• Title/Summary/Keyword: 개선안

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A Study on Improvements on Legal Structure on Security of National Research and Development Projects (과학기술 및 학술 연구보고서 서비스 제공을 위한 국가연구개발사업 관련 법령 입법론 -저작권법상 공공저작물의 자유이용 제도와 연계를 중심으로-)

  • Kang, Sun Joon;Won, Yoo Hyung;Choi, San;Kim, Jun Huck;Kim, Seul Ki
    • Proceedings of the Korea Technology Innovation Society Conference
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    • 2015.05a
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    • pp.545-570
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    • 2015
  • Korea is among the ten countries with the largest R&D budget and the highest R&D investment-to-GDP ratio, yet the subject of security and protection of R&D results remains relatively unexplored in the country. Countries have implemented in their legal systems measures to properly protect cutting-edge industrial technologies that would adversely affect national security and economy if leaked to other countries. While Korea has a generally stable legal framework as provided in the Regulation on the National R&D Program Management (the "Regulation") and the Act on Industrial Technology Protection, many difficulties follow in practice when determining details on security management and obligations and setting standards in carrying out national R&D projects. This paper proposes to modify and improve security level classification standards in the Regulation. The Regulation provides a dual security level decision-making system for R&D projects: the security level can be determined either by researcher or by the central agency in charge of the project. Unification of such a dual system can avoid unnecessary confusions. To prevent a leakage, it is crucial that research projects be carried out in compliance with their assigned security levels and standards and results be effectively managed. The paper examines from a practitioner's perspective relevant legal provisions on leakage of confidential R&D projects, infringement, injunction, punishment, attempt and conspiracy, dual liability, duty of report to the National Intelligence Service (the "NIS") of security management process and other security issues arising from national R&D projects, and manual drafting in case of a breach. The paper recommends to train security and technological experts such as industrial security experts to properly amend laws on security level classification standards and relevant technological contents. A quarterly policy development committee must also be set up by the NIS in cooperation with relevant organizations. The committee shall provide a project management manual that provides step-by-step guidance for organizations that carry out national R&D projects as a preventive measure against possible leakage. In the short term, the NIS National Industrial Security Center's duties should be expanded to incorporate national R&D projects' security. In the long term, a security task force must be set up to protect, support and manage the projects whose responsibilities should include research, policy development, PR and training of security-related issues. Through these means, a social consensus must be reached on the need for protecting national R&D projects. The most efficient way to implement these measures is to facilitate security training programs and meetings that provide opportunities for communication among industrial security experts and researchers. Furthermore, the Regulation's security provisions must be examined and improved.

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A Data-based Sales Forecasting Support System for New Businesses (데이터기반의 신규 사업 매출추정방법 연구: 지능형 사업평가 시스템을 중심으로)

