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The dramatic spread of Coronavirus Disease 2019 (COVID-19) has profound impacts on every continent and life. Due to human-to-human transmission of COVID-19, nuclear medicine staffs also cannot escape the risk of infection from workplaces. Every staff in the nuclear medicine department must prepare for and respond to COVID-19 pandemic which tailored to the characteristics of our profession. This article provided the guidance prepared by the Korean Society of Nuclear Medicine (KSNM) in cooperation with the Korean Society of Infectious Disease (KSID) and Korean Society for Healthcare-Associated Infection Control and Prevention (KOSHIC) in managing the COVID-19 pandemic for the nuclear medicine department. We hope that this guidance will support every practice in nuclear medicine during this chaotic period.

Background Advances in minimally invasive surgery have expanded the indications for interlaminar full-endoscopic discectomy. Although the clinical outcomes for this approach may be equivalent to those of conventional microscopic discectomy, the supporting evidence is still based on small, single-center, prospective, and retrospective studies. Therefore, a multicenter randomized controlled trial is warranted. Methods This will be a prospective, multicenter, randomized controlled trial comparing the efficacy and safety of interlaminar full-endoscopic discectomy to those of conventional microscopic discectomy. The trial will enroll 100 participants with a lumbar disc herniation, 50 in each group. The primary outcome will be the Oswestry Disability Index (ODI) score at 12 months post-surgery. Secondary outcomes will be back and leg pain (visual analog scale); the ODI; the EuroQol-5-dimension score; patient satisfaction; and walking distance/time and time to return to daily activities post-surgery. Surgical outcomes will include postoperative drainage, operative time, duration of hospital stay, postoperative creatine kinase level as an indicator of muscle injury, and postoperative scarring. Postoperative magnetic resonance imaging, computed tomography, and simple radiography will be performed to evaluate radiographic outcomes between the two surgical approaches. Surgery-related complications and adverse effects will be evaluated as safety outcomes. A single assessor at each participating hospital, blinded to group allocation, will assess the enrolled participants at baseline, at 2 weeks, and at 3, 6, and 12 months postoperatively. Discussion This trial is designed to determine whether interlaminar full-endoscopic discectomy is clinically comparable to microscopic discectomy to treat lumbar disc herniations. All efforts will be made to reduce bias, including adequate sample size, blinded analyses, and multicenter prospective registration. The outcomes will inform practice, providing the evidence needed for using interlaminar full-endoscopic over microscopic discectomy by confirming the potential of this technique to improve patient satisfaction and clinical outcomes. Trial registration: Clinical Research Information Service; cris.nih.go.kr. (KCT0006277); protocol version (v1, June 8, 2021).

BACKGROUND The Controlled Oral Word Association Test (COWAT) evaluates frontal lobe and executive function. Therefore, it can be helpful in differentiating cognitive deficits. However, there are no studies comparing the COWAT performance according to the type and stage of cognitive impairment. OBJECTIVE To compare performance among persons with Alzheimer dementia (AD), vascular dementia (VaD), and Parkinson disease dementia (PDD) on the COWAT according to stage of cognitive impairment. DESIGN Retrospective chart review. SETTINGS University hospital rehabilitation psychology center. PATIENTS We reviewed the medical records of 246 persons diagnosed with mild cognitive impairment (MCI) or dementia using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Korean-Instrumental Activities of Daily Living (K-IADL). Patients were divided into a control group, Alzheimer groups (amnestic mild cognitive impairment [aMCI] + AD), Vascular groups (vascular mild cognitive impairment [VaMCI] + VaD), and Parkinson groups (Parkinson disease-mild cognitive impairment [PD-MCI] + PDD). METHODS Total scores (ie, total number of words produced in 60 seconds on the semantic and phonemic fluency tests of the COWAT) were analyzed. Secondary analysis included calculating percentage scores of words produced during each of the four, 15-second segments from the total number of words produced in each trial. RESULTS All MCI groups scored significantly lower than the control group on both semantic and phonemic fluency tests. Among the dementia groups, the VaD (mean ± SD, 5.6 ± 5.1) and PDD (5.5 ± 5.5) groups' scores were significantly lower and worse than that of the AD (11.0 ± 8.8) group on the phonemic test (P

PURPOSE: This study aimed to construct a database of the effective doses (ED) from F-18 fluorodeoxyglucose (FDG) torso positron emission tomography/computed tomography (PET/CT) in Korea to provide data that supports the reduction of the CT dose of PET/CT and optimization of PET/CT protocols in Korea. METHODS: We investigated data of ED and CT parameters of FDG PET/CT. The data were analyzed by body weight groups. RESULTS: A total of 31 hospitals participated in the survey (99 adults). The mean total EDs (± SD) were 8.77 ± 2.76, 10.93 ± 3.14, and 12.57 ± 3.79 mSv for the 55-, 70-, and 85-kg groups, respectively. The FDG EDs were 4.80 ± 0.98, 6.05 ± 1.15, and 6.89 ± 1.52 mSv, and the CT EDs were 4.00 ± 2.12, 4.88 ± 2.51, and 5.68 ± 2.89 mSv, respectively. Of the enrolled hospitals, 54.5% used ultra-low-dose CT protocols, and their CT ED was significantly lower than low-dose CT group in all groups (2.9 ± 1.0, 3.2 ± 1.1, and 3.3 ± 1.0 mSv vs. 6.6 ± 1.6, 7.2 ± 2.1, and 7.9 ± 2.2 mSv, all p

