• Journal of Korean Neurosurgical Society
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• 제56권4호
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• pp.303-309
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• 2014

Objective : The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. Methods : We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. Results : Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. Conclusion : The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.

• 한국산학기술학회논문지
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• 제21권9호
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• pp.151-160
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• 2020

정부의 주요 정책으로 다양한 스마트시티 사업들이 활발히 추진되고 있다. 이러한 정부주도 스마트시티의 성공은 현재 진행 중인 사업들의 성과를 확산 보급시킬 수 있는 지속가능한 거버넌스 구축에 달려있다. 이에 본 연구에서는 미국과 유럽의 스마트시티 정책 사례를 성과 확산의 관점에서 비교 분석하여 국내 스마트시티 거버넌스 구축을 위한 정책방향을 제안하였다. 비교항목은 시범도시, 스마트시티 기술과 서비스의 확산, 성과의 측정, 스마트시티 지식정보의 축적, 표준화로 구분하였다. 분석결과 미국과 유럽의 스마트시티 정책은 성공사례 창출과 확산을 위해 시범도시를 구축하고, 민간부문의 참여기회를 확대하고, 평가체계 개발과 표준화를 통한 기술과 서비스의 재사용과 확산 추진하는 등 각 지표별 항목들이 유기적으로 연계된 것으로 나타났다. 분석된 결과를 바탕으로 국내 스마트시티 성과확산을 위해 시범도시 후속방안의 조기 마련, 사업성과 평가체계 구축, 통합된 지식축적 체계 마련, 민간분야 참여확대를 위한 본격적인 산업활성화 정책추진의 네 가지 정책방향을 제시하였다. 본 연구의 결과는 시범단지와 실증사업 중심으로 진행되고 있는 정부 스마트시티 정책의 후속 과제 발굴과 세부 추진방법을 구체화에 활용될 수 있을 것이다.

• 한국경영정보학회:학술대회논문집
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• 한국경영정보학회 2008년도 춘계학술대회
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• pp.957-962
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• 2008

We propose a model for the line expansion problem in the AMOLED (Active Matrix Organic Light Emitting Diodes) industry, which now faces market uncertainty: for example, changing customer needs, technological development path, etc. We focus on the optimal investment time and size of the AMOLED production lines. In particular, employed here is the ROV (Real Options Valuation) model to show how to capture the value of line expansion and to determine the optimal investment time. The ROV framework provides a systematic procedure to quantify an expected outcome of a flexible decision which is not possible in the frame of the traditional NPV (Net Present Value) approach. Furthermore, we also use Monte Carlo simulation to measure the uncertainty associated with the line expansion decision; Monte Carlo simulation estimates the volatility of a decision alternative. Lastly, we present a scenario planning to be conducted for what-if analysis of the ROV model.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.419-427
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• 2020

Background This study evaluated the Blossom system, an innovative self-filling, rate-controlled, pressure-responsive saline tissue expander (TE) system. We investigated the feasibility of utilizing this technology to facilitate implant-based and combined flap with implant-based breast reconstruction in comparison to conventional tissue expansion. Methods In this prospective, single-center, single-surgeon pilot study, participants underwent either implant-based breast reconstruction or a combination of autologous flap and implantbased breast reconstruction. Outcome measures included time to full expansion, complications, total expansion volume, and pain scores. Results Fourteen patients (TEs; n=22), were included in this study. The mean time to full expansion was 13.4 days (standard error of the mean [SEM], 1.3 days) in the combination group and 11.7 days (SEM, 1.4 days) in the implant group (P=0.78). The overall major complication rate was 4.5% (n=1). No statistically significant differences were found in the complication rate between the combination group and the implant group. The maximum patient-reported pain scores during the expansion process were low, but were significantly higher in the combination group (mean, 2.00±0.09) than in the implant group (mean, 0.29±0.25; P=0.005). Conclusions The reported average duration for conventional subcutaneous TE expansion is 79.4 days, but this pilot study using the Blossom system achieved an average expansion duration of less than 14 days in both groups. The Blossom system may accommodate single-stage breast reconstruction. The overall complication rate of this study was 4.5%, which is promising compared to the reported complication rates of two-stage breast reconstruction with TEs (20%-45%).