  • Jun, Seung-Pyo;Sung, Tae-Eung;Choi, San
    • Journal of Intelligence and Information Systems
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    • v.23 no.1
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    • pp.1-22
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    • 2017
  • Analysis of future business or investment opportunities, such as business feasibility analysis and company or technology valuation, necessitate objective estimation on the relevant market and expected sales. While there are various ways to classify the estimation methods of these new sales or market size, they can be broadly divided into top-down and bottom-up approaches by benchmark references. Both methods, however, require a lot of resources and time. Therefore, we propose a data-based intelligent demand forecasting system to support evaluation of new business. This study focuses on analogical forecasting, one of the traditional quantitative forecasting methods, to develop sales forecasting intelligence systems for new businesses. Instead of simply estimating sales for a few years, we hereby propose a method of estimating the sales of new businesses by using the initial sales and the sales growth rate of similar companies. To demonstrate the appropriateness of this method, it is examined whether the sales performance of recently established companies in the same industry category in Korea can be utilized as a reference variable for the analogical forecasting. In this study, we examined whether the phenomenon of "mean reversion" was observed in the sales of start-up companies in order to identify errors in estimating sales of new businesses based on industry sales growth rate and whether the differences in business environment resulting from the different timing of business launch affects growth rate. We also conducted analyses of variance (ANOVA) and latent growth model (LGM) to identify differences in sales growth rates by industry category. Based on the results, we proposed industry-specific range and linear forecasting models. This study analyzed the sales of only 150,000 start-up companies in Korea in the last 10 years, and identified that the average growth rate of start-ups in Korea is higher than the industry average in the first few years, but it shortly shows the phenomenon of mean-reversion. In addition, although the start-up founding juncture affects the sales growth rate, it is not high significantly and the sales growth rate can be different according to the industry classification. Utilizing both this phenomenon and the performance of start-up companies in relevant industries, we have proposed two models of new business sales based on the sales growth rate. The method proposed in this study makes it possible to objectively and quickly estimate the sales of new business by industry, and it is expected to provide reference information to judge whether sales estimated by other methods (top-down/bottom-up approach) pass the bounds from ordinary cases in relevant industry. In particular, the results of this study can be practically used as useful reference information for business feasibility analysis or technical valuation for entering new business. When using the existing top-down method, it can be used to set the range of market size or market share. As well, when using the bottom-up method, the estimation period may be set in accordance of the mean reverting period information for the growth rate. The two models proposed in this study will enable rapid and objective sales estimation of new businesses, and are expected to improve the efficiency of business feasibility analysis and technology valuation process by developing intelligent information system. In academic perspectives, it is a very important discovery that the phenomenon of 'mean reversion' is found among start-up companies out of general small-and-medium enterprises (SMEs) as well as stable companies such as listed companies. In particular, there exists the significance of this study in that over the large-scale data the mean reverting phenomenon of the start-up firms' sales growth rate is different from that of the listed companies, and that there is a difference in each industry. If a linear model, which is useful for estimating the sales of a specific company, is highly likely to be utilized in practical aspects, it can be explained that the range model, which can be used for the estimation method of the sales of the unspecified firms, is highly likely to be used in political aspects. It implies that when analyzing the business activities and performance of a specific industry group or enterprise group there is political usability in that the range model enables to provide references and compare them by data based start-up sales forecasting system.

Study on the Difference in Intake Rate by Kidney in Accordance with whether the Bladder is Shielded and Injection method in 99mTc-DMSA Renal Scan for Infants (소아 99mTc-DMSA renal scan에서 방광차폐유무와 방사성동위원소 주입방법에 따른 콩팥섭취율 차이에 관한 연구)

  • Park, Jeong Kyun;Cha, Jae Hoon;Kim, Kwang Hyun;An, Jong Ki;Hong, Da Young;Seong, Hyo Jin
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.27-31
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    • 2016
  • Purpose $^{99m}Tc-DMSA$ renal scan is a test for the comparison of the function by imaging the parenchyma of the kidneys by the cortex of a kidney and by computing the intake ratio of radiation by the left and right kidney. Since the distance between the kidneys and the bladder is not far given the bodily structure of an infant, the bladder is included in the examination domain. Research was carried out with the presumption that counts of bladder would impart an influence on the kidneys at the time of this renal scan. In consideration of the special feature that only a trace amount of a RI is injected in a pediatric examination, research on the method of injection was also carried out concurrently. Materials and Methods With 34 infants aged between 1 month to 12 months for whom a $^{99m}Tc-DMSA$ renal scan was implemented on the subjects, a Post IMAGE was acquired in accordance with the test time after having injected the same quantity of DMSA of 0.5mCi. Then, after having acquired an additional image by shielding the bladder by using a circular lead plate for comparison purposes, a comparison was made by illustrating the percentile of (Lt. Kidney counts + Rt. Kidney counts)/ Total counts, by drawing the same sized ROI (length of 55.2mm X width of 70.0mm). In addition, in the format of a 3-way stopcock, a Heparin cap and direct injection into the patient were performed in accordance with RI injection methods. The differences in the count changes in accordance with each of the methods were compared by injecting an additional 2cc of saline into the 3-way stopcock and Heparin cap. Results The image prior to shielding of the bladder displayed a kidney intake rate with a deviation of $70.9{\pm}3.18%$ while the image after the shielding of the bladder displayed a kidney intake rate with a deviation of $79.4{\pm}5.19%$, thereby showing approximately 6.5~8.5% of difference. In terms of the injection method, the method that used the 3-way form, a deviation of $68.9{\pm}2.80%$ prior to the shielding and a deviation of $78.1{\pm}5.14%$ after the shielding were displayed. In the method of using a Heparin cap, a deviation of $71.3{\pm}5.14%$ prior to the shielding and a deviation of $79.8{\pm}3.26%$ after the shielding were displayed. Lastly, in the method of direct injection into the patient, a deviation of $75.1{\pm}4.30%$ prior to the shielding and a deviation of $82.1{\pm}2.35%$ after the shielding were displayed, thereby illustrating differences in the kidney intake rates in the order of direct injection, a Heparin cap and the 3-way methods. Conclusion Since a substantially minute quantity of radiopharmaceuticals is injected for infants in comparison to adults, the cases of having shielded the bladder by removing radiation of the bladder displayed kidney intake rates that are improved from those of the cases of not having shielded the bladder. Although there are difficulties in securing blood vessels, it is deemed that the method of direct injection would be more helpful in acquisition of better images since it displays improved kidney intake rate in comparison to other methods.

