• Title/Summary/Keyword: 장기요소

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Multivessel Coronary Revascularization with Composite LITA-RA Y Graft (좌내흉동맥-요골동맥 복합이식편을 이용한 다중혈관 관상동맥우회술)

  • Lee Sub;Ko Mgo-Sung;Park Ki-Sung;Ryu Jae-Kean;Jang Jae-Suk;Kwon Oh-Choon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.359-365
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    • 2006
  • Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

Clinical Analysis of Arteriovenous Fistula in Chronic Renal Failure Patients (만성 신부전 환자에서의 동정맥루 조성술의 임상고찰)

  • Song Chang-Min;Ahn Jae-Bum;Kim In-Sub;Kim Woo-Sik;Shin Yong-Chul;Yoo Hwan-Kuk;Kim Byung-Yul
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.692-698
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    • 2006
  • Background: Owing to the fact that the average life span has increased and the progress in medical science has been made, the number of patients with chronic renal failure (CRF) who have to take hemodialysis (HD) has been going up gradually. Accordingly, it is considered to be as a significant issue to obtain blood vessels which can be used repetitively and supply enough blood flows. Therefore, there have been various kinds of study on an inosculation rate andfactors influencing it following an arteriovenous fistula (AV fistula) and lots of studies are ongoing for the purpose of escalating the inosculation rate. The authors analyzed the effects of short-term result, age, sex, diabetes and hypertension on arteriovenous inosculations in 134 anatomical snuffbox operated subjects among the patients who have taken an AV fistula at this center. Material and Method: Based on 134 patients who underwent an AV fistula at the department of thoracic surgery of this center from July, 2000 to May, 2004, the difference in arteriovenous inosculation rate was compared and analyzed depending or age (discriminated by 65-year-old), sex and the condition of the presence or absence of diabetes and hypertension. Correlation analyses were conducted for each parameter and statistical tests were performed by using SPSS for windows Release 11.0.1, which were determined to be statistically significant if p value was below 0.05. Result: The total number of operations was 169 including 35 of re-operations. The male/female rate was 70 : 64 (52% : 48%). The average age was $56.3{\pm}12.26$ years and there were 33 (24%) old aged patients above 65-year-old; there were 103 (71%) patients with hypertension and 90 (67%) patients with diabetes. Overall arteriovenous inosculation rate was $93{\pm}2.4%,\;91{\pm}2.7%,\;89{\pm}3.0%$ at 6, 12, 24 months, respectively. The arteriovenous inosculation rate of above 65-year-old patient group was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ and below 64-year-old patient group's was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ at given time points, respectively, which showed higher inosculation rate in below 64-year-old patient group with a statistical significance (p=0.0034). However, no statistical significance was found between the patients with hypertension and diabetes and the patients with no complication. In addition, there was no statistical significance in inosculation rate between male and female. Conclusion: The arteriovenous inosculation ratewas higher in the treated patient below 64-year-old than in the treated patient above 65-year-old. Thus it is advantageous for increase in long-term inosculation rate to obtain hemodialysis routes at an early age. The conditions of sex and the presence or absence of diabetes and hyper- tension do not make statistically significant effect on the arteriovenous inosculation rate.

Cooperation Strategy in the Business Ecosystem and Its Healthiness: Case of Win - Win Growth of Samsung Electronics and Partnering Companies (기업생태계 상생전략과 기업건강성효과: 삼성전자와 협력업체의 상생경영사례를 중심으로)