Compressive femoral neuropathy is a disabling condition accompanied by difficulty in hip flexion and knee extension. It may result from retroperitoneal hematoma or bleeding, or from complications associated with pelvic, hip surgery, and renal transplants. A 55-year-old female with autosomal dominant polycystic kidney disease presented with proximal muscle weakness in lower extremities. The patient experienced recurrent renal cyst infection, with aggravated weakness during each event. Electromyography and nerve conduction study revealed bilateral femoral neuropathy. Computed tomography and magnetic resonance images were added to further identify the cause. As a result, a diagnosis of femoral neuropathy caused by enlarged polycystic kidney was made. Cyst infection was managed with antibiotics. Renal function was maintained by frequent regular hemodialysis. While avoiding activities that may increase abdominal pressure, rehabilitation exercises were provided. Motor strength in hip flexion and knee extension improved, and was confirmed via electrodiagnostic studies.

OBJECTIVE To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy. METHODS The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM. RESULTS McNemar's test revealed that the two diagnostic modalities did not show diagnostic concurrence (p

The background of this paper is new social trend of more public's interest in the implementation of the pledge of the local governors who were elected by citizens. In these days the election pledge for enhanced local governmental policies became more important. The objective of this paper is to suggest the model of election pledge management for local government heads based on machine learning focused on On-Nara document system. The system is currently used by Korean governmental organizations for document processes. The methods to prove a comparative advantage of the proposed model are the comparison tests between As-Is system and To-Be system based on a few criteria such as time, efficiency and extraction rate. Through this model, local governors could present systematic goals and road map of pledges in order to get closer to citizens and local residents. In other words, this study proposes a model, so called ELM(Election pledge management for Local governors Model), for efficiently extracting necessary data from planned and implemented details of pledge projects that are prepared in the form of unstructured documents. We carried out research to prove empirically our machine learning-based model is more efficient than current semi-manual system with some automated processes in order to manage efficiently the pledge project implementation of local governors to get the results. In conclusion, this research proved that the proposed model is more competitive than the existing models. In the 4th industrial revolution era the new approach using machine learning and big data will become more popular.

The purpose of this study was to estimate average radiation exposure from 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) examinations and to analyze possible factors affecting the radiation dose. A nation-wide questionnaire survey was conducted involving all institutions that operate PET/CT scanners in Korea. From the response, radiation doses from injected FDG and CT examination were calculated. A total of 105 PET/CT scanners in 73 institutions were included in the analysis (response rate of 62.4%). The average FDG injected activity was 310 ± 77 MBq and 5.11 ± 1.19 MBq/kg. The average effective dose from FDG was estimated to be 5.89 ± 1.46 mSv. The average CT dose index and dose-length product were 4.60 ± 2.47 mGy and 429.2 ± 227.6 mGy∙cm, which corresponded to 6.26 ± 3.06 mSv. The radiation doses from FDG and CT were significantly lower in case of newer scanners than older ones (P < 0.001). Advanced PET technologies such as time-of-flight acquisition and point-spread function recovery were also related to low radiation dose (P < 0.001). In conclusion, the average radiation dose from FDG PET/CT is estimated to be 12.2 mSv. The radiation dose from FDG PET/CT is reduced with more recent scanners equipped with image-enhancing algorithms., Graphical Abstract

This study aimed to analyze the risk factors for secondary new vertebral compression fractures (SNVCFs) after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures.We evaluated the association of SNVCFs (adjacent vertebral compression fractures [AVCFs] and remote vertebral compression fractures) with clinical, radiographic, and PVP procedure-related morphologic parameters based on the data collected from 402 patients over a minimum follow-up of 4 years after PVP. Procedure-related morphologic parameters were assessed using a three-dimensional voxel-based analysis. Univariate and multivariate regression analyses were conducted.On univariate analysis, bone mineral density (BMD), preoperative compression ratio, preoperative sagittal index (SI), and intradiscal bone cement leakage were significantly associated with SNVCF and AVCF (P0.05), whereas only BMD and preoperative SI were significantly associated with remote vertebral compression fracture (P0.05). A large ratio of bone cement volume to vertebral body volume and skewed bone cement distribution along the inferior-to-superior axis were especially significant risk factors for AVCF (P = 0.027 and P = 0.029, respectively). On multivariate analysis, BMD was significantly associated with SNVCF (P = 0.041), whereas upper adjacent intradiscal bone cement leakage was significantly associated with AVCF (P = 0.003).Low BMD, high preoperative compression ratio, and high preoperative SI may be predictive factors for SNVCFs. In particular, to prevent AVCF, the injected bone cement should be distributed both evenly and symmetrically along the inferior-to-superior axis and the relative bone cement volume should not be excessive. Bone cement should be injected carefully to avoid upper adjacent intradiscal leakage. Prompt BMD correction is important to prevent SNVCF.

It is important to study and apply the application method developed to service from the SCM module for designing SaaS level to the cloud system, which supports SCM tasks such as procurement, purchase, logistics and standard information as to industrial sectors. These industrial sectors are divided into sewing clothes manufacturing, other metal processing product manufacturing and building construction business in terms of usage targets of cloud-based common collaboration platform. In addition, based on the importance and object of works such as common collaboration process, cloud-based common collaboration platform objective model is designed by selecting development model and service model suitable for this study. The cloud-based common collaboration platform will be used by many and unspecified companies, which is provided as the form of public cloud. Target model design means SaaS level finally. In the case of module development costs of collaboration works, it is required to be studied more to the future. By the way, in the case of the common collaboration module, the SCM tasks which can be applied to all industrial sectors have been calculated, which was based on the manufacturing industry. Since the SCM-related functions provided by the cloud-based common collaboration platform are not specific to the specified companies sectors, they are available to all companies. Furthermore, the SCM-related functions provided by the cloud-based common collaboration platform are various and selected by the modules freely because they are provided at the level of the cloud SaaS. The SCM-related functions provided by the cloud-based common collaboration platform are easy to select. It is necessary to make universal service available to the enterprise unlike the government that has been carrying out the support project to the specified company sectors on a one-to-one basis.

