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Giant Coronary Artery Aneurysm Presenting as a Calcified Mediastinal Mass a, Coronary Artery Fistula - A case report - (종격동 종양으로 오인된 거대관상동맥류와 관상동맥루 - 치험 1례 -)

  • Yoon, You-Sang;Lee, Cheol-Joo;Choi, Ho;Kang, Jun-Kyu;Choi, Jin-Wook;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.787-791
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    • 2001
  • Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

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Implementation Strategy for the Elderly Care Solution Based on Usage Log Analysis: Focusing on the Case of Hyodol Product (사용자 로그 분석에 기반한 노인 돌봄 솔루션 구축 전략: 효돌 제품의 사례를 중심으로)

  • Lee, Junsik;Yoo, In-Jin;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.25 no.3
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    • pp.117-140
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    • 2019
  • As the aging phenomenon accelerates and various social problems related to the elderly of the vulnerable are raised, the need for effective elderly care solutions to protect the health and safety of the elderly generation is growing. Recently, more and more people are using Smart Toys equipped with ICT technology for care for elderly. In particular, log data collected through smart toys is highly valuable to be used as a quantitative and objective indicator in areas such as policy-making and service planning. However, research related to smart toys is limited, such as the development of smart toys and the validation of smart toy effectiveness. In other words, there is a dearth of research to derive insights based on log data collected through smart toys and to use them for decision making. This study will analyze log data collected from smart toy and derive effective insights to improve the quality of life for elderly users. Specifically, the user profiling-based analysis and elicitation of a change in quality of life mechanism based on behavior were performed. First, in the user profiling analysis, two important dimensions of classifying the type of elderly group from five factors of elderly user's living management were derived: 'Routine Activities' and 'Work-out Activities'. Based on the dimensions derived, a hierarchical cluster analysis and K-Means clustering were performed to classify the entire elderly user into three groups. Through a profiling analysis, the demographic characteristics of each group of elderlies and the behavior of using smart toy were identified. Second, stepwise regression was performed in eliciting the mechanism of change in quality of life. The effects of interaction, content usage, and indoor activity have been identified on the improvement of depression and lifestyle for the elderly. In addition, it identified the role of user performance evaluation and satisfaction with smart toy as a parameter that mediated the relationship between usage behavior and quality of life change. Specific mechanisms are as follows. First, the interaction between smart toy and elderly was found to have an effect of improving the depression by mediating attitudes to smart toy. The 'Satisfaction toward Smart Toy,' a variable that affects the improvement of the elderly's depression, changes how users evaluate smart toy performance. At this time, it has been identified that it is the interaction with smart toy that has a positive effect on smart toy These results can be interpreted as an elderly with a desire to meet emotional stability interact actively with smart toy, and a positive assessment of smart toy, greatly appreciating the effectiveness of smart toy. Second, the content usage has been confirmed to have a direct effect on improving lifestyle without going through other variables. Elderly who use a lot of the content provided by smart toy have improved their lifestyle. However, this effect has occurred regardless of the attitude the user has toward smart toy. Third, log data show that a high degree of indoor activity improves both the lifestyle and depression of the elderly. The more indoor activity, the better the lifestyle of the elderly, and these effects occur regardless of the user's attitude toward smart toy. In addition, elderly with a high degree of indoor activity are satisfied with smart toys, which cause improvement in the elderly's depression. However, it can be interpreted that elderly who prefer outdoor activities than indoor activities, or those who are less active due to health problems, are hard to satisfied with smart toys, and are not able to get the effects of improving depression. In summary, based on the activities of the elderly, three groups of elderly were identified and the important characteristics of each type were identified. In addition, this study sought to identify the mechanism by which the behavior of the elderly on smart toy affects the lives of the actual elderly, and to derive user needs and insights.

