• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.373-379
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• 2010

Purpose : This study was performed to investigate the epidemiologic and clinical features of 13 respiratory viruses in children with acute lower respiratory tract infections (ALRIs). Methods : Nasopharyngeal aspirates were prospectively obtained from 325 children aged 15 years or less from May 2008 to April 2009 and were tested for the presence of 13 respiratory viruses by multiplex real-time-polymerase chain reaction (RT-PCR). Results : Viruses were identified in 270 children (83.1%). Co-infections with ${\geq}2$ viruses were observed in 71 patients (26.3 %). Respiratory syncytial virus (RSV) was the most common virus detected (33.2%), followed by human rhinovirus (hRV) (19.1%), influenza virus (Flu A) (16.9%), human metapneumovirus (hMPV) (15.4%), parainfluenza viruses (PIVs) (8.3%), human bocavirus (hBoV) (8.0%), adenovirus (ADV) (5.8%), and human coronavirus (hCoV) (2.2%). Clinical diagnoses of viral ALRIs were bronchiolitis (37.5%), pneumonia (34.5%), asthma exacerbation (20.9%), and croup (7.1%). Clinical diagnoses of viral bronchiolitis and pneumonia were frequently demonstrated in patients who tested positive for RSV, hRV, hMPV, or Flu A. Flu A and hRV were most commonly identified in children older than 3 years and were the 2 leading causes of asthma exacerbation. hRV C was detected in 14 (4.3%) children, who were significantly older than those infected with hRV A ($mean{\pm}SD$, $4.1{\pm}3.5$ years vs. $1.7{\pm}2.3$ years; P =0.009). hBoV was usually detected in young children ($2.3{\pm}3.4$ years) with bronchiolitis and pneumonia. Conclusion : This study described the features of ALRI associated with 13 respiratory viruses in Korean children. Additional investigations are required to define the roles of newly identified viruses in children with ALRIs.

• Journal of Gastric Cancer
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• v.5 no.1
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• pp.40-46
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• 2005

Purpose: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. Materials and Methods: 40 patients who underwent a complete resection of a GIST during the period $1996\~2003$ at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk. groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. Results: The mean age of the 40 patients was $61.3\pm11.1$years, and the male-to-female ratio was 1：1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, $Gleevec^{(R)}$). The treated patients have survived until now; however, two of non-treated patients died from disease progression. Conclusion: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.290-297
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• 1997

Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.298-308
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• 1997

Background : Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. Methods : The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. Results : The PEFR measured with MPFM was significantly related to the PEFR and $FEV_1$ measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r = 0.92 ; p < 0.001 ; for $FEV_1$, r = 0.78 ; p < 0.001). The accuracy of MPFM was within 100(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being 16.5L/min(percentage of difference being 2.90%) or 10.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or 20.49~+9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p > 0.05) and the coefficient of variation($2.4{\pm}1.2%$) of PEFR measured with MPFM was significantly lower than that($5.2{\pm}3.5%$) with standard pneumotachygraph in normal (p < 0.05). Conclusion : This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.365-373
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• 1999

Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.776-784
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• 1998

Background: The cyclin D1 gene is one of the most frequently amplified chromosomal regions(11q13) in human carcinomas. In laryngeal and head and neck carcinomas, its overexpression has been shown to be associated with advanced local invasion and presence of lymph node metastases. Cyclin D1 may therefore playa key role in cell growth regulation and tumorigenesis. Lung cancer is a worldwide problem and in many contries it is the most lethal malignancy. As relapse is frequent after resection of early stage non-small cell lung cancer, there is an urgent need to define prognostic factors. Purpose: This study was undertaken to evaluate the prognostic value of the cyclin D1, that is one the G1 cyclins which control cell cycle progression by allowing G1 to S phase transition, on the patients in radically resected non-small cell lung cancer. Method: Total 81 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from January 1, 1983 to July 31, 1995 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for cyclin D1. Results : The histologic classification of the tumor was based on WHO criteria, and the specimens included 45 squamous cell carcinomas, 25 adenocarcinomas and 11 large cell carcinomas. Cyclin D1 overexpression was noted in 26 cases of 81 cases tested (30.9%). Cyclin D1 expression was not significantly associated with cell types of the tumor, pathological staging and the size of the tumor. But cyclin D1 overexpression was significantly correlated with positive lymph node metastasis(p=0.035). The mean survival duration was $22.76{\pm}3.50$ months in cyclin D1 positive group and $45.38{\pm}5.64$ months in eyclin D1 negative group. There was a nearly significant difference in overall survival between cyclin D1 positive and negative groups(p=0.0515) in radically resected non-small cell lung cancer. Conclusion: Based on this study, cyelin D1 overexpression appears an important poor prognostic indicator in non-small cell lung cancer and may have diagnostic and prognostic importance in the treatment of resectable non-small cell lung cancer.