  • Sung, Changyong;Kim, Ki-Chan;In, Sungyong
    • The Journal of Small Business Innovation
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    • v.19 no.4
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    • pp.19-39
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    • 2016
  • With increasing adoption of smart products and complexity, companies have shifted their strategies from stand alone and competitive strategies to business ecosystem oriented and cooperative strategies. The win-win growth of business refers to corporate efforts undertaken by companies to pursue the healthiness of business between conglomerates and partnering companies such as suppliers for mutual prosperity and a long-term corporate soundness based on their business ecosystem and cooperative strategies. This study is designed to validate a theoretical proposition that the win-win growth strategy of Samsung Electronics and cooperative efforts among companies can create a healthy business ecosystem, based on results of case studies and surveys. In this study, a level of global market access of small and mid-sized companies is adopted as the key achievement index. The foreign market entry is considered as one of vulnerabilities in the ecosystem of small and mid-sized enterprises (SMEs). For SMEs, the global market access based on the research and development (R&D) has become the critical component in the process of transforming them into global small giants. The results of case studies and surveys are analyzed mainly based on a model of a virtuous cycle of Creativity, Opportunity, Productivity, and Proactivity (the COPP model) that features the characteristics of the healthiness of a business ecosystem. In the COPP model, a virtuous circle of profits made by the first three factors and Proactivity, which is the manifestation of entrepreneurship that proactively invests and reacts to the changing business environment of the future, enhances the healthiness of a given business ecosystem. With the application of the COPP model, this study finds major achievements of the win-win growth of Samsung Electronics as follows. First, Opportunity plays a role as a parameter in the relations of Creativity, Productivity, and creating profits. Namely, as companies export more (with more Opportunity), they are more likely to link their R&D efforts to Productivity and profitability. However, companies that do not export tend to fail to link their R&D investment to profitability. Second, this study finds that companies with huge investment on R&D for the future, which is the result of Proactivity, tend to hold a large number of patents (Creativity). And companies with significant numbers of patents tend to be large exporters as well (Opportunity), and companies with a large amount of exports tend to record high profitability (Productivity and profitability), and thus forms the virtuous cycle of the COPP model. In addition, to access global markets for sustainable growth, SMEs need to build and strengthen their competitiveness. This study concludes that companies with a high level of proactivity to invest for the future can create a virtuous circle of Creativity, Opportunity, Productivity, and Proactivity, thereby providing a strategic implication that SMEs should invest time and resources in forming such a virtuous cycle which is a sure way for the SMEs to grow into global small giants.

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The Royal and Sajik Tree of Joseon Dynasty, the Culturo-social Forestry, and Cultural Sustainability (근세조선의 왕목-사직수, 문화사회적 임업, 그리고 문화적 지속가능성)