Cephalometric study on head posture according to the Classification of Malocclusion (부정교합 분류에 따른 두경부 위치의 두부방사선 계측학적 연구)

  • Hwang, Chung-Ju;Kim, Suk-Hyun;Kil, Jae-Kyung
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.221-230
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    • 1997
  • It has been known that head posture may influence directly and/or indirectly the growth and development of craniofacial morphology and can also be influenced by the funtional demand of physiologic activity. It was reported that facial morphology has close relationships with hyoid bone position and head posture. In many previous studies, Natural Head Posture(NHP) was guided, and also it was shown that NHP has high degree of reproducibility. Otherwise, There was few study about the relationship of head posture, with routine cephalometric film which is used for clinical orthodontic purpose. In this study, according to the Wits and ANB of initial cephalometric film which was taken with vertical pendulum as representative of true vertical reference line. We classified the subjects which is comprised of 60 adult female patients into Class I, II, III (Cl I, II, III)and we tried to find out the correlation of head posture and hyoid bone position according to the classification of malocclusion. As a result of our research, we found the followigs. 1. In comparison of vertical position of hyoid bone relative to the cranial base. the position of hyoid bone of Cl III was lower than that of Cl II. 2. In comparison of anteriorpostes or position of hyoid bone, relative to the cervical column. The position of hyoid bone of Cl III was more anterior than that of a II 3. in comparison of vertical position of hyoid bone relative to mandible. There was no significant correlation aumoug the groups of malocclusion. 4. ANB and Wits showed no significant correlation with hyoid bone position. 5. The relative extension of head, which was noted in Cl II, showed negative with Sum, ANB. 6. In Cl II and Cl III, Post to Ant facial height showed positive correlation with NSL/VER.

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DIFFERENT WAYS OF SURGICAL MANAGEMENT FOR CHILDREN WITH CONFOUND ODONTOMA IN THE MANDIBLE (아동의 하악골에 발생한 복합 치아종의 외과적 처치에 관한 증례보고)

  • Chung, Woo-Sung;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.3
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    • pp.499-506
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    • 1999
  • The odontoma is relatively a common benign odontogenic tumor and caused by overgrowth of odontogenic tissues. The recent classification by World Health Organization divides odontoma into 2 groups such as compound odontoma and complex odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. The etiology of odontoma is unknown and almost asymptomatic. So, it usually is found in routine radiographic examination, and most common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth. It can occurs almost anywhere in jaws. It is desirable that odontoma should be removed by surgical enucleation including follicle and surrounding soft tissues. Considering the age and behavioral cooperation of patient, the development of permanent dentition, the location of odontoma in jaw, the need for the concomitant operative dentistry, operation is performed in outpatient department with/without sedation or under general anesthesia with endotracheal intubation. In this case report, 2 patients with compound odontoma were treated by surgical enucleation including follicle and surrounding soft tissues. One patient, about 5 years old, was treated under general anesthesia and concomitant operative dentistry was performed. The other patient, about 11 years old, was treated under local anesthesia in outpatient department. In 2 cases, after 4 months, surgical defects were filled with new bone and normalization of eruption path of impacted permanent teeth was observed.

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The Image of Changgyeongwon and Culture of Pleasure Grounds during the Japanese Colonial Period (일제강점기 창경원의 이미지와 유원지 문화)

  • Kim, Jeoung-Eun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.6
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    • pp.1-15
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    • 2015
  • Changgyeongwon emerged as pleasure grounds following the creation of a museum, zoo and botanical garden in Changgyeonggung Palace during the Japanese colonial period. Pleasure grounds offer space for entertainment and have maintained the image of a paradise apart from reality. This study examined the creation process of pleasure grounds within a royal palace and the following spatial changes. By analyzing the image of Changgyeongwon as an artificial paradise, this study explored its landscape and cultural aspects. Literature reviews on the intention and process showed that the Changgyeongwon pleasure grounds were created as a 'royal garden' for the amusement of Sunjong, as well as 'public pleasure grounds' in the process of colonization. It was one of the first public spaces open to everyone who could afford the entrance fee. The layout of Changgyeongwon was studied by a comparison and analyzation of modern plans and photographs. It was composed of the central museum zone, northern botanical garden zone, and southern zoological garden zone. A conservatory and greenhouse to exhibit and maintain tropical plants were intensively built in the botanical garden zone while an aviary was created on the zoo pond. In the vicinity of the aviary a vivarium was constructed. Museum exhibition facilities included a main building as well as existing buildings, and a western flower garden was created between the buildings. Space for children including a playground and horse-riding course were created in the 1930's. The paradisiacal image and pleasure grounds culture of Changgyeongwon were studied as follows. Firstly, it shows that Changgyeongwon's paradisiacal image where rare animals and exotic plants were open to the public was promoted by the zoo and botanical garden. This led to the creation of new popular leisure activities such as flower appreciation and animal watching. Secondly, Changgyeongwon offered an urban leisure space, symbolizing the 'non-urban nature within the city' where the urban residents could escape from the daily routine. Thirdly, Changgyeongwon was known for its 'fantastic night landscape' by its night opening during the cherry blossom season. This cherry blossom viewing at night sadly degenerated by various shows and drinking, and as a result, an image of a deviant paradise was given to Changgyeongwon. Changgyeongwon contributed to creating a new space with its diverse facilities, and the public embraced the urban culture through experiences of pleasure and entertainment.

