• Title/Summary/Keyword: 확장증

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Strategic Approach of Dredging the Port of Busan with the Change of Global Port Logistics Circumstances: Focusing on Financial Validity (항만물류환경 변화에 따른 부산항의 증심 준설 전략 - 재무적 타당성을 중심으로 -)

  • Ha, Myung-Shin;Chang, Byoung-Ky
    • Journal of Korea Port Economic Association
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    • v.24 no.2
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    • pp.131-154
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    • 2008
  • The purpose of this paper is to verify the financial validity of dredging the port of Busan with the change of global port logistics circumstances. In order to do so, NPV, IRR, B/C ratio, DPP techniques are adopted. The whole dredging at Northern port area is supposed to be negative at the depth of 16m water. Based upon its financial validity, however, the priority is Shinsundae (option 1) followed by Shinsundae (option 1) and Gamman (option 1), Shinsundae (option 1) and Gamman (option 2), Shinsundae (option 2) and Gamman (option 2), Shinsundae (option 2) and Gamman (option 2) and ShinGamman in sequence. In addition to this, Busan New port is considered to be the positive financial validity at the dredging of 16m water depth. This is because the ultra containerships of over 8,000TEU are trying to call at the port and Hanjin shipping and Hyundai Merchant shipping companies which are now the most significant customers in Northern port are scheduled to divert it.

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Reoperation for Dysfunction of Cardiac Valve Prosthesis (인공 심장판막 기능부전 환자에서의 심장판막 재치환술)

  • 윤정섭;김치경;조규도;이성호;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.242-246
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    • 1998
  • From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

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Evaluation of Lymph Node Staging of Chest CT in NSCLCa (비소세포 폐암의 임파절 병기판정에 대한 흉부 전산화 단층 촬영의 효용성 연구)

  • Sung, Sook-Whan;Kim, Young-Tae;Kim, Doo-Sang;Kim, Joo-Hyun;Lim, Jung-Ki
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.271-278
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    • 1998
  • In order to access the value of computed tomography in mediastinal LN staging of NSCLCa, 581 LN stations of 77 patients were selected from 552 patients who were diagnosed as Lung Ca and operated in Seoul National University Hospital from 1992 to 1995. The selection criteria were as follows ; the patients 1) whose preoperative chest CTs were available; 2) underwent curative resection (lobectomy or more) with complete lymph node dissection; 3) whose final pathologic diagnosis were proven to be non-small cell lung cancer. We adopted Receiver Operating Characteristic curve method to determine a proper size criterion for diagnosing malignant mediastinal adenopathy. From curve analysis, we decided the size criterion of lymph node to 1 cm in their short axis. Using this size criterion, it's sensitivity was 43.9%, specificity was 87.4%, and accuracy was 83.1%. Eventhough we couldn't determine the precise size criterion for the adenoca, it seemed that shorter than 1 cm size criterion should be applied in that particular cell type. Lymph node stations associated with the tuberculosis or bronchiectasis tend to be overestimated in nodal staging and have relatively high false positive rate. The low sensitivity of CT scan suggest that radical and complete dissection or precise mediastinal lymph node evaluation through the surgical approach is mandatory.

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Clinical Observation of the Pulmonary Aspergilloma (폐국균종(Plulmonary Aspergilloma)의 임상적 고찰)

  • Kim, Hyeung-Il;Kim, Sung-Sook;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.157-165
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    • 1993
  • The authors conducted a clinical observation of 13 cases of pulmonary aspergilloma at Yeungnam University Hospital from March 1983 to March 1992, and the following results were observed : 1) The male to female ratio was 1 : 1.2, and the age distribution was ranged 30 to 67 years old. 2) All cases were symptomatic : hemoptysis, cough, sputum and dyspnea. Especially, hemoptysis was the presenting compliant in 10 patients(77%). 3) The underlying lung disease were pulmonary tuberculosis in 9, COPD in 5 and bronchiectasis in 2, 3 cases were without underlying disease. 4) According to radiographic appearance, 8 cases had the typical crescent sign and 5 cases were seen nodular lesion. And the lesions of 11 cases were located in both upper lung. 5) 10 cases were treated with surgical resection. Among these cases, 8 cases were alieved and 2 cases, died. And other 3 cases were treated with conservative treatment. We suggest that these findings would be helpful for the diagnosis and treatment of pulmonary aspergilloma and further study might be needed to evaluate the prognosis of pulmonary aspergilloma.

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A Case of Acute Respiratory Distress Syndrome Caused by Nitric Acid Inhalation (질산(Nitric Acid) 증기 흡입에 의한 급성호흡곤란증후군 1예)

  • Kim, Dae Sung;Yoon, Hye Eun;Lee, Seung Jae;Kim, Yong Hyun;Song, So Hyang;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.690-695
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    • 2005
  • Nitric acid is an oxidizing agent used in metal refining and cleaning, electroplating, and other industrial applications. Its accidental spillage generates oxides of nitrogen, including nitric oxide (NO) and nitrogen dioxide ($NO_2$), which cause chemical pneumonitis when inhaled. The clinical presentation of a nitric acid inhalation injury depends on the duration and intensity of exposure. In mild cases, there may be no symptoms during the first few hours after exposure, or the typical symptoms of pulmonary edema can appear within 3-24 hours. However, in cases of prolonged exposure, progressive pulmonary edema develops instantaneously and patients may not survive for more than 24 hours. We report a case of a 44-year-old male who was presented with acute respiratory distress syndrome after nitric acid inhalation. He complained of cough and dyspnea of a sudden onset after inhaling nitric acid fumes at his workplace over a four-hour period. He required endotracheal intubation and mechanical ventilation due to fulminant respiratory failure. He was managed successfully with mechanical ventilation using positive end expiratory pressure and systemic corticosteroids, and recovered fully without any deterioration in his pulmonary function.