• 구강회복응용과학지
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• 제27권1호
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• pp.109-115
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• 2011

점차적으로 폭경이 증가하는 나사들을 이용하여 치조능확장술을 시행하고 임프란트를 식립하였다. 임상적으로 양호한 결과를 얻었으며 수술 중 협측 피질골판 골절은 발생하지 않았다. 임프란트 주변 결손부와 협측 피질골판 상방에 자가치아골이식재를 이식함으로써 부가적인 치조능 확장 효과와 동시에 협측 피질골판 흡수를 보상하였다. 치조능 폭경이 협소한 부위에 임프란트를 식립할 때 나사를 이용한 확장술은 성공적이고 예측 가능한 술식이며 자가치아골이식재는 치조능증대술과 골유도재생술을 위해 사용될 수 있다.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.261-270
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• 2021

Objective : Decompressive craniectomy (DC) can partially remove the unyielding skull vault and make affordable space for the expansion of swelling brain contents. The objective of this study was to compare clinical outcome according to DC surface area (DC area) and side. Methods : A total of 324 patients underwent different surgical methods (unilateral DC, 212 cases and bilateral DC, 112 cases) were included in this retrospective analysis. Their mean age was 53.4±16.6 years (median, 54 years). Neurological outcome (Glasgow outcome scale), ventricular intracranial pressure (ICP), and midline shift change (preoperative minus postoperative) were compared according to surgical methods and total DC area, DC surface removal rate (DC%) and side. Results : DC surgery was effective for ICP decrease (32.3±16.7 mmHg vs. 19.2±13.4 mmHg, p<0.001) and midline shift change (12.5±7.6 mm vs. 7.8±6.9 mm, p<0.001). The bilateral DC group showed larger total DC area (125.1±27.8 ㎠ for unilateral vs. 198.2±43.0 ㎠ for bilateral, p<0.001). Clinical outcomes were nonsignificant according to surgical side (favorable outcome, p=0.173 and mortality, p=0.470), significantly better when total DC area was over 160 ㎠ and DC% was 46% (p=0.020 and p=0.037, respectively). Conclusion : DC surgery is effective in decrease the elevated ICP, decrease the midline shift and improve the clinical outcome in massive brain swelling patient. Total DC area and removal rate was larger in bilateral DC than unilateral DC but clinical outcome was not influenced by DC side. DC area more than 160 ㎠ and DC surface removal rate more than 46% were more important than DC side.

• 의학교육논단
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• 제15권1호
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• pp.19-24
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• 2013

In medicine, rapid changes in information, technology, socio-economic interests, and globalization affect the medical education focused on the competencies of doctors, and the number of medical schools that are adopting an outcome-based curriculum (OBC) is increasing worldwide. This paper introduces the OBC model of 5 trailblazing medical schools from the UK, US, and Australia, comparing their unique features, followed by brief comment about Canada and the EU as well. On developing an OBC, the process of establishing the top outcomes for graduates is similar and the outcomes comprise knowledge, skills, and attitudes about science, patients, colleagues, society, and themselves. Implementing the outcomes down into the sub-levels of the curriculum is much more complicated and time-consuming. Assessing the achievement of every outcome is essential and requires the use of many tools in addition to the traditional written examination. From the perspective of adult learning theory, self-directed learning, team-learning, and individual and flexible achievement are tested and executed in an OBC. The gradual expansion and further innovation of an OBC is expected so that tomorrow's doctors will be able to meet the challenges of the future.

• The Journal of Korean Physical Therapy
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• 제26권3호
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• pp.169-174
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• 2014

Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.

