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The Effect of Hounsfield Unit Value with Conventional Computed Tomography and Intraoperative Distraction on Postoperative Intervertebral Height Reduction in Patients Following Stand-Alone Anterior Cervical Discectomy and Fusion

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung;Woo, Joon Bum;Kim, Young Ha
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.96-106
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    • 2022
  • Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

A Case Study on the Online Fractional Investment Securitization Platform (온라인 분할 투자 증권화 플랫폼 사례 연구)

  • Tae Hyup ROH
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.1
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    • pp.747-754
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    • 2023
  • With the development of information and communication technology, online fractional investment platforms have emerged through the convergence of online platform technology and new investment techniques for asset-backed derivatives. In this study, the concept and previous studies of the online fractional investment platform business, commercialization models and service processes, market status, and pending discussions and alternatives were presented. Recently, the Securities and Futures Commission's decision on securitization of split ownership has become an important guide to the stable business sustainability of platform operators, but academic research is needed according to the current status and case analysis. To identify specific market issues, examples of representative online fractional investment securitization platform businesses such as "MusiCow" for music copyright, "Tessa" based on art, "Kasa" for real estate, "Piece" based on real assets, and "BangCow" for Korean beef shipments were analyzed. Through the case analysis of this study, the characteristics of the business model according to the basic assets of the online fractional investment platform were compared and presented. Since most business models are judged to be securitic, they must comply with the provisions of the Capital Markets Act or be recognized as the target of innovative financial services. From a practical point of view, it is meaningful in that it presented improvement directions that online fractional securitization platform operators should consider and organized institutional considerations for investor protection.

Psychological Interpretation of Imagery Experiences in the Bonny Method of Guided Imagery and Music (BMGIM) Focused on the Cases of Two Women from a Jungian Perspective (BMGIM 심상경험의 심리학적 해석 : 융 학파의 관점에서 본 두 여성의 사례를 중심으로)

  • An-Gie Kim
    • Sim-seong Yeon-gu
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    • v.35 no.1
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    • pp.1-65
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    • 2020
  • BMGIM is a method of individual psychotherapy which seeks to achieve self-knowledge via imagery experiences evoked by music. When dealing with imagery in BMGIM, emphasis is placed on the insight of the client, but there are occasions when clients sometimes are confused because they cannot understand their imagery experiences. Also therapists and clients tend to consider experiences of BMGIM from a causalistic-reductive perspective. In order to understand the meaning of BMGIM imagery experiences, in this thesis imagery experiences are interpreted from a Jungian perspective that understands imagery as a symbol and stresses the purposive meaning. At first the definition and procedures of BMGIM are dealt with, secondly music and imagery as components of BMGIM are examined, and lastly the symbolic meaning of two female clients' BMGIM imageries are discussed. Looking into deeply imagery experiences, both therapist and clients newly came to realize not only the symbolic meaning of imageries but also the purposive meaning of wounds and sufferings of clients, especially I was able to confirm the following three points. First, just like dreams or active imagination, BMGIM also deals with spontaneous contents of the psyche. Second, the autonomy of the objective psyche which orients the development of personality, healing and wholeness is also revealed in BMGIM. Lastly, Jungian perspective aids in understanding the meaning of the imagery experiences in a more deep and abundant way. From this point, BMGIM can also be seen as a useful therapeutic tool which deals with the unconscious such as dream analysis or active imagination.

Influences of Firm Characteristics and the Host Country Environment on the Degree of Foreign Market Involvement (기업특성과 호스트국가 환경이 해외시장 관여도에 미치는 영향에 관한 연구)

