• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.436-442
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• 2007

Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.53-58
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• 2013

Purpose: To optimize correction method for SPECT/CT, image quality consisting of resolution and contrast was evaluated using three radioisotopes ($^{99m}Tc$, $^{201}Tl$ and $^{131}I$) and three different correction methods; attenuation correction (AC), scatter correction (SC) and both attenuation and scatter correction (ACSC). Materials and Methods: Images were acquired with a SPECT/CT scanner and a conventional CT protocol with an OESM reconstruction algorithm (2 iterations and 10 subsets). For resolution measurement, fixed radioactivity (2.22 kBq) was infused into a spatial resolution phantom and full width at half maximum (FWHM) was measured using a vendor-provided software. For contrast evaluation, radioactive source with a ratio of 1:8 to background was filled in a Flanged Jaszczak phantom and percent contrast (%) were calculated. All the parameters for image quality were compared with non-correction (NC) method. Results: As compared with NC, image resolution of all three isotopes were significantly improved by AC and ACSC, not by SC. In particular, ACSC showed better resolution than AC alone for $^{99m}Tc$ and $^{201}Tl$. Image contrast of all three radioisotopes in a sphere with the largest diameter were enhanced by all correction methods. ACSC showed the highest contrast in all three radioisotopes, which was the most accurate in $^{99m}Tc$ (85.9%). Conclusion: Image quality of SPECT/CT was improved in all the radioisotopes by CT-based attenuation correction methods, except SC alone. SC failed to improve resolution in any radioisotopes, but it was effective in contrast enhancement. ACSC would be the best correction method as it improved resolution in radioisotopes with low energy levels and contrast in radioisotope with low energy levels. However, in radioisotope with high energy level, AC would be better than ACSC for resolution improvement.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.373-378
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• 1999

Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.148-153
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• 2005

Purpose : The aim of this study was to determine the reference ranges of serum albumin levels depending on the gestational ages of preterm infants. We also intended to compare the mean serum albumin levels between groups of preterm infants that did not develop clinical disorders later, and groups that did develop clinical disorders such as respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity, apnea and bronchopulmonary dysplasia. We also examined the significance of serum albumin as a predictor for the development of clinical disorders. Methods : The records of 208 neonates with gestational ages from 23 weeks to 41 weeks were reviewed retrospectively. The mean albumin concentrations with reference ranges by gestational ages were determined. Statistics for each two of group were compared. Logistic regression analysis was used to model odd ratio, and 95 percent confidence interval as a mean of the association between predictors and outcome. Results : Serum albumin levels were at 23-24 weeks gestation was 2.36 g/dL, rising to 3.43 g/dL in full term babies. There were significant mean differences between the clinical groups and control groups for each clinical disorder such as respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity and apnea in premature babies of 30-36 weeks of gestation. Low serum albumin appeared to be associated with increased risks of clinical disorders. Conclusion : The normal serum albumin levels in preterm infants should be defined according to the gestational ages. Lower albumin levels increase the risks of the later development of clinical disorders, which are common in premature infants.

• The Korean Society of Law and Medicine
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• v.21 no.1
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• pp.153-185
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• 2020

In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.35 no.2
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• pp.93-101
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• 1999

