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Heart Transplantation: the Seiong General Hospital Experience (심장이식 환자의 임상적 고찰)

  • 박국양;박철현
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.606-613
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    • 1996
  • Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).

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The Multi-door Courthouse: Origin, Extension, and Case Studies (멀티도어코트하우스제도: 기원, 확장과 사례분석)

  • Chung, Yongkyun
    • Journal of Arbitration Studies
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    • v.28 no.2
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    • pp.3-43
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    • 2018
  • The emergence of a multi-door courthouse is related with a couple of reasons as follows: First, a multi-door courthouse was originally initiated by the United States government that increasingly became impatient with the pace and cost of protracted litigation clogging the courts. Second, dockets of courts are overcrowded with legal suits, making it difficult for judges to handle those legal suits in time and causing delays in responding to citizens' complaints. Third, litigation is not suitable for the disputant that has an ongoing relationship with the other party. In this case, even if winning is achieved in the short run, it may not be all that was hoped for in the long run. Fourth, international organizations such as the World Bank, UNDP, and Asia Development Bank urge to provide an increased access to women, residents, and the poor in local communities. The generic model of a multi-door courthouse consists of three stages: The first stage includes a center offering intake services, along with an array of dispute resolution services under one roof. At the second stage, the screening unit at the center would diagnose citizen disputes, then refer the disputants to the appropriate door for handling the case. At the third stage, the multi-door courthouse provides diverse kinds of dispute resolution programs such as mediation, arbitration, mediation-arbitration (med-arb), litigation, and early neutral evaluation. This study suggests the extended model of multi-door courthouse comprised of five layers: intake process, diagnosis and door-selection process, neutral-selection process, implementation process of dispute resolution, and process of training and education. One of the major characteristics of extended multi-door courthouse model is the detailed specification of individual department corresponding to each process within a multi-door courthouse. The intake department takes care of the intake process. The screening department plays the role of screening disputes, diagnosing the nature of disputes, and determining a suitable door to handle disputes. The human resources department manages experts through the construction and management of the data base of mediators, arbitrators, and judges. The administration bureau manages the implementation of each process of dispute resolution. The education and training department builds long-term planning to procure neutrals and experts dealing with various kinds of disputes within a multi-door courthouse. For this purpose, it is necessary to establish networks among courts, law schools, and associations of scholars in order to facilitate the supply of manpower in ADR neutrals, as well as judges in the long run. This study also provides six case studies of multi-door courthouses across continents in order to grasp the worldwide picture and wide spread phenomena of multi-door courthouse. For this purpose, the United States and Latin American countries including Argentina and Brazil, Middle Eastern countries, and Southeast Asian countries (such as Malaysia and Myanmar), Australia, and Nigeria were chosen. It was found that three kinds of patterns are discernible during the evolution of a multi-door courthouse model. First, the federal courts of the United States, land and environment court in Australia, and Lagos multi-door courthouse in Nigeria may maintain the prototype of a multi-door courthouse model. Second, the judicial systems in Latin American countries tend to show heterogenous patterns in terms of the adaptation of a multi-door courthouse model to their own environments. Some court systems of Latin American countries including those of Argentina and Brazil resemble the generic model of a multi-door courthouse, while other countries show their distinctive pattern of judicial system and ADR systems. Third, it was found that legal pluralism is prevalent in Middle Eastern countries and Southeast Asian countries. For example, Middle Eastern countries such as Saudi Arabia have developed various kinds of dispute resolution methods, such as sulh (mediation), tahkim (arbitration), and med-arb for many centuries, since they have been situated at the state of tribe or clan instead of nation. Accordingly, they have no unified code within the territory. In case of Southeast Asian countries such as Myanmar and Malaysia, they have preserved a strong tradition of customary laws such as Dhammthat in Burma, and Shriah and the Islamic law in Malaysia for a long time. On the other hand, they incorporated a common law system into a secular judicial system in Myanmar and Malaysia during the colonial period. Finally, this article proposes a couple of factors to strengthen or weaken a multi-door courthouse model. The first factor to strengthen a multi-door courthouse model is the maintenance of flexibility and core value of alternative dispute resolution. We also find that fund raising is important to build and maintain the multi-door courthouse model, reflecting the fact that there has been a competition surrounding the allocation of funds within the judicial system.