  • Yi, Cheong-Ho;Chun, Young Woo
    • Journal of Korean Society of Forest Science
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    • v.98 no.1
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    • pp.66-81
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    • 2009
  • From a new perspective of "humans and the culture of forming and conserving the environment", the sustainable forest management can be reformulated under the concept of "cultural sustainability". Cultural sustainability is based on the emphasis of the high contribution to sustainability of the culture of forming and conserving the environment. This study extracts the implications to cultural sustainability for the modern world by investigating a historical case of the culturo-social pine forestry in the Joseon period of Korea. In the legendary and recorded acts by the first king Taejo, Seonggye Yi, Korean red pine (Pinus densiflora) was the "Royal tree" of Joseon and also the "Sajik tree" related intimately with the Great Sajik Ritual valued as the top rank within the national ritual regime that sustained the Royal Virtue Politics in Confucian political ideology. Into the Neo-Confucian faith and royal rituals of Joseon, elements of geomancy (Feng shui), folk religion, and Buddhism had been amalgamated. The deities worshipped or revered at the Sajik shrine were Earth-god (Sa) and crop-god (Jik). And it is the Earth god and the concrete entity, Sajik tree, that contains the legacy of sylvan religion descended from the ancient times and had been incorporated into the Confucian faith and ritual regime. Korean red pine as the Royal-Sajik tree played a critical role of sustaining the religio-political justification for the rule of the Joseon's Royalty. The religio-political symbolism of Korean red pine was represented in diverse ways. The same pine was used as the timber material of shrine buildings established for the national rituals under Neo-Confucian faith by the royal court of Joseon kingdom before the modern Korea. The symbolic role of pine had also been expressed in the forms of royal tomb forests, the Imposition Forest (Bongsan) for royal coffin timber (Whangjangmok), and the creation, protection, conservation and bureaucratic management of the pine forests in the Inner-four and Outer-four mountains for the capital fortress at Seoul, where the king and his family inhabit. The religio-political management system of pine forests parallels well with the kingdom's economic forest management system, called "Pine Policy", with an array of pine cultivation forests and Prohibition Forests (Geumsan) in the earlier period, and that of Imposition Forests in the later period. The royal pine culture with the economic forest management system had influenced on the public consciousness and the common people seem to have coined Malrimgat, a pure Korean word that is interchangeable with the Chinesecharacter words of prohibition-cultivation land or forest (禁養地, 禁養林) practiced in the royal tomb forests, and Prohibition and Imposition Forests, which contained prohibition landmarks (Geumpyo) made of stone and rock on the boundaries. A culturo-social forestry, in which Sajik altar, royal tomb forests, Whangjang pine Prohibition and Imposition forests and the capital Inner-four and Outer-four mountain forests consist, was being put into practice in Joseon. In Joseon dynastry, the Neo-Confucian faith and royal rituals with geomancy, folk religion, and Buddhism incorporated has also played a critical humanistic role for the culturo-social pine forestry, the one higher in values than that of the economic pine forestry. The implications have been extracted from the historical case study on the Royal-Sajik tree and culturo-social forestry of Joseon : Cultural sustainability, in which the interaction between humans and environment maintains a long-term culturo-natural equilibrium or balance for many generations, emphasizes the importance that the modern humans who form and conserve environment need to rediscover and transform their culturo-natural legacy into conservation for many generations and produce knowledge of sustainability science, the transdisciplinary knowledge for the interaction between environment and humans, which fulfills the cultural, social and spiritual needs.

Improvement of Certification Criteria based on Analysis of On-site Investigation of Good Agricultural Practices(GAP) for Ginseng (인삼 GAP 인증기준의 현장실천평가결과 분석에 따른 인증기준 개선방안)

  • Yoon, Deok-Hoon;Nam, Ki-Woong;Oh, Soh-Young;Kim, Ga-Bin
    • Journal of Food Hygiene and Safety
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    • v.34 no.1
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    • pp.40-51
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    • 2019
  • Ginseng has a unique production system that is different from those used for other crops. It is subject to the Ginseng Industry Act., requires a long-term cultivation period of 4-6 years, involves complicated cultivation characteristics whereby ginseng is not produced in a single location, and many ginseng farmers engage in mixed-farming. Therefore, to bring the production of Ginseng in line with GAP standards, it is necessary to better understand the on-site practices of Ginseng farmers according to established control points, and to provide a proper action plan for improving efficiency. Among ginseng farmers in Korea who applied for GAP certification, 77.6% obtained it, which is lower than the 94.1% of farmers who obtained certification for other products. 13.7% of the applicants were judged to be unsuitable during document review due to their use of unregistered pesticides and soil heavy metals. Another 8.7% of applicants failed to obtain certification due to inadequate management results. This is a considerably higher rate of failure than the 5.3% incompatibility of document inspection and 0.6% incompatibility of on-site inspection, which suggests that it is relatively more difficult to obtain GAP certification for ginseng farming than for other crops. Ginseng farmers were given an average of 2.65 points out of 10 essential control points and a total 72 control points, which was slightly lower than the 2.81 points obtained for other crops. In particular, ginseng farmers were given an average of 1.96 points in the evaluation of compliance with the safe use standards for pesticides, which was much lower than the average of 2.95 points for other crops. Therefore, it is necessary to train ginseng farmers to comply with the safe use of pesticides. In the other essential control points, the ginseng farmers were rated at an average of 2.33 points, lower than the 2.58 points given for other crops. Several other areas of compliance in which the ginseng farmers also rated low in comparison to other crops were found. These inclued record keeping over 1 year, record of pesticide use, pesticide storages, posts harvest storage management, hand washing before and after work, hygiene related to work clothing, training of workers safety and hygiene, and written plan of hazard management. Also, among the total 72 control points, there are 12 control points (10 required, 2 recommended) that do not apply to ginseng. Therefore, it is considered inappropriate to conduct an effective evaluation of the ginseng production process based on the existing certification standards. In conclusion, differentiated certification standards are needed to expand GAP certification for ginseng farmers, and it is also necessary to develop programs that can be implemented in a more systematic and field-oriented manner to provide the farmers with proper GAP management education.

