• Title/Summary/Keyword: Functional Approach

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Surgical Treatment of Acyanotic Tetralogy of Fallot (비청색성 팔로사징의 외과적 치료)

  • 천종록;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.749-755
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    • 1998
  • Background: Twelve patients with acyanotic tetralogy of Fallot(TOF), characterized by the combination of a malaligned ventricular septal defect(VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. Materials and methods: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months(mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. Results: The preoperative mean right ventricle to pulmonary artery(RV-PA) pressure gradients were 52.3 mmHg on 2D- echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients(50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients(mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. Conclusions: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.

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Design Evaluation Model Based on Consumer Values: Three-step Approach from Product Attributes, Perceived Attributes, to Consumer Values (소비자 가치기반 디자인 평가 모형: 제품 속성, 인지 속성, 소비자 가치의 3단계 접근)

  • Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.23 no.4
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    • pp.57-76
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    • 2017
  • Recently, consumer needs are diversifying as information technologies are evolving rapidly. A lot of IT devices such as smart phones and tablet PCs are launching following the trend of information technology. While IT devices focused on the technical advance and improvement a few years ago, the situation is changed now. There is no difference in functional aspects, so companies are trying to differentiate IT devices in terms of appearance design. Consumers also consider design as being a more important factor in the decision-making of smart phones. Smart phones have become a fashion items, revealing consumers' own characteristics and personality. As the design and appearance of the smartphone become important things, it is necessary to examine consumer values from the design and appearance of IT devices. Furthermore, it is crucial to clarify the mechanisms of consumers' design evaluation and develop the design evaluation model based on the mechanism. Since the influence of design gets continuously strong, various and many studies related to design were carried out. These studies can classify three main streams. The first stream focuses on the role of design from the perspective of marketing and communication. The second one is the studies to find out an effective and appealing design from the perspective of industrial design. The last one is to examine the consumer values created by a product design, which means consumers' perception or feeling when they look and feel it. These numerous studies somewhat have dealt with consumer values, but they do not include product attributes, or do not cover the whole process and mechanism from product attributes to consumer values. In this study, we try to develop the holistic design evaluation model based on consumer values based on three-step approach from product attributes, perceived attributes, to consumer values. Product attributes means the real and physical characteristics each smart phone has. They consist of bezel, length, width, thickness, weight and curvature. Perceived attributes are derived from consumers' perception on product attributes. We consider perceived size of device, perceived size of display, perceived thickness, perceived weight, perceived bezel (top - bottom / left - right side), perceived curvature of edge, perceived curvature of back side, gap of each part, perceived gloss and perceived screen ratio. They are factorized into six clusters named as 'Size,' 'Slimness,' 'No-Frame,' 'Roundness,' 'Screen Ratio,' and 'Looseness.' We conducted qualitative research to find out consumer values, which are categorized into two: look and feel values. We identified the values named as 'Silhouette,' 'Neatness,' 'Attractiveness,' 'Polishing,' 'Innovativeness,' 'Professionalism,' 'Intellectualness,' 'Individuality,' and 'Distinctiveness' in terms of look values. Also, we identifies 'Stability,' 'Comfortableness,' 'Grip,' 'Solidity,' 'Non-fragility,' and 'Smoothness' in terms of feel values. They are factorized into five key values: 'Sleek Value,' 'Professional Value,' 'Unique Value,' 'Comfortable Value,' and 'Solid Value.' Finally, we developed the holistic design evaluation model by analyzing each relationship from product attributes, perceived attributes, to consumer values. This study has several theoretical and practical contributions. First, we found consumer values in terms of design evaluation and implicit chain relationship from the objective and physical characteristics to the subjective and mental evaluation. That is, the model explains the mechanism of design evaluation in consumer minds. Second, we suggest a general design evaluation process from product attributes, perceived attributes to consumer values. It is an adaptable methodology not only smart phone but also other IT products. Practically, this model can support the decision-making when companies initiative new product development. It can help product designers focus on their capacities with limited resources. Moreover, if its model combined with machine learning collecting consumers' purchasing data, most preferred values, sales data, etc., it will be able to evolve intelligent design decision support system.

