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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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A study on the effect of air velocity through a damper on smoke extraction performance in case of fire in road tunnels (도로터널 화재 시 집중배기방식의 배기포트 통과풍속이 배연성능에 미치는 영향에 관한 연구)

  • Ryu, Ji-Oh;Na, Kwang-Hoon
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.22 no.4
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    • pp.347-365
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    • 2020
  • In order to resolve traffic problems in urban areas and to increase the area of green spaces, tunnels in downtown areas are being increased. Additionally, the application of large port smoke extraction ventilation systems is increasing as a countermeasure to smoke extraction ventilation for tunnels with high potential for traffic congestion. It is known that the smoke extraction performance of the large port smoke extraction system is influenced not only by the amount of the extraction flow rate, but also by various factors such as the shape of the extraction port (damper) and the extraction air velocity through a damper. Therefore, in this study, the design standards and installation status of each country were investigated. When the extraction air flow rate was the same, the smoke extraction performance according to the size of the damper was numerically simulated in terms of smoke propagation distance, compared and evaluated, and the following results were obtained. As the cross-sectional area of the smoke damper increases, the extraction flow rate is concentrated in the damper close to the extraction fan, and the smoke extraction rate of the damper in downstream decreases, thereby increasing the smoke propagation distance on the downstream side. In order to prevent such a phenomenon, it is necessary to reduce the cross-sectional area of the smoke damper and increase the velocity of passing air through the damper so that the pressure loss passing through the damper increases, thereby reducing the non-uniformity of smoke extraction flow rate in the extraction section. In this analysis, it was found that when the interval distance of the extraction damper was 50 m, the air velocity passing through damper was 4.4 m/s or more, and when the interval distance of the extraction dampers was 100 m, the air velocity passing through damper was greater than 4.84 m/s, it was found to be advantageous to ensure smoke extraction performance.

Part-time Employment in Japan and Taiwan (일본과 대만의 시간제 고용에 관한 연구)

  • 이혜경;장혜경
    • Korea journal of population studies
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    • v.23 no.2
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    • pp.79-112
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    • 2000
  • This study was focused on the contrasting pattern of part-time employment between Japan and Taiwan where the environments are similar in terms of expanding service industries and increasing flexibility of labor. In Japan, the expansion of part-time employment and its feminization have occurred, whereas they have not at all in Taiwan. The purpose of this study was to examine the reasons behind this phenomena, and to explore what relations they might have with the supply of women\`s labor in each country. Data analysis showed the following results. First, when the phenomena of part-time employment in Japan and Taiwan are summarized as \`active\` and \`inactive\` models, the difference could be explained by a structure-oriented approach rather than an individual-oriented approach. In other words, the difference between the two countries is mainly because of the structural characteristics of the labor market. a combination of capitalism and patriarchy, and an effect of state welfare and family policies rather than a \`voluntaristic choice\` due tn household work and child rearing. In light of this. the labor market segmentation and flexibility of labor theory in particular provided a useful frame for explanation. Second, with regard to the supply of women\`s labor, the difference between Japan and Taiwan could be found in the structure of the labor market and in family response strategies. The large corporation-oriented and strictly divided labor market structure in Japan activated part-time employment and its feminization, whereas, the small family-oriented businesses and less divided labor market in Taiwan supported the continuity of full-time employment of married women. There was also a room for informal employment in Taiwan which made part-time employment unnecessary. This study showed that even within similar environments of expanding service industry and pursuing flexibility of labor different measures and adaptations were possible. The case of Taiwan in particular, showed the significance of an informal labor market which was a part of industrialization process and a strategy of producing various products through a subcontracting network.

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International Comparison Study on the Science & Practical Arts (Technology·Home Economics) Curricula about Continuity of the 'System' and 'Energy' as a Big Concepts (과학과 실과(기술·가정) 교육과정에 제시된 '시스템'과 '에너지' 핵심 개념의 연계성에 대한 국제 비교 연구)

  • Park, Kyungsuk;Jeong, Hyeondo
    • Journal of Science Education
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    • v.42 no.1
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    • pp.27-48
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    • 2018
  • The purposes of this study are to derive suggestions and implications to improve the continuity of Korean Science & Practical Arts (Technology Home Economics) curricula through international comparative analysis with focus on the science curricula or standards in five countries (Canada, New Zealand, Singapore, the United States, Korea). Original documents of the national curriculums or standards of each country collected from NCIC comparatively analyzed the big concepts of the 'system' and 'energy' based on features of related components of curriculum contents, vertical, and lateral connectivity. The results indicated that the big concepts of systems and energy were used internationally to consider the curriculum continuity. In most countries, the big concept of system was used as a framework to integrate science with technology or other contents. In particular, it was also utilized to strengthen vertical and lateral connectivity in earth science and space science contents area. In the comparison of countries for the system as the big concept, New Zealand focused interrelationship between system and human activities, systems' interaction, levels and features of system concept for the linkage between grades and subjects on the basis of level. In the case of Canada and Singapore, science and technology are combined to strengthen contents' connection. However, the revised 2015 curriculum has a lack of continuity and sequence because the concepts of system and energy were concentrated on a specific grade and contents' area. The curriculum was not developed systematically for multiple grades according to their levels. In conclusion, Korean science curriculum requires sufficient understanding of students' learning and research on learning progressions and curriculum continuity. In addition, it is very important to constitute the curriculum based on the vertical and lateral connectivity in order to improve science education and to foster students' key competencies and abilities.

