• Title/Summary/Keyword: Factor replacement

Search Result 387, Processing Time 0.028 seconds

Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients (승모판폐쇄부전증를 가진 소아 환자에서 승모판성형술의 임상적 고찰)

  • Sim, Hyung-Tae;Yun, Tae-Jin;Park, Jeong-Jun;Jung, Sung-Ho;Uhm, Ju-Yeon;Jhang, Won-Kyoung;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
    • /
    • v.40 no.8
    • /
    • pp.536-545
    • /
    • 2007
  • Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years, The mean age was $5.3{\pm}5.3$ years and the mean body weight was $20,0{\pm}16.3\;kg$. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were $93.3{\pm}4.6%$ and $76.1{\pm}8.2%$, respectively. The 5-year freedom from mitral valve replacement rate was $83.6{\pm}6.7%$. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.

Risk Factor Analysis for Operative Death and Brain Injury after Surgery of Stanford Type A Aortic Dissection (스탠포드 A형 대동맥 박리증 수술 후 수술 사망과 뇌손상의 위험인자 분석)

  • Kim Jae-Hyun;Oh Sam-Sae;Lee Chang-Ha;Baek Man-Jong;Hwang Seong-Wook;Lee Cheul;Lim Hong-Gook;Na Chan-Young
    • Journal of Chest Surgery
    • /
    • v.39 no.4 s.261
    • /
    • pp.289-297
    • /
    • 2006
  • Background: Surgery for Stanford type A aortic dissection shows a high operative mortality rate and frequent postoperative brain injury. This study was designed to find out the risk factors leading to operative mortality and brain injury after surgical repair in patients with type A aortic dissection. Material and Method: One hundred and eleven patients with type A aortic dissection who underwent surgical repair between February, 1995 and January 2005 were reviewed retrospectively. There were 99 acute dissections and 12 chronic dissections. Univariate and multivariate analysis were performed to identify risk factors of operative mortality and brain injury. Resuit: Hospital mortality occurred in 6 patients (5.4%). Permanent neurologic deficit occurred in 8 patients (7.2%) and transient neurologic deficit in 4 (3.6%). Overall 1, 5, 7 year survival rate was 94.4, 86.3, and 81.5%, respectively. Univariate analysis revealed 4 risk factors to be statistically significant as predictors of mortality: previous chronic type III dissection, emergency operation, intimal tear in aortic arch, and deep hypothemic circulatory arrest (DHCA) for more than 45 minutes. Multivariate analysis revealed previous chronic type III aortic dissection (odds ratio (OR) 52.2), and DHCA for more than 45 minutes (OR 12.0) as risk factors of operative mortality. Pathological obesity (OR 12.9) and total arch replacement (OR 8.5) were statistically significant risk factors of brain injury in multivariate analysis. Conclusion: The result of surgical repair for Stanford type A aortic dissection was good when we took into account the mortality rate, the incidence of neurologic injury, and the long-term survival rate. Surgery of type A aortic dissection in patients with a history of chronic type III dissection may increase the risk of operative mortality. Special care should be taken and efforts to reduce the hypothermic circulatory arrest time should alway: be kept in mind. Surgeons who are planning to operate on patients with pathological obesity, or total arch replacement should be seriously consider for there is a higher risk of brain injury.