ImportanceThere have only been a few large-scale studies that have included a risk factor analysis for CTS. No prior study has investigated the relationship between the occurrence of CTS and stratified socioeconomic status, which is closely related to a person’s type of job.ObjectiveTo confirm the known risk factors for CTS and also to determine the correlation between stratified socioeconomic status and the occurrence of CTS.DesignWe conducted this study using a retrospective cohort model based on the combined databases of the Korean National Health Insurance System from 2003–2013, a database compiled using information from a national periodic health-screening program that is used for reimbursement claims.SettingThe setting was a population-based retrospective cohort study.ParticipantsFirst, we randomly sampled 514,795 patients who represented 10% of the 5,147,950 people who took part in periodic health screenings from 2002–2003. Existing CTS patients were excluded from this group. Therefore, this study finally included 512,942 participants and followed their medical records from 2003–2013.Main Outcomes and MeasuresDesired outcomes were the incidence rate of CTS and the hazard ratios according to stratified socioeconomic status.ResultsA correlation analysis showed that CTS was more likely to occur in patients from a lower socioeconomic status.Conclusions and RelevanceCTS was associated with people of a lower socioeconomic status who work in simple but repetitive manual labor jobs. We believe that the results of our study will be helpful to determine the pathophysiology of CTS and to set up a new industrial health policy for this condition.Key PointsQuestionWhat is the relationship between stratified socioeconomic status and the incidence of carpal tunnel syndrome (CTS)?FindingsIn this retrospective population-based cohort study that included 512,942 participants sampled from the Korean National Health Insurance System(KNHIS) database, the incidence rate and hazard ratios for CTS tended to increase with lower socioeconomic status.ImplicationsLow socioeconomic status was identified as a risk factor for the incidence of CTS.

Tentorial dural arteriovenous fistula (DAVF) is a rare vascular disease, which has high risk of intracranial hemorrhage. We present two cases of tentorial DAVF which were successfully treated with single trial of transarterial embolization using Onyx. We briefly reviewed the types of the tentorial DAVF and strategies of treatment.

Objective To evaluate the effect of custom molded foot orthoses on children with growing pains of the lower extremities. Methods Children with growing pains were recruited during a clinic visit. None had any bony deformities, inflammatory joint disease or depression. Resting calcaneal stance position (RCSP) and calcaneal pitch angle were measured, and individual custom molded rigid foot orthoses were prescribed using the inverted orthotic technique to control for foot overpronation using the RCSP angle. Pain sites, degree and frequency of pain, and balance ability were evaluated using Balance Master computerized posturography prior to foot orthosis fitting, and 1 and 3 months later. Results Twenty children completed the study. Seventeen (75%) had overpronated feet. Significant improvements were noted after 1 and 3 months in pain degree and frequency, and after 3 months in balancing ability. Conclusion The use of custom molded foot orthoses is a good method for treating children with multiple musculoskeletal pains in the leg.

We report a theranostic nanoparticle that can express ultrasound (US) imaging and simultaneous therapeutic functions for cancer treatment. We developed doxorubicin-loaded calcium carbonate (CaCO3) hybrid nanoparticles (DOX-CaCO3-MNPs) through a block copolymer templated in situ mineralization approach. The nanoparticles exhibited strong echogenic signals at tumoral acid pH by producing carbon dioxide (CO2) bubbles and showed excellent echo persistence. In vivo results demonstrated that the DOX-CaCO3-MNPs generated CO2 bubbles at tumor tissues sufficient for echogenic reflectivity under a US field. In contrast, the DOX-CaCO3-MNPs located in the liver or tumor-free subcutaneous area did not generate the CO2 bubbles necessary for US contrast. The DOX-CaCO3-MNPs could also trigger the DOX release simultaneously with CO2 bubble generation at the acidic tumoral environment. The DOX-CaCO3-MNPs displayed effective antitumor therapeutic activity in tumor-bearing mice. The concept described in this work may serve as a useful guide for development of various theranostic nanoparticles for US imaging and therapy of various cancers.

AIM Oblique lateral interbody fusion (OLIF) is a minimally invasive surgical method that can provide an access to the lumbar spine without direct dissection of psoas muscle and the need for intraoperative neuromonitoring (IOM) is questionable. The aim of this study was to examine and document the transient and persistent perioperative complications in patients who underwent OLIF for degenerative lumbar disease without IOM. MATERIAL AND METHODS A total of 129 consecutive patients who were diagnosed as degenerative spinal disease from L1 to S1 and underwent mini-open OLIF were identified and retrospectively reviewed. All patients were classified as two groups; non-IOM group and IOM group. According to the relation to surgical procedure, the complications were divided into two groups; "procedurerelated" and "procedure-unrelated". Based on the effect of duration, the complications were defined as "transient" where the symptom is relieved within 30 days postoperatively, and "persistent" where the symptom remains for more than 30 days postoperatively. RESULTS The study groups comprised 57 cases in the IOM group and 72 in the non-IOM group. The complication rate was 24.6% (transient; 17.6%, persistent; 7.0%) in the IOM group and 29.2% (transient; 25.0%, persistent; 4.2%) in the non-IOM group. The incidence of postoperative leg symptoms related to lumbar plexus and/or psoas muscle injury was 6 transient and 3 persistent in the IOM group (overall 15.3%), and 12 transient and 3 persistent in the non-IOM group (overall 20.9%). CONCLUSION Mini-open OLIF can be safely carried out without the aid of IOM.

