• Title/Summary/Keyword: joint system

Search Result 3,744, Processing Time 0.041 seconds

DENTAL TREATMENT IN A PATIENT WITH FUKUYAMA TYPE MUSCULAR DYSTROPHY UNDER TOTAL INTRAVENOUS ANESTHESIA USING PROPOFOL (후쿠야마 선천성 근이영양증 환자의 프로포폴을 이용한 전정맥마취 하 치과치료)

  • Jin, Dallae;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.40 no.1
    • /
    • pp.66-71
    • /
    • 2013
  • Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol $3{\sim}3.5{\mu}g/mL$. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.

Oncologic Results and Functional Assessment of Limb Salvage Surgery in Primary Bone Tumors Around the Shoulder Girdle (견관절 주위 원발성 골 종양에서 사지 구제술의 종양학적 결과 및 기능적 평가)

  • Lee, Sang-Hoon;Yoo, Jae-Ho;Oh, Joo-Han;Suh, Sung-Wook;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.8 no.3
    • /
    • pp.96-105
    • /
    • 2002
  • Purpose: The purpose of this study was to assess the oncologic results and functional outcomes of limb salvage surgery performed in patients of primary bone tumors of the shoulder girdle. Materials and Methods: Twenty-nine patients who underwent limb sparing resection for shoulder girdle neoplasm between 1982 and 2001 were analyzed. Follow up periods averaged 7 years and 1 month. Mean age of the patients was 35 (11~71) years. There were 14 males and 15 females. Primary malignant bone tumors of shoulder girdle (proximal humerus 21, scapula 3, both 1) were 23 cases; osteosarcomas 7, chondrosarcoma 14, parosteal osteosarcoma 1, hemangioendothelioma 1, and giant cell tumor of proximal humerus were 6 cases. Limb salvage surgery was performed by curettage and cementing in 7 patients, by cement molding arthroplasty in 10 patients, and by tumor prosthesis in 7 patients, by other method such as resection only, bone graft, arthrodesis in 5 patients. The Musculoskeletal Tumor Society functional rating system was used to assess functional outcomes. Results: One osteosarcoma and 2 chondrosarcoma patients died, and the survival of the salvaged limb was 88.6% at the final follow-up. There were 6 local recurrences, 2 lung metastases, 2 local recurrences and lung metastases. The functional outcome was 80%. There was statistically significant difference of functional results among the patients treated by cement filling (86%), cement molding arthroplasty and IM nailing (71%), and tumor prosthesis (83%). (p=0.034) There were three complications including 1 radial nerve palsy and 1 axillary nerve palsy, and 1 wound infection. Dislodgement of vascularized fibular graft in one patient was treated by internal fixation. Conclusion: Limb salvage surgery seems to be useful method to treat bone tumors of the shoulder girdle.

  • PDF

Comparison of Response Systems and Education Courses against HNS Spill Incidents between Land and Sea in Korea (국내 HNS 사고 대응체계 및 교육과정에 관한 육상과 해상의 비교)