Prospect and Analysis about curriculum of the Department of Dental Laboratory Technology in the whole country (전국치기공과의 교과과정분석과 전망)

  • Park, Yong-Duck;Hwang, Kyung-Sook;Kim, Nam-Jung
    • Journal of Technologic Dentistry
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    • v.25 no.1
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    • pp.203-218
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    • 2003
  • The 3 year graduate school course of the dental technician, which has been enforced since 1994 till the present date, differs from the currently existing 2 year graduate course because of an 8 weeks clinical field training course being newly executed and an imposed curriculum about manufacturing specialized prosthetics like all-ceramic, double prosthetic technology, attachment, and implant. Even though nearly 10 years have passed, the education program of the 18 colleges have still not been standardized and the subjects differing a little, while some are still not following the 3 years graduate course. The goal of this research is to emphasize the qualities of the 3 years graduate program and enable the dental technician to handle clinical models in the dental technical clinic right after graduation by adding clinical field training in the dental technician education program of the 18 colleges. Also in accordance to a national and international increase in esthetical prosthetics, credits, weekly study hours, education practice time of specialized prosthetic dental technology can be analyzed as follows. 1. In the year 2003, currently colleges start clinical practice education starting from the 1st semester of the 2nd year junior year, to the 2nd semester of 3rd year the varying in time with adequate class time, and credits. The average credit is 9.56, and weekly average class time is 18.00 hours. later clinical trainee education will be adjusted to the 3 year graduate school course to 10 credits and 20 hours and the adequate education period should be the 2nd semester of 3rd grade when most basic clinical education has been covered. 2. Currently in the year 2003, all-ceramic education has an average credit of 8.01 in 17 colleges with an exception of Ma-san college. The weekly average theoretical education is 4.94 hours, weekly clinical education of 7.88 hours and currently in 14 colleges porcelain technical class usually starts in the 1st semester of the 2nd year. All-ceramic education is thought to have adequate credits, timing, and weekly study hours. 3. Currently in 2003 implant education is enforced in 11 colleges including Bu-san Catholic university and the education period is usually in the 3rd year. Out of the 11 colleges, only Bu-san Catholic univ., Ma-san and Shinheung college have practice training classes. We knew that Shingu, Dongu, Mokpo science colleges have practice training as a curriculum, namely specific prosthetics laboratory. Out of the 9 colleges enforcing implant education the average credits taken are 2.56, and the average hours of weekly theory education is 2.14, but with the exception of Shinheung college which has an implant practice training course theory and practice classes are not divided. Therefore implant education is thought to start in the 3rd year as a 3 credit course with 3 hours of theory and practice each. 4. Currently in 2003, theoretical attachment education is given in 15 colleges and including practical training it is given in 10 colleges. The education starts 1st semester of the 2nd year till the 2nd semester of the 3rd year. The average credit of attachment theory education in the 15 colleges was 3.64, the average weekly theoretical education was 2.64, and the average weekly practice training out of the schools teaching it was 3.20. Later attachment education is thought to start the 1st semester of the 3rd year as a 3 credit course with 2 hours of theory class and 3 hours of practice training. 5. Double prosthetic technology is currently carried out in Dae-jon Health Science college(2nd year 2nd semester, 2 credits, theory 2hours), Gimcheon college (1 credit, 2 hours of practical training), Bu-san Catholic university (4th year 2nd semester, 4 hours of theory. practice). When the 3 year course is enforced, education will start 1st semester of the 3rd year with 2hours of theory and practice each. 6. The newly installed programs of the 3 year education is clinical field training, and specialized prosthetic manufacturing practice like all-ceramic, double prosthetic technology, attachment, and implant. If such education is to be effectively managed, a primary precursor as systemic basic clinical education is thought to be important. 7. Nationally in the 18 colleges of dental technology the currently executed curriculum course had varying subjects, class time according to the subject, and credits by each college. The curriculum difference between the colleges must be settled.