Twelve Years of Experience with Vascular Ring Surgery (혈관륜 수술의 12년 경험 보고)

  • Kim, Yun-Seok;Goo, Hyun-Woo;Jhang, Won-Kyoung;Yun, Tae-Jin;Seo, Dong-Man;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.749-756
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    • 2009
  • Background: Vascular ring is a rare anomaly of the aortic arch. We did surgical repair procedures on 16 cases of vascular ring over the past 12 years. This article reviews our results. Material and Method: Between 1995 and 2007, 16 patients (5 with double aortic arch, 7 with right aortic arch-left ligamentum, 4 with pulmonary artery sling) underwent surgical repair. Mean age at the time of the operation were as follows: double aortic arch, $5.7{\pm}5.5$ years; right aortic arch-left ligamentum, $6.1{\pm}13.4$ years; pulmonary artery sling, $2.9{\pm}2.6$ years. Five patients (71%) with right aortic arch-left ligamentum had an associated Kommerell's diverticulum. Two patients (40%) with double aortic arch, 2 patients (28.6%) with right aortic arch-left ligament and 4 patients (100%) with pulmonary artery sling had associated airway stenosis. Cardiac anomalies were present in 8 of 16 patients. Result: There was no peri-operative or post-operative mortality. The mean hospital stay was $27.1{\pm}38.2$ days. None of our patients underwent reoperation. Conclusion: Vascular ring is rare, but, it needs surgical correction. It is important to suspect the diagnosis and to validate with echocardiography. Preoperative and postoperative computed tomography and bronchoscopy are useful to evaluate the airway and surrounding structures.

A Survey on Status of Pregnancy and Delivery at a Rural Village, Nepal(Dolakha Bazar Area) (네팔 돌카지역의 임신분만 환경)

  • Ahn, Young-Woo;Kang, Yune-Sik;Kam, Sin;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.721-732
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    • 1996
  • This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year$(1994.4.13\sim1995.4.12)$ at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows ; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8 % of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.

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An Analysis of the Policy-Knowledge-Power Dynamics in Higher Education Reform in Transitional Myanmar (전환기 미얀마 정치사회변화와 신(新)고등교육 개혁: 정책·지식·권력의 역동을 중심으로)

  • Hong, Moon-Suk
    • Korean Journal of Comparative Education
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    • v.28 no.3
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    • pp.135-159
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    • 2018
  • This thesis compares and analyzes the dynamics between policy, knowledge and power of Myanmar's higher education development. The papers begins by exploring the dynamics during the Socialist Military Regime(1962~1988), the Collapse of Higher Education Era(1988~2010), Thein Sein's Reform Era(2010~2015) and the current Aung San Suu Kyi's Civilian Era(2015~Now). By highlighting recent dramatic policy changes, the article argues that the policy discourse on the subject of internationalization of higher education and the technocratization of education development policy by the current Civilian Government in its new policy discourse, that resulted in the active participation as well as the contributions of international donors has directly impacted on the policy dynamics around the Comprehensive Education Sector Review and the introduction of the National Education Strategic Plan 2016~2020. Further, by examining complex interaction between the current domestic education stakeholders and international donors in education sector in Myanmar, this thesis argues that the new analytical framework on the understanding of policy dynamics in developing countries goes beyond the national level. The paper argues that there needs to be broadening of the analytical framework towards the multidimensional analysis perspective that includes global, national as well as local level policy, knowledge and power dynamics in Myanmar's dynamically changing higher education sector.

Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2015 (설비공학회 분야의 최근 연구 동향 : 2015년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.28 no.6
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    • pp.256-268
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    • 2016
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2015. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering were carried out in the areas of flow, heat and mass transfer, cooling and heating, and air-conditioning, the renewable energy system and the flow inside building rooms. Research issues dealing with air-conditioning machines and fire and exhausting smoke were reduced. CFD seems to be spreading to more research areas. (2) Research works on heat transfer area were carried out in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the economic analysis of GHG emission, micro channel heat exchanger, effect of rib angle on thermal performance, the airside performance of fin-and-tube heat exchangers, theoretical analysis of a rotary heat exchanger, heat exchanger in a cryogenic environment, the performance of a cross-flow-type, indirect evaporative cooler made of paper/plastic film. In the area of pool boiling and condensing, the bubble jet loop heat pipe was studied. In the area of industrial heat exchangers, researches were performed on fin-tube heat exchanger, KSTAR PFC and vacuum vessel at baking phase, the performance of small-sized dehumidification rotor, design of gas-injection port of an asymmetric scroll compressor, effect of slot discharge-angle change on exhaust efficiency of range hood system with air curtain. (3) In the field of refrigeration, various studies were carried in the categories of refrigeration cycle, alternative refrigeration/energy system, system control. In the refrigeration cycle category, a cold-climate heat pump system, $CO_2$ cascade systems, ejector cycles and a PCM-based continuous heating system were investigated. In the alternative refrigeration/energy system category, a polymer adsorption heat pump, an alcohol absorption heat pump and a desiccant-based hybrid refrigeration system were investigated. In the system control category, turbo-refrigerator capacity controls and an absorption chiller fault diagnostics were investigated. (4) In building mechanical system research fields, eighteen studies were reported for achieving effective design of the mechanical systems, and also for maximizing the energy efficiency of buildings. The topics of the studies included energy performance, HVAC system, ventilation, and renewable energies, piping in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment was mostly focused on indoor environment and building energy. The main researches of indoor environment were related to the user and location awareness technology applied dimming lighting control system, the lighting performance evaluation for light-shelves, the improvement evaluation of air quality through analysis of ventilation efficiency and the evaluation of airtightness of sliding and LS window systems. The subjects of building energy were worked on the energy saving estimation of existing buildings, the developing model to predict heating energy usage in domestic city area and the performance evaluation of cooling applied with economizer control. The studies were also performed related to the experimental measurement of weight variation and thermal conductivity in polyurethane foam, the development of flame spread prevention system for sandwich panels, the utilization of heat from waste-incineration facility in large-scale horticultural facilities.

Corona Blue and Leisure Activities : Focusing on Korean Case (코로나 블루와 여가 활동 : 한국 사례를 중심으로)

  • Sa, Hye Ji;Lee, Won Sang;Lee, Bong Gyou
    • Journal of Internet Computing and Services
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    • v.22 no.2
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    • pp.109-121
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    • 2021
  • As the global COVID-19 pandemic is prolonged, the Corona Blue phenomenon, combined with COVID-19 and blue, is intensifying. The purpose of this study is to analyze the current trend of Corona Blue in consideration of the possibility of increasing mental illness and the need for countermeasures, especially after COVID-19. This study tried to find out the relationship between stress and leisure activities before and after COVID-19 by using Corona Blue news article analysis through the topic modeling method, and questionnaire find out the help of stress and leisure activities. This study was compared and analyzed using two research methods. First, a total of 363 news articles were analyzed through topic modeling based on newspaper articles from January 2020, when COVID- 19 was upgraded to the "border" stage, until September, where the social distancing stage was strengthened to stage 2.5 in Korea. As a result of the study, a total of 28 topics were extracted, and similar topics were grouped into 7 groups: mental-demic, generational spread, causes of depression acceleration, increased fatigue, attitude to coping with long-term wars, changes in consumption, and efforts to overcome depression. Second, the SPSS statistical program was used to analyze the level of stress change according to leisure activities before/after COVID-19 and the main help according to leisure activities. As a result of the study, it was confirmed that the average difference in stress reduction according to participation in leisure activities before COVID-19 was larger than after COVID-19. Also, leisure activities were found to be effective in stress relief even after COVID-19. In addition, if the main help from leisure activities before COVID-19 was the meaning of relaxation and recharging through physical and social activities. After COVID-19, psychological roles such as mood swings through nature, outdoor activities, or intellectual activities were found to play a large part. As such, in this study, it was confirmed that understanding the current status of Corona Blue and coping with leisure in extreme stress situations has a positive effect. It is expected that this research can serve as a basis for preparing realistic and desirable leisure policies and countermeasures to overcome Corona Blue.