  • Maktoba, Omar;Nwankwo, Sonny
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.2
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    • pp.5-16
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    • 2009
  • Against the backdrop of the increasing trend towards economic globalisation, many international firms are indicating that decisions on how to enter foreign markets remains one of the key strategic challenges confronting them. Despite the rich body of literature on the topic, the fact that these challenges have continued to dominate global marketing strategy discourses point to someevident lacunae. Accordingly, this paper considers the variables, categorised in terms of firm contexts (standardisation, market research, competition, structure, competitive advantage) and host country-contexts (economic development, cultural differences, regulation and political risk), which influence the degree of involvement of UK companies in overseas markets. Following hypotheses were drawn from literature review: H1: The greater the level of competition, the higher the degree of involvement in the overseas market. H2: The more centralised the firm's organisation structure, the higher the degree of involvement in the overseas market. H3a: The adoption of a low cost-approach to competitive advantage will lead to a higher degree of involvement. H3b: The adoption of an innovation-approach to competitive advantage will lead to a higher degree of involvement. H3c: The adoption of a market research approach to competitive advantages will lead to a higher degree of involvement. H3d: The adoption of a breadth of strategic target-approach to competitive advantage will lead to a lower degree of involvement. H4: The higher the degree of standardisation of the international marketing mix the higher the degree of involvement. H5: The greater the degree of economic development in the host market, the higher the degree of involvement. H6: The greater the cultural differences between home and host countries, the lower the degree of involvement. H7: The greater the difference in regulations between the home country and the host country, the lower the degree of involvement. H8: The higher the political risk in the host country, the lower the degree of involvement. A questionnaire instrument was constructed using, wherever possible, validated measures of the concepts to serve the aims of this study. Following two sets of mailings, 112 usable completed questionnaires were returned. Correlation analysis and multiple regression analysis were used to analyze data. Statistically, the paper suggests that factors relating to the level of competition, competitive advantages and economic development are strong in influencing foreign market involvements. On the other hand, unexpectedly, cultural factors (especially individualism/collectivism and low and high power distance dimensions) proved to have weak moderating effects. The reason for this, in part, is due to the pervading forces of globalisation and the attendant effect on global marketing. This paper has contributed to the general literature in a way that point to two mainimplications. First, with respect to research on national systems, the study may hold out some important lessons especially for developing nations. Most of these nations are known to be actively seeking to understand what it takes to attract foreign direct investment, expand domestic market and move their economies from the margin to the mainstream global economy. Second, it should be realised that competitive conditions remain in constant flux (even in mature industries and mature economies). This implies that a range of home country factors may be as important as host country factors in explaining firms' strategic moves and the degree of foreign market involvement. Further research can consider the impact of the home country environment on foreign market involvement decisions. Such an investigation will potentially provide further perspectives not only on the influence of national origin but also how home country effects are confounded with industry effects.

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Characterization of Domestic Earthquake Events for the Safety Assessment of the Geological Disposal System (심지층 처분시스템의 안전성평가를 위한 국내 지진 발생 특성 평가)

  • Kim, Jung-Woo;Cho, Dong-Keun;Ko, Nak-Youl;Jeong, Jongtae
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.13 no.2
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    • pp.87-98
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    • 2015
  • Safety assessments of geological radioactive waste disposal systems, need to consider the abnormal scenario in which a system is impacted by external events in addition to a reference scenario. In this study, the characterization and prediction of an earthquake as an external event which will impact disposal systems were conducted probabilistically and statistically for the safety assessment. The domestic earthquake data were analyzed, and the prediction methodologies of the earthquake were suggested with a computational example. From the results, the earthquake occurrence rates in Korea ranged from 0.4 /yr to 36.2 /yr depending on the data set and the completeness magnitude. From a conservative point of view, the earthquake occurrence rate in the disposal system was suggested as 5.4×10-4 /yr considering the area of the disposal system. At that time, the completeness magnitude of an earthquake was 2.3. This study will be followed by an appraisal of impacts associated with external events on the geological disposal system, and it will contribute to improvements in reliability of the safety assessment.