Objective To investigate the correlation between the Montreal Cognitive Assessment (MoCA) and functional outcome among subacute stroke patients with cognitive dysfunction. Methods Records of 61 inpatients were reviewed. Patients were divided into two groups based on their initial MoCA score. MoCA score of 11 was set as the differentiating criterion. We compared the improvements in Modified Barthel Index (MBI) from initial assessment to discharge between the two groups. Results There were no significant differences between the two groups in relation to age, duration from onset to admission, hospitalization period, or years of education. In a comparison of the results of Mini-Mental Status Examinations (MMSE) administered at admission and again at discharge, there was significantly more improvement in MMSE scores in the group with low MoCA scores than in the group with high MoCA scores. However, the group with high MoCA scores also showed high MBI scores at discharge and exhibited greater MBI improvement. Conclusion Higher initial MoCA scores (which reflect preservation of executive function) indicate better functional outcome in the subacute stroke phase.

Background/Aims: In dementia patients, a deficit in activities of daily living (ADL) is one of the main problems. Our objective was to assess ADL using the Korean Modified Barthel Index (K-MBI) in patients with Alzheimer's disease (AD) plus cerebrovascular disease (CVD) treated with a rivastigmine patch for 24 weeks in an open-label, observational study. Methods: 29 patients were enrolled who met the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ ANDRA) criteria and had a score of 10-26 on the Korean version of the Mini-Mental State Examination (K-MMSE). After the rivastigmine patch had been applied for 24 weeks, changes in self-care activities were assessed using the K-MBI. Results: The average age of the patients was 62.8 years, and they had an average K-MMSE score of 16.2. Patients showed a mean improvement of 21.9 points, as compared with the baseline K-MBI score of 30.3 (p < 0.05). Significantly better outcomes were seen in secondary outcome variables, for example the K-MMSE and backward digit span. The most frequent adverse events were skin problems, such as itching sensation (10%). Conclusion: In this multicenter, open-label, observational study, the rivastigmine patch was associated with improvements in ADL in patients with AD plus CVD.

Destruction of dopaminergic neurons in the substantia nigra pars compacta (SNpc) is a common pathophysiology of Parkinson's disease (PD). Characteristics of PD patients include bradykinesia, muscle rigidity, tremor at rest and disturbances in balance. For about four decades, PD animal models have been produced by toxin-induced or gene-modified techniques. However, in mice, none of the gene-modified models showed all 4 major criteria of PD. Moreover, distinguishing between PD model pigs and normal pigs has not been well established. Therefore, we planned to produce a pig model for PD by chronic subcutaneous administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), neurotoxin. Changes in behavioral patterns of pigs were thoroughly evaluated and a new motor scoring system was established for this porcine model that was based on the Unified Parkinson's Disease Rating Scale (UPDRS) in human PD patients. In summary, this motor scoring system could be helpful to analyze the porcine PD model and to confirm the pathology prior to further examinations, such as positron emission tomography-computed tomography (PET-CT), which is expensive, and invasive immunohistochemistry (IHC) of the brain.

The purposes of this study are (1) to examine the relationships among attitude on SNS use, subjective norm, perceived behavioral control, and SNS use, (2) to analyze effect of SNS use on bonding network and bridging network, (3) to consider moderating effect of the gender on the relationship between SNS use and Social network. We conducted a survey for 20-30`s SNS user. The results of analysis using the Structural Equation Model(SEM) represent that attitude on SNS use, subjective norm, and perceived behavioral control are significant determinants of the SNS use. SNS use affects bonding network and bridging network. An interesting result was observed that the gender had moderating effect on the relationship between SNS use and social network. Based on these results, we suggest theoretical and practical implications of this study.

Objective Cerebral aneurysm (CA) is an important acquired cerebrovascular disease that can cause catastrophic results. MicroRNAs (miRNAs) are small non-coding RNAs, playing essential roles in modulating basic physiologic and pathological processes. Currently, evidences have been established about biologic relationship between miRNAs and abdominal aortic aneurysms. However, biologic roles of miRNAs in CA formation have not been explained yet. We employed microarray analysis to detect and compare miRNA expression profiles in late stage of CA in rat model. Methods Twenty-six, 7-week-old male Sprague-Dawley rats underwent a CA induction procedure. The control animals (n=11) were fed a normal diet, and the experimental animals (n=26) were fed a normal diet with 1% normal saline for 3 months. Then, the rats were sacrificed, their cerebral arteries were dissected, and the five regions of aneurysmal dilation on the left posterior communicating artery were cut for miRNA microarrays analysis. Six miRNAs (miRNA-1, miRNA-223, miRNA-24-1-5p, miRNA-551b, miRNA-433, and miRNA-489) were randomly chosen for validation using real-time quantitative PCR. Results Among a set of differentially expressed miRNAs, 14 miRNAs were over-expressed more than 200% and 6 miRNAs were down-expressed lower than 50% in the CA tissues. Conclusion The results show that miRNAs might take part in CA formation probably by affecting multiple target genes and signaling pathways. Further investigations to identify the exact roles of these miRNAs in CA formation are required.