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A Preliminary Study on Depressive Symptoms and Glycemic Controls in Diabetic Patients (당뇨병 환자에서의 우울 및 관련증상에 관한 예비적 연구)

  • Ko, Seung-Hyun;Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Seung-Pil;Ahn, Yoo-Bae;Song, Ki-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.165-173
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    • 2004
  • Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

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The way to make training data for deep learning model to recognize keywords in product catalog image at E-commerce (온라인 쇼핑몰에서 상품 설명 이미지 내의 키워드 인식을 위한 딥러닝 훈련 데이터 자동 생성 방안)

  • Kim, Kitae;Oh, Wonseok;Lim, Geunwon;Cha, Eunwoo;Shin, Minyoung;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.1-23
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    • 2018
  • From the 21st century, various high-quality services have come up with the growth of the internet or 'Information and Communication Technologies'. Especially, the scale of E-commerce industry in which Amazon and E-bay are standing out is exploding in a large way. As E-commerce grows, Customers could get what they want to buy easily while comparing various products because more products have been registered at online shopping malls. However, a problem has arisen with the growth of E-commerce. As too many products have been registered, it has become difficult for customers to search what they really need in the flood of products. When customers search for desired products with a generalized keyword, too many products have come out as a result. On the contrary, few products have been searched if customers type in details of products because concrete product-attributes have been registered rarely. In this situation, recognizing texts in images automatically with a machine can be a solution. Because bulk of product details are written in catalogs as image format, most of product information are not searched with text inputs in the current text-based searching system. It means if information in images can be converted to text format, customers can search products with product-details, which make them shop more conveniently. There are various existing OCR(Optical Character Recognition) programs which can recognize texts in images. But existing OCR programs are hard to be applied to catalog because they have problems in recognizing texts in certain circumstances, like texts are not big enough or fonts are not consistent. Therefore, this research suggests the way to recognize keywords in catalog with the Deep Learning algorithm which is state of the art in image-recognition area from 2010s. Single Shot Multibox Detector(SSD), which is a credited model for object-detection performance, can be used with structures re-designed to take into account the difference of text from object. But there is an issue that SSD model needs a lot of labeled-train data to be trained, because of the characteristic of deep learning algorithms, that it should be trained by supervised-learning. To collect data, we can try labelling location and classification information to texts in catalog manually. But if data are collected manually, many problems would come up. Some keywords would be missed because human can make mistakes while labelling train data. And it becomes too time-consuming to collect train data considering the scale of data needed or costly if a lot of workers are hired to shorten the time. Furthermore, if some specific keywords are needed to be trained, searching images that have the words would be difficult, as well. To solve the data issue, this research developed a program which create train data automatically. This program can make images which have various keywords and pictures like catalog and save location-information of keywords at the same time. With this program, not only data can be collected efficiently, but also the performance of SSD model becomes better. The SSD model recorded 81.99% of recognition rate with 20,000 data created by the program. Moreover, this research had an efficiency test of SSD model according to data differences to analyze what feature of data exert influence upon the performance of recognizing texts in images. As a result, it is figured out that the number of labeled keywords, the addition of overlapped keyword label, the existence of keywords that is not labeled, the spaces among keywords and the differences of background images are related to the performance of SSD model. This test can lead performance improvement of SSD model or other text-recognizing machine based on deep learning algorithm with high-quality data. SSD model which is re-designed to recognize texts in images and the program developed for creating train data are expected to contribute to improvement of searching system in E-commerce. Suppliers can put less time to register keywords for products and customers can search products with product-details which is written on the catalog.