A Basic Study on the Establishment of Preservation and Management for Natural Monument(No.374) Pyeongdae-ri Torreya nucifera forest of Jeju (천연기념물 제374호 제주 평대리 비자나무 숲의 보존·관리방향 설정을 위한 기초연구)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Oh, Hae-Sung;Choi, Byung-Ki;Lee, Jong-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.32 no.1
    • /
    • pp.93-106
    • /
    • 2014
  • In this study, Analyze environment of location, investigation into vegetation resources, survey management status and establish to classify the management area for Natural monument No.374 Pyengdae-ri Torreya nucifera forest. The results were as follows: First, Torreya nucifera forest is concerned about influence of development caused by utilization of land changes to agricultural region. Thus, establish to preservation management plan for preservation of prototypical and should be excluded development activity to cause the change of terrain that Gotjawal in the Torreya nucifera forest is factor of base for generating species diversity. Secondly, Torreya nucifera forest summarized as 402 taxa composed 91 familly 263 genus, 353 species, 41 varieties and 8 forms. The distribution of plants for the first grade & second grade appear of endangered plant to Ministry of Environment specify. But, critically endangered in forest by changes in habitat, diseases and illegal overcatching. Therefore, when establishing forest management plan should be considered for put priority on protection. Thirdly, Torreya nucifera representing the upper layer of the vegetation structure. But, old tree oriented management and conservation strategy result in poor age structure. Furthermore, desiccation of forest on artificial management and decline in Torreya nucifera habitat on ecological succession can indicate a problem in forest. Therefore, establish plan such as regulation of population density and sapling tree proliferation for sustainable characteristics of the Torreya nucifera forest. Fourth, Appear to damaged of trails caused by use. Especially, Scoria way occurs a lot of damaged and higher than the share ratio of each section. Therefore, share ratio reduction Plan should be considered through the additional development of tourism routes rather than the replacement of Scoria. Fifth, Representing high preference of the Torreya nucifera forest tourist factor confirmed the plant elements. It is sensitive to usage pressure. And requires continuous monitoring by characteristic of Non-permanent. In addition, need an additional plan such as additional development of tourism elements and active utilizing an element of high preference. Sixth, Strength of protected should be differently accordance with importance. First grade area have to maintenance of plant population and natural habitats. Set the direction of the management. Second grade areas focus on annual regeneration of the forest. Third grade area should be utilized demonstration forest or set to the area for proliferate sapling. Fourth grade areas require the introduced of partial rest system that disturbance are often found in proper vegetation. Fifth grade area appropriate to the service area for promoting tourism by utilizing natural resources in Torreya nucifera forest. Furthermore, installation of a buffer zone in relatively low ratings area and periodic monitoring to the improvement of edge effect that adjacent areas of different class.

A Study on the Characteristics of Enterprise R&D Capabilities Using Data Mining (데이터마이닝을 활용한 기업 R&D역량 특성에 관한 탐색 연구)

  • Kim, Sang-Gook;Lim, Jung-Sun;Park, Wan
    • Journal of Intelligence and Information Systems
    • /
    • v.27 no.1
    • /
    • pp.1-21
    • /
    • 2021
  • As the global business environment changes, uncertainties in technology development and market needs increase, and competition among companies intensifies, interests and demands for R&D activities of individual companies are increasing. In order to cope with these environmental changes, R&D companies are strengthening R&D investment as one of the means to enhance the qualitative competitiveness of R&D while paying more attention to facility investment. As a result, facilities or R&D investment elements are inevitably a burden for R&D companies to bear future uncertainties. It is true that the management strategy of increasing investment in R&D as a means of enhancing R&D capability is highly uncertain in terms of corporate performance. In this study, the structural factors that influence the R&D capabilities of companies are explored in terms of technology management capabilities, R&D capabilities, and corporate classification attributes by utilizing data mining techniques, and the characteristics these individual factors present according to the level of R&D capabilities are analyzed. This study also showed cluster analysis and experimental results based on evidence data for all domestic R&D companies, and is expected to provide important implications for corporate management strategies to enhance R&D capabilities of individual companies. For each of the three viewpoints, detailed evaluation indexes were composed of 7, 2, and 4, respectively, to quantitatively measure individual levels in the corresponding area. In the case of technology management capability and R&D capability, the sub-item evaluation indexes that are being used by current domestic technology evaluation agencies were referenced, and the final detailed evaluation index was newly constructed in consideration of whether data could be obtained quantitatively. In the case of corporate classification attributes, the most basic corporate classification profile information is considered. In particular, in order to grasp the homogeneity of the R&D competency level, a comprehensive score for each company was given using detailed evaluation indicators of technology management capability and R&D capability, and the competency level was classified into five grades and compared with the cluster analysis results. In order to give the meaning according to the comparative evaluation between the analyzed cluster and the competency level grade, the clusters with high and low trends in R&D competency level were searched for each cluster. Afterwards, characteristics according to detailed evaluation indicators were analyzed in the cluster. Through this method of conducting research, two groups with high R&D competency and one with low level of R&D competency were analyzed, and the remaining two clusters were similar with almost high incidence. As a result, in this study, individual characteristics according to detailed evaluation indexes were analyzed for two clusters with high competency level and one cluster with low competency level. The implications of the results of this study are that the faster the replacement cycle of professional managers who can effectively respond to changes in technology and market demand, the more likely they will contribute to enhancing R&D capabilities. In the case of a private company, it is necessary to increase the intensity of input of R&D capabilities by enhancing the sense of belonging of R&D personnel to the company through conversion to a corporate company, and to provide the accuracy of responsibility and authority through the organization of the team unit. Since the number of technical commercialization achievements and technology certifications are occurring both in the case of contributing to capacity improvement and in case of not, it was confirmed that there is a limit in reviewing it as an important factor for enhancing R&D capacity from the perspective of management. Lastly, the experience of utility model filing was identified as a factor that has an important influence on R&D capability, and it was confirmed the need to provide motivation to encourage utility model filings in order to enhance R&D capability. As such, the results of this study are expected to provide important implications for corporate management strategies to enhance individual companies' R&D capabilities.