Acute Kidney Injury Models: Focus on the Therapeutic Effects of Stem Cell in Preclinical Approach (줄기세포 연구를 위한 급성신장손상 모델)

  • Nam, Hyun-Suk;Woo, Jae-Seok;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.533-539
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    • 2010
  • Stem cell-based therapy is under intensive investigation to treat acute renal failure (ARF). The purpose of this study was to evaluate available ARF models, and suggest a model appropriate to therapeutic evaluation of the stem cells in preclinical approach by determining the optimum concentration of nephrotoxic agents and duration of ischemia induction. Three different types of available acute kidney injury (AKI) animal models were analyzed using rats: Cisplatin (saline, 5 and 7.5 mg/kg, IP) or glycerol (saline, 8 and 10 ml/kg, IM)-induced nephrotoxicity as toxic models and ischemia-induced (sham, 35 and 45 minutes) nephropathy as an ischemic model. The relevance and applicability to investigate especially the regenerative ability of stem cells were evaluated regarding morphology, renal function and survival at this time point. In the point of renal function, 10 ml glycerol/kg and 7.5 mg cisplatin/kg model in toxic models and 45 min model in ischemia models showed significant decrease for the longer observation time compared to 8 ml glycerol/kg, 5 mg cisplatin/kg and the 35 min ischemia models, respectively. All groups were observed no mortality except 45 min-ischemia model with 50% survival. Histological significant alterations including cast formation in the tubular lumen, tubular necrosis and apoptosis were revealed on the second day in either ischemiaor glycerol-induced models, and on day 5 in cisplatin-induced models. The results indicate that ischemia 35 min-, cisplatin 7.5 mg/kg- and glycerol 10 ml/kg-induced AKI would be ideal animal models to monitor a outcome parameter related to the therapeutic effects on renal function with noninvasive techniques in the same animal at multiple time points. Our findings also suggest that the best time points for the functional or histological interpretation of renal will be on day 2 in both glycerol- and ischemia-induced AKI models and on day 5 in cisplatin-induced AKI.

Wedge-Shaped Resection for Massive Xanthomatosis of Achilles Tendon (양측 아킬레스건에 발생한 거대 황색종의 쐐기형 절제술을 이용한 수술적 치료)

  • Kim, Sungmin;Ahn, Yeong Seub;Jung, Dong-Min;Jung, Sung Taek
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.157-163
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    • 2021
  • Purpose: Xanthomatosis of the Achilles tendons is rare. In some patients, however, the lesions in the Achilles tendon need to be removed, which may be painful and disfiguring. While studies of successful surgical outcomes for the total resection and reconstruction of the Achilles tendon have been reported, reconstruction surgery has a technical challenge, and extended surgical exposures are required. This study analyzed five cases of bilateral xanthoma of the Achilles tendon, which was treated surgically using a wedge-shaped tendon-sparing approach to eliminate the need for tendon reconstruction. Materials and Methods: From July 2010 to May 2018, five patients with xanthomatosis in both Achilles tendons underwent wedge-shaped tendon preserving surgery. The average age was 49 years (range, 40-55 years), and the follow-up period was 21.4 months (range, 12-31 months). The patients consisted of three males and two females. Complications related to surgery were recorded. The outcome measures included the range of motion of the ankle joint, American Orthopaedic Foot and ankle Society (AOFAS) ankle/hindfoot score, and visual analogue scale (VAS) for overall satisfaction at the last follow-up. The availability of a single-limb heel raise and returning time to work were also measured. Results: Wound dehiscence that did not require secondary surgery was noted in one patient. At the last follow-up, the range of motion of the ankle joint was normal in all patients. The mean AOFAS ankle/hindfoot score was 91 (range, 85-96) and the VAS for the overall satisfaction ranged from 8 to 10. The average time between surgery and return to work was 27.6 days (range, 17-58 days) and all patients could perform a single-limb heel raise test. Conclusion: The tendon-sparing technique, which can preserve the anatomical functioning of the Achilles tendon, could be an excellent surgical approach because it has very promising functional and cosmetic surgical outcomes in patients with Achilles tendon xanthomatosis.