  • Kim, Kwang-Soo;Gang, Jin Hee;Lee, Moonjin
    • Journal of the Korean Society of Marine Environment & Safety
    • /
    • v.21 no.6
    • /
    • pp.662-671
    • /
    • 2015
  • As the type of Hazardous and Noxious Substances(HNS) becomes various and the transport volume of HNS increases, HNS spill incidents occur frequently on land and the sea. In view of various damages to human lives and properties by HNS spills, it is necessary to educate and train professional personnel in preparation for and response to potential HNS spills. This study shows the current state of response systems and education courses against HNS spill incidents on land and the sea to compare those with each other between land and sea in Korea. Incident command system on land are basically similar to that at sea, but leading authority which is responsible for combating HNS spills at sea is changeable depending on the location of HNS spill, as it were, Korea Coast Guard(KCG) is responsible for urgent response to HNS spill at sea, while municipalities are responsible for the response to HNS drifted ashore. Education courses for HNS responders on land are established at National Fire Service Academy(NFSA), National Institute of Chemical Safety(NICS), etc., and are diverse. Education and training courses for HNS responder at sea are established at Korea Coast Guard Academy(KCGA) and Marine Environment Research & Training Institute(MERTI), and are comparatively simple. Education courses for dangerous cargo handlers who work in port where land is linked to the sea are established at Korea Maritime Dangerous Goods Inspection & Research Institute(KOMDI), Korea Port Training Institute(KPTI) and Korea Institute of Maritime and Fisheries Technology(KIMFT). Through the comparison of education courses for HNS responders between land and sea, some recommendations such as extension of education targets, division of an existing integrated HNS course into two courses composed of operational level and manager level with respective refresh course, on-line cyber course and joint inter-educational institute course in cooperation with other relevant institutes are proposed for the improvement in education courses of KCG and KOEM(Korea Marine Environment Management Corporation) to educate and train professionals for combating HNS spills at sea in Korea.

Prognostic Factors for Local Control in Early Glottic Cancer Treated with Radiation Therapy (방사선치료를 받은 조기 성문암 환자의 국소 종양 제어에 관한 예후 인자)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Keun;Nah Byung Sik;Cho Jae-Shik;Lim Sang-Chull
    • Radiation Oncology Journal
    • /
    • v.18 no.4
    • /
    • pp.226-232
    • /
    • 2000
  • Purpose :This study was performed to find out the prognostic factors affecting local control in early glottic cancer treated with radiation therapy alone. Materials and Methods :We analysed 37 patients of histologically confirmed early glottic cancer treated at Chonnam National University Hospital between July Im and December 1995, retrospectively. Age of patients ranged from 30 to 73 years (median; 59 years). Thirty-five (95$\%$) patients were male. Histological type was all squamous cell carcinoma. According to the staging system of 1997 American Joint Committee on Cancer, 37 patients were restaged as follows: Tla; U (73$\%$), Tlb; 3 (8$\%$), 72: 7 (19$\%$). Radiation therapy was done using 6 MV X-ray of linear accelerator The range of total radiation dose delivered to the glottic lesion was between 5,040 cGy and 7,020 cGy (median; 6,600 cGy). Median follow-up period was U months. local control rates were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of control rates between comparable groups. Multivariate analysis using Cox proportional hazard model was done to find out prognostic factors affecting local control. Results:5 year survival rate of 37 patients was 89$\%$. Local control rate of 37 patients was 74$\%$ in 5 years. We included age, 7-stage, anterior commissure involvement, fraction size, total radiation dose, treatment time of radiotherapy as potential prognostic factors in univariate and multivariate analysis. As a result, treatment time had statistical significance in local control rate in both univariate (p=0.026) and multivariate (p=0.017) analysis. Complication was not recorded except one patient with hypothyroidism. Conclusion :This study revealed that overall treatment time of radiation was a significant factor affecting local control rate.

  • PDF

Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.8 no.1
    • /
    • pp.1-11
    • /
    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

  • PDF

The Study on New Radiating Structure with Multi-Layered Two-Dimensional Metallic Disk Array for Shaping flat-Topped Element Pattern (구형 빔 패턴 형성을 위한 다층 이차원 원형 도체 배열을 갖는 새로운 방사 구조에 대한 연구)