OBJECTIVE The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. METHODS We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. RESULTS The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were 2.21±24.57 mmH2O. The frequency of CSF lumbar tapping was 2.06±1.26 times. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was -3.69±19.20 mmH2O. The mean frequency of CSF lumbar tapping was 2.07±1.25 times. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was 38.07±23.58 mmH2O. The mean frequency of CSF lumbar tapping was 1.44±1.01 times. Pressure difference greater than 35 mmH2O was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant (p=0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. CONCLUSION Under-drainage of CSF should be suspected if CSF lumbar tapping pressure is 35 mmH2O higher than the valve opening pressure and shunt malfunction evaluation or adjustment of the valve opening pressure should be made.

The purpose of this study was to evaluate the effects of metatarsal pad (MP) compared with barefoot and MP with using different insoles on gait. 15 healthy females who had no history of injury in the lower extremity with an average age of 22.7 year(SD=1.35), height of 160 cm(SD=3.4), weight of 48.8 kg(SD=5.52) and average foot size of 232.5 mm(SD=6.8) participated in this study as the subjects. The subjects walked on a treadmill under four different experimental conditions: 1) walking with barefoot, 2) walking wearing MP 3) walking wearing a soft insole with MP(SIMP), 4) walking wearing a rigid insole with MP(HIMP). During walking, foot pressure data such as force, contacting area, peak pressure, and mean pressure was collected using Pedar-X System(Novel Gmbh, Germany) and EMG activity of lower limb muscles such as tibialis anterior(TA), lateral gastrocnemius(LG), rectus femoris(RF), and musculus biceps femoris(MBF) was gathered using Delsys EMG Work System(Delsys, USA). Collected data was then analyzed using paired t-test in order to investigate the effects of each of experimental conditions. As a result of the analysis, when MP and HIMP were equipped, overall contacting area was increased while the force, peak pressure and the mean pressure were decreased. Especially, when the SIMP was equipped, every data were significantly decreased. In case of EMG, wearing MP, SIMP and HIMP made three muscles(TA, LG, RF)'s activity decrease. A result of the analysis will be able to apply for manufacturing functional shoes, diabetes shoes, senior shoes and lower extremity orthosis. Significance of the study due to a metatarsal pad and the insole is to analyze the changes in muscle strength.

The purpose of this study is to examine the causal relationship s among knowledge management system(KMS) quality, perceived ease of use, perceive d usefulness, attitude, and continuance use of KMS. The results of data analysis by str uctured equation model(SEM) indicate that KMS quality significantly influences individual's perceived ease of use and perceived usefulness. Perceived ease of use affects individual' s perceived usefulness on KMS. Individual's perceived ease of use and perceived usefulnes s affect on the creation of a positive attitude, and attitude affects continuance use of KMS. Based on the results, theoretical and practical implications of this study are discus sed.키워드: 지식관리시스템, 지식관리, 기술수용이론, 지속적 사용, 경찰청knowledge management system(KMS), knowledge management(KM), tec hnology acceptance model(TAM), continuance use * 안양대학교 도시행정학과 조교수(hongjaelee@anyang.ac.kr) ￭￭ 논문접수일자:2011년 8월 9일 ￭ 최초심사일자:2011년 8월 16일 ￭ 게재확정일자:2011년 9월 12일정보관리학회지, 28(3): 219-238, 2011. [http ://dx.doi.org/10. 3743/KOSIM.2011.28.3.219]

Background: We aimed to evaluate the immunologic nature of sentinel lymph nodes (SLNs) in gastric cancer patients and to determine whether it can predict non-SLN metastasis. Methods: Sentinel lymph node samples were collected from 64 gastric carcinoma patients who had undergone gastrectomy with SLN biopsy. One representative SLN sample was selected from each patient and was subjected to immunostaining for CD8, CD57, FOXP3, and DC-LAMP. The numbers of marker-positive cells in each sample were counted. The relationships between various immune cell densities and clinicopathologic parameters or metastasis status of SLNs and non-SLNs were sought. Results: High FOXP3+ Treg density of the SLN was found to be significantly associated with the presence of metastasis in either SLNs or non-SLNs. DC-LAMP+ cell density of the SLN was the highest at the isolated tumours cell level, and this decreased along with an increase in tumour metastasis in either SLNs or non-SLNs. Univariate and multivariate logistic regression models revealed that high FOXP3+ Treg density of the SLN was an independently significant predictor of non-SLN metastasis. Conclusions: This study is the first to indicate an important role of SLNs in metastatic dissemination of gastric cancer. Our findings suggest that Tregs could be a new therapeutic target for regulating the metastasis of gastric cancer.

The purposes of this study are to find factors that have influences on the knowledge contribution activities, and to offer some suggestions to impro ve the knowledge contribution. Especially this study suggests to improve knowledge contributio n by analyzing both on-line and off-line knowledge contribution activities in the public se ctor. The results of data analysis by structured equation model(SEM) indicate that leader ship, intrinsic motivation, and knowledge quality significantly influence on-line and off-l ine knowledge contribution. Based on the results, the potential implications for the strate gy of effective knowledge contribution are discussed.키워드: 지식기여, 지식관리, 지식공유, 지식관리시스템knowledge contribution, knowledge management(KM), knowledge sha ring, knowledge management system(KMS) *** 안양대학교 도시행정학과 조교수 (hongjaelee@anyang.ac.kr) ( 제1저자)성균관대학교 국정관리대학원 석사과정 (seonakim@hanmail.net) ( 공동저자) ￭ 논문접수일자:2010년 8월 13일 ￭ 최초심사일자:2010년 8월 21일 ￭ 게재확정일자:2010년 8월 27일 ￭ 정보관리학회지, 27(3): 169-187, 2010. [DOI:10.3743/KOSIM.2010.27.3.169]

