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Role of the Inferior Thyroid Vein after Left Brachiocephalic Vein Division During Aortic Surgery

  • Park, Hyung-Ho;Kim, Bo-Young;Oh, Bong-Suk;Yang, Ki-Wan;Seo, Hong-Joo;Lim, Young-Hyuk;Kim, Jeong-Jung
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.530-534
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    • 2002
  • Background: In aortic surgery, division and ligation of the left brachiocephalic vein(LBV) may improve exposure of the aortic arch but controversy continues about the safety of this division and whether a divided vein should be reanastomosed after arch replacement was completed. The safety of LBV division and the fate of the left subclavian venous drainage after LBV division were studied. Material and Method: From November 1998 to January 2001, planned division and ligation of the LBV on the mid-line after median sternotomy was peformed in 10 patients during the aortic surgery with the consideration of local anatomy and distal aortic anastomosis. Assessment for upper extremity edema and neurologic symptoms, measurement of venous pressure in the right atrium and left internal jugular vein, and digital subtraction venography(DSV) of the left arm were made postoperatively. Result: In 10 patients there was improvement in access to the aortic arch for procedures on the ascending aorta or aortic arch. The mean age of patients was 62 years(range 24 to 70). Follow-up ranged from 3 weeks to 13 months. One patient died because of mediastinitis from methicilline-resistant staphylococcus aureus strain. All patients had edema on the left upper extremity, but resolved by the postoperative day 4. No patient had any residual edema or difficulty in using the left upper extremity during the entire follow-up period. No patient had postoperative stroke. Pressure difference between the right atrium and left internal jugular vein was peaked on the immediate postoperative period(mean peak pressure difference = 25mmHg), but gradually decreased, then plated by the postoperative day 4. In all DSV studies left subclavian vein flowed across the midline through the inferior thyroid venous plexus. Conclusion: We conclude that division of LBV is safe and reanastomosis is not necessary if inferior thyroid vein, which is developed as a main bridge connecting the left subclavian vein with right venous system, is preserved.

A Study on the Meaning and Types of Banpo [斑布] during the Joseon Dynasty (조선시대 반포(斑布)의 의미와 형식 연구)

  • Ree, Jiwon
    • Korean Journal of Heritage: History & Science
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    • v.53 no.3
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    • pp.164-183
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    • 2020
  • In the textile culture of the Joseon Dynasty, the historic record of Banpo is fragmentary and contains many missing details. The main reason is a lack of associated literature, and it is also significant that the actual substance used is not clear at present. Banpo is a kind of cotton, but this has not been confirmed in the traditional textiles that are currently handed down. The word Ban [斑] in Banpo means "stain", and the letter Po [布] means "fabric". At the border of white discourse, Banpo did not receive attention as a research topic. This study is an attempt to restore some of the textile culture of the Joseon Dynasty through Banpo. Banpo is not just limited to the Joseon Dynasty; it is an important material for examining the development of textile culture and exchange in East Asia. This study was broadly divided into three parts. First, the record and meaning of Banpo during the Joseon Dynasty were examined. Records of Banpo can be seen from the early Joseon period during King Sejo and Seongjong, and the production and actual use of Banpo have been confirmed. Banpo was maintained until the beginning of the 20th century, but is no longer observed. Banpo is a woven fabric made of cotton yarn dyed in many colors and has appeared in Southeast Asia since ancient times. In East Asia, there are other fabrics similar to Banpo, such as Ho [縞], Sum [纖], and Chim [綅]. In particular, the correlation between Banpo and Ho is an important link in understanding Banpo in the Joseon Dynasty. Second, the meaning of Banpo was examined from various angles through comprehensive analysis of Chinese and Japanese literature records and cases. The appearance and development of Banpo moved in sync with the period when cotton was introduced into East Asia. In East Asia, cotton was introduced and produced in earnest from the end of the Song Dynasty to the beginning of the Yuan Dynasty, and the meaning of Banpo was diversified. In China, the name of Banpo was changed to Hwapo [花布], Gizapo [碁子布], Gizahwapo [棋子花布], etc. Japan was late to introduce cotton and developed it in acceptance of the changed meaning. In Japan, use of the name Banpo is not on record, but a Ryujo [柳條] fabric of the same type as banpo has been identified. This Ryujo is the same concept as Ho and Hwapo, and later merged into Ho. Names such as Ho, Hwapo, Banpo, etc. were used differently in each country, but the form was shared across East Asia. Third, based on the meaning of Banpo shared in East Asia, the format of Banpo in the Joseon Dynasty was classified. The format of Banpo in the Joseon Dynasty can be divided into grid and striped versions. The name Banpo disappeared over time, but the form remained and was passed down until recently. I hope that this study will help restore Banpo in the future.