Factors affecting the final adult height in survivors of childhood brain tumors (소아 뇌종양 환자의 최종 성인키에 영향을 미치는 인자)

  • Yun, Kyong-Ah;Lee, Young Ah;Shin, Choong Ho;Yang, Sei Won;Shin, Hee Young;Ahn, Hyo Seop;Kim, Il Han
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.1
    • /
    • pp.65-73
    • /
    • 2007
  • Purpose : Short stature is an important complication that impairs the quality of life in survivors of childhood brain tumors. We studied their final adult height (FAH) to evaluate risk factors for short stature. Methods : We reviewed the medical data of 95 survivors of childhood brain tumors (64 males and 31 females) who had been followed up from 1982 to 2006, reached FAH, and had a more than five year-disease-free survival. Results : Final adult height standard deviation score (FAHTSDS: $mean{\pm}SD$) of the patients was lower than those of general population ($-1.15{\pm}1.72$), HTSDS at diagnosis ($-0.13{\pm}1.57$), and target HTSDS ($-0.49{\pm}0.69$). FAHTSDS of craniopharyngioma patients did not decrease ($0.57{\pm}1.17$), but those of germ cell tumor and medulloblastoma patients were significantly reduced ($-1.20{\pm}1.45$, $-2.70{\pm}1.46$; P<0.05). The patients treated with craniospinal radiation or chemotherapy had lower FAHTSDS ($-1.93{\pm}1.58$, $-2.27{\pm}1.44$; P<0.01). In the spinal irradiation group, the younger the age at diagnosis was, the more the loss of FAH (r=0.442, P<0.01). Growth hormone replacement (GHR) didn't improve FAHTSDS, but starting GHR under 12 years was an independent factor for improving FAH once treatment methods were taken into account (P=0.01). Conclusion : The younger age at diagnosis, spinal radiation and chemotherapy were all important risk factors of height loss, and height gain was expected in patients who received GHR under the age of 12 years. Therefore, regular check-ups of growth and early intervention with growth hormones are needed for high risk groups to improve FAH.

Relation of Neoaortic Root Dilation and Aortic Insufficiency after Arterial Switch Operation (동맥전환술 후의 신생대동맥근부 확장과 대동맥판막폐쇄부전의 관계)