The Effects of Self-Determination on Entrepreneurial Intention in Office Workers: Focusing on the Dual Mediation of Innovativeness and Prception of the Startup Support System (직장인의 자기결정성이 창업의지에 미치는 영향: 혁신성과 창업지원정책인식의 이중매개를 중심으로)

  • Lim, Jae Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.75-91
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    • 2024
  • Recently, global business environment is changing dramatically along with the acceleration of technological innovation amid the war, climatic change, and geopolitical instability. Accordingly, it is difficult to predict or plan for the future as the volatility, complexity, ambiguity, and uncertainty of the industrial ecosystem continue to increase. Therefore, organizations are undergoing inevitable restructuring in accordance with their survival strategy, for instance, removing marginal businesses or firing. Accordingly, office workers are seeking a startup as an alternative for their continuous economic activity amid rising anxiety factors that make them think they would lose their jobs unintentionally. Here, this study is aimed to verify through what paths office workers' self-determination influences the process of converting to a startup. For this study, an online survey was carried out, and 310 respondents' valid data were analyzed through SPSS and AMOS. To sum up the results, first, office workers' self-determination did not have significant effects on entrepreneurial intention. However, it was confirmed that self-determination had positive (+) effects on innovativeness and perception of the startup support system. This result shows that their psychology works to prepare step by step by accumulating innovative experiences and increasing perception of the startup support system from a long-term life path perspective rather than challenging startups right way. Second, innovativeness is found to have positive (+) effects on entrepreneurial intention. Also, perception of the startup support system had positive (+) effects on entrepreneurial intention. This implies that when considering startups, they are highly aware of the government's various startup support systems. Third, innovativeness is found to have positive (+) effects on perception of the startup support system. It is judged that perception of the startup support system is valid for prospective founders to exhibit their innovativeness and realize new ideas. Fourth, it was confirmed that innovativeness and perception of the startup support system mediated correlation between self-determination and entrepreneurial intention, and perception of the startup support system mediated correlation between innovativeness and entrepreneurial intention, which shows that it is a crucial factor in entrepreneurial intention. Although previous studies related to startups deal with students mostly, this study targets office workers who form a great part in economic activities, which makes it academically valuable in terms of being differentiated from others and extending the scope of research. Also, when we consider the fact that the motivation for self-determination alone fails to stimulate entrepreneurial intention and the complete mediation of innovativeness and the startup support system, it has great implications in practical aspects such as the government's human and material support systems. In the selection and analysis of samples, this study exhibits a limitation that the problem of common method bias is not completely resolved. Also, additional definitive research is needed on whether entrepreneurial intention is formed and converted into startup behavior. Academically and practically, this study deals with the relationship between humans' psychological motives and startups which has not been handled sufficiently in previous studies. The conversion of office workers to startups is expected to have effects on individuals' economic stability and the state's job creation; therefore, it needs to be investigated continuously for its great value.