  • 엄순영;스코벨레프;전순익;최재익;박한규
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
    • /
    • v.13 no.7
    • /
    • pp.667-678
    • /
    • 2002
  • In this paper, a new radiating structure with a multi-layered two-dimensional metallic disk array was proposed for shaping the flat-topped element pattern. It is an infinite periodic planar array structure with metallic disks finitely stacked above the radiating circular waveguide apertures. The theoretical analysis was in detail performed using rigid full-wave analysis, and was based on modal representations for the fields in the partial regions of the array structure and for the currents on the metallic disks. The final system of linear algebraic equations was derived using the orthogonal property of vector wave functions, mode-matching method, boundary conditions and Galerkin's method, and also their unknown modal coefficients needed for calculation of the array characteristics were determined by Gauss elimination method. The application of the algorithm was demonstrated in an array design for shaping the flat-topped element patterns of $\pm$20$^{\circ}$ beam width in Ka-band. The optimal design parameters normalized by a wavelength for general applications are presented, which are obtained through optimization process on the basis of simulation and design experience. A Ka-band experimental breadboard with symmetric nineteen elements was fabricated to compare simulation results with experimental results. The metallic disks array structure stacked above the radiating circular waveguide apertures was realized using ion-beam deposition method on thin polymer films. It was shown that the calculated and measured element patterns of the breadboard were in very close agreement within the beam scanning range. The result analysis for side lobe and grating lobe was done, and also a blindness phenomenon was discussed, which may cause by multi-layered metallic disk structure at the broadside. Input VSWR of the breadboard was less than 1.14, and its gains measured at 29.0 GHz. 29.5 GHz and 30 GHz were 10.2 dB, 10.0 dB and 10.7 dB, respectively. The experimental and simulation results showed that the proposed multi-layered metallic disk array structure could shape the efficient flat-topped element pattern.

Space Development and Law in Asia (아시아의 우주개발과 우주법)

  • Cho, Hong-Je
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.28 no.2
    • /
    • pp.349-384
    • /
    • 2013
  • The Sputnik 1 launching in 1957 made the world recognize the necessity of international regulations on space development and activities in outer space. The United Nations established COPUOS the very next year, and adopted the mandate to examine legal issues concerning the peaceful uses of outer space. At the time, the military sector of the U.S.A. and the Soviet Union were in charge of the space development and they were not welcomed to discuss the prohibition of the military uses of outer space at the legal section in the COPUOS. Although both countries had common interests in securing the freedom of military uses in outer space. As the social and economic benefits derived from space activities have become more apparent, civil expenditures on space activities have continued to increase in several countries. Virtually all new spacefaring states explicitly place a priority on space-based applications to support social and economic development. Such space applications as satellite navigation and Earth imaging are core elements of almost every existing civil space program. Likewise, Moon exploration continues to be a priority for such established spacefaring states as China, Russia, India, and Japan. Recently, Companies that manufacture satellites and ground equipment have also seen significant growth. On 25 February 2012 China successfully launched the eleventh satellite for its indigenous global navigation and positioning satellite system, Beidou. Civil space activities began to grow in China when they were allocated to the China Great Wall Industry Corporation in 1986. China Aerospace Corporation was established in 1993, followed by the development of the China National Space Administration. In Japan civil space was initially coordinated by the National Space Activities Council formed in 1960. Most of the work was performed by the Institute of Space and Aeronautical Science of the University of Tokyo, the National Aerospace Laboratory, and, most importantly, the National Space Development Agency. In 2003 all this work was assumed by the Japanese Aerospace Exploration Agency(JAXA). Japan eases restrictions on military space development. On 20 June 2012 Japan passed the Partial Revision of the Cabinet Establishment Act, which restructured the authority to regulate Japanese space policy and budget, including the governance of the JAXA. Under this legislation, the Space Activities Commission of the Ministry of Education, Culture, Sports, Science, and Technology, which was responsible for the development of Japanese space program, will be abolished. Regulation of space policy and budget will be handed over to the Space Strategy Headquarter formed under the Prime Minister's Cabinet. Space Strategy will be supported by a Consultative Policy Commission as an academics and independent observers. By revoking Article 4 (Objectives of the Agency) of a law that previously governed JAXA and mandated the development of space programs for "peaceful purposes only," the new legislation demonstrates consistency with Article 2 of the 2008 Basic Space Law. In conformity with the principles laid down in the 1967 Outer Space Treaty JAXA is now free to pursue the non-aggressive military use of space. New legislation is the culmination of a decade-long process that sought ways to "leverage Japan's space development programs and technologies for security purposes, to bolster the nation's defenses in the face of increased tensions in East Asia." In this connection it would also be very important and necessary to create an Asian Space Agency(ASA) for strengthening cooperation within the Asian space community towards joint undertakings.

