• Investigative Magnetic Resonance Imaging
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• v.9 no.2
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• pp.109-116
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• 2005

Purpose : To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. Materials and Methods : Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm<, 1-2 cm, and >2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. Results : In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p=0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm<, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28%, p=0.023). Conclusion : Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (<2 cm) and could improve detection of the small hepatic metastases (<1 cm) from colorectal carcinoma.

• Korean Journal of Child Education & Care
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• v.18 no.2
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• pp.85-102
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• 2018

The purpose of this study is to determine the working conditions and demands of the assistant workforce at childcare centers, and to provide suggestions on policies for childcare teachers. To achieve the purpose of the study, a total of 190 assistant teachers, nursing helpers, alternative teachers and others were surveyed online during the month of August 2017. The survey examined the employment route and working motives, working conditions and environment, job and educational difficulties for analyzing the work conditions and demands of ancillary staff. For the analysis method, SPSS 12.0 was used to analyze frequency and difference. The main findings are as follows. First, childcare center assistants were able to work at their respective times, making it mandatory for them to enter the workforce, and making job openings for ancillary teachers. Second, 73.7% said the daily working hours were '4 hours to 8 hours' under the conditions and 57.9% said 'More than 510,000 won to less than 1 million won.' Average amount of rest time per day was about 30 minutes, and 17% had no rest periods. Third, based on the job and education status, ancillary personnel performed "infant and child guidance and interaction", "Cleaning and cleanliness related tasks" most actively, and "care for cleaning and cleanliness" and "care for morning and night care". Fourth, in the job trouble and difficulty, ancillary staff found it difficult to satisfy with wage related complaints and job insecurity, and the reason for agreeing to the non-regular workforce becoming a regular worker was found to be due to the stability of employment. Lastly, the most urgent tasks to solve the problem of non-regular workers were to fill the wage gap between regular and irregular workers, shorten the working hours and improve the working conditions. The policy implications are presented based on the above findings.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Korean Journal of Agricultural Science
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• v.9 no.1
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• pp.357-370
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• 1982

Recent concern regarding price and availability of fossil fuels has spurred the interest in alternative sources for farm crop drying. Among the available options such as biomass energy, wind power, nuclear energy and solar energy etc., the increasing attention is being directed to the utilization of heat from solar energy especially for farm crop drying. Even though solar energy is dispersed over a large land area and only a relatively small amount of energy can be simply collected, the advantages of solar energy is that the energy is free, non-polluting. The study reported here was designed to help supply the informations for the development of simple and relatively inexpensive solar warehouse for farm crop drying and storage. Specifically, the objectives of this study were to determine the performance of the solar collector fabricated, to compare solar supplemented heat drying with natural air drying and to develop a simulation model of temperature in stored grain, which can be used to study the effects due to changes in ambient air temperature. For those above objectives, solar collector was fabricated from available materials. Corrugated steel galvanized sheet, painted flat black, was used as absorbers and clear 0.2mm polyethylene sheet was the cover material. The warehouse for rough rice drying and storage was constructed with concrete block, and the solar collector was used as the roof of warehouse instead of original roofing system of it. The results obtained in this study were as follows: 1. The thermal efficiency of the solar collector was average 26 percent and the overall heat transfer coefficient of the collector was approximately $25kJ/hr.m^2\;^{\circ}K$. 2. Solar heated air was sufficient to dry one cubic meter of rough rice from 23.5 to 15.0 percent in 7 days and natural air was able to dry the same amount of rough rice from 20.0 to 5 percent in l2 days. 3. Drying with solar heat reduced the required drying time to dry the same amount of rough rice into a half compared to natural air drying, but overdrying problems of the bottom layer were so severe that these problems should be thoroughly analyzed. 4. Simulation model of temperature in stored grain was developed and the results of predicted temperature agreed well with test results. 5. Based on those simulated temperature, changes in the grain-temperature were a large at the points of the wallside and the damage of the grain would be severe at the contact area of wall.