IMMOBILIZATION OF LOWER MANDIBULAR ALVEOLAR BONE FRACTURE USING RESIN-WIRE OPEN CAP SPLINT (하악 유전치부 치조골 골절시 resin-wire open cap splint를 이용한 고정)

  • Kwon, Joung-Hyun;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.175-180
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    • 2008
  • Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

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A Study on the Product Design Process in I-Business Environment Focusing on Development of the Internet-based Design Process - (e-비지니스환경에서의 제품디자인 프로세스에 관한 기초연구-인터넷기반의 디자인 프로세스 개발을 중심으로-)

  • 이수봉;이돈희
    • Archives of design research
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    • v.16 no.1
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    • pp.181-198
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    • 2003
  • The purpose of this study is to develop a on-line design tool for effectively coping with e-Business environment, or product design process into a Cyber model for traditional manufacturers which attempts new product development under such environment. It was finally developed as a model named $\ulcorner$Design Vortal Site; e-BVDS) that was based on the structure and style of internet web site. Results of the study can be described as follows ; \circled1 e-Business is based on the Internet. All processes in the context of e-Business require models whose structure and method of use are on-line styles. \circled2 In case that a traditional manufacturing business is converted into e-Business, it is better to first consider Hybrid Model that combines resources and advantages of both such traditional and digital businesses. \circled3 The product design process appropriate for e-Business environment has to have a structure and style that ensure utilization of the process as an Internet web site, active participation by product developers and interactive communication between participants in designing and designers. \circled4 $\ulcorner$e-BDVS) makes possible the use of designers around the wend like in-house designers, overcoming lack in creativity, ideas and human resources traditional business organizations face. However, the operation of $\ulcorner$e-BDVS$\lrcorner$ requires time and budget investments in securing related elements and conditions. \circled5 Cyber designers under $\ulcorner$e-BDVS$\lrcorner$ can easily perform all design projects in cyber space. But they have some limits in playing a role as designers and they have difficulty in getting rewards if such projects completed by them are not finally accepted. \circled6 $\ulcorner$e-BDVS) ensures the rapid use of a wide range of design information and data, reception of a variety of solutions and ideas and effective design development, all of which are not possible through traditional processes. However, this process may not be suitable to be used routine process or tool. \circled7 $\ulcorner$e-BDVS$\lrcorner$ makes it possible for out-sourcing or partners businesses to overcome restrictions in time and space and improve productivity and effectiveness. But such they may have to continue off-line works that can not be treated on-line.

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Characteristics of User's Behavior across Generations for space planing in General Hospital (종합병원 환경계획을 위한 세대별 종합병원 이용행태 특성분석)

  • Park, Hey Kyung;Oh, Ji Young
    • Korea Science and Art Forum
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    • v.28
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    • pp.105-116
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    • 2017
  • This study is a basic research to suggest user-centered general hospital environmental design guidelines, which aims to analyze user's behavior characteristics across generation in general hospital. For this purpose, this study constructed an analysis tool through the literature review with regard to generation and behavior characteristics in general hospital. Besides, an online survey regarding user's behavior in general hospital was conducted targeting from 20s to 60s, 300 persons for each group, total 1,500 persons for about 3 weeks since September 1, 2016. The results of this study are as follows: (1) Based on the generation, there were significant differences in relevant categories of their visiting frequency, visiting purpose, visiting hour, transportation, companion, behavior during the wait and selection of a general hospital. (2) In all generation, they responded that they have visited once or twice per year. People in 20s and 30s responded that their visit for the hospital is to receive specific treatment, while other people in 40s, 50s and 60s visit the hospital majorly for routine check-ups. Therefore, it is imperative for a health check-up center to design an environmental plan that reflects the characteristics of elders in 40s, 50s and 60s. (3) People in 40s, 50s and 60s usually visit a general hospital in the mornings of weekdays, while generations in 20s and 30s responded that they mostly visit the hospital in the mornings of weekend. (4) When they visit a general hospital, people in their 20s are usually using public transportations, while people in their 30s to 60s are using their own vehicle. (5) People in their 20s majorly visited 'lobby'. In older generations, they tend to visit 'outpatient clinic'. Therefore, it is necessary to build an outpatient clinic environment that considers the elderly. (6) Patients majorly responded that they are using their cell phone, while waiting for their clinic call. In elder generations, they responded that they are more likely watching TVs, reading books/magazines or doing nothing. Therefore, it is essential to provide cell-phone related services and environmental supports. Visually attractive media can be utilized for this purpose.