• Journal of Korean Society of Forest Science
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• v.77 no.3
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• pp.294-302
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• 1988

The experiment was carried out to investigate the properties of bark extractives form Larix epilepsies and to evacuate their suitability as a bonding agent. The yield and reactivity were measured to examine the influence of temperature and time and the effect of carbonation and sulfonation. To define the possibility of practical application as wood adhesives the viscosity and gelation time were measured at 33% concentration. The results obtained were summarized as follows : 1. As the both yield and reactivity were high, extraction for 2 hours at $80^{\circ}C$ was the optimal temperature and time. 2. The highest effect achieved at 1% $Na_2CO_3$ about carbonation and 1% $Na_2SO_3$ : $NaHSO_3$ and 0.25% $Na_2SO_3$ about sulfonation. The sulfonation of 0.25% $Na_2SO_3$ increased the yield and reactivity most highly. 3. By using hot water as extraction liquid the yield was 17.2%, while the addition of 1% and 5% NaOH to the extraction liquid increased the yield to 38.6% and 44.6%, respectively. 4. Hot water extracts showed the highest reactivity(68.8%). The addition of 1% and 5% NaOH led to decrease in reactivity(49.3% and 25.8%, respectively). 5. At 33% concentration of the extracts the viscosity appeared very variable. Significantly high values of viscosity was measured in 1% NaOH solution, while very low values appeared for 5% NaOH solution. 6. The shortest gelation time was determined at pH 7 to 10 and the highest at pH 4. The use of paraformaldehyde resulted in gelation times longer than those of 37% formaldehyde solution. 7. Except the sulfonation extracts of hot water and 1% NaOH, the other extracts were found unsuitable due to high viscosity(1% NaOH extracts, sulfonation extracts) or to curing inability(5% NaOH extracts, sulfonation extracts of 5% NaOH). 8. From the three extract solutions which appeared to be suitable for use as bonding agents the hot water extracts and the sulfonation extracts of hot water were superior in extract reactivity, while the sulfonation extracts of 1% NaOH exceeded the other two extracts in extract yield.

• Journal of the Korean Geographical Society
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• v.40 no.3 s.108
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• pp.253-273
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• 2005

In recent years, there are strong social demands to characterize the spatial distribution of mountains in Korea. This study aims to develop a 'Sanjulgi-Jido(mountain ridge map)' that might be used not only to satisfy these social demands but also to effectively present the spatial distribution of mountains and drainage basins in the Korean Peninsular. The 'Sanjulgi-Jido' developed in this study is a map that presents the continuity of mountains based on the drainage divides that are delineated by a pre-defined drainage basin size and elevation. This study first validated the Bakdudaegan system through the analyses of a digital elevation model. The Bakdudaegan system has long been recognized as the Koreans traditional conceptual framework to characterize the spatial distribution of mountains. The analyses showed that the Bakdudaegan system has several problems to represent the mountain systems in Korea, which includes 1) the lack of the representativeness of drainage basins, 2) inaccuracy to depict the boundary of drainage basins, 3) the lack of representativeness of mountains, and 4) geo-polical issue that confines the spatial extent of mountain systems within the Korean Peninsular. In order to represent the mountains system in a more quantitative manner, we applied several terrain analysis techniques to understand the spatial distribution of mountains and drainage basins. Based on these analyses, we developed an hierarchical system to classify the continuity (If mountains, which are presented as the spatial distribution of drainage divides with a certain elevation. The first-order Sanjulgi is the drainage divides whose drainage basin are bigger than $5,000km^2$ and the point elevation is above 100m. The next order Sanjulgi is delineated as the size of drainage basin is successively divided by two. This kind of design is able to provide a logical framework to present the mountain systems at different details, depending on the purpose and scale of maps. We also provide several empirical functions to calculate various geomorphological indices for each order of Sanjulgi. The 'Sanjulgi Jido' is similar with the Bakdudaegan system, since it characterizes the continuity of mountains based on the spatial distribution of the drainage divide. It, however, has more scientific criteria to define the scale and continuity of mountains. It should be also noted that the 'Sanjulgi Jido' proposed has different logical and methodological background, compared with the mountain range map that explains the genesis of mountain systems in addition to the continuity of mountains.