To develop environmentally friendly constructed wetlands(CWs) for treating domestic sewage which was produced in farming and fishing village, the efficiency of water treatment at different ventilation systems in the vertical bed, depths of horizontal bed, and sewage loads was investigated. In the vertical bed, BOD and COD by duplex ventilation system were lower than those by single ventilation system. But T-N and T-P concentrations by both ventilation systems in the vertical bed were little different. In the horizontal bed, BOD, COD, T-N and T-P in 1.0 m and 1.3 m depths were little different. To reduce the CWs' area and to improve the pollutant removal efficiencies, the optimum depth of horizontal bed was 1.3 m. In single and duplex ventilation CWs, the removal rate of BOD, COD, SS, T-N and T-P decreased slightly with the sewage load increases. In same sewage load conditions, the removal rates of BOD, COD, SS, T-N and T-P by duplex ventilation CWs were higher than those by single ventilation CWs. In summary, to effectively treat domestic sewage from farming and fishing village, the optimum constructed wetlands would be the duplex ventilation CWs. Key Words

A constructed wetland which was composed of aerobic and anaerobic areas was evaluated for 3 years to effectively treat the sewage produced in farming and fishing communities. For 3 years in a constructed wetland, biochemical oxygen demand(BOD), chemical oxygen demand(COD), suspended solids(SS), total nitrogen(T-N), and total phosphorus(T-P) in effluent were 0.211.8, 1.041.9, 1.16.5, 460 and 0.023.51 mg/L, respectively. Removal rate of BOD, COD and SS in effluent were 97, 92 and 99%, respectively, in the third year. As time goes by, removal rate of T-N and T-P in treated water in aerobic area and effluent were gradually increased in a constructed wetland. In the third year, removal rate in effluent were 62 and 73%, respectively. By the seasons, removal rate of BOD, COD, SS, T-N and T-P were 9798, 8791, 99, 4361 and 7686%, respectively. Removal rate of BOD, COD, SS and T-P were not affected by the seasons, but that of T-N in winter and spring were decreased than the other seasons.

The purposes of this study are to examine the factors influencing the user satisfaction of knowledge management system(KMS) and the influence of the user satisfaction on the performance, and to search the strategies for effective KMS operating. The results of covariance structural analyses indicate that the factors-knowledge quality and KMS quality significantly influence the user satisfaction. User satisfaction also significantly affects the performance. Based on the results, this study discusses the potential implications for the strategies of KMS implementing to improve the user satisfaction and performance. 키워드: 지식관리시스템, 지식품질, 시스템 품질, 사용자 만족도, 성과 knowledge management system, knowledge quality, KMS quality, user satisfaction, performance *안양대학교 도시행정학과 전임강사(hongjaelee@anyang.ac.kr) ■논문접수일자:2008년 11월 4일 ■최초심사일자:2008년 11월 7일 ■게재확정일자:2008년 11월 21일 ■情報管理學會誌, 25(4): 67-85, 2008. [DOI:10.3743/KOSIM.2008.25.4.067] 68 情報管理學會誌 第25卷 第4號 2008

To effectively treat the domestic sewage that was produced on a small-scale in farming and fishing village in order to encourage an ecologically friendly environment, a small-scale sewage treatment apparatus using natural purification methods that consisted of an aerobic and an anaerobic plots were constructed. The efficiency of sewage treatment according to the sewage loading was investigated to obtain the optimum sewage loading in small-scale sewage treatment apparatus. Removal rate of pollutants according to the sewage loading were in the order of >. Therefore, the optimum sewage loading was 300 L m-2 day-1. Under the optimum sewage loading, removal rate of BOD, , turbidity, T-N and T-P were 99, 94, 99, 49 and 89%, respectively. However, to satisfy the water quality standard in effluent in small-sclae sewage treatment apparatus for domestic sewage treatment, the low removal efficiency of T-N and T-P must be improved. So to improve the removal rate of T-N and T-P, the efficiency of sewage treatment according to the improved sewage treatment process such as, re-treatment at aerobic plot, anaerobic condition of aerobic plot, changing the filter media sizes and the depths in anaerobic plot, and also addition of oyster shells to filter media at anaerobic plot were investigated. In case of 150 cm depth in anaerobic plot with filter medium A (effectivity particle size 1.50 mm) and addition of oyster shells to filter media at anaerobic plot, removal rate of T-N and T-P in both plots were increased by 10 and 3%, and 14 and 7% in comparison with 100 cm depth in anaerobic plot with filter medium B(effectivity particle size 0.95 mm), respectively. The optimum improved sewage treatment process in small-scale sewage treatment apparatus were 150 cm depth in anaerobic plot with filter medium A and addition of oyster shells to filter media at anaerobic plot.