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A Study on the Influence of Nascent Entrepreneurs Motivation and Preparation on the Business Continuity: Based on the Mediation Effect of Start-up Satisfaction (초기창업자의 창업동기와 창업준비가 사업계속의도에 미치는 영향에 관한 연구: 창업만족도의 매개효과를 중심으로)

  • Han, Hyang Won;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.5
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    • pp.77-98
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    • 2020
  • Recently, the government provided about 35 trillion won to start-ups through a large amount of start-up support funds from the Korea Credit Guarantee Fund and the Korea Development Bank, and more than 100 trillion won to start-ups over the past three years.(2015-2018) The Ministry of SMEs and Startups announced that a total of 1.4517 trillion won will be supported by 16 ministries (90 projects) after surveying start-up support projects by ministries in 2020 to create a start-up country. Indeed, among the budgets supported by the Ministry of SMEs and Startups, startups accounted for 85%, while scale-ups (growth and maturity) were only 15%. However, the survival rate of Korean start-ups was far lower than that of developed countries. The survival rate for the three years after the start-up was 39.1 percent, with only about 4 out of 10 surviving, with 27.5 percent surviving for five years, and only 3 out of 10 surviving. On the other hand, overseas start-ups have a survival rate of twice as high as that of Korea for five years. Accordingly, this study aims to empirically analyze and examine the need for research on nascent entrepreneurs, which have recently been actively supported by the government, as well as the impact of start-up motivation and start-up preparation on the intention to continue business. The survey was conducted from April 1 to May 15, 2020 for nascent entrepreneurs nationwide, and 222 of the total 245 copies were analyzed, and the questionnaire was measured using the Likert 5-point scale. As a result of the analysis, first, all factors constituting start-up motivation were adopted by significantly affecting start-up satisfaction. In addition, among the sub-factors of nascent entrepreneurs' preparation, item preparation was adopted as a significant influence on start-up satisfaction. Second, the nascent entrepreneurs' satisfaction level was adopted by having a significant impact on the business continuity. Third, some of the motivations for self-realization of the motivation for start-ups were adopted by having a significant impact on the business continuity. In addition, the preparation of items for the start-up preparation of nascent entrepreneurs was partially adopted as they had a significant impact on the business continuity. Fourth, it was adopted by the mediation effect of start-up satisfaction between the motivation of the nascent entrepreneurs' preparation and the business continuity. In addition, it was adopted by the medium effect of start-up satisfaction between the nascent entrepreneurs' preparation and the business continuity. Based on the results of these studies, it is intended to draw practical implications, and to provide useful policy implications to increase nascent entrepreneurs' satisfaction and continue to carry out their start-ups.

An Investigation of Reliability and Safety Factors in RC Flexural Members Designed by Current WSD Standard Code (현행(現行) 허용응력설계법(許容應力設計法)으로 설계(設計)되는 RC 휨부재(部材)의 신뢰성(信賴性)과 안전율(安全率) 고찰(考察))

  • Shin, Hyun Mook;Cho, Hyo Nam;Chung, Hwan Ho
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.1 no.1
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    • pp.33-42
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    • 1981
  • Current standard code for R.C. design consists of two conventional design parts, so called WSD and USD, which are based on ACI 318-63 and 318-71 code provisions. The safety factors of our WSD and USD design criteria which are taken primarily from ACI 318-63 code are considered to be not appropriate compared to out country's design and construction practices. Furthermore, even the ACI safety factors are not determined from probabilistic study but merely from experiences and practices. This study investigates the safety level of R.C. flexural members designed by the current WSD safety provisions based on Second Moment Reliability theory, and proposes a rational but efficient way of determining the nominal safety factors and the associated flexural allowable stresses of steel bars and concretes in order to provide a consistent level of target reliability. Cornell's Mean First-Order Second Moment Method formulae by a log normal transformation of resistance and load output variables are adopted as the reliability analysis method for this study. The compressive allowable stress formulae are derived by a unique approach in which the balanced steel ratios of the resulting design are chosen to be the corresponding under-reinforced sections designed by strength design method with an optimum reinforcing ratio. The target reliability index for the safety provisions are considered to be ${\beta}=4$ that is well suited for our level of construction and design practices. From a series of numerical applications to investigate the safety and reliability of R.C. flexural members designed by current WSD code, it has been found that the design based on WSD provision results in uneconomical design because of unusual and inconsistent reliability. A rational set of reliability based safety factors and allowable stress of steel bars and concrete for flexural members is proposed by providing the appropriate target reliability ${\beta}=4$.