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The Behaviors of Phosphorus-32 and Ptoassium-42 under the Control of Thermoperiod and Potassium Level (가리(加里)와 온도주기성(溫度週期性)이 고구마 생육(生育) 및 인(燐)-32, 가리(加里)-42 동태(動態)에 미치는 영향(影響))

  • Kim, Y.C.
    • Korean Journal of Soil Science and Fertilizer
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    • v.1 no.1
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    • pp.89-115
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    • 1968
  • 1. The experiment was carried out for investigating the interaction between potassium nutrition and thermoperiod (as an environment regulating factor) in relation to behaviors of several nutrients including phosphorus-32 and Potassium-42 in IPOMOEA BATAS. 2. To obtain same condition to trace the behaviors of phosphorus and potassum-42 they were simultaneously incorporated to roots. The determination of each CPM by counting twice with adequate interval and calculating true CPM of each isotope according to different half-life, was carried out with satisfactory. 3. Some specific symptoms i.e, chlorosis and withering of growing point under the condition of lower potassium level were found and was accelerated by the low night temperature. 4. A manganese shortage in growing point of the lower potassium level was found by activiation analysis and very low distribution ratio of phosphorus-32 and potassium-42 in the growing point of the lower potassium level was manifested, though the contents of nitrogen, phosphorus, potassium, sodium and magnesium were not in great difference. 5. In addition to the low water content with appearence of "hard", shorterning internode and lower ratio of roots to shoot as well as the symptoms of potassium deficiency such as brown spot in leaf blade and necrosis of leaf margin were appeared at later stage of experiment at the lower potassium level. 6. Very stimulating vegetative growth, e.g, large plant length, leaf expansion, increasing node number and fresh weight as well as high ratio of roots to shoot, high water content was resulted in the condition of higher potassium level. 7. A specific interaction between higher potassium level and thermoperiod was found, that is, the largest tuber production and the largest ratio of roots to shoot were resulted in the combined condition of higher potassium level and constant temperature while the largest plant length, fresh weight etc. i.e. the most stimulative vegetative growth was resulted in the combined condition of higher potassium level and low night temperature. 8. Comparatively low water content in the former condition of stimulative tuber production was resulted(especially at the tuber thickening stage), while high water content in the latter condition of stimulative vegetation was resulted though the higher potassium level made generally high water contents. 9. The nitrogen contents of soluble and insoluble did not make distinct difference between the lower and higher potassium level. 10. Though the phosphorus contents were not distinctly different by the potassium level, the lower potassium level made the percentage of phosphorus increased at tuber forming stage accumulating more phosphorus in roots, while the higher potassium level decreased percentage of phosphorus at that stage. 11. The higher potassium level made distinctly high potassium contents than the lower potassium level and increased contents at the tuber forming stage through both conditions. 12. The sodium contents were low in the condition of higher potassium level than the lower potassium level and decreased at tuber forming stage in both conditions, on the contary of potassium. 13. Except the noticeable deficeney of manganese in the growing point of the lower potassium level, mangense and magnesium contents in other organs did not make distinct difference according to the potassium level. 14. Generally more uptake and large absorption rate of phosphorus-32 and potassium-42 were resulted at the higher potassium level, and the most uptake, and the largest absorption rate of phosphorus and potassium-42 (especially potassium-42 at tuber forming stage) were resulted in the condition of higher potassium level and constant temperature which made the highest tuber production. 15. The higher potassium level stimulated the translocation of phoshorus-32 and potassium-42 from roots to shoots while the lower potassium level suppressed or blocked the translocation. 16. Therefore, very large distribution rate of $p^{32}$, $K^{42}$ in shoot, especially, in growing point, compared with roots was resulted in the higher potassium level. 17. The lower potassium level suppressed the translocation of phosporus-32 from roots to shoot more than that of potassium-42. 18. The uptake of potassium-42 and translocation in IPOMOEA BATATAS were more vivid than phosphorus-32. 19. A specific interaction between potassium nutrition and thermoperiod which resulted the largest tuber production etc. was discussed in relation to behaviors of minerals and potasium-42 etc. 20. Also, the specific effect of the lower and higher potassium level on the growth pattern of IPOMOEA BATATAS were discussed in relation to behaviors of minerals and isotopes. 21. An emphasize on the significance of the higher potassium level as well as the interaction with the regulating factor and problem of potassium level (gradient) for crops product ion were discussed from the point of dynamical and variable function of potassium.