Behavior and decomposition velocity of pollutants on various forms from domestic sewage in sewage treatment plant were investigated in order to obtain the basic data for improving the removal efficiency of pollutants and to reduce the area in constructed wetland by natural purification method. The removal amounts of BODs and CODs in aerobic bed were significantly higher than those of the other beds. In aerobic bed, the removal amounts of IBOD and ICOD were more than those for SBOD and SCOD, respectively, whereas the removal amounts of BODs and CODs in anoxic and anaerobic beds were little different. The removal amounts of SSs in aerobic bed were also higher than those for the other beds, and the removal amounts of VSS in all beds were more than those for FSS. The removal amounts of DTN and DTP in all beds were more than those for STN and STP, respectively. In addition, the decomposition velocities of TBOD, TCOD and TSS in aerobic bed were 30.79, 17.15 and 29.96 . Moreover, the decomposition velocities of BODs, CODs and SSs in aerobic bed were very rapid than those in the other beds. On the other hand, the decomposition velocities of BODs, CODs and SSs in anoxic and anaerobic beds were a little different regardless of the forms of pollutant. The decomposition velocities constants of T-N in aerobic, anoxic and anaerobic beds were 4.78, 0.12 and 0.10 , respectively. Moreover, the decomposition velocities constants of T-P in aerobic, anoxic and anaerobic beds were 13.09, 0.12 and 0.13 respectively. The decomposition velocity of T-Ns and T-Ps in aerobic bed were slightly rapid than those in the other beds, whereas the decomposition velocities of T-Ns and T-Ps in anoxic and anaerobic beds were slightly different regardless of the forms of pollutant.

Objective To investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke. Methods The subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment. Results The upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group. Conclusion In this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke.

In this paper, we present an asynchronous, accurate, and real-time distance measurement method using chirp signals, which is capable of accurately locating and tracking, thus forming an ad-hoc network among smartphones in an indoor (e.g., smart meeting room) environment. We then implement our proposed method on top of commercial off-the-shelf smartphones without modifying their hardware or OS kernel. Our experimental results demonstrate that it takes

To develop small-scale sewage treatment apparatus for detached house of agricultural village, a small-scale sewage treatment apparatus by natural purification method that consisted of packaged form of aerobic, anoxic and anaerobic bed was constructed. The efficiency of sewage treatment according to the sewage treatment method, sewage loading, and the injection method of sewage were investigated for small-scale sewage treatment apparatus of packaged form of aerobic, anoxic and anaerobic bed. The removal rate of pollutants according to the sewage treatment method for small-scale sewage treatment apparatus was high in the order of aerobic-anoxic-anoxic bed . The removal rate of pollutants according to injection method of sewage in small-scale sewage treatment apparatus was high in the order of continuous injection intermittent injection. When loaded under the optimum conditions, removal rate of BOD, COD, SS, T-N and T-P were 99, 95, 99, 83 and 96%, respectively, through this 3-stepped small-scale treatment apparatus arrayed with the order of aerobic, anoxic and anaerobic bed.

The frequent economic losses incurred with H9N2 low pathogenic avian influenza viruses (LPAI) infection have raised serious concerns for the poultry industry. A 1-dose regimen with inactivated H9N2 LPAI vaccine could not prevent vaccinated poultry from becoming infected and from shedding wild viruses. A study was conducted to determine whether a 2-dose regimen of inactivated H9N2 LPAI vaccine could enhance the immunologic response in chickens. Such gel-primed and mineral oil-boosted regimen has produced encouraging results associated with improved immune responses to an H9N2 LPAI. This strategy could be cost effective and helpful for preventing avian influenza virus in the poultry industry.

OBJECTIVE To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on post-stroke dysphagia. METHODS Subacute (

The purpose of this study was to compare power Doppler sonography with conventional color Doppler sonography for the detection of the vascularity of hepatocellular carcinomas after transcatheter arterial chemoembolization. Of the 93 embolized hepatocellular carcinomas, hypervascularity was demonstrated in 36 on angiography; power Doppler sonography correctly identified pulsatile flow signals in 33 (92%) of these 36, whereas color Doppler sonography identified flow signals in 24 (67%). A statistically significant difference was noted when the sizes of the nodules were 30 mm or less. Despite technical difficulties, such as flash artifact, power Doppler sonography is superior to color Doppler sonography for detection of hypervascularity, especially in small embolized nodules of hepatocellular carcinoma (30 mm or less in diameter).

To evaluate the usefulness of known computed tomographic (CT) criteria for the differentiation of simple and strangulated small-bowel obstructions.CT scans of 84 patients with simple (n = 43) and strangulated (n = 41) small-bowel obstructions caused by adhesions, hernia, and volvulus were reviewed retrospectively. Diagnoses were made with surgery (n = 55) and during clinical follow-up (n = 29). CT criteria evaluated were configuration of obstructed bowel loop, target sign, bowel wall thickening and enhancement, changes in mesentery and mesenteric vasculature, and amount and attenuation of ascites.CT findings that enabled the detection of strangulated obstructions were poor or no enhancement of bowel wall (sensitivity, 34%; specificity, 100%) and a serrated beak (sensitivity, 32%; specificity, 100%). When these two findings were excluded from analysis, a large amount of ascites, an unusual course of mesenteric vasculature, and diffuse engorgement of mesenteric vasculature were shown to be useful CT findings for performing multivariate regression analysis. Application of these five CT findings enabled identification of 35 (85%) of 41 patients with strangulated obstructions.Detecting a combination of selected, known CT criteria increases the diagnostic accuracy of CT to enable differentiation of simple and strangulated small-bowel obstructions.

OBJECTIVE: The purpose of this study was to evaluate ERCP and CT findings of ectopic drainage of the common bile duct into the duodenal bulb. CONCLUSION: Although rare, the diagnosis of ectopic drainage of the common bile duct into the duodenal bulb is important to prevent inadvertent damage during biliary tract or gastric surgery and to clarify the cause of chronic peptic ulcers.

