation of the guideline. Excluding those without blood glucose and HbA1c data, we used the data of 5,161 subjects (2,281 men and 2,880 women) over the age of 20 years from the 2015 Korean National Health and Nutrition Examination Survey. The correlation efficient of fasting plasma glucose (FPG) and HbA1c was 0.79, indicating a strong relationship. Howeve, the correlation efficient of FPG and HbA1c was low, showing 0.27 in non-diabetes, 0.39 in IFG, and 0.66 in diabetes, showing a strong relationship. The cutoff value of HbA1c for predicting diabetes using ROC curve was 6.05% (sensitivity 84.6%, and specificity 92.0%), and AUC was 0.941 (0.937 in men, and 0.946 in women). The cutoff value of HbA1c for predicting IFG using ROC curve was 5.55% (sensitivity 64.5%, and specificity 70.0%), and AUC was 0.733 (0.708 in men, and 0.764 in women). Therefore, it may not be appropriate to apply the guidelines for diagnosing IFG since sensitivity and specificity were below 70%. For future studies retarding the cutoff value of HbA1c in predicting IFG, high sensitivity and specificity are expected if we segment the reference range of IFG.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.165-181
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• 1999

Treatment mechanics should be individualized to be suitable for each patient's personal teeth and anatomic environment to get a best treatment result with the least harmful effects to teeth and surrounding tissues. Especially, the change of biomechanical reaction associated with that of the centers of resistance of teeth should be considered when crown-to-root ratio changed due to problematic root resorption and/or periodontal disease during adult orthodontic treatment. At the present study, in order to investigate patterns of initial displacements of anterior teeth under certain orthodontic force when crown-to-root ratio changed in not only normal periodontal condition but also abnormal periodontal and/or teeth condition, the changes of the centers of resistance for maxillary and mandibular 6 anterior teeth as a segment were studied using the laser reflection technique, the lever & pulley force applicator and the photodetector with these quantified variables reducing alveolar bone 2mm by 2mm for each of maxillary 6 anterior teeth until the total amount of 8mm and root 2mm by 2mm for each of mandibular 6 anterior ones until the total amount of 6mm. The results were as follows: 1. Under unreduced condition, the center of resistance during initial displacement of maxillary 6 anterior teeth was located at the point of about $42.4\%$ apically from cemento-enamel junction(CEJ) of the averaged tooth of them and kept shifting to about $76.7\%$ with alveolar bone reduction. 2. The distance from the averaged alveolar crest level of maxillary 6 anterior teeth to the center of resistance for the averaged tooth of them kept decreasing with alveolar bone reduction, but the ratio to length of the averaged root embedded in the alveolar bone was stable at around $33\%$ regardless of that. 3. Under unreduced condition, the center of resistance during initial displacement of mandibular 6 anterior teeth was located at the Point of about $43\%$ apically from CEJ of the averaged tooth of them and this ratio kept increasing to about $54\%$ with root reduction. But the distance from CEJ to the center of resistance decreased from around 5.3mm to around 3.3mm, that is to say, the center of resistance kept shifting toward CEJ with the shortening of root length. 4. A unit reduction of alveolar bone had greater effects on the change of the centers of resistance than that of root did during initial Phase of each reduction. But both of them had similar effects at the middle region of whole length of the averaged root.

• The korean journal of orthodontics
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• v.33 no.6 s.101
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• pp.419-435
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• 2003