Numerical Evaluation of Debris Transport During LOCA Blow-Down Phase of OPR1000 Nuclear Power Plant (CFD 를 이용한 OPR1000 원자력발전소 파단방출이동에 대한 수치해석적 평가)

  • Choi, Kyung-Sik;Park, Jong-Pil;Jeong, Ji-Hwan;Kim, Won-Tae
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.3
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    • pp.255-262
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    • 2011
  • In a loss-of-coolantaccident, considerable debris may be generated and transported to the recirculation sump. The accumulation of debris will reduce the netpositivesuctionhead and threaten the safety of thenuclear power plant. Both NEI 04-07 and USNRC SER suggesteda CFD methodology. However, additional investigation is needed to consider the unique characteristics of nuclear power plants. The transport of the generated debris is strongly influenced by the break location and the plant characteristics, including the configuration.In this paper, a CFD methodology for blow-down transport evaluation is proposed and applied to an OPR1000 nuclear power plant. The results show that the percentage of small debris transported to the upper containment is 32%, which is 7% larger than the valuegiven in the NEI 04-07 baseline analysis. This result may be used as a point of reference in future analytical studies.

A Study of Strategic Approach for Course and Program Outcomes Assessment (교과목 및 프로그램 학습성과 평가의 전략적 접근)

  • Kim, Cheong-Sig
    • Journal of Engineering Education Research
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    • v.10 no.2
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    • pp.73-86
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    • 2007
  • The purpose of this study is to suggest directions to improve engineering education and the assessment system of our country. For this object, the present situation of engineering education and assessment system in Korea have been reviewed and next, for those of study, the research papers and publications about the environment of college education are analyzed. Finally, an improved assessment system is suggested. It has already passed out for 6 years since execute the accreditation for engineering education in our country now, but essential point for step in accreditation for engineering education is how the evaluator can make the outcomes of studying. This is not a new terminology that is deformed according to special quality of college of engineering which prefer out-come based of study than process based of study to mean accomplishment in engineering education. The evaluation that estimate program is a skill, but an assessment method is not the meaning of individual student accomplishment also, it is the measure of validity estimation that should be estimate ability of students who complete program by proper authority. However, a new evaluation strategy that assess student outcome by person who consider the objectivity and validity, reliability should be develop for decision making of ABEEK. It is an original, private discussion for assessment strategy about the method for student learning outcomes assessment.

Price Comparison between Online and Offline Distribution Channel: Differences of Store type, Product Category and Price type (온라인과 오프라인 유통경로의 가격비교에 관한 연구: 점포, 제품, 가격유형에 따른 차이를 중심으로)

  • Park, Cheol;Kim, Dong-Tak
    • Journal of Distribution Research
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    • v.11 no.1
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    • pp.99-124
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    • 2006
  • The purposes of the study are two-folds. First, it analyzes how factors other than price(e.g. delivery service, saving point policies, free gifts) impact total price for various products and different types of stores. Second, it analyzes how to increase market efficiencies through price level, price differences, and the frequency of price changes for different shops, various products and different types of transactions. By analyzing the price level within different types of stores, there found that prices at on-line store were lower than off-line shops. It also found price differences between pure on-line, hybrid, and off-line store. Comparing prices by product size, there found that pure on-line shops have a lower price compared to others. The results showed that on-line store had lower price variation compared to off-line shops. When comparing pure on-line store to hybrid store, hybrid store had lower price variation. In terms of the frequency of price changes, hybrid stores had higher price fluctuations. In terms of total price differences for delivery distances, pure on-line store had great price fluctuation, excluding cosmetic goods. In conclusion, if we consider price level and price fluctuations, on-line store had more efficiencies and was superior in terms of price effectiveness. Hybrid shops, on the other hand, had greater advantages for seasonal goods and dominant products. Therefore, market entry strategies should differ based on order quantity, type of store(pure on-line, hybrid, off-line), product characteristics(seasonality, product life), etc.