A simple experimental method was used in an attempt to realize the elevation of the fishing ability of purse seine in the sea area of Cheju Island, the changes of seine volume and tension in the purseline during pursing. Experiments carried out on the six types simplified reduced model seines which were made of knotless nettings. The nettings were woven in different leg length 4.3, 5.0, 5.5, 6.0, 6.6 and 7.7mm of polyester 28 tex two threads two-ply twine, and each of the seines were named I, II, III, IV, V and Ⅵ seine. Dimension of seine models were 450cm for corkline and 85cmfor seine depth, each seines rigged up 160g of float for a floatline and 50g (underwater weight) of lead for a leadline. These model purse seines were made of the scale of 1/200 of its full scale, a 120 ton in the near sea of Cheju Island. Designing and testing for the model purse seines were based on the Tauti's law. Experiments were measured in the observation channel of a flume tank at the static conditions set up shooting and pursing equipments. Motion of purse seine during purse line was recorded by the two sets video camera for VTR which were placed in top and front of the model seine. The reading coordinate of seine volume carried out by the video digitization system, disk data for the purseline tension. An analysis were performed on the changes seine volume and tension in the purseline during pursing. The results obtained were as follows: 1. The seine volume during pursing was largest for Ⅵ seine with smallest d/l followed by V, IV, III, II and I seines, and tension in the purseline was small. 2. Seine volume during pursing can be expressed by the following equation; CVt=l-EXP[｛2.79 (d/l）＋0.35｝t-33.37 (d/l) ＋ 0.57] Where CVt is volume ratio, d is twine diameter, l is leg length and t is pursing time (sec). 3. Tension in the purse line during pursing can be expressed by the following equation; T= 1- EXP ｛0.57t ＋ 13.36 (d/l)+2.97｝ Where T is tension (kg) in the purseline during pursing.

• Tuberculosis and Respiratory Diseases
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• v.50 no.4
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• pp.415-425
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• 2001

Background : The correlation between the high resolution computed tomography(HRCT) emphysema score and the physiologic parameters including resting and exercise pulmonary function test was investigated in 14 patients($60.6{\pm}10.3$ years) with pulmonary emphysema. Methods : The patients underwent a HRCT, a resting pulmonary function test, and incremental exercise testing(cycle ergometer, 10 W/min). Computed tomography scans were obtained on a GE highlight at 10 mm intervals using 10 mm collimation, from the apex to the base after a full inspiration. The emphysema scores were determined by a CT program 'Density mask' outlining the areas with attenuation values less than -900 HU, indicating the emphysema areas, and providing an overall percentage of lung involvement by emphysema. Results : Among the resting PFT parameters, only the diffusing capacity(r=-0.75) and $PaO_2$ (r=-0.66) correlated with the emphysema score(p<0.05). Among the exercise test parameters, the emphysema score correlated significantly with the maximum power(r=-0.74), maximum oxygen consumption(r=-0.68), anaerobic threshold(V-slope method: r=-0.69), maximal $O_2$-pulse(r=-0.73), and the physiologic dead space ratio at the maximum workload(r=-0.80)(p<0.01). Conclusion: We could find that exercise testing parameters showed a much better correlation with the HRCT emphysema score, which is known to have a good correlation with the pathologic severity than the resting PIT parameters. Therefore it is suggested that exercise testing is superior to resting PIT for estimating in the estimation of the physiologic disturbance in emphysema patients.

• KIPS Transactions on Computer and Communication Systems
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• v.1 no.3
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• pp.143-150
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• 2012

A simulation methodology and corresponding program based on it is to be discussed for analyzing the effects of the networking operation of existing DHC system in connection with CHP system on-site. The practical simulation for arbitrary areas with various building compositions is carried out for the analysis of operational features in both systems, and the various aspects of thermal energy grids with connecting operation are highlighted through the detailed assessment of predicted results. The intrinsic operational features of CHP prime movers, gas engine, gas turbine etc., are effectively implemented by realizing the performance data, i.e. actual operation efficiency in the full and part loads range. For the sake of simplicity, a simple mathematical correlation model is proposed for simulating various aspects of change effectively on the existing DHC system side due to the connecting operation, instead of performing cycle simulations separately. The empirical correlations are developed using the hourly based annual operation data for a branch of the Korean District Heating Corporation (KDHC) and are implicit in relation between main operation parameters such as fuel consumption by use, heat and power production. In the simulation, a variety of system configurations are able to be considered according to any combination of the probable CHP prime-movers, absorption or turbo type cooling chillers of every kind and capacity. From the analysis of the thermal network operation simulations, it is found that the newly proposed methodology of mathematical correlation for modelling of the existing DHC system functions effectively in reflecting the operational variations due to thermal energy grids with connecting operation. The effects of intrinsic features of CHP prime-movers, e.g. the different ratio of heat and power production, various combinations of different types of chillers (i.e. absorption and turbo types) on the overall system operation are discussed in detail with the consideration of operation schemes and corresponding simulation algorithms.

