Geochemical data have been regarded as one of the important environmental variables in the environmental management. Since they are often sampled at sparse locations, it is important not only to predict attribute values at unsampled locations, but also to assess the uncertainty attached to the prediction for further analysis. The main objective of this paper is to exemplify how indicator geostatistics can be effectively applied to geochemical data processing for providing decision-supporting information as well as spatial distribution of the geochemical data. A whole geostatistical analysis framework, which includes probabilistic uncertainty modeling, classification and risk analysis, was illustrated through a case study of cadmium mapping. A conditional cumulative distribution function (ccdf) was first modeled by indicator kriging, and then e-type estimates and conditional variance were computed for spatial distribution of cadmium and quantitative uncertainty measures, respectively. Two different classification criteria such as a probability thresholding and an attribute thresholding were applied to delineate contaminated and safe areas. Finally, additional sampling locations were extracted from the coefficient of variation that accounts for both the conditional variance and the difference between attribute values and thresholding values. It is suggested that the indicator geostatistical framework illustrated in this study be a useful tool for analyzing any environmental variables including geochemical data for decision-making in the presence of uncertainty.
The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).
Purpose: Exercise intervention after surgery has been found to improve physical fitness and quality of life (QOL). The purpose of this study was to investigate the feasibility and effects of a postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) undergoing minimally invasive gastrectomy. Materials and Methods: Twenty-four patients treated surgically for early gastric cancer were enrolled in the PREP-GC. The exercise program comprised sessions of In-hospital Exercise (1 week), Home Exercise (1 week), and Fitness Improvement Exercise (8 weeks). Adherence and compliance to PREP-GC were evaluated. In addition, body composition, physical fitness, and QOL were assessed during the preoperative period, after the postoperative recovery (2 weeks after surgery), and upon completing the PREP-GC (10 weeks after surgery). Results: Of the 24 enrolled patients, 20 completed the study without any adverse events related to the PREP-GC. Adherence and compliance rates to the Fitness Improvement Exercise were 79.4% and 99.4%, respectively. Upon completing the PREP-GC, patients also exhibited restored cardiopulmonary function and muscular strength, with improved muscular endurance and flexibility (P<0.05). Compared to those in the preoperative period, no differences were found in symptom scale scores measured using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Quality of Life Questionnaire-Stomach Cancer-Specific Module (QLQ-STO22); however, higher scores for global health status and emotional functioning were observed after completing the PREP-GC (P<0.05). Conclusions: In gastric cancer patients undergoing minimally invasive gastrectomy, PREP-GC was found to be feasible and safe, with high adherence and compliance. Although randomized studies evaluating the benefits of exercise intervention during postoperative recovery are needed, surgeons should encourage patients to participate in systematic exercise intervention programs in the early postoperative period (Registered at the ClinicalTrials.gov, NCT01751880).
Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows : 1) North Korea s strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipment and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the case with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.
Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.
Safe blast criteria based on the concept of scaled distances can be obtained from the statistical analysis on measured peak particle velocity data of blast vibrations. Two types of scaled distance widely used in Korea are the square root scaled distance (SRSD) and cube root scaled distance (CRSD). In contrast to SRSD scheme, however, the function of maximum charge per delay for CRSD increases without bound after the intersection point of these two functions despite of the similar goodness of fits. To prevent structural damage that may be caused by the excessive charge in the case of CRSD, it is suggested that CRSD be used within a specified distance slightly beyond the intersection point. On the other hand, there are several attempts that predict vibration level(VL) from the peak particle velocity(PPV) or estimate VL based on the scaled distances without considering their frequency spectra. It appears that these attempts are conducted in blasting contracts only for the purpose of satisfying the environment-related law, which mainly deals with the annoyance aspects of noises and vibrations in human life. But, in principle there could no correlation between peaks of velocity and acceleration over entire frequency spectrum. Therefore, such correlations or estimations should be conducted only between the waves with the same or very similar frequency spectra. Finally, it is a known fact that structural damage due to ground vibration is related to PPV level, the safety level criteria for structures should be defined by allowable PPV levels together with their zero crossing frequencies (ZCF).