A Study on Differentiation and Improvement in Arbitration Systems in Construction Disputes (건설분쟁 중재제도의 차별화 및 개선방안에 관한 연구)

  • Lee, Sun-Jae
    • Journal of Arbitration Studies
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    • v.29 no.2
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    • pp.239-282
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    • 2019
  • The importance of ADR(Alternative Dispute Resolution), which has the advantage of expertise, speed and neutrality due to the increase of arbitration cases due to domestic and foreign construction disputes, has emerged. Therefore, in order for the nation's arbitration system and the arbitration Organization to jump into the ranks of advanced international mediators, it is necessary to research the characteristics and advantages of these arbitration Organization through a study of prior domestic and foreign research and operation of international arbitration Organization. As a problem, First, education for the efficient promotion of arbitrators (compulsory education, maintenance education, specialized education, seminars, etc.). second, The effectiveness of arbitration in resolving construction disputes (hearing methods, composition of the tribunal, and speed). third, The issue of flexibility and diversity of arbitration solutions (the real problem of methodologies such as mediation and arbitration) needs to be drawn on the Arbitration laws and practical problems, such as laws, rules and guidelines. Therefore, Identify the problems presented in the preceding literature and diagnosis of the defects and problems of the KCAB by drawing features and benefits from the arbitration system operated by the international arbitration Institution. As an improvement, the results of an empirical analysis are derived for "arbitrator" simultaneously through a recognition survey. As a method of improvement, First, as an optimal combination of arbitration hearing and judgment in the settlement of construction disputes,(to improve speed). (1) A plan to improve the composition of the audit department according to the complexity, specificity, and magnification of the arbitration cases - (1)Methods to cope with the increased role of the non-lawyer(Specialist, technical expert). (2)Securing technical mediators for each specialized expert according to the large and special corporation arbitration cases. (2) Improving the method of writing by area of the arbitration guidelines, second, Introduction of the intensive hearing system for psychological efficiency and the institutional improvement plan (1) Problems of optimizing the arbitration decision hearing procedure and resolution of arbitration, and (2) Problems of the management of technical arbitrators of arbitration tribunals. (1)A plan to expand hearing work of technical arbitrator(Review on the introduction of the Assistant System as a member of the arbitration tribunals). (2)Improved use of alternative appraisers by tribunals(cost analysis and utilization of the specialized institution for calculating construction costs), Direct management of technical arbitrators : A Study on the Improvement of the Assessment Reliability of the Appraisal and the Appraisal Period. third, Improvement of expert committee system and new method, (1) Creating a non-executive technical committee : Special technology affairs, etc.(Major, supports pre-qualification of special events and coordinating work between parties). (2) Expanding the standing committee.(Added expert technicians : important, special, large affairs / pre-consultations, pre-coordination and mediation-arbitration). This has been shown to be an improvement. In addition, institutional differentiation to enhance the flexibility and diversity of arbitration. In addition, as an institutional differentiation to enhance the flexibility and diversity of arbitration, First, The options for "Med-Arb", "Arb-Med" and "Arb-Med-Arb" are selected. second, By revising the Agreement Act [Article 28, 2 (Agreement on Dispute Resolution)], which is to be amended by the National Parties, the revision of the arbitration settlement clause under the Act, to expand the method to resolve arbitration. third, 2017.6.28. Measures to strengthen the status role and activities of expert technical arbitrators under enforcement, such as the Act on Promotion of Interestments Industry and the Information of Enforcement Decree. Fourth, a measure to increase the role of expert technical Arbitrators by enacting laws on the promotion of the arbitration industry is needed. Especially, the establishment of the Act on Promotion of Intermediation Industry should be established as an international arbitration agency for the arbitration system. Therefore, it proposes a study of improvement and differentiation measures in the details and a policy, legal and institutional improvement and legislation.