Factors Associated with Care Burden among Family Caregivers of Terminally Ill Cancer Patients (말기암환자 가족 간병인의 간병 부담과 관련된 요인)

  • Lee, Jee Hye;Park, Hyun Kyung;Hwang, In Cheol;Kim, Hyo Min;Koh, Su-Jin;Kim, Young Sung;Lee, Yong Joo;Choi, Youn Seon;Hwang, Sun Wook;Ahn, Hong Yup
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.61-69
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    • 2016
  • Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.

Function of the Korean String Indexing System for the Subject Catalog (주제목록을 위한 한국용어열색인 시스템의 기능)

  • Yoon Kooho
    • Journal of the Korean Society for Library and Information Science
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    • v.15
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    • pp.225-266
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    • 1988
  • Various theories and techniques for the subject catalog have been developed since Charles Ammi Cutter first tried to formulate rules for the construction of subject headings in 1876. However, they do not seem to be appropriate to Korean language because the syntax and semantics of Korean language are different from those of English and other European languages. This study therefore attempts to develop a new Korean subject indexing system, namely Korean String Indexing System(KOSIS), in order to increase the use of subject catalogs. For this purpose, advantages and disadvantages between the classed subject catalog nd the alphabetical subject catalog, which are typical subject ca-alogs in libraries, are investigated, and most of remarkable subject indexing systems, in particular the PRECIS developed by the British National Bibliography, are reviewed and analysed. KOSIS is a string indexing based on purely the syntax and semantics of Korean language, even though considerable principles of PRECIS are applied to it. The outlines of KOSIS are as follows: 1) KOSIS is based on the fundamentals of natural language and an ingenious conjunction of human indexing skills and computer capabilities. 2) KOSIS is. 3 string indexing based on the 'principle of context-dependency.' A string of terms organized accoding to his principle shows remarkable affinity with certain patterns of words in ordinary discourse. From that point onward, natural language rather than classificatory terms become the basic model for indexing schemes. 3) KOSIS uses 24 role operators. One or more operators should be allocated to the index string, which is organized manually by the indexer's intellectual work, in order to establish the most explicit syntactic relationship of index terms. 4) Traditionally, a single -line entry format is used in which a subject heading or index entry is presented as a single sequence of words, consisting of the entry terms, plus, in some cases, an extra qualifying term or phrase. But KOSIS employs a two-line entry format which contains three basic positions for the production of index entries. The 'lead' serves as the user's access point, the 'display' contains those terms which are themselves context dependent on the lead, 'qualifier' sets the lead term into its wider context. 5) Each of the KOSIS entries is co-extensive with the initial subject statement prepared by the indexer, since it displays all the subject specificities. Compound terms are always presented in their natural language order. Inverted headings are not produced in KOSIS. Consequently, the precision ratio of information retrieval can be increased. 6) KOSIS uses 5 relational codes for the system of references among semantically related terms. Semantically related terms are handled by a different set of routines, leading to the production of 'See' and 'See also' references. 7) KOSIS was riginally developed for a classified catalog system which requires a subject index, that is an index -which 'trans-lates' subject index, that is, an index which 'translates' subjects expressed in natural language into the appropriate classification numbers. However, KOSIS can also be us d for a dictionary catalog system. Accordingly, KOSIS strings can be manipulated to produce either appropriate subject indexes for a classified catalog system, or acceptable subject headings for a dictionary catalog system. 8) KOSIS is able to maintain a constistency of index entries and cross references by means of a routine identification of the established index strings and reference system. For this purpose, an individual Subject Indicator Number and Reference Indicator Number is allocated to each new index strings and new index terms, respectively. can produce all the index entries, cross references, and authority cards by means of either manual or mechanical methods. Thus, detailed algorithms for the machine-production of various outputs are provided for the institutions which can use computer facilities.

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