The purpose of this study was to evaluate growth changes and skeletal characteristics of Korean children with Class III malocclusions from 10 to 14 years of skeletal age. Radiographs of 60 children with Class III malocclusion and 60 normal controls were assessed. Both groups were subdivided into 6 samples according to sex and skeletal age. Skeletal age was assessed using handwrist X-rays using the Greulich and Pyle norms. The Krogman-Walker plane (occipitale-maxillon) through Sella was used as a reference plane in this study with x-axis perpendicular to the x-axis. Sir Student t-tests were conducted to compare the control group with the Class III group according to each gender a:nd age. The characteristics of Class III malocclusion group compared to the control group included shorter anterior and posterior cranial base, shorter and retrusive maxilla, forger mandible, increased molar-incisor distance, retroclined lower incisors, labially proclined upper incisors, and anteriorly located mandibular molar, smaller upper and middle facial depth, and larger lower facial depth. Landmarks representing facial depth, size of maxilla and mandible, and their AP relationship including anterior facial height indicate that growth characteristic was determined early in life. But growth Pattern of cranial base and some of the dental landmarks showed progressive divergence between Control and Class III groups with age. The position of the posterior border of the mandible was found to be significantly forward in both females and males by the age of 14 and at the anterior border in males and females at all ages. Hyperdivergent mandibular plane, changes in anterior segment of mandible, small anterior cranial base, and decrease in cranial base flexure was also noted.

• The korean journal of orthodontics
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• v.25 no.1 s.48
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• pp.73-85
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• 1995

Multi-Vertical Loop Arch Wire(MVLAW) is a kind of appliance for uprighting the mesially inclined posterior teeth axes simultaneously. In this study MVLAW was classified as 3 types by modifing the vertical loop design and named type A, B and C. Each MVLAW was fabricated from .017'x.025' TMA wire and preactivated at the distal end of the open vertical loop with 10 degree tip-back bend(type B has an electric welding stop at the distal end of each loop and type C has no electric welding stop). Type A MVLAW was preactivated at the apex of each open vertical loop with 10 degree tip-back bend(the electric welding stop of type A is positionod at the mesial side of each loop). The aim of the present study was to identify when and which MVLAW is more effective to correct the buccal segment axes simultaneously. The Photoelastic overview of the upper and lower right quadrant showed that stress concentrations were observed in its photoelastic model. The obtained results were as follows : 1. Higher level compression can be seen clearly at the distal curvature of the lower 1st and 2nd molar when A type MVLAW was applied without short class m elastic, but mild compression cannot be seen at the distal curvature of lower anterior teeth using the class m elastic. 2. Higher concentration was presented at the mesial curvature from the lower 1st premolar to the 2nd molar than the anterior teeth when B type MVLAW without short class III elastic was applied, but using the short class III elastic, higher concentration of compression was presented in the anterior teeth area. 3. Areas of higher compression and tension were not observed at the mesial and distal curvature of the entire 1ower teeth except lower central and lateral incisors in C type MVLAW without short class III elastic, but using the short class III elastic, higher concentration was seen at the mesial curvature of the lower 1st premolar and 1ower anterior teeth.

• CRM연구
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• v.3 no.2
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• pp.43-68
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• 2010