A Study on the Thermal Conductivity Measurement for Planting Mats of Landscaping (조경용 식생매트의 열전도율 측정에 관한 연구)

  • Cha, Uk Jin;Yang, Geon Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.6
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    • pp.85-96
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    • 2018
  • Developed nations have implemented various policies to reduce greenhouse gases since the 1997 Kyoto Protocol in order to minimize the effects of global warming. Korea should also reduce energy consumption in the industrial sector, and the transportation and building sectors in order to achieve its greenhouse gas reduction target of 37 percent compared to the Business As Usual levels. The government implements various laws and regulations for reducing energy consumption. To reduce energy consumption in the building sector, in particular, the Energy Conservation Design Standards are enforced according to the 'Enforcement Support for Green Building Construction'. The amount of electricity used to maintain room temperature at $28^{\circ}C$ in these buildings have a 30% reduction (measured on the walls and rooftop) in power usage compared to buildings not required to meet these standards. Although the effect of these energy savings on landscaping is proven, this demonstration is not effective for energy saving since it is not a suitable method for the 'Energy Saving Design Standards of Buildings'. For landscaping to be effective as far as a component of energy reduction, the perfusion rate of the building should be calculated based on the thermal conductivity of the component materials for the energy saving designs with respect to the basis of Article 14 of the Green Building Act. Therefore, the purpose of this study is to ensure that the planting-based mats currently being widely used in the landscape industry can have insulating performance suitable for the 'Energy Saving Design Standards' of Buildings according to the 'Enable Green Building Construction Methods'.

Study on Governance Legislation for Responses to Maritime Ship Disasters (해양 선박재난 대응을 위한 거버넌스 법제 연구)

  • Bang, Hosam;Ha, Minjae
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.2
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    • pp.334-345
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    • 2022
  • The Enforcement Decree of the Framework Act on the Management of Disasters and Safety Article 3-2 specifies two 'disaster management supervision agencies' for responding to shipping disasters. These are the Korea Coast Guard, which is an on-scene disaster-responding and coordinating agency, and the Ministry of Ocean and Fisheries, which is a government department, thereby leading to possibilities for confusion. In the case of shipping disasters, where a personnel entitled full power to deal with shipping disasters is designated and his/her powers and duties are clearly made, relationship of leading and supporting agencies is made clear, and command system is simplified, an efficient response to shipping disasters is made possible. In the management of shipping disasters, all the disaster management processes, that is, prevention-preparedness-response-recovery, should be dealt with systematically and consistently. Notably, to swiftly and efficiently cope with a disastrous situation, the decision-making and command system must be simplified. The establishment of a command system and decision-making must be made independently, based on expertise. In the US, irrespective of the type of disasters, the FEMA plays a leading role and the USCG responds a response to maritime disasters by establishing the Incident Command System or Unified Command System that is an incident management system. In the UK, the MCA supervises an event and responds to it, and the SOSREP has full power to work with command and coordination independently. SOSREP, among others, is necessary to prevent an inefficient dealing of a shipping disaster owing to confrontation between participants. With reference to such leading States' practice, the Korean government should make a standardized and simplified response to maritime disasters. This study deals with a new maritime disaster responding system and provides an idea of the revision of the existing legal regime.