  • 박한기;김도균;홍유선;이종균;최재영;조범구;박영환
    • Journal of Chest Surgery
    • /
    • v.36 no.12
    • /
    • pp.921-927
    • /
    • 2003
  • Arterial switch operation (ASO) has been the most effective surgical option for transposition of the great arteries. But, the inappropriate dilation of the neoaortic root has been reported and its effect on neoaortic valve function and growth of aorta has not been well documented. Material and Method: Forty-eight patients who underwent cardiac catheterization during follow up after arterial switch operation were included in this study. Arterial switch operation was performed at a median age of 18 days (range 1∼211 days). Preoperative cardiac catheterization was performed in 26 patients and postoperative catheterization was performed in all patients at 15.8$\pm$9.6 months after ASO. Postoperative ratios of the diameters of neoaortic annulus, root and aortic anastomosis against the descending aorta were compared to the size of preoperative pulmonary annular, root and sinotubular junction. Preoperative and operative parameters were analyzed for the risk factors of neoaortic insufficiency. Result: There were two clinically significant neoaortic insufficiencies (grade$\geq$II/IV) during follow up, one of which required aortic valve replacement. Another patient required reoperation due to aortic stenosis on the anastomosis site. Post-operatively, neoaortic annulus/DA ratio increased from 1.33$\pm$0.28 to 1.52$\pm$.033 (p=0.01) and neoaortic root/DA ratio increased form 2.02$\pm$0.40 to 2.56$\pm$0.38 (p<0.0001). However, the aortic anastomosis/DA ratio showed no statistically significant difference (p=0.06). There was no statistically significant correlation between the occurrence of neoaortic insufficiency and neoaortic annulus/DA ratio and neoaortic root/DA ratio. Non-neonatal repair (age>30days) (p=0.02), preopeative native pulmonaic valve stenosis (p=0.01), and bisuspid pulmonic valve (p=0.03) were the risk factors for neoaortic insufficiency in univariate risk factor analysis. Conclusion: After ASO, aortic anastomosis site showed normal growth pattern proportional to the descending aorta, but neoaortic valve annulus and root were disproportionally dilated. Significant neoaortic valve insufficiency rarely developed after ASO and neoaortic annulus and root size do not correlate with the presence of postoperative neoarotic insufficiency. ASO after neonatal period, preoperative native pulmonary valve stenosis, and bicuspid native pulmonic valve are risk factors for the development of neoaortic insufficiency.

Derivation of Mouse ES Cells from Isolated Blastomeres in Culture Media Supplemented with LIF (LIF를 첨가한 배양액을 이용한 할구 유래 생쥐 배아줄기세포주의 확립)

  • Cho, Jae-Won;Lim, Chun-Kyu;Ko, Duck-Sung;Kang, Hee-Jung;Jun, Jin-Hyun
    • Development and Reproduction
    • /
    • v.12 no.1
    • /
    • pp.77-86
    • /
    • 2008
  • This study was carried out to investigate the effect of leukemia inhibitory factor (LIF) on the derivation of mouse ES cells from isolated blastomeres. Two-cell stage mouse embryos were obtained from superovulated BDF1 female mice. Collected embryos were cultured to blastocyst stage in culture medium supplemented with 0, 1,000, 2,500 or 5,000 U/mL of LIF. Cultured blastocysts were examined by counting the number of cells in the inner cell mass (ICM) and trophectoderm (TE) using differential staining method. When 2-cell embryos were cultured with 2,500 U/ml of LIF, the cell numbers of ICM significantly increased in comparing with those of the control($21.0{\pm}4.0$ vs. $15.9{\pm}5.0$, P<0.01) and 1,000 U/mL of LIF-containing group ($21.0{\pm}4.0$ vs. $16.6{\pm}4.9$, P<0.05). We used an ES cell establishment medium with 20% Knockout Serum Replacement and 0.01 mg/mL ACTH instead of fetal bovine serum. Establishing efficacy of ES cell lines were the highest in 2,500 U/mL of LIF-containing group as 36.7% (11/30). This culture medium was applied to the culture of isolated blastomeres and to derivate ES cell lines. Three ES cell lines (21.4%) from isolated blastomeres of 2-cell stage embryos were established. In further experiments, we could establish one ES cell line (4.0%) from single blastomere of 4-cell stage embryo. The subcultured ES cells and their embryoid bodies were characterized by analyzing gene expression for undifferentiation and differentiation marker gene using immunocytochemistry and RT-PCR. In conclusion, LIF supplementation in culture medium could increase the cell number in ICM of blastocysts and support derivation of ES cell lines from isolated blastomeres.