A Study on Market Expansion Strategy via Two-Stage Customer Pre-segmentation Based on Customer Innovativeness and Value Orientation (고객혁신성과 가치지향성 기반의 2단계 사전 고객세분화를 통한 시장 확산 전략)

  • Heo, Tae-Young;Yoo, Young-Sang;Kim, Young-Myoung
    • Journal of Korea Technology Innovation Society
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    • v.10 no.1
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    • pp.73-97
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    • 2007
  • R&D into future technologies should be conducted in conjunction with technological innovation strategies that are linked to corporate survival within a framework of information and knowledge-based competitiveness. As such, future technology strategies should be ensured through open R&D organizations. The development of future technologies should not be conducted simply on the basis of future forecasts, but should take into account customer needs in advance and reflect them in the development of the future technologies or services. This research aims to select as segmentation variables the customers' attitude towards accepting future telecommunication technologies and their value orientation in their everyday life, as these factors wilt have the greatest effect on the demand for future telecommunication services and thus segment the future telecom service market. Likewise, such research seeks to segment the market from the stage of technology R&D activities and employ the results to formulate technology development strategies. Based on the customer attitude towards accepting new technologies, two groups were induced, and a hierarchical customer segmentation model was provided to conduct secondary segmentation of the two groups on the basis of their respective customer value orientation. A survey was conducted in June 2006 on 800 consumers aged 15 to 69, residing in Seoul and five other major South Korean cities, through one-on-one interviews. The samples were divided into two sub-groups according to their level of acceptance of new technology; a sub-group demonstrating a high level of technology acceptance (39.4%) and another sub-group with a comparatively lower level of technology acceptance (60.6%). These two sub-groups were further divided each into 5 smaller sub-groups (10 total smaller sub-groups) through two rounds of segmentation. The ten sub-groups were then analyzed in their detailed characteristics, including general demographic characteristics, usage patterns in existing telecom services such as mobile service, broadband internet and wireless internet and the status of ownership of a computing or information device and the desire or intention to purchase one. Through these steps, we were able to statistically prove that each of these 10 sub-groups responded to telecom services as independent markets. We found that each segmented group responds as an independent individual market. Through correspondence analysis, the target segmentation groups were positioned in such a way as to facilitate the entry of future telecommunication services into the market, as well as their diffusion and transferability.

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The Accuracy of Tuberculosis Notification Reports at a Private General Hospital after Enforcement of New Korean Tuberculosis Surveillance System (새로운 국가결핵감시체계 시행 후 한 민간종합병원에서 작성된 결핵정보관리보고서의 정확도 조사)

  • Kim, Cheol Hong;Koh, Won-Jung;Kwon, O Jung;Ahn, Young Mee;Lim, Seong Young;An, Chang Hyeok;Youn, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.178-190
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    • 2003
  • Background : The committee of tuberculosis(TB) survey planning for the year 2000 decided to construct the Korean Tuberculosis Surveillance System (KTBS), based on a doctor's routine reporting method. The successful keys of the KTBS rely on the precision of the recorded TB notification forms. The purpose of this study was to determine that the accuracy of the TB notification form written at a private general hospital given to the corresponding health center and to improve the comprehensiveness of these reporting systems. Materials and Methods : 291 adult TB patients who had been diagnosed from August 2000 to January 2001, were enrolled in this study. The lists of TB notification forms were compared with the medical records and the various laboratory results; case characteristics, history of previous treatment, examinations for diagnosis, site of the TB by the international classification of the disease, and treatment. Results : In the list of examinations for a diagnosis in 222 pulmonary TB patients, the concordance rate of the 'sputum smear exam' was 76% but that of the 'sputum culture exam' was only 23%. Among the 198 cases of the sputum culture exam labeled 'not examined', 43(21.7%) cases proved to be true 'not examined', 70 cases(35.4%) were proven to be 'culture positive', and 85(43.0%) cases were proven to be 'culture negative'. In the list of examinations for a diagnosis in 69 extrapulmonary TB patients, the concordance rate of the 'smear exam other than sputum' was 54%. In the list of treatments, the overall concordance rate of the 'type of registration' in the TB notification form was 85%. Among the 246 'new' cases on the TB notification form, 217(88%) cases were true 'new' cases and 13 were proven to be 'relapse', 2 were proven to be 'treatment after failure', one was proven to be 'treatment after default', 12 were proven to be 'transferred-in' and one was proven to be 'chronic'. Among the 204 HREZ prescribed regimen, 172(84.3%) patients were taking the HREZ regimen, and the others were prescribed other drug regimens. Conclusion : Correct recording of the TB notification form at the private sectors is necessary for supporting the effective TB surveillance system in Korea.