• 유통과학연구
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• 제13권7호
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• pp.53-61
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• 2015

Purpose - This research analyzes overseas expansion support systems for small- and medium-sized enterprises in Germany and Japan. Germany and Japan have developed overseas expansion support policies for such enterprises. The study then explores the implications for Korea and its local governments. Research design, data, and methodology - We did a comparative analysis of Japan and Germany and their support for overseas expansion of small and medium companies. Data were mainly collected from the Ministry of Economy, Trade and Industry (Japan) and the Germany Trade and Invest (Germany) agency through statistics and literature surveys, and analysis studies. Results - First, human resources cultivation and funding support policies, which both Germany and Japan use as part of small- and medium-sized enterprise policies, should be modified to Korean circumstances and to reflect its own small- and medium-sized enterprise support needs. Second, both the German policies that support overseas expansion of small- and medium-sized enterprises and those of Japan's include the philosophy and methods that put an emphasis on these enterprises, despite the fact that there are big differences in the overseas policies in these two countries. Third, German and Japanese governments are embracing the idea that small- and medium-sized enterprises are key to their national economies and implementing policies based on the ratio occupied by these enterprises in the domestic consumption or GDP. In other words, Germany and Japan consider small- and medium-sized enterprises as central to their nation's industry, and assess them as economic industry that should definitely exist for the continued survival of big businesses, and not just as merely supplemental to big business. Fourth, whereas Germany emphasizes support to product exhibition in its overseas expansion support policies, Japan is providing integrated support containing foreign direct investment to small- and medium-sized enterprises. Fifth, there are differences in the overseas expansion support in Germany and Japan in terms of their support to big business. Whereas Germany considers support to big business unnecessary, Japan is implementing active support policies to areas corresponding to big business. Korea will have to benchmark the policies of Germany and Japan, and decide whether or not to give full support to small- and medium-sized enterprises, while excluding areas supporting big business. Conclusions - Based on this analysis of German and Japanese overseas expansion support policies, we need to choose the policies that will engender a solid outcome and derive modified policies for the circumstances of Korea. Additionally, we can use the comparison of the overseas support policies of Japan and Germany to choose small- and medium-sized enterprise overseas expansion support policies for Korea. However, we cannot provide specific overseas support policies by industry. This point will be referenced as a limitation of this study. In future research, we expect that some researchers will take an empirical approach to exploring Korean overseas expansion support through collecting cases of overseas support policies and interviewing policy authorities.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.204-213
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• 2016

Syndromic craniosynostosis has severe cranial stenosis and deformity, combined with hypoplastic maxillary bone and other developmental skeletal lesions. Among these various lesions, upper air way obstruction by hypoplastic maxillary bone could be the first life-threatening condition after birth. Aggressive cranial vault expansion for severely deformed cranial vaults due to multiple synostoses is necessary even in infancy, to normalize the intracranial pressure. Fronto-orbital advancement (FOA) is recommended for patients with hypoplastic anterior part of cranium induced by bicoronal and/or metopic synostoses, and posterior cranial vault expansion is recommended for those with flattening of the posterior part of the cranium by lambdoid synostosis. Although sufficient spontaneous reshaping of the cranium can be expected by expansive cranioplasty, keeping the cranial bone flap expanded sufficiently is often difficult when the initial expansion is performed during infancy. So far distraction osteogenesis (DO) is the only method to make it possible and to provide low rates of re-expansion of the cranial vault. DO is quite beneficial for both FOA and posterior cranial vault expansion, compared with the conventional methods. Associated hydrocephalus and chronic tonsillar herniation due to lambdoid synostosis can be surgically treatable. Abnormal venous drainages from the intracranial space and air way obstruction should be always considered at any surgical procedures. Neurosurgeons have to know well about the managements not only of the deformed cranial vault and the associated brain lesions but also of other multiple skeletal lesions associated with syndromic craniosynostosis, to improve treatment outcome.