Predictors of Long-term Mortality after Hospitalization for Acute Exacerbation of COPD (만성폐쇄성폐질환의 급성악화로 입원했던 환자에서 장기간 사망의 예측인자)

  • Jung, Hae-Seon;Lee, Jin Hwa;Chun, Eun Mi;Moon, Jin Wook;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.205-214
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    • 2006
  • Background : Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD. Methods : We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded. Results : Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean $FEV_1$ was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality. Conclusion : Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.

NetFPGA based capsulator Implementation and its performance evaluation for Future Internet OpenFlow Testbed (미래인터넷 OpenFlow 테스트베드 구축을 위한 NetFPGA기반 캡슐레이터 구현 및 성능평가)

  • Choi, Yun-Chul;Min, Seok-Hong;Kim, Byung-Chul;Lee, Jae-Yong;Kim, Dae-Young
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.47 no.7
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    • pp.118-127
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    • 2010
  • Current TCP/IP-based Internet architecture has been used for over 30 years, however it will confront with fundamental problems due to new protocol extension limitation since communication environments will change drastically and various user requirements will be emerging in near future. To solve these problems, major countries have started Future Internet researches based on clean slate approach and they will deploy large-scale testbed to experiment and verify new functions. OpenFlow switch technology has been proposed as a new experimental technology for independent protocol that can utilized the legacy network devices and does not interfere with the production Internet traffic. Korea also started Future Internet testbed project called FIRST and OpenFlow switch with NetFPGA card will be used to deploy this testbed. To interconnect distributed testbed using OpenFlow switches, logical tunnel should be established by encapsulating MAC frame inside a unicast IP packet between OpenFlow switches because OpenFlow switches are not directly connected. In this paper, we have implemented a NetFPGA-based that performs MAC in IP tunneling between various OpenFlow switch sites implemented in domestic research network KOREN. The performance evaluation shows that the NetFPGA-based capsulator reveals better performance than the software-based tunneling and it can be utilized as a testbed for experimentation of Future Internet technologies.

5 Cases of Congenital Esophagobronchial Fistula in Adult (성인에서 발견된 선천성 식도기관지루 5예)

  • Lim, Chang-Young;Choi, Soo-Jeon;Lee, Bong-Chun;Kim, Dong-Soon;Jeon, Woo-Ki;Kim, Joung-Sook;Lee, Shin-Yeong;Oh, Sang-Joon;Kwak, Young-Tae;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.1
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    • pp.52-57
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    • 1993
  • Congenital esophagobronchial fistula presented in adult life is rare and usual1y manifests as recurrent pneumonias or other chronic suppurative complications such as bronciectasis. Most of congenital esophagobronchial fistula can be diagnosed by esophagography and can be cured by fistulectomy and/or resection of destroyed pulmonary lobes. We recently experienced 5 cases (2 female and 3 male patients) of congenital esophagobronchial fistula (all of them were Braimbridge type I). Mean age of the patients at the time of diagnosis of esophagobronchial fistula was 53.8 year-old (44-70 year-old) and mean duration of symptoms and complications such as cough after swallowing water, recurrent pneumonias and bronchiectasis was 29 years (12-50 years). 4 patients were treated by fistulectomy and resection of destroyed lobes with abolition of symptoms. So we report 5 cases of congenital esophagobronchial fistula with review of literatures.

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A Study on the Causes of Hwa-byung and Practical Use of Psychodrama for Treatment of Hwa-byung : (focused on middle-aged women) (화병(火病)의 원인과 치료를 위한 사이코드라마의 활용 방안 연구 : 중년여성을 중심으로)

  • Byun, Sang-Hae;Eo, Ji-Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.4 no.2
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    • pp.1-19
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    • 2009
  • American Psychiatric Association defined hwa-byung as a unique mental illness of Korea, a kind of anger syndrome. This illness caused by the Korean culture is more often found on women than men, especially middle-aged women. The cause of hwa-byung mainly depends on the traditional family structure of Korea formed by Confucianism. Other causes that many middle-aged women suffer from hwa-byung are that their low education level originated in their wrong-recognized position in society and poverty in the past makes them not to be able to control their minds effectively(social psychological factor), and that they get stressed and depressed because of loss of their position in the family after their children leave home and the menopause which hurts their feminine beauty (physiological factor). So, this program aims at letting them to; 1) experience catharsis of the negative feelings which causes hwa-byung by expressing in psychodrama, 2) ease the symptoms of hwa-byung by relaxing their mind, 3) understand themselves through sharing their feelings and thinking at the group level, 4) acquire the opportunities to stabilize and expand their role in their real lives through the role playing.

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Revisit of the Extended Indications and Clinical Utilities of Arterialized Venous Flap for Hand Reconstruction (수부 재건을 위한 동맥화 정맥 피판의 확장된 적응증과 임상적 유용성의 재조명)

  • Woo, Sang-Hyun;Kim, Kyung-Chul;Lee, Gi-Jun;Ha, Seung-Han;You, Sun-O;Kim, Joo-Sung
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.1-13
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    • 2005
  • Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

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