Jeong, Hii Sun;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun;Tark, Kwan Chul
Archives of Plastic Surgery
/
v.33
no.4
/
pp.407-412
/
2006
Purpose: Various attempts of reconstruction for pharyngoesophageal defects after ablative surgery have been made to restore the function of the pharyngoesophagus. A fabricated tubed radial forearm free flap or free jejunal free flap was used when the width of remnant pharyngeal wall was less than 50% of the normal width. However there are many disadvantages such as stricture, saliva leakage and fistula formation on tubed radial forearm free flap. The jejunal free flap has the problem such as short pedicle, poor tolerance of ischemic time, wet voice and delayed transit of swallowed food due to the uncoordinated contraction. The authors studied the utility of patch-type radial forearm free flap using the remnant posterior pharyngeal wall of the hypopharynx. Methods: Retrospective reviews in Severance Hospital were made on 25 patients who underwent reconstruction surgery with patched radial forearm free flap because of the hypopharyngeal cancer between 1996 and 2005. The patients of Group I had the narrow posterior pharyngeal wall and its width was less than 3centimeters after the tumor was resected. Those of Group II had the partial pharyngectomy and the width of the remnant pharynx was larger than 3 centimeters. Results: Seven patients belonged to the group I and the flap of this group had 100% survival rate. One case of fistula and no swallowing discomfort due to stricture was reported. The Group II including 18 patients also had the 100% flap survival rate. Neither fistula nor stricture was seen but the lower diet grade was checked. Conclusion: The patch type radial forearm free flap using the remnant pharyngeal wall have the advantage of the radial forearm free flap, and furthermore this flap is the safe reconstructive method even if the width of the remnant pharyngeal wall is less than 30% of that of normal pharynx.
Heat exchanger tube array in a heat recovery steam generator is exposed to the hot exhaust gas flow and it could cause the flow induced vibration, which could damage the heat exchanger tube array. It is needed for the structural safe operation of the heat exchanger to establish the characteristics of flow induced vibration in the tube array. The researches for the flow induced vibration of typical heat exchangers have been conducted by using single cicular tube or circular tube array and the nondimensional PSD(Power Spectral Density) function with the Strouhal number, fD/U, had been derived by experimental method. From the present study, the basis for the application of flow induced vibration to the heat recovery steam generator tube array would be prepared. For the previous mentioned purpose, the present CFD analysis introduced a single fin tube and calculated with the unsteady laminar flow over the single fin tube. The characteristics of vortex shedding and lift and drag fluctuation over the fin tube was investigated. The derived nondimensional lift PSD was compared with the results of the previous experimental studies and the characteristics of lift and drag PSD over a single fin tube was established from the present CFD study.
Appropriate speed limits at a reasonable level in urban roads are highly important factors for efficient and safe movement. Thus, it is greatly necessary to develop the objective models or methodology based on engineering study considering factors such as traffic accident rates, roadside development levels, and roadway geometry characteristics etc. The purpose of this study is to develop the estimate model of appropriate speed limits at each road sections in urban roads using traffic information big data and field specific data and to review the effects of accident decrease. In this study, the estimate method of appropriate speed limits in directional two or more lanes of urban roads is reflecting features of actual variables in a form of adjustment factor on the basis of the maximum statutory speed limits. As a result of investigating and testing influential variables, the main variables to affect the operating speed are the function of road, the existence of median, the width of lane, the number of traffic entrance/exit path and the number of traffic signal or nonsignal at intersection and crosswalk. As a result of testing this model, when the differences are bigger between the real operating speed and the recommended speed limits using model developed in this study, the accident rate generally turns out to be higher. In case of using the model proposed in this study, it means accident rate can be lower. When the result of this study is applied, the speed limits of directional two or more lane roads in Seoul appears about 11km/h lower than the current speed limits. The decrease of average operating speed caused by the decrease of speed limits is 2.8km/h, and the decrease effect of whole accidents according to the decrease of speed is 18% at research road. In case that accident severity is considered, the accident decrease effects are expected to 17~24% in fatalities, 11~17% in seriously injured road user, 6~9% in slightly injured road user, 5~6% in property damage only accidents.
While the concept of Home Network is laying by and its interests are increasing by means of digitalizing of the information communication infrastructure, many efforts are in progress toward convenient lives. Moreover, as information household appliances which have a junction of connecting to the network are appearing over the past a few years, the demands against intellectual Home Services are increasing. In this paper, by being based upon Multimedia which is an essential factor for developing of various application services on ubiquitous computing environments, we suggest a simplified application model that could apply the information to the automated processing system after studying user's behavior patterns using authentication and access control for identity certification of users. In addition, we compared captured video images in the fixed range by pixel unit through some time and checked disorder of them. And that made safe of user certification as adopting self-developed certification method which was used 'Hash' algorism through salt function of 12 byte. In order to show the usefulness of this proposed model, we did some testing by emulator for control of information after construction for Intellectual Multimedia Server, which ubiquitous network is available on as a scheme so as to check out developed applications. According to experimental results, it is very reasonable to believe that we could extend various multimedia applications in our daily lives.
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