  • PDF

The Effects of Psychological Contract Violation on OS User's Betrayal Behaviors: Window XP Technical Support Ending Case (심리적 계약 위반이 OS이용자의 배신 행동에 미치는 영향: 윈도우 XP 기술적 지원서비스 중단 사례)

  • Lee, Un-Kon
    • Asia pacific journal of information systems
    • /
    • v.24 no.3
    • /
    • pp.325-344
    • /
    • 2014
  • Technical support of Window XP ended in March, 8, 2014, and it makes OS(Operating System) users fall in a state of confusion. Sudden decision making of OS upgrade and replacement is not a simple problem. Firms need to change the long term capacity plan in enterprise IS management, but they are pressed for time and cost to complete it. Individuals can not help selecting the second best plan, because the following OSs of Window XP are below expectations in performances, new PC sales as the opportunities of OS upgrade decrease, and the potential risk of OS technical support ending had not announced to OS users at the point of purchase. Microsoft as the OS vendors had not presented precaution or remedy for this confusion. Rather, Microsoft announced that the technical support of the other following OSs of Wndow XP such as Window 7 would ended in two years. This conflict between OS vendor and OS users could not happen in one time, but could recur in recent future. Although studies on the ways of OS user protection policy would be needed to escape from this conflict, few prior studies had conducted this issue. This study had challenge to cautiously investigate in such OS user's reactions as the confirmation with OS user's expectation in the point of purchase, three types of justice perception on the treatment of OS vendor, psychological contract violation, satisfaction and the other betrayal behavioral intention in the case of Window XP technical support ending. By adopting the justice perception on this research, and by empirically validating the impact on OS user's reactions, I could suggest the direction of establishing OS user protection policy of OS vendor. Based on the expectation-confirmation theory, the theory of justice, literatures about psychological contract violation, and studies about consumer betrayal behaviors in the perspective of Herzberg(1968)'s dual factor theory, I developed the research model and hypothesis. Expectation-confirmation theory explain that consumers had expectation on the performance of product in the point of sale, and they could satisfied with their purchase behaviors, when the expectation could have confirmed in the point of consumption. The theory of justice in social exchange argues that treatee could be willing to accept the treatment by treater when the three types of justice as distributive, procedural, and interactional justice could be established in treatment. Literatures about psychological contract violation in human behaviors explains that contracter in a side could have the implied contract (also called 'psychological contract') which the contracter in the other side would sincerely execute the contract, and that they are willing to do vengeance behaviors when their contract had unfairly been broken. When the psychological contract of consumers had been broken, consumers feel distrust with the vendors and are willing to decrease such beneficial attitude and behavior as satisfaction, loyalty and repurchase intention. At the same time, consumers feel betrayal and are willing to increase such retributive attitude and behavior as negative word-of-mouth, complain to the vendors, complain to the third parties for consumer protection. We conducted a scenario survey in order to validate our research model at March, 2013, when is the point of news released firstly and when is the point of one year before the acture Window XP technical support ending. We collected the valid data from 238 voluntary participants who are the OS users but had not yet exposed the news of Window OSs technical support ending schedule. The subject had been allocated into two groups and one of two groups had been exposed this news. The data had been analyzed by the MANOVA and PLS. MANOVA results indicate that the OSs technical support ending could significantly decrease all three types of justice perception. PLS results indicated that it could significantly increase psychological contract violation and that this increased psychological contract violation could significantly reduce the trust and increase the perceived betrayal. Then, it could significantly reduce satisfaction, loyalty, and repurchase intention, and it also could significantly increase negative word-of-month intention, complain to the vendor intention, and complain to the third party intention. All hypothesis had been significantly approved. Consequently, OS users feel that the OSs technical support ending is not natural value added service ending, but the violation of the core OS purchase contract, that it could be the posteriori prohibition of OS user's OS usage right, and that it could induce the psychological contract violation of OS users. This study would contributions to introduce the psychological contract violation of the OS users from the OSs technical support ending in IS field, to introduce three types of justice as the antecedents of psychological contract violation, and to empirically validate the impact of psychological contract violation both on the beneficial and retributive behavioral intentions of OS users. For practice, the results of this study could contribute to make more comprehensive OS user protection policy and consumer relationship management practices of OS vendor.