• Journal of Home Health Care Nursing
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• v.11 no.1
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• pp.5-13
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• 2004

The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

• Journal of Intelligence and Information Systems
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• v.16 no.4
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• pp.85-97
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• 2010

Internet communities are a typical space for knowledge creation and use on the Internet as people discuss their common interests within the internet communities. When we define 'Knowledge Communities' as internet communities that are related to knowledge creation and use, they are categorized into 4 different types such as 'Search Engine,' 'Open Communities,' 'Specialty Communities,' and 'Activity Communities.' Each type of knowledge community does not remain the same, for example. Rather, it changes with time and is also affected by the external business environment. Therefore, it is critical to develop processes for practical use of such changeable knowledge communities. Yet there is little research regarding a strategic framework for knowledge communities as a source of knowledge creation and use. The purposes of this study are (1) to find factors that can affect knowledge creation and use for each type of knowledge community and (2) to develop a strategic framework for practical use of the knowledge communities. Based on previous research, we found 7 factors that have considerable impacts on knowledge creation and use. They were 'Fitness,' 'Reliability,' 'Systemicity,' 'Richness,' 'Similarity,' 'Feedback,' and 'Understanding.' We created 30 different questions from each type of knowledge community. The questions included common sense, IT, business and hobbies, and were uniformly selected from various knowledge communities. Instead of using survey, we used these questions to ask users of the 4 representative web sites such as Google from Search Engine, NAVER Knowledge iN from Open Communities, SLRClub from Specialty Communities, and Wikipedia from Activity Communities. These 4 representative web sites were selected based on popularity (i.e., the 4 most popular sites in Korea). They were also among the 4 most frequently mentioned sitesin previous research. The answers of the 30 knowledge questions were collected and evaluated by the 11 IT experts who have been working for IT companies more than 3 years. When evaluating, the 11 experts used the above 7 knowledge factors as criteria. Using a stepwise linear regression for the evaluation of the 7 knowledge factors, we found that each factors affects differently knowledge creation and use for each type of knowledge community. The results of the stepwise linear regression analysis showed the relationship between 'Understanding' and other knowledge factors. The relationship was different regarding the type of knowledge community. The results indicated that 'Understanding' was significantly related to 'Reliability' at 'Search Engine type', to 'Fitness' at 'Open Community type', to 'Reliability' and 'Similarity' at 'Specialty Community type', and to 'Richness' and 'Similarity' at 'Activity Community type'. A strategic framework was created from the results of this study and such framework can be useful for knowledge communities that are not stable with time. For the success of knowledge community, the results of this study suggest that it is essential to ensure there are factors that can influence knowledge communities. It is also vital to reinforce each factor has its unique influence on related knowledge community. Thus, these changeable knowledge communities should be transformed into an adequate type with proper business strategies and objectives. They also should be progressed into a type that covers varioustypes of knowledge communities. For example, DCInside started from a small specialty community focusing on digital camera hardware and camerawork and then was transformed to an open community focusing on social issues through well-known photo galleries. NAVER started from a typical search engine and now covers an open community and a special community through additional web services such as NAVER knowledge iN, NAVER Cafe, and NAVER Blog. NAVER is currently competing withan activity community such as Wikipedia through the NAVER encyclopedia that provides similar services with NAVER encyclopedia's users as Wikipedia does. Finally, the results of this study provide meaningfully practical guidance for practitioners in that which type of knowledge community is most appropriate to the fluctuated business environment as knowledge community itself evolves with time.