One of the recent research trends that universities are increasingly adopting the concept of 'customer' and the customer-oriented strategy has urged us to research enterprise-wide CRM strategy adaptable to university administration. As the first step of CRM strategy for university management, we try to validate the difference of CRM strategic factors among university types. Drawing upon both CRM process and customer equity drivers, which have been recognized as core frameworks for CRM strategy, we developed those survey instruments adoptable into university industry, and validated statistically-significant difference among 12 types of university group constructed by the levels of university evaluation and the location of the universities. We collected 261 responses from 177 universities from all over the country and analyzed the data to see the levels of CRM processes consisting of customer acquisition, retention, and expansion, and customer equity drivers consisting of value equity, brand equity, and relationship equity by using multivariate ANOVA(MANOVA). The result confirms the explicit differences of the levels of CRM processes and customer equity drivers between the groups by university evaluation levels(high/middle/low). However, the analysis failed to show the significant differences of those between the group by university locations(the capital/the suburbs/the six megalopolises/other countries). More specifically, the level of activities for customer acquisition and retention of the universities in the higher-graded group are significantly different from those in the lower-graded group from the perspective of CRM process. In terms of customer equity drivers, the levels of both brand equity and relationship equity of the higher-graded group are significantly higher than those of both middle and lower-graded group. In addition, we found that the value equity between the higher and lower-graded groups, and the brand equity between the middle and lower-graded groups are different each other. This study provides an important meaning in that we tried to consider CRM strategy which has been mainly addressed in profit-making industries in terms of non-profit organization context. Our endeavors to develop and validate empirical measurements adoptable to university context could be an academic contribution. In terms of practical meaning, the processes and results of this study might be a guideline to many universities to build their own CRM strategies. According to the research results, those insights could be expressed in several messages. First, we propose to universities that they should plan their own differentiated CRM strategies according to their positions in terms of university evaluation. For example, although it is acceptable that a university in lower-level group might follow the CRM process strategy of the middle-level group universities, it is not a good idea to imitate the customer acquisition and retention activities of the higher-level group universities. Moreover, since this study reported that the level of universities' brand equity is just correlated with the level of university evaluation, it might be pointless for the middle or lower-leveled universities if they just copy their brand equity strategies from those of higher-leveled ones even though such activities are seemingly attractive. Meanwhile, the difference of CRM strategy by university position might provide universities with the direction where they should go for their CRM strategies. For instance, our study implies that the lower-positioned universities should improve all of the customer equity drivers with concerted efforts because their value, brand, and relationship equities are inferior compared with the higher and middle-positioned universities' ones. This also means that they should focus on customer acquisition and expansion initiatives rather than those for customer retention because all of the customer equity drivers could be influenced by the two kinds of CRM processes (KIm and Lee, 2010). Surely specific and detailed action plans for enhancing customer equity drivers should be developed after grasping their customer migration patterns illustrated by the rates of acquisition, retention, upgrade, downgrade, and defection for each customer segment.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.236-245
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• 2000

Background: Transbronchial lung biopsy(TBLB) has known to yield useful information for pulmonary infiltrates of uncertain etiology, However, its safety and usefulness have not been conclusive in the critically ill patients with respiratory failure. Moreover, TBLB has not been recommended for patients with mechanical ventilation. This study was conducted to investigate the diagnostic values and risks of Will performed on critically ill patients at bedside to obtain information on the pulmonary infiltrate of unknown etiology. Methods: Twenty patients(21 admissions with 23 cases) with diffuse pulmonary infiltrates who were treated in a medical intensive care unit of a tertiary referral hospital from January 1994 to May 1998, were enrolled for the study. Their medical records were retrospectively reviewed. TBLB was opted when a noninvasive diagnostic work-up failed to reveal the cause for the pulmonary infiltrate. The procedure was performed at patients' bedside without assistance of fluoroscopy. Bronchial washing or bronchoalveolar lavage was performed on the same pulmonary segment before performing TBLB. Results: Adequate specimens were obtained in 18 cases(78%). TBLB provided a specific diagnosis in two cases. The results of TBLB suggested the underlying etiology in 9 cases; bacterial pneumonitis(4), hypersensitivity pneumonitis(1), polymyositis(1), radiation fibrosis(1), idiopathic pulmonary fibrosis(1), and BOOP(1). Therapeutic decisions were altered in 11 cases(47.8%) based on the TBLB results. Pneumocystis carinii was found in the BAL fluid of another case. Ten patients with a therapeutic change and ten patients without a management change had mortality rates of 40% and 80%, respectively. The APACHE III scores were significantly higher in patients with complications($72.8{\pm}21.8$) compared with those without complications ($48.3{\pm}18.9$)(p<0.05). The complication rates were higher in those with mechanical ventilation(50%) than in those without Mechanical ventilation(33%), but the difference was not statistically significant(p=0.3). Conclusions: TBLB may be a useful diagnostic option for critically ill patients with unknown cause of pulmonary infiltrates. However, it should be cautious be used with care for patients with mechanical ventilation or for severely ill patients.