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Inflammatory Reponse of the Lung to Hypothermia and Fluid Therapy after Hemorrhagic Shock in Rats (흰쥐에서 출혈성 쇼크 후 회복 시 저체온법 및 수액 치료에 따른 폐장의 염증성 변화)

  • Jang, Won-Chae;Beom, Min-Sun;Jeong, In-Seok;Hong, Young-Ju;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.879-890
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    • 2006
  • Background: The dysfunction of multiple organs is found to be caused by reactive oxygen species as a major modulator of microvascular injury after hemorrhagic shock. Hemorrhagic shock, one of many causes inducing acute lung injury, is associated with increase in alveolocapillary permeability and characterized by edema, neutrophil infiltration, and hemorrhage in the interstitial and alveolar space. Aggressive and rapid fluid resuscitation potentially might increased the risk of pulmonary dysfunction by the interstitial edema. Therefore, in order to improve the pulmonary dysfunction induced by hemorrhagic shock, the present study was attempted to investigate how to reduce the inflammatory responses and edema in lung. Material and Method: Male Sprague-Dawley rats, weight 300 to 350 gm were anesthetized with ketamine(7 mg/kg) intramuscular Hemorrhagic Shock(HS) was induced by withdrawal of 3 mL/100 g over 10 min. through right jugular vein. Mean arterial pressure was then maintained at $35{\sim}40$ mmHg by further blood withdrawal. At 60 min. after HS, the shed blood and Ringer's solution or 5% albumin was infused to restore mean carotid arterial pressure over 80 mmHg. Rats were divided into three groups according to rectal temperature level($37^{\circ}C$[normothermia] vs $33^{\circ}C$[mild hypothermia]) and resuscitation fluid(lactate Ringer's solution vs 5% albumin solution). Group I consisted of rats with the normothermia and lactate Ringer's solution infusion. Group II consisted of rats with the systemic hypothermia and lactate Ringer's solution infusion. Group III consisted of rats with the systemic hypothermia and 5% albumin solution infusion. Hemodynamic parameters(heart rate, mean carotid arterial pressure), metabolism, and pulmonary tissue damage were observed for 4 hours. Result: In all experimental groups including 6 rats in group I, totally 26 rats were alive in 3rd stage. However, bleeding volume of group I in first stage was $3.2{\pm}0.5$ mL/100 g less than those of group II($3.9{\pm}0.8$ mL/100 g) and group III($4.1{\pm}0.7$ mL/100 g). Fluid volume infused in 2nd stage was $28.6{\pm}6.0$ mL(group I), $20.6{\pm}4.0$ mL(group II) and $14.7{\pm}2.7$ mL(group III), retrospectively in which there was statistically a significance between all groups(p<0.05). Plasma potassium level was markedly elevated in comparison with other groups(II and III), whereas glucose level was obviously reduced in 2nd stage of group I. Level of interleukine-8 in group I was obviously higher than that of group II or III(p<0.05). They were $1.834{\pm}437$ pg/mL(group I), $1,006{\pm}532$ pg/mL(group II), and $764{\pm}302$ pg/mL(group III), retrospectively. In histologic score, the score of group III($1.6{\pm}0.6$) was significantly lower than that of group I($2.8{\pm}1.2$)(p<0.05). Conclusion: In pressure-controlled hemorrhagic shock model, it is suggested that hypothermia might inhibit the direct damage of ischemic tissue through reduction of basic metabolic rate in shock state compared to normothermia. It seems that hypothermia should be benefit to recovery pulmonary function by reducing replaced fluid volume, inhibiting anti-inflammatory agent(IL-8) and leukocyte infiltration in state of ischemia-reperfusion injury. However, if is considered that other changes in pulmonary damage and inflammatory responses might induce by not only kinds of fluid solutions but also hypothermia, and that the detailed evaluation should be study.