• Journal of Chest Surgery
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• v.30 no.2
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• pp.152-157
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• 1997

From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. worthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age(median : 43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients(6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients : repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1 Used valves were 51. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturlal survival rate was 85.3%. Postoperative complications were low cardiac utput in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79 $\pm$ 0.66 preoperatively to 1.25 $\pm$ 0.49 postoperatively(p < 0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57 $\pm$ 0.06 to 0.54 $\pm$ 0.05 (p < 0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1070-1075
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• 1998

Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

• Journal of Global Scholars of Marketing Science
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• v.8
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• pp.375-402
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• 2001

While the national economy has rapidly grown, both insufficience in indirect capital facilities of society and attempt to avoid having a logistical job as one of the so-called dirty, difficult and dangerous jobs have resulted in the leak of labor in the logistical industry. First of all, it was shown that the functional utilization level of the logistical information system had a partial effect on the logistical performance, that the reduction of logistical costs was influenced by the information system of connecting and supporting functions, and that the improvement of customer service was significantly influenced by only the supporting-function system. Second, the logistical performance was partially influenced by the linkage between logistical activities, only the customer linkage had a significant effect on the reduction of logistical costs, and the improvement of customer service was influenced by the intra-company linkage. Third, in verifying a hypothesis that the logistical information system's functional utilization level and organizational structure would interact with each other and have an effect on the logistical performance, it was shown that based on their mutual interaction at a normalized level this center's functional information