Mineralogy and Biogeochemistry of Intertidal Flat Sediment, Muan, Chonnam, Korea (전남 무안 갯벌 퇴적물에 관한 광물학적 및 생지화학적 연구)

  • Park, Byung-No;Lee, Je-Hyun;Oh, Jong-Min;Lee, Seuug-Hee;Han, Ji-Hee;Kim, Yu-Mi;Seo, Hyun-Hee;Roh, Yul
    • Journal of the Mineralogical Society of Korea
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    • v.20 no.1 s.51
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    • pp.47-60
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    • 2007
  • While sedimentological researches on Western coastal tidal flats of Korea have been much pelformed previously, mineralogical and biogeochemical studies are beginning to be studied. The objectives of this study were to investigate mineralogical characteritics of the inter-tidal flat sediments and to explore phase transformation of iron(oxyhydr)oxides and biomineralization by metal-reducing bacteria enriched from the inter-tidal flat sediments from Muan, Jeollanam-do, Korea. Inter-tidal flat sediment samples were collected in Chungkye-myun and Haeje-myun, Muan-gun, Jeollanam-do. Particle size analyses were performed using the pipette method and sedimentation method. The separates including sand, silt and clay fractions were examined by scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM), and X-ray diffiaction (XRD). After enriching the metal-.educing bacteria from the into,-tidal flat sediments, the bacteria were used to study phase transformation of the synthesized iron (oxyhydr)oxides and iron biomineralization using lactate or glucose as the electron donors and Fe(III)-containing iron oxides as the electron accepters. Mineralogical studies showed that the sediments of tidal flats in Chung]rye-myun and Haeje-myun consist of quartz, plagioclase, microcline, biotite, kaolinite and illite. Biogeochemical researches showed that the metal-reducing bacteria enriched from the inter-tidal flat sediments reduced reddish brown akaganeite and mineralized nanometer-sized black magnetite. The bacteria also reduced the reddish brown ferrihydrite into black amorphous phases and reduced the yellowish goethite into greenish with formation of nm-sized phases. These results indicate that microbial Fe(III) reduction may play one of important roles in iron and carbon biogeochemistry as well as iron biomineralization in subsurface environments.

The Analysis of the Current Status of Medical Accidents and Disputes Researched in the Korean Web Sites (인터넷 사이트를 통해 살펴본 의료사고 및 의료분쟁의 현황에 관한 분석)

  • Cha, Yu-Rim;Kwon, Jeong-Seung;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.297-316
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    • 2006
  • The increasing tendency of medical disputes is one of the remarkable social phenomena. Especially we must not overlook the phenomenon that production and circulation of information related to medical accidents is increasing rapidly through the internet. In this research, we evaluated the web sites which provide the information related to medical accidents using the keyword "medical accidents" in March 2006, and classified the 28 web sites according to the kinds of establishers. We also analyzed the contents of the sites, and checked and compared the current status of the web sites and problems that have to be improved. Finally, we suggested the possible solutions to prevent medical accidents. The detailed results were listed below. 1. Medical practitioners, general public, and lawyers were all familiar with and prefer the term "medical accidents" mainly. 2. In the number of sites searched by the keyword "medical accidents", lawyer had the most sites and medical practitioners had the least ones. 3. Many sites by general public and lawyers had their own medical record analysts but there was little professional analysts for dentistry. 4. General public were more interested in the prevention of medical accidents but the lawyers were more interested in the process after medical accidents. The sites by medical practitioners dealt with the least remedies of medical accidents, compared with other sites. 5. General public wanted the third party such as government intervention into the disputes including the medical dispute arbitration law or/and the establishment of independent medical dispute judgment institution. 6. In the comparison among the establishers of web sites, medical practitioners dealt with the least examples of medical accidents. 7. The suggestion of cases in counseling articles related to dental accidents were considered less importantly than the reality. 8. Whereas there were many articles about domestic cases related to the bloody dental treatment, in the open counseling articles the number of dental treatment regarding to non insurance treatment was large. 9. In comparing offered information of medical accidents based on the establishers, general public offered vocabularies, lawyers offered related laws and medical practitioners offered medical knowledge relatively. 10. They all cited the news pressed by the media to offer the current status of domestic medical accidents. Especially among the web sites by general public, NGOs provided the plentiful statistical data related to medical accidents. 11. The web sites that collect the medical accidents were only two. As a result of our research, we found out that, in the flood of information, medical disputes can be occurred by the wrong information from third party, and the medical practitioners have the most passive attitudes on the medical accidents. Thus, it is crucial to have the mutual interchange and exchange of information between lawyer, patients and medical practitioners, so that based on clear mutual comprehension we can solve the accidents and disputes more positively and actively.