Influence of Anatomy, Associated Anomalies, Age, and Surgical Methods on the Surgical Results of Aortic Coarctation (대동맥교약증 환아의 해부학적 형태, 동반심기형, 연령, 수술방법등이 수술결과에 미치는 영향)

  • 이정렬;김혜순
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.363-372
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    • 1997
  • One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.

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Clinical Utility of Turbo Contrase-Enhanced MR Angiography for the Major Branches of the Aortic Arch (대동맥궁 주요 분지들의 고속 조영증강 자기공명혈관조영술의 임상적 유용성)

  • Su Ok Seong
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.96-103
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    • 1998
  • Purpose : To assess the clinical utility of turbo contrast-enhanced magnetic resonance angiography(CE MRA) in the evaluation of the aortic arch and its major branches and to compare the image quality of CE MRA among different coils used. Materials and Methods : Turbo three-phase dynamic CE MRA encompassing aortic arch and its major branches was prospectively performed after manual bolus IV injection of contrast material in 29 patients with suspected cerebrovascular diseases at 1.0T MR unit. the raw data were obtained with 3-D FISH sequence (TR 5.4ms, TE 2.3ms, flip angle 30, slab thickness 80nm, effective slice thickness 4.0mm, matrix size $100{\times}256$, FOV 280mm). Total data acquisition time was 4. to 60 seconds. We subjectively evaluated the imge quality with three-rating scheme : "good" for unequivocal normal finding, "fair" for relatively satisfactory quality to diagnose 'normal' despite intravascular low signal, and "poor" for equivocal diagnosis or non-visualization of the origin or segment of the vessels due to low signal or artifacts which needs catheter angiography. At the level of the carotid bifurcation, it was compared with conventional 2D-TOF MRA image. Overall image quality was also compared visually and quantitatively by measuring signal-to-noise ratios (SNRs) of the ascending aorta, the innominate artery and both common carotid arteries among the three different coils used(CP body array(n=12), CP neck array(n=9), and head-and-neck(n=8). Results : Demonstration of the aortic arch and its major branches was rated as "good" in 55% (16/29) and "fair" in 34%(10/29). At the level of the carotid bifurcation, image quality of turbo CE MRA was same as or better than conventional 2D-TOF MRA in 65% (17/26). Overall image quality and SNR were significantlygreater with CP body array coil than with CP neck array or head-and-neck coil. Conclusions : Turbo CE MRA can be used as a screening exam in the evaluation of the major branches of the aortic arch from their origin to the skull base. Overall imagequality appears to be better with CP body array coil than with CP neck array coil or head-and-neck coil.

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Hwangsang's Exchanges with Chusa Family and Poetic Embodiment (황상(黃裳)의 추사가(秋史家)와의 교류와 시적 형상화)