UNLABELLED Objective : Esophageal stethoscope has the advantage of being non-invasive, easily placed and capability to monitor the heart sound. This study was designed to determine whether the ratio of S1 to S2 analyzed by esophageal stethoscope and wireless bluetooth transmission can be accurate indicator that express the correlation with blood pressure. METHODS Total 33 adult male and female without cardiac disorder and with normal heart rhythm were selected randomly as the subjects of this Study. Two microphones were used with one for acquisition of heart sound by connecting it to the esophageal stethoscope while the other was used to measure the background noise in the operating room. After having transmitted the heart sound measured with the esophageal stethoscope to the receiver by using bluetooth module, it was saved in PC and outputted, following removal of noise in the operating room and the respiratory sound. S1 and S2 were measured with computation of the ratio of S1 to S2. Correlations between the systolic blood pressure with each of the S1, S2 and ratio of S1 to S2 were examined by using correlation analysis. RESULTS The ratio of S1 to S2 displayed the highest correlation with the systolic blood pressure, with S1 and S2 also displaying positive correlation with the systolic blood pressure. CONCLUSION As the result of analysis of the heart sound and the systolic blood pressure measured by using the esophageal stethoscope, the radio of S1 to S2 displayed greater correlation with the systolic blood pressure in comparison to the S1.

【Objective : In order to develop a novel nerve guidance channel using porcine small intestinal submucosa (SIS) for nerve regeneration, we investigated the possibility of SIS, a tissue consisting of acellular collagen material without cellular immunogenicity, and containing many kinds of growth factors, as a natural material with a new bioactive functionality. Methods : Left sciatic nerves were cut 5 mm in length, in 14 Sprague-Dawley rats. Grafts between the cut nerve ends were performed with a silicone tube (Silicon group, n=7) and rolled porcine SIS (SIS group, n=7). All rats underwent a motor function test and an electromyography (EMG) study on 4 and 10 weeks after grafting. After last EMG studies, the grafts, including proximal and distal nerve segments, were retrieved for histological analysis. Results : Foot ulcers, due to hypesthesia, were fewer in SIS group than in Silicon group. The run time tests for motor function study were 2.67 seconds in Silicon group and 5.92 seconds in SIS group. Rats in SIS group showed a better EMG response for distal motor latency and amplitude than in Silicon group. Histologically, all grafts contained some axons and myelination. However, the number of axons and the degree of myelination were significantly higher in SIS group than Silicon group. Conclusion : These results show that the porcine SIS was an excellent option as a natural biomaterial for peripheral nerve regeneration since this material contains many kinds of nerve growth factors. Furthermore, it could be used as a biocompatible barrier covering neural tissue.】

Objective To identify the subtle change of postural control in elderly patients with unilateral knee osteoarthritis (OA) with computerized dynamic posturography. Method Twenty-two healthy women and twenty-six women with unilateral knee OA, aged 60 and over, were enrolled. The computerized posturographic measures included a weight bearing pattern during squatting and sit-to -stand, sway velocity of center of gravity (COG) during one leg standing, on-axis velocity and directional control of COG during rhythmic weight shift, rising index during sit-to-stand, end sway during tandem walk, and movement time during step up/over. Results It was shown that patients bore significantly less weight on the affected side during the 30 o and 60 o squat and sit-to-stand. Sway velocity of COG during one leg standing was greater whereas the on-axis velocity and directional control during the front/back rhythmic weight shift were significantly lower in the patient group. The rising index during sit-to-stand was significantly lower and movement time during step up/over with the affected side was significantly longer in patients. Conclusion This study demonstrated in detail a decline of postural balance by utilizing computerized posturography in elderly women with unilateral knee OA. They had less weight-bearing, more sway, and less ability of intentional postural control on the affected side.

Study Design. A retrospective clinical data analysis. Objective. To determine the therapeutic effectiveness of lumbar total disc replacement (TDR) using ProDisc-L (Synthes Spine, West Chester, PA) in the patients with degenerative disc diseases (DDD) with a minimum follow-up of 5 years. Summary of Background Data. Early successful clinical results of lumbar TDR have been reported. However, few reports have published its therapeutic effectiveness in the long term. Methods. The patients were examined preoperatively and at 3 months, 1 year, 2 years, and more than 5 years postoperatively, and assessed using visual analog scale (VAS), Oswestry disability index (ODI), physical health component summary (PCS) of the 36-Item Short Form Health Survey questionnaire, and sporting activity scale scores. At last follow-up visits, two additional questions were asked: satisfaction with surgery and willingness to undergo the same treatment. Finally, clinical success was assessed using the Food and Drug Administration definition. Results. Thirty-five patients were included in the study. The mean follow-up period was 72 months (6 years). Postoperatively, all outcome measure scores (VAS, mean ODI, PCS, and sports activity scores) immediately improved and these improvements were maintained at last follow-up visits with statistical significance. However, outcome score improvements were observed to be slightly, though significantly, lower at last follow-up visits than at 1 or 2 years postoperatively. Eighty-eight percent of patients were “satisfied” or “somewhat satisfied” with treatment and 60% were prepared to undergo the same treatment again. Twenty-five patients (71.4%) achieved clinical success. Conclusion. This study reveals that lumbar TDR using ProDisc-L is a safe and effective treatment for chronic back pain caused by lumbar DDD as assessed at more than 5 years postoperatively. Nevertheless, outcome scores were slightly, though significantly lower at last follow-up visits than at 1 and 2 years postoperatively. A longer-term follow-up study is warranted.