  • PDF

An Analysis of Validity and Satisfaction for Objectives of Small and Medium Business(SMB) Administration Subsidy the Human Resource Development Program(HRDP) and the Customized Employment Program(CEP) in Specialized High Schools (중소기업 특성화고 인력양성사업과 취업맞춤반의 성과 목표에 대한 타당도 및 만족도 분석 연구)

  • Lee, Byung Wook;Ahn, Jae Yeong;Kang, Chol Min
    • 대한공업교육학회지
    • /
    • v.41 no.1
    • /
    • pp.68-87
    • /
    • 2016
  • This research conducted a survey for total 166 teachers of schools so as to analyze validity and satisfaction for performance objectives of SMB administration subsidy the HRDP and the CEP in Specialized High School. The results of research are as follows. First, teachers recognize that purpose of HRDP is to expand employment of specialized high school and provide human resource of SMB. And, they recognize that HRDP is important to improve school outcomes and makes a positive effect on the improvement of school outcomes. Second, teachers recognize that objectives of HRDP are improvement of student's understanding for SMB, improvement of teacher's understanding for SMB, improvement of SMB's understanding of school, cultivation of student's occupational view, systematization of career guiding program based on employment process, strengthening of industry-academia cooperation education, improvement of the level of student's skill, fulfillment of workplace experience and practice focusing workplace learning, training of customized human resource for SMB, improvement of student's adaptation to the workplace, improvement of employment rate for SMB, expansion of job opportunities for students with SMB, preparation of the base of connection between school and SMB, publicity of school, expansion of opportunities to cooperate between SMB and school, establishment of cooperative system among industrial association and school, introduction and operation of the employment connective model for joint education and employment, strengthening of field professionalism of teachers. However, satisfaction for the achievement of objectives of HRDP except for strengthening of industry-academia cooperation education and improvement of employment rate for SMB is relatively lower than the validity. Third, teachers in charge of human resource training business of middle and small sized company's specialized high school recognize that objectives of CEP are expansion of job opportunities for students with SMB, excavation of good-quality SMB, expansion of opportunities to cooperate between SMB and school, fulfillment of workplace learning, improvement of student's major foundation and in-depth skill, improvement of literacy, math, teamwork and communication abilities for students' job performance, improvement of student's working attitude and student's proper career exploration decision. However, satisfaction for achievement of objectives of CEP is relatively lower than the validity.

An Analysis of Prognostic Factors Affecting the Outcome of Radiation Therapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 곁과 및 생존율에 관한 예후인자 분석)

  • Jung, Young-Yeon;Kim, Ok-Bae;Kim, Jin-Hee
    • Radiation Oncology Journal
    • /
    • v.23 no.2
    • /
    • pp.71-77
    • /
    • 2005
  • Purpose: This retrospective study was conduced to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients ($27.9\%$) were at Stage 11, 13 ($30.2\%$) were at Stage III and 18 ($41.9\%$) were at Stage IV Histopathologically, there were 15 ($34.9\%$) squamous cell carcinomas, 8 ($18.5\%$) nonkeratinizing carcinomas, 17 ($39.5\%$) undifferentiated carcinomas, and 3 ($7.0\%$) lymphoepitheliomas. Among the total 43 patients, 31 patients ($72.1\%$) were treated with only radiation therapy. Neoadjuvant chemotherapy was peformed on 7 patients ($16.3\%$) and concurrent chemoradiotherapy was performed on S patients ($11.6\%$). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy), The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was $90.7\%$. The five year overall survival and disease free survival rates were $50.7\%$ and $48.9\%$, respectively. On the multivariate analysis, the age, T-stage ($T_{1-3}\;vs\;T_4$), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p<0.05). The patterns of failure were as follows: local failure only in 3 patients ($7.0\%$), local and systemic failure in 1 patient ($2.3\%$), and distant metastasis only in 11 patients ($25.6\%$). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (7$T_{1-3}\;vs\;T_4$), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In audition, research for more effective chemotherapeutical regimens and schedules is also needed.