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A Study on the Effects of the Breath Efficiency & Lung Capacity Improvement Using Recorder Playing Focused on Breath Training (리코더 연주를 통한 뇌졸중 노력성 폐활량과 호흡 효율성 향상 연구)

  • Choi, Sung Joo
    • Journal of Music and Human Behavior
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    • v.4 no.1
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    • pp.31-46
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    • 2007
  • The purpose of the study was to improve the efficiency of Breath & Forced Vital Capacity(FVC) of Stroke Patients Using Record Playing Focused on Breath Training. The Training of Forced Vital Capacity(FVC) is focused on trunk muscles reinforce for Breathing. So the study tried to play Recorder for reinforcing FVC. The play included the two parts. One was for solo play, the other was play in concert base on solo play using Korea country song, Arirang. The Recorder play used abdominal breath, Pursed-lip & Paced methods. The course of play included Long Tone, Staccato, Crescendo, Decrescendo and throughout the course we tried to improve the efficiency & Quantity of breathe. Experiment performed at Social welfare institute for the old. They played & checked FVC, $FEV_1$, $FEV_1/FVC$ before & after breathe 19 times for 6 weeks using Spirovit SP-1, Schiller. After experiment we performed statical process(p<0.05) using statical Package software. The findings were as follows: Analysis for Experiment showed the numerical Value of increasing Of FVC, $FEV_1$, $FEV_1/FVC$. Increasing Percentage of Measured/Predicted FVC, $FEV_1$ (or calculated based on theory) ration was 25%, 13% and Quantity of FVC, $FEV_1$ 35%, 40%. Also $FEV_1/FVC$ Ratio(showed efficiency of breathe) raised 13%. And experiment data was confirmed by statical process. The experiment data was valuable under p<0.05. In Conclusion we think the results of experiment showed the efficiency of Music therapy for Breathe(FVC, $FEV_1$, $FEV_1/FVC$) reinforce.

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A study on an evaluation model for industrial information systems by industry sectors (업종별 특성을 고려한 기업정보화 성숙모형)

  • 진경수;임춘성;박찬권
    • Proceedings of the CALSEC Conference
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    • 2002.01a
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    • pp.86-106
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    • 2002
  • Informatization is a process that corporation's external environmental factors and internal environmental factors influence as complex. is a phenomenon that appears via this process. To evaluate that informatization was propeled well or informatization level is high can be dangerous work extremely by only once-over-lightly some factors, organization information ability is superior or infrastructure is constructed well. Therefore, an evaluation for industrial information systems that consider corporation's external environment and internal environment configurationally and objective estimation through this is required in national dimension. This research sorted types of business using types of business classification of 2001 EIII(Evaluation Indices of Industrial Informatization) laying stress on corporation's product and product production process for reflecting various industrial classification. And we are dividing whole our country corporations by manufacture industry, the construction industry, distribution industry, service industry, banking industry 5 types of business. To see such classed types industry classification from consistent viewpoint, we saw them within new framework, purchase, operation, physical distribution, marketing and sale. service etc. laying stress on primary businesses except support businesses of planning, financial management etc. To draw special quality of business center from primary business of each types of business, we draw industry classification Key Capability that centers when plans corporation's corporate strategy and information strategy. And we deducted industrial classification key production business connected with industry classification Key Capability. After drawing an evaluation items for industrial information systems in informatization analysis viewpoint laying stress on drawn businesses. Finally we did Case Study by making out an evaluation for industrial information systems questionnaire that considers special quality of manufacturing industry. Through EIII that consider the industrial classification, we could know that it explains the corporation's purchase, production, distribution in general and detail.

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An Analysis of Elements in Yen-Ben Street That Form a Sense of Place as an Ethnic Enclave (소수민족집단체류지역(Ethnic Enclave)으로서의 옌볜거리의 장소성 형성 요인 분석)

  • Han, Sung-Mi;Im, Seung-Bin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.36 no.6
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    • pp.81-90
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    • 2009
  • This study seeks those elements that form a sense of place in Yen-Ben Street, which represents a typical ethnic enclave in Seoul, to provide a basic resource in the creation of an urban landscape that can provide a positive space for cultural diversity. The results of the study can be summarized as follows: First, the element of a physical environment that develops a sense of place was in fact the poor dwellings that correspond to the economic condition of Korean Chinese. While this element has a negative cognition to outsiders, Korean Chinese feel positively toward it. Secondly, signboards were a physical element of sense of place which retains cultural identity as a means of communication inside the community. Thirdly, it was found that activities such as shopping, recreation, and the exchange of information that are found in the pursuit of daily life act as an essential element in the formation of a sense of place even more than architectural elements. Fourthly, the appropriation of space by Korean Chinese and the isolation from the surroundings were obvious. This isolation is perceived as a negative sense of place formation to outsiders in Yen-Ben Street. Fifthly, the aspects of cultural dualism, mingling the concepts of home country, language, writing, and food have also affected the formation of a sense of place in the area. Sixthly, transience was a prominent phenomenon of Yen-Ben Street and is strengthened by illegal immigration. Although transience causes negative impacts such as in a lack of concern for the residential environment, it acts as a positive factor in the sense of place by mitigating uneasiness, and strengthening insider ties and cooperation.