• Korean Journal of Poultry Science
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• v.16 no.2
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• pp.91-100
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• 1989

This study was conducted to observe 1) the changes of cellular association in seminiferous tubles from 2 to 8 weeks of age, and 2) the cycle phenomena of seminiferous epithelia at 14 weeks of age in Japanese quail. Total 80 birds were examined at a week interval from 2 to 8 weeks, and 14 weeks of age. The results were summarized as follows： 1) The body and testis weights showed most prominent increase during 4 to 5 weeks and 6 to 8 weeks of age respectively. And also the diameters of seminiferous tubles were abruptly enlaged during 6 to 8 weeks of age. 2) Genocytes in the seminiferous tubles were still in existence at 3 weeks of age, however they did not come out after 4 weeks of age. Spermatogonia, primary spermatocytes and spermatids made their first arpearances in the seminiferous from 3, 4 and 6 weeks of age, respectively. Spermatozoa were observed for the first time at 7 weeks of age, but full spermatogenic activity was completed from 8 weeks of age. 3) At 14 weeks of age, the average weight at testis was 3.7g and its ratio to the body weight was approximately 3.0 percent. And at this age, average diameter of seminiferous tubules was 192.08 $\mu\textrm{m}$, and average numbers of spermatogonia, spermatocytes, spermatids and spermatozoa within the cross section of seminiferous tubules were 7.74, 40.81, 28.42, 104.55 and 105.98, respectively. Spermatogonia and spermatid were classfied into 2 and 3 types, respectively. 4) At 14 weeks of age, the cycle of seminiferous epithelium could be divided into S stages with following characteristics. (1) Stage I： Seminiferous tubules showing type I and II spermatids. (2) Stage II： Seminiferous tubules showing type III spermatids only. (3) Stage III： Immature spermatozoa gathered near the sertoli cytoplasm. (4) Stage IV： Forming a bundle of 15-20 spematozoa. (5) Stage V： Spermatozoa bundle leaving the sertoli cytoplasm into lumen of the seminferous tubule. 5) Usually 2-3 stages of the seminiferous epithelium cycle were concurrently appeared within a tubular cross section, and frequency of each stage from I to V within cross section of seminiferous tubules were 11.91%, 27.03%, 27.96%, 19.04% and 17.98%, respectively.

• Journal of Korean Society of Forest Science
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• v.73 no.1
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• pp.43-54
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• 1986

This study was carried out to investigate the influence of light intensity on the growth of Korean white pine (Pinus koraiensis) seedlings. The seedlings were grown under four different relative light intensities: 100%, 63%, 37%, and 19% of full sunlight by covering with saran screen on seed bed. The results obtained were summarized as follows; 1. The highest shoot elongation was found at 37% in relative light intensity (RLI) plot, and the best growth in root, seedling length and diameter increment appeared at 100% on RLI plot. Contribution rates of shading to growth in shoot elongation, root growth, seedling length, and diameter increment were 9.3%, 26.2%, 21.0%, and 48.7%, respectively. 2. The greatest number of one-year-old needle fascicle was found at 100% in RLI plot, whereas that of two-year-old needle fascicle appeared at 37% in RLI plot. The contribution rate of the light intensity to number of needle fascicle was 3.9% and factor of leaf age contributed to number of needle fascicle in 27.8%. The length of needles grown under different light intensities varied with needle ages. The longest length of new needles appeared at 37% in RLI plot, but old needles were not clear in influence of light intensity. The contribution rate to needle length by the light intensity was 2.5%. 3. The heaviest value of the fresh and dry weight of seedlings appeared at 100% of RLI plot then decreased with light intensity. The contribution rates to fresh and dry weight by the shading were 38% and 7.6% respectively. 4. The largest value of the dry weight of needles appeared at 100% of RLI plot and then decreased with light intensity. The contribution rates to dry weight of needles by the light intensity was 13.18%. 5. The values of T/R ratio increased with decreased light intensity and the contribution rate was 7.0%. 6. Positive correlation and linear regressions were recognized between dry weight of leaf and other factors (dry weight of shoot, root, seedling and diameter increment).