Understanding the Relationship between Value Co-Creation Mechanism and Firm's Performance based on the Service-Dominant Logic (서비스지배논리하에서 가치공동창출 매커니즘과 기업성과간의 관계에 대한 연구)

  • Nam, Ki-Chan;Kim, Yong-Jin;Yim, Myung-Seong;Lee, Nam-Hee;Jo, Ah-Rha
    • Asia pacific journal of information systems
    • /
    • v.19 no.4
    • /
    • pp.177-200
    • /
    • 2009
  • AIn the advanced - economy, the services industry hasbecome a dominant sector. Evidently, the services sector has grown at a much faster rate than any other. For instance, in such developed countries as the U.S., the proportion of the services sector in its GDP is greater than 75%. Even in the developing countries including India and China, the magnitude of the services sector in their GDPs is rapidly growing. The increasing dependence on service gives rise to new initiatives including service science and service-dominant logic. These new initiatives propose a new theoretical prism to promote the better understanding of the changing economic structure. From the new perspectives, service is no longer regarded as a transaction or exchange, but rather co-creation of value through the interaction among service users, providers, and other stakeholders including partners, external environments, and customer communities. The purpose of this study is the following. First, we review previous literature on service, service innovation, and service systems and integrate the studies based on service dominant logic. Second, we categorize the ten propositions of service dominant logic into conceptual propositions and the ones that are directly related to service provision. Conceptual propositions are left out to form the research model. With the selected propositions, we define the research constructs for this study. Third, we develop measurement items for the new service concepts including service provider network, customer network, value co-creation, and convergence of service with product. We then propose a research model to explain the relationship among the factors that affect the value creation mechanism. Finally, we empirically investigate the effects of the factors on firm performance. Through the process of this research study, we want to show the value creation mechanism of service systems in which various participants in service provision interact with related parties in a joint effort to create values. To test the proposed hypotheses, we developed measurement items and distributed survey questionnaires to domestic companies. 500 survey questionnaires were distributed and 180 were returned among which 171 were usable. The results of the empirical test can be summarized as the following. First, service providers' network which is to help offer required services to customers is found to affect customer network, while it does not have a significant effect on value co-creation and product-service convergence. Second, customer network, on the other hand, appears to influence both value co-creation and product-service convergence. Third, value co-creation accomplished through the collaboration of service providers and customers is found to have a significant effect on both product-service convergence and firm performance. Finally, product-service convergence appears to affect firm performance. To interpret the results from the value creation mechanism perspective, service provider network well established to support customer network is found to have significant effect on customer network which in turn facilitates value co-creation in service provision and product-service convergence to lead to greater firm performance. The results have some enlightening implications for practitioners. If companies want to transform themselves into service-centered business enterprises, they have to consider the four factors suggested in this study: service provider network, customer network, value co-creation, and product-service convergence. That is, companies becoming a service-oriented organization need to understand what the four factors are and how the factors interact with one another in their business context. They then may want to devise a better tool to analyze the value creation mechanism and apply the four factors to their own environment. This research study contributes to the literature in following ways. First, this study is one of the very first empirical studies on the service dominant logic as it has categorized the fundamental propositions into conceptual and empirically testable ones and tested the proposed hypotheses against the data collected through the survey method. Most of the propositions are found to work as Vargo and Lusch have suggested. Second, by providing a testable set of relationships among the research variables, this study may provide policy makers and decision makers with some theoretical grounds for their decision making on what to do with service innovation and management. Finally, this study incorporates the concepts of value co-creation through the interaction between customers and service providers into the proposed research model and empirically tests the validity of the concepts. The results of this study will help establish a value creation mechanism in the service-based economy, which can be used to develop and implement new service provision.