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A Bottom up Filtering Tuple Selection Method for Continuous Skyline Query Processing in Sensor Networks (센서 네트워크에서 연속 스카이라인 질의 처리를 위한 상향식 필터링 투플 선정 방법)

  • Sun, Jin-Ho;Chung, Chin-Wan
    • Journal of KIISE:Databases
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    • v.36 no.4
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    • pp.280-291
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    • 2009
  • Skyline Query processing is important to wireless sensor applications in order to process multi-dimensional data efficiently. Most skyline researches about sensor network focus on minimizing the energy consumption due to the battery powered constraints. In order to reduce energy consumption, Filtering Method is proposed. Most existing researches have assumed a snapshot skyline query processing and do not consider continuous queries and use data generated in ancestor node. In this paper, we propose an energy efficient method called Bottom up filtering tuple selection for continuous skyline query processing. Past skyline data generated in child nodes are stored in each sensor node and is used when choosing filtering tuple. We also extend the algorithms, called Support filtering tuple(SFT) that is used when we choose the additional filtering tuple. There is a temporal correlation between previous sensing data and recent sensing data. Thus, Based on past data, we estimate current data. By considering this point, we reduce the unnecessary communication cost. The experimental results show that our method outperforms the existing methods in terms of both data reduction rate(DRR) and total communication cost.

A study of symptoms and pathogenesis of hakgil(瘧疾) in the chinese traditional medical literature until chung(淸) dinasty (학질(瘧疾)의 증상(症狀)과 기전(機轉)에 대한 문헌적(文獻的) 고찰(考察) -청대(淸代)까지 중국의서(中國醫書)를 중심(中心)으로-)

  • Ryu, Jeong-A;Park, Chan-Guk
    • Journal of Korean Medical classics
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    • v.12 no.1
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    • pp.168-195
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    • 1999
  • The hakgil is the important disease in the oriental medicine historically. In the preseant time also this disease continually appear all over the world. So purpose of this study is that consider the symptoms and pathogenesis of hakgil(瘧疾) with the point of view of oriental medicine. And in this study, the results are summarized as the followings. 1. The symptos of hakgil(瘧疾). 1) Rigor and heat spasm : The main symptoms of hakgil is the severe and periodical rigor and heat spasm. Generally the rigor first appear and later the heat spasm appear. According to the first and last, severe and weak, the hakgil is classified to hanhak(寒瘧), onhak(溫瘧), danhak(癉瘧), binhak(牝瘧). 2) The regulation of the time of spasm : The spasm occour in the same time daily or one time in two days, three days or several days. And the spasm time is regulary in day or night. 3) The term between the spasm and next one become later or faster. It can be decided that the becoming worse and better in the disease with the signs. 4) The seasonal property Generally the hakgil appear in summer and early autumn. 5) The other kind of hakgil there are five-organ hakgil(五臟瘧), six-kyung hakgil(六經瘧), janghak(瘴瘧), kuihak(鬼瘧), six-gi hakgil(六氣瘧), damhak(痰瘧), sikhak(食瘧), and so on. 6) The pulse condition of the hakgil is chiefly hyun(弦). 2. The pathogenesis of the hakgil 1) The cause of the hakgil The causes of the hakgil first are the seo(暑) or heat(熱) that make the problem in the cycle of five phases(五行). In the consequence, il open the hole of skin so that the pathogenic factors easily invade the humanbody and at the same time the pathogenic factor in the inside easily come out, that make the spasm. In the second time the pathogenic factor of yin(陰) - wind(風), cold(寒), water(水) invade through the opened skin to combine with the factor in the inside. Such condition make the hakgil and the accessory spasm. 2)The pathogenesis of hakgil(瘧疾) (1) The rigor and heat spasm of hakgil(瘧疾) appear because in summer the human body don't accomplish a task of summer because of hot weather or heat, so in autumn the ki(氣) of human body separate into yin(陰) and yang(陽), and the skin of human body is weaken so the saki(邪氣: pathogenic factors) is easily come into the human body. At this time the circulation of ki(氣) is obstructed, so the jungki(精氣: vital substance) apply to straighten the circulation of ki(氣), if the jungki(精氣: vital substance) help the yin(陰) the rigor spasm appear in the opposit direction the jungki(精氣: vital substance) help the yang(陽) the heat spasm appear. (2) The period of circulation of ki(氣) and jungki(精氣: vital substance) is one day, so the general period of spasm of hakgil(瘧疾) is one day, But if the saki(邪氣: pathogenic factors) come into the human body deeply, the jungki(精氣: vital substance) cannot apply 10 straighten the circulation of ki(氣) every day so the period of spasm become longer.

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