Study on the Short-Term Hemodynamic Effects of Experimental Cardiomyoplasty in Heart Failure Model (심부전 모델에서 실험적 심근성형술의 단기 혈역학적 효과에 관한 연구)

  • Jeong, Yoon-Seop;Youm, Wook;Lee, Chang-Ha;Kim, Wook-Seong;Lee, Young-Tak;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.224-236
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    • 1999
  • Background: To evaluate the short-term effect of dynamic cardiomyoplasty on circulatory function and detect the related factors that can affect it, experimental cardiomyoplasties were performed under the state of normal cardiac function and heart failure. Material and Method: A total of 10 mongrel dogs weighing 20 to 30kg were divided arbitrarily into two groups. Five dogs of group A underwent cardiomyoplasty with latissimus dorsi(LD) muscle mobilization followed by a 2-week vascular delay and 6-week muscle training. Then, hemodynamic studies were conducted. In group B, doxorubicin was given to 5 dogs in an IV dose of 1 mg/kg once a week for 8 weeks to induce chronic heart failure, and simultaneous muscle training was given for preconditioning during this period. Then, cardiomyoplasties were performed and hemodynamic studies were conducted immediately after these cardiomyoplasties in group B. Result: In group A, under the state of normal cardiac function, only mean right atrial pressure significantly increased with the pacer-on(p<0.05) and the left ventricular hemodynamic parameters did not change significantly. However, with pacer-on in group B, cardiac output(CO), rate of left ventricular pressure development(dp/dt), stroke volume(SV), and left ventricular stroke work(SW) increased by 16.7${\pm}$7.2%, 9.3${\pm}$3.2%, 16.8${\pm}$8.6%, and 23.1${\pm}$9.7%, respectively, whereas left ventricular end-diastole pressure(LVEDP) and mean pulmonary capillary wedge pressure(mPCWP) decreased by 32.1${\pm}$4.6% and 17.7${\pm}$9.1%, respectively(p<0.05). In group A, imipramine was infused at the rate of 7.5mg/kg/hour for 34${\pm}$2.6 minutes to induce acute heart failure, which resulted in the reduction of cardiac output by 17.5${\pm}$2.7%, systolic left ventricular pressure by 15.8${\pm}$2.5% and the elevation of left ventricular end-diastole pressure by 54.3${\pm}$15.2%(p<0.05). With pacer-on under this state of acute heart failu e, CO, dp/dt, SV, and SW increased by 4.5${\pm}$1.8% and 3.1${\pm}$1.1%, 5.7${\pm}$3.6%, and 6.9${\pm}$4.4%, respectively, whereas LVEDP decreased by 11.7${\pm}$4.7%(p<0.05). Comparing CO, dp/dt, SV, SW and LVEDP that changed significantly with pacer-on, both under the state of acute and chronic heart failure, augmentation widths of these left ventricular hemodynamic parameters were significantly larger under the state of chronic heart failure(group B) than acute heart failure(group A)(p<0.05). On gross inspection, variable degrees of adhesion and inflammation were present in all 5 dogs of group A, including 2 dogs that showed no muscle contraction. No adhesion and inflammation were, however, present in all 5 dogs of group B, which showed vivid muscle contractions. Considering these differences in gross findings along with the following premise that the acute heart failure state was not statistically different from the chronic one in terms of left ventricular parameters(p>0.05), the larger augmentation effect seen in group B is presumed to be mainly attributed to the viability and contractility of the LD muscle. Conclusion: These results indicate that the positive circulatory augmentation effect of cardiomyoplasty is apparent only under the state of heart failure and the preservation of muscle contractility is important to maximize this effect.

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