The Relationship Between Son Preference and Fertility (남아 선호와 출산력간의 관계)

  • 이성용
    • Korea journal of population studies
    • /
    • v.26 no.1
    • /
    • pp.31-57
    • /
    • 2003
  • This study is intended to examine (l)whether the value of son-for example, old age security and succession of family lineage- causing son preference in the traditional society can be explained at the individual level, (2)whether women without son in the son preference country continue her childbearing until having at least one son or give up the desire of having a son at a certain level. To accomplish these purposes, the 1974 Korean National Fertility Survey data are analyzed by the quadratic hazard models controlling unobserved heterogeneity. Unlike ordinary regression model, even omitted variables that affect hazard rates and are uncorrelated with the included independent variables can distort the parameter estimates in the hazard model. Therefore the nonparametric maximum likelihood estimator(NPMLE) of a mixing distribution developed by Heckman and Singer is used to control unobserved heterogeneity. Based on the statistical result in this study, the value of son causing son preference is determined at the societal level, not at the individual level. And Korean women without a son did not continue endlessly childbearing during child bearing ages until having a son. In general, they gave up the desire having a son when she had born six daughters continuously. Thus, 30-40 years ago, the number of daughters that women without a son giving up the desire of son was six, which is about the level of total fertility rate during 1960s. In these days, we can often see many women who have only two or three daughters and do not any son. This means that the level of giving up the desire of son, which is one factor representing the strength of son preference, becomes lower. If the strength of son preference did not become much weaker, then the fertility rates in Korea could not reach the below replacement level.

Induction of Midbrain Dopaminergic Phenotype in Nurr 1-Over expressing Human Neural Stem Cells (사람 신경 간세포에서 도파민 신경세포 분화유도에 대한 Nurr 1 유전자의 역할 규명)

  • Kim, Han-Jip;Lee, Haksup;Kim, Hyon-Chang;Min, Churl-Ki;Lee, Myung-Ae;Kim, Seung-Up;Han, Jin;Youm, Jae-Boum;Kim, Nari;Park, Won, Sun;Kim, Taeho;Kim, Euiyong;Han, Il-Yong
    • KSBB Journal
    • /
    • v.20 no.5 s.94
    • /
    • pp.363-370
    • /
    • 2005
  • Neural stem cells (NSCs) of the central nervous system (CNS) have raised a great interest not only for their importance in basic neural development but also for their therapeutic potentials in neurologically degenerative diseases such as Parkinson's, Alzheimer and stroke. During the CNS development, two molecular cascades determine specification of midbrain dopamine system. In one pathway, FGF-8, sonic hedgehog and transcription factor Nurr1 specify dopamine neurotransmitter phenotype. In the other, transcription factors $Lm{\times}lb\;and\;Pt{\times}3$ are required for induction of dopaminergic neurons. In Nurr1 knockout mouse, tyrosine hydroxylase (TH) positive cells fail to appear in substantia nigra, indicating that Nurr1 is essential in specification of dopaminergic cell phenotype. In this study, we used the immortalized human NSCs retrovirally transduced with Nurr1 gene to probe the Nurr1 mediated mechanism to induce dopamine phenotype. While Nurr1 over-expression alone did not generate dopamine phenotype in NSCs, applications of retinoid and forskolin induced expression of TH and AADC mRNAs. In addition, co-cultures of Nurr1 expressing NSCs with human astrocytes induced a marked increase of TH expression. In this co-culture system, the addition of retinoid and forskolin dramatically increased expression of TH. These results indicate that the immortalized human NSCs with Nurr1 gene could have a clinical utility for cell replacement for the Parkinson patients.