• Journal of Elementary Mathematics Education in Korea
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• v.5 no.1
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• pp.99-120
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• 2001

The purpose of this thesis is to find the guiding direction of mathematical communication in lower grade students of elementary school and to present a new direction about the effect of using concrete material in communication. It is expected that mathematical communication increases when concrete material is used for the students of the lower grades, who are in concrete operational period. Therefore, this study ai s to investigate what characteristics there are in mathematical communication of second grade students and what effect concrete materials have on mathematical communication and learning. The analysis of the teaching record shows that the second grade students use alternative terms in the process of communication since they are not familiar with mathematical symbols or terms, which is a characteristic of communication in a mathematics class in which concrete material is used. In the process of teaming the students apply their living experiences to their teaming. Since a small number of students lead class, the interaction between students is also led by them. The direction of communication in a small group is not centered around solution of a problem, and most students show a more interest in finding answers than in the process of learning. The effect that concrete material has on communication plays an important role in promoting students' speaking activity; it allows students to identify and correct their errors more easily. It also makes students' activities more predictable, and it increases a small group activities through the medium of concrete material. However, it was also noticed that students' listening activities are not appropriately developed since they do not pay attention to a teacher who uses concrete material. The effects that concrete material has on mathematics class can be summarized as follows. Concrete material promotes students' participation in class by triggering their interest of learning of mathematics and helps them to understand the course of learning. It also helps the teaming and formation of concepts for children of low academic performance. And it makes a phased learning possible according to students' ability to use concrete material and to solve a problem. Based upon the results above mentioned, the use of concrete material is absolutely needed in mathematics classes of lower grade elementary school students since it increases communication and gives much influence on mathematics learning. Therefore, teachers need to develop teaching or learning method which can help increase communication, considering the characteristics of students' communication.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.130-136
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• 2008

Purpose: Lamivudine is known to be effective for the treatment of chronic hepatitis B in adults. However, data on lamivudine therapy in pediatrics is limited. The aim of this study was to evaluate the efficacy and durability of lamivudine therapy for chronic hepatitis B in Korean children. Methods: A total of 44 children (27 males and 17 females, ages 6 months to 14.8 years, mean age 6.7 years) with chronic hepatitis B who received lamivudine (3 mg/kg/day, max 100 mg) for at least 12 months were enrolled. We evaluated the serum AST, ALT and serological HBV markers (HBsAg and anti-HBs, HBeAg and anti HBe, and HBV DNA) periodically. Predictive three year cumulative seroconversion rates were obtained using the Kaplan-Meier method. Results: Twenty one (48%) of 44 children achieved seroconversion of HBeAg by three years, while 23 (42%) children did not. HBV DNA was cleared in 34 (77%) children and the serum ALT levels were normalized in 41 children (93%). The three year cumulative seroconversion rates were 60% for HBeAg, and the clearance rates were 76% for HBV DNA. Eighteen children who discontinued lamivudine after HBeAg seroconversion maintained the therapeutic response for three years (treatment duration 13~58 months mean 24 months). Viral breakthrough developed in 12 children (27%) during the therapy and the YMDD mutation was documented in 11 children (25%). The mean duration for the development of a mutation was 22.7 months. Loss of HBsAg occurred in 6 children (14%). The pretreatment ALT levels were higher in responders; however, the differences were not statistically significant (p>0.05). Conclusion: The results of this study showed that lamivudine treatment had a favorable effect and durable therapeutic response in children with chronic hepatitis B. Long term follow-up and alternative therapy are warranted for those patients who do not respond to this treatment.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.362-368
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• 2007

Background: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. Material and Method: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax undewent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a blob larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant blob via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. Result: Multiple or single blob lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and blob was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of $30{\pm}3$ months, no recurrence occurred in both the operative group and the non-operative group. Conclusion: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.266-272
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• 2010

Background: Deep vein thrombosis (DVT) is a serious disease that causes life-threatening pulmonary embolism and chronic venous insufficiency. Anticoagulation is the standard therapy for DVT. However, the results of standard anticoagulation for treating DVT have been disappointing, so endovascular treatment is commonly performed nowadays. The aim of this study was to evaluate the efficacy of an endovascular procedure for treating patients with DVT. Material and Method: We retrospectively evaluated the clinical data of 29 DVT patients who underwent an endovascular procedure between December 2006 and July 2008. We compared the results of the 29 patients with the results of another 45 patients who were treated with only aspirin and heparin. Result: The patient’s mean age was 55.4 years in the intervention group and 53.7 years in the control group. DVT occurred more frequently in the females. Catheter-directed thrombolysis was performed in 22 patients (75.8%). Aspiration thrombectomy was performed in 18 patients (62%) and a endovascular stent was placed in 25 patients (86.2%). Fifteen patients (51.7%) underwent percutaneous insertion of a retrievable IVC filter for the prevention of pulmonary embolism. In the control group, thirty nine patients (86.7%) were treated with low-molecular heparin, and seven patients (15.6%) who were contraindicated for warfarin were treated with aspirin. No bleeding complications occurred during thrombolysis or anticoagulation. We analyzed the statistical data according to recurrence of DVT and the incidence of post-thrombotic syndrome (PTS) during the follow-up period. The intervention group had a significantly lower incidence of PTS (p-value=0.008), but they had the same result as the control group for the recurrence of DVT. In addition, death from the DVT did not occur in the intervention group. Thus, we obtained better clinical outcomes in the intervention group as compared to those in the anticoagulation only group. Conclusion: Endovascular procedures are effective alternative modalities, as compared to systemic anticoagulation, for the treatment of DVT. But more studies are needed to determine the specific indications and to validate the long-term efficacy of endovascular procedures for the treatment of DVT.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.127-132
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• 2010