  • Gu, sawhae;Kim, gyusun
    • (The)Study of the Eastern Classic
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    • no.59
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    • pp.157-181
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    • 2015
  • This thesis pursued exchanges of Hwangsang with Chusa Family, who existed in the 19th century. What was Chusa to Hwangsang and what was Hwangsang to Chusa? The answer is concluded to the question of which existence Chusa was to Hwangsang but not of which existence Hwangsang was to Chusa. However, disregarding social positions of the nobles and the commoners, brothers of Chusa also cherished Hwangsang and respectfully treated him as a poet at all times. Chusa was a critic who recognized Hwangsang as a successor to Dasan poetics and became a patron of the literary circles on the other hand. Hwangsang's Chinese poems related to Chusa Family are counted as 45 JE 52 SU in total which consist of 31 JE 34 SU in "CHIWONYUGO" and 14 JE 18 SU in "CHIWONSOGO", On the other hand, Chinese poems which Chusa wrote for Hwangsang are only a few pieces shown in "WANDANGJEONJIP". Hwangsang first met three brothers including Chusa in September 1853 when he came up to the capital for the 4th time. Jeong Hak-yeon, the oldest son of Dasan Jeang Yak-yong, played an important role in the whole process that Hwangsang met Chusa's three brothers and was recognized as a poet. As the oldest son of Dasan Family, Jeong Hak-yeon made efforts in various ways for Hwangsang. Hwangsang tried his efforts to exhibit his ability as a poet to Chusa and to get Chusa's introduction of his poetical works. Considering Chusa's importance in then literary circles, the introduction seemed to reflect recognition by the literary circles in the metropolis and it also showed that Hwangsang was no more than an obscure poet in the provincial area. Poetical composition of Hwangsang for Chusa three brothers commonly contained friendship, intimacy and special respect at all times. Seeing from exchange process between Hwangsang and Dasan Family or Chusa Family, it is found that mutual exchanges were actively made in the mid-nineteenth century overcoming regional differentiation between capital and province, or feudalism class distinction of social positions of the nobles and the commoners.

The effect of COVID-19 characteristics and transmission risk concerns on smart learning acceptance: Focusing on the application of the integrated model of ISSM and HBM (코로나-19의 특징과 전파위험 걱정이 스마트 러닝 수용에 미치는 영향: ISSM과 HBM의 통합 모형 적용을 중심으로)

  • Pyo, GyuJin;Kim, Yang Sok;Noh, Mijin;Han, Mu Moung Cho;Rahman, Tazizur;Son, Jaeik
    • Journal of Digital Convergence
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    • v.19 no.7
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    • pp.57-70
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    • 2021
  • As COVID-19 spreads, people's interest in smart learning that can do non-face-to-face learning is increasing nowadays. In this study, we aim to empirically analyze how users' thoughts on COVID-19 and the information quality and system quality of smart learning systems affect users' acceptance of smart learning and examine the effect of perceived sensitivity and severity of COVID-19 on the satisfaction and use of smart learning through concerns about the risk of transmission. In addition, we examined the influence of information quality composed of content quality and interaction quality and system quality composed of system accessibility and functionality on the use of smart learning through user satisfaction. To verify the validity of the proposed model, we conducted a survey on 334 users with experience in using smart learning, and performed the analysis using Smart PLS 3.0. According to the analysis results, among information quality and system quality, only functionality has a positive (+) effect on the satisfaction of smart learning, and satisfaction has a positive (+) effect on the usage behavior. However, it is found that accessibility among system quality do not affect satisfaction, and concern about the risk of transmission has a negative effect on satisfaction. This study can provide meaningful guidelines to researchers when researching smart learning to support students' learning in a pandemic situation of a new infectious disease, such as COVID-19. It will also be able to provide useful implications for educational institutions and companies related to smart learning.

How did 'Partisan' become 'The red': The impossibility of pain-representation in the 1970s-1980s - Focusing on Lee Byung-Ju's 『Jirisan』 ('빨치산'은 어떻게 '빨갱이'가 되었나: 1970-80년대 고통의 재현불가능성 -이병주의 『지리산』을 중심으로)