Strategic Issues in Managing Complexity in NPD Projects (신제품개발 과정의 복잡성에 대한 주요 연구과제)

  • Kim, Jongbae
    • Asia Marketing Journal
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    • v.7 no.3
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    • pp.53-76
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    • 2005
  • With rapid technological and market change, new product development (NPD) complexity is a significant issue that organizations continually face in their development projects. There are numerous factors, which cause development projects to become increasingly costly & complex. A product is more likely to be successfully developed and marketed when the complexity inherent in NPD projects is clearly understood and carefully managed. Based upon the previous studies, this study examines the nature and importance of complexity in developing new products and then identifies several issues in managing complexity. Issues considered include: definition of complexity : consequences of complexity; and methods for managing complexity in NPD projects. To achieve high performance in managing complexity in development projects, these issues need to be addressed, for example: A. Complexity inherent in NPD projects is multi-faceted and multidimensional. What factors need to be considered in defining and/or measuring complexity in a development project? For example, is it sufficient if complexity is defined only from a technological perspective, or is it more desirable to consider the entire array of complexity sources which NPD teams with different functions (e.g., marketing, R&D, manufacturing, etc.) face in the development process? Moreover, is it sufficient if complexity is measured only once during a development project, or is it more effective and useful to trace complexity changes over the entire development life cycle? B. Complexity inherent in a project can have negative as well as positive influences on NPD performance. Thus, which complexity impacts are usually considered negative and which are positive? Project complexity also can affect the entire organization. Any complexity could be better assessed in broader and longer perspective. What are some ways in which the long-term impact of complexity on an organization can be assessed and managed? C. Based upon previous studies, several approaches for managing complexity are derived. What are the weaknesses & strengths of each approach? Is there a desirable hierarchy or order among these approaches when more than one approach is used? Are there differences in the outcomes according to industry and product types (incremental or radical)? Answers to these and other questions can help organizations effectively manage the complexity inherent in most development projects. Complexity is worthy of additional attention from researchers and practitioners alike. Large-scale empirical investigations, jointly conducted by researchers and practitioners, will help gain useful insights into understanding and managing complexity. Those organizations that can accurately identify, assess, and manage the complexity inherent in projects are likely to gain important competitive advantages.

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Development of a Model of Brain-based Evolutionary Scientific Teaching for Learning (뇌기반 진화적 과학 교수학습 모형의 개발)

  • Lim, Chae-Seong
    • Journal of The Korean Association For Science Education
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    • v.29 no.8
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    • pp.990-1010
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    • 2009
  • To derive brain-based evolutionary educational principles, this study examined the studies on the structural and functional characteristics of human brain, the biological evolution occurring between- and within-organism, and the evolutionary attributes embedded in science itself and individual scientist's scientific activities. On the basis of the core characteristics of human brain and the framework of universal Darwinism or universal selectionism consisted of generation-test-retention (g-t-r) processes, a Model of Brain-based Evolutionary Scientific Teaching for Learning (BEST-L) was developed. The model consists of three components, three steps, and assessment part. The three components are the affective (A), behavioral (B), and cognitive (C) components. Each component consists of three steps of Diversifying $\rightarrow$ Emulating (Executing, Estimating, Evaluating) $\rightarrow$ Furthering (ABC-DEF). The model is 'brain-based' in the aspect of consecutive incorporation of the affective component which is based on limbic system of human brain associated with emotions, the behavioral component which is associated with the occipital lobes performing visual processing, temporal lobes performing functions of language generation and understanding, and parietal lobes, which receive and process sensory information and execute motor activities of the body, and the cognitive component which is based on the prefrontal lobes involved in thinking, planning, judging, and problem solving. On the other hand, the model is 'evolutionary' in the aspect of proceeding according to the processes of the diversifying step to generate variants in each component, the emulating step to test and select useful or valuable things among the variants, and the furthering step to extend or apply the selected things. For three components of ABC, to reflect the importance of emotional factors as a starting point in scientific activity as well as the dominant role of limbic system relative to cortex of brain, the model emphasizes the DARWIN (Driving Affective Realm for Whole Intellectual Network) approach.

Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.598-604
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    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

Effect of retinoic acid on the bystander effect in gene therapy using the Herpes Simplex Virus thymidine kinase (Herpes Simplex Virus thymidine kinase gene을 이용한 유전자 치료에서 retinoic acid가 bystander effect에 미치는 영향)

  • Park, Jae Yong;Kim, Chang Ho;Jung, Tae Hoon;Albelda, Steven M.
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.162-174
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    • 1997
  • Background : Metabolic cooperation via gap junctional intercellular communication (GJIC) is an important mechanism of the bystander effect in gene therapy using the Herpes Simplex Virus thymidine kinase/ganciclovir (HSVtk) "prodrug" system. Since retinoids have been reported to increase GJIC by induction of connexin 43 expression, we hyporthesized that treatment of tumor cells with retinoic acid could augment the bystander effect of the HSVtk/GCV system and result in improved tumor cell killing by enhancing GJIC. Methods : We transferred HSVtk gene to SKHep-J cell line that does not express connexin43, and also transferred the gene to human and murine mesothelioma cell lines that express connexin43. We verified that retinoic acid enhanced GJIC utilizing a functional double-dye transfer study and evaluated the effects of retinoic acid on the growth rate of tumor cells. We then tested the effects of retinoic acid on bystander-mediated cell killing. Results : Addition of all-trans retinoic acid (RA) increased GJIC in cell lines expressing connexin 43 and was asspciated with more efficient in vitro bystander killing in cells transduced with HSVtk via adenoviral and retroviral vectors. In contrast, there was no increase in the efficiency of the bystander effect after exposure to RA in a cell line which had no delectable connexin 43. Conclusion : These results provide evidence that retinoids can augment the efficiency of cell killing with the HSVtk/GCV system by enhancing bystander effect and may thus be a promising new approach to improve responses in gene therapy utilizing the HSVtk system to treat tumors.

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Screening of salt-tolerance plants using transgenic Arabidopsis that express a salt cress cDNA library (Salt cress 유전자의 형질전환을 통한 내염성 식물체 선별)

  • Baek, Dongwon;Choi, Wonkyun;Kang, Songhwa;Shin, Gilok;Park, Su Jung;Kim, Chanmin;Park, Hyeong Cheol;Yun, Dae-Jin
    • Journal of Plant Biotechnology
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    • v.41 no.2
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    • pp.81-88
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    • 2014
  • Salt cress (Thellungiella halophila or Thellungiella parvula), species closely related to Arabidopsis thaliana, represents an extremophile adapted to harsh saline environments. To isolate salt-tolerance genes from this species, we constructed a cDNA library from roots and leaves of salt cress plants treated with 200 mM NaCl. This cDNA library was subsequently shuttled into the destination binary vector [driven by the cauliflower mosaic virus (CaMV) 35S promoter] designed for plant transformation and expression via recombination- assisted cloning. In total, 305,400 pools of transgenic BASTA-resistant lines were generated in Arabidopsis using either T. halophila or T. parvula cDNA libraries. These were used for functional screening of genes involved in salt tolerance. Among these pools, 168,500 pools were used for primary screening to date from which 7,157 lines showed apparent salt tolerant-phenotypes in the initial screen. A secondary screen has now identified 165 salt tolerant transgenic lines using 1,551 (10.6%) lines that emerged in the first screen. The prevalent phenotype in these lines includes accelerated seed germination often accompanied by faster root growth compared to WT Arabidopsis under salt stress condition. In addition, other lines showed non-typical development of stems and flowers compared to WT Arabidopsis. Based on the close relationship of the tolerant species to the target species we suggest this approach as an appropriate method for the large-scale identification of salt tolerance genes from salt cress.

SINUS FLOOR GRAFTING USING CALCIUM PHOSPHATE NANO-CRYSTAL COATED XENOGENIC BONE AND AUTOLOGOUS BONE (칼슘포스페이트 나노-크리스탈이 코팅된 골이식재와 자가골을 병행 이용한 상악동 거상술)

  • Pang, Kang-Mi;Li, Bo-Han;Alrashidan, Mohamed;Yoo, Sang-Bae;Sung, Mi-Ae;Kim, Soung-Min;Jahng, Jeong-Won;Kim, Myung-Jin;Ko, Jea-Seung;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.3
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    • pp.243-248
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    • 2009
  • Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.