Background: Femoropopliteal artery bypss grafting is an effective form of treatment for infrainguinal artery occlusive disease in those patients who have either intermittent claudication or resting critical ischemia. The objective of this analysis was to evaluate the long-term patency of a femoropopliteal bypass graft that is classified as an above-the-knee saphenous vein graft or an above-the-knee PTFE (polytetrafluoroethylene) graft. Material and Method:From January 1998 to February 2005, 103 above-the-knee femoro-popliteal bypasses were performed on 87 patients. There were 74 male and 13 female patients with a mean age of $65.7{\pm}9.69$ (range: 31~82). The surgical indications were intermittent claudication in 65 cases (74.7%), foot ulceration in 2 cases (2.3%), foot necrosis in 10 ases (11.5%) and toe necrosis in 10 cases (11.5%). For the bypass graft, a reversed saphenous vein was used in 31 limbs and a polytetrafluoroethylene (PTFE) prosthesis was used in 72 limbs (6 mm: 27 limbs, 8 mm: 45 limbs). The perioperative risk factors were diabetes mellitus in 33 cases (37.9%), hypertension in 47 cases (54.0%), a history of ischemic heart disease in 13 cases (14.9%) and smoking in 72 cases (82.8%). Result:There were three perioperative deaths (3.4%) and seven late deaths (8.3%). Major leg amputation was necessary in 12 patients (13.8%) during the entire course of the study. The primary patency rate at 5 years for the vein grafts, the 8 mm-PTFE grafts and the 6 mm-PTFE grafts were 84.7%, 77.4% and 74.2%, respectively and the overall primary patency rate was 78.7%, and there were no significant statistical differences among the graft groups. By using multivariate analysis, the number of patent tibial arteries was determined to be a significant factor that influenced the primary graft patency rate (p<0.005), but risk factors such as diabetes mellitus, ischemic heart disease, smoking and age had no statistically significant affect on the primary graft patency rates. Conclusion: The great saphenous vein is considered the most durable conduit for infrainguinal revascularization, but the overall results of this study show that saphenous vein and PTFE grafts have comparable patency rates when used above the knee in patients with claudication or critical ischemia. The use of PTFE above the knee is a reasonable alternative for a femoro-poplitael bypass and it is associated with acceptable long term patency rates.

• Journal of the Korean Institute of Gas
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• v.23 no.6
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• pp.90-96
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• 2019

Natural gas has been regarded as one of major alternative fuels, because of the increment of mining shale gas and supplying PNG(Pipeline Natural Gas) from Russia. Thus, it needs to broaden the usage of natural gas as the increasing its supplement. In this situation, application of natural gas on the transport area is a good suggestion to reduce exhaust emissions such as CO₂(carbon dioxides) and soot from vehicles. For this reason, natural gas can be applied to SI(spark ignition) engines due to its anti-knocking and low auto-ignitibility characteristics. Recently, since turbocharged SI engine has been widely used, it needs to apply natural gas on the turbocharged SI engine. However, there is a major challenge for using natural gas on turbocharged SI engine, because it is hard to make natural gas direct injection in the cylinder, while gasoline is possible. As a result, there is a loss of fresh air when natural gas is injected by MPI (multi-point injection) method under the same intake pressure with gasoline-fueled condition. It brings the power reduction. Therefore, in this research, intake pressure was increased by controling the turbocharger system under natural gas-fueled condition to improve power output. The goal of improved power is the same level with that of gasoline-fueled condition under the maximum torque condition of each engine speed. As a result, the maximum power levels, which are the same with those of gasoline-fueled conditions, with improved brake thermal efficiency could be achieved for each engine speed (from 2,000 to 6,000 rpm) by increasing intake pressure 5-27 % compared to those of gasoline-fueled conditions.