  • Park, Suk-Ja
    • Journal of Popular Narrative
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    • v.27 no.2
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    • pp.143-177
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    • 2021
  • In the history of Korean literature, evaluations on 『Jirisan』 (Lee Byeong-ju) are bisected. Some evaluate it as a novel of authentic records which reproduces the history before and after the emancipation objectively while others say it takes advantage of anti-communistic ideology. This study analyzes that difference is resulted not from the distinction of perspectives but from cracks in the text. This is associated with the process of 『Jirisan』's publication. 『Jirisan』 was published serially in 『Sedae』 from 1972, and then, part of the manuscript was published in 1978 and the whole edition published in a series came to be republished in 1981. After that, in 1981 and 1985, part of the follow-up story was printed on the magazine, and then, with the memoirs of those two years as materials, the sixth and seventh volumes were again published through 'revision'. In other words, the publication of 『Jirisan』 is divided into that of the edition published in a series and that of the edition published in 1985 including the contents of revision. The theme of the work, 『Jirisan』 differs according to the point of its completion you may think of. This researcher pays attention to the difference of perspectives between the contents up to the fifth volume and those of the sixth and seventh volumes. Particularly, his evaluation on 'partisans' seems to have changed. In the edition published in a series, he extended 'partisans' into the independence movement in the Japanese colonial era under the Revitalizing Reforms system and adopted the representation of 'partisans' three-dimensionally whereas in the sixth and seventh volumes, he reproduced 'partisans' as beings that were the 'doctrinaire' and 'vicious' 'Reds' and had to be punished. In brief, with 『Jirisan』, he represented 'partisans' in the background of history before and after the emancipation and segmented the discourse, representation and ideology of the Cold War system, but in the process of revision, he stitched up 'partisans' as beings that were evil and losers. Consequently, with 『Jirisan』, he revealed the process of division and contention that proceeded around anti-communism/capitalism within the abyss of the 1970's to 80's and reproduced 'partisans' as beings that were either 'hostile (the Reds)' or 'unknown (losers)

A study on artificial flowers in the late Joseon Dynasty, focusing on a birthday banquet inBongsudang Hall in 1795 (1795년 봉수당 진찬(奉壽堂進饌)으로 보는 조선 후기 채화(綵花) 고찰)

  • LEE Kyunghee;KIM Youngsun
    • Korean Journal of Heritage: History & Science
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    • v.56 no.1
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    • pp.182-205
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    • 2023
  • The use of royal artificial flowers was finally found through schematics and records in Wonhaeng Eulmyojeongri Uigwe, which organized the procession to Hwaseong in 1795. The results of classifying the uses of artificial flowers in the brthday banquet at Bongsudang Hall in 1795 and considering the shape, user, and usage are as follows. According to literature records, artificial flowers were made with high-quality materials such as gold, silver, and silk thread in the early period, but were mainly made of paper in the later period. Artificial flowers were used for decorating official hats, Bongsudang Hall, and banquet tables. The Sagwonhwa was used for decoration of the official hats of members of the royal family, and the one on the top was called Eosam-Sagwonhwa. At the birthday banquet inBongsudang Hall, King Jeongjo and Hyegyeonggung used the Eosam-Sagwonhwa and put it on the right side of the official hats. Officials put peach blossom with two petals on the left side of the official hats for decoration. The artificial flowers for decoration of the official hats of musicians and dancers were more expensive and flashier than the officials' ones. Depending on the dance, several artificial flowers were inserted into the official hats. When measuring the size of artificial flowers, the scale used was when making a ceremonial article. For artificial flowers for decoration of the banquet hall, red and white peach blossoms were placed in two jars with dragons painted on them and them placed on two red-painted tables, respectively. The table and jar with flowers were tied together with a red cotton string and fixed so as not to fall over. The artificial flowers for decoration of the banquet table of King Jeongjo, Hyegyeonggung, and the king's sisters were a large lotus, medium-sized lotus, peony, rose, and specially made peach flowers. The artificial flowers for decoration of the banquet table of guests and officials were small lotuses and peach blossoms. The artificial flowers used in the birthday banquet at Bongsudang Hall the most were peach blossoms, and peaches had the meaning of longevity and exorcism. It is expected that the above research results will be helpful in understanding the characteristics and usage of artificial flowers in the period of King Jeongjo and use in reproducing royal feasts and producing traditional cultural contents.

A Study on the Excavated Sab(a funeral fan) from Lime-filled Tomb and Lime-layered Tomb during the Joseon Dynasty (조선시대 회격·회곽묘 출토 삽(翣)에 대한 고찰)

  • Yi, Seung Hae;An, Bo Yeon
    • Korean Journal of Heritage: History & Science
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    • v.41 no.2
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    • pp.43-59
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    • 2008
  • Sap(?, a funeral fan) is a funeral ceremonial object used in association with a Confucian ceremonial custom, which was crafted by making a wooden frame, attaching a white cloth or a thick paper onto it, drawing pictures on it, and making a holder for a handle. According to Liji(Records of Rites), Sap was used since the Zhou Dynasty, and these Chinese Sap examples are no big different than the Korean Sap examples, which were described in Joseon Wangjo Sillok(Annals of the Joseon Dynasty), Gukjo Oryeui(the Five Rites of the State), and Sarye Pyeollam(Handbook on Four Rituals). This study explored Sap excavated in lime-filled tombs and lime-layered tombs of aristocrats dating back to Joseon, as well as their historical records to examine Sap's characteristics according to their examples, manufacturing methods, and use time. The number and designs of Sap varied according to the deceased' social status aristocrats used mainly one pair of 亞-shaped Bulsap, and a pair of Hwasap with a cloud design depicted on it. A Sap was wrapped twice with Chojuji paper or Jeojuji paper, and for the third time with Yeonchangji paper. Then, it was covered with a white ramie, a hemp, a cotton, a silk satin, etc. Bobul(an axe shape and 亞-shape design) was drawn on both sides of Sap, and a rising current of cloud was drawn at the peripheral area mainly with red or scarlet pigments. Sap, which were excavated from aristocrats'lime-filled and lime-layered tombs, are the type of Sap which were separated from its handle. These excavated Sap are those whose long handles were burnt during the death carriage procession, leaving Sap, which later were erected on both sides of the coffin. The manufacturing process of excavated relics can be inferred by examining them. The excavated relics are classified into those with three points and those with two points according to the number of point. Of the three-point type(Type I), there is the kind of relic that was woven into something like a basket by using a whole wood plate or cutting bamboo into flat shapes. The three-point Sap was concentrated comparatively in the early half of Joseon, and was manufactured with various methods compared with its rather unified overall shape. In the meantime, the two-point Sap was manufactured with a relatively formatted method; its body was manufactured in the form of a rectangle or a reverse trapezoid, and then its upper parts with two points hanging from them were connected, and the top surface was made into a curve(Type II) or a straight line(Type III) differentiating it from the three-point type. This manufacturing method, compared with that of the three-point type, is simple, but is not greatly different from the three-point type manufacturing method. In particular, the method of crafting the top surface into a straight line has been used until today. Of the examined 30 Sap examples, those whose production years were made known from the buried persons'death years inscribed on the tomb stones, were reexamined, indicating that type I was concentrated in the first half of the $16^{th}$ century. Type II spanned from the second half of the $16^{th}$ century to the second half of the $17^{th}$ century, and type III spanned from the first half of the $17^{th}$ century to the first half of the $18^{th}$ century. The shape of Sap is deemed to have changed from type I to type II and again from type II to type III In the $17^{th}$ century, which was a time of change, types II and III coexisted. Of the three types of Sap, types II and III re similar because they have two points; thus a noteworthy transit time is thought to have been the middle of the $16^{th}$ century. Type I compared with types II and III is thought to have required more efforts and skills in the production process, and as time passed, the shape and manufacturing methods of Sap are presumed to have been further simplified according to the principle of economy. The simplification of funeral ceremonies is presumed to have been furthered after Imjinwaeran(Japanese invasion of Joseon, 1592~1598), given that as shown in the Annals of King Seonjo, state funerals were suspended several times. In the case of Sap, simplification began from the second half of the $16^{th}$ century, and even in the $18^{th}$ century, rather than separately crafting Sap, Sap was directly drawn on the coffin cover and the coffin. However, in this simplification of form, regulations on the use of Sap specified in Liji were observed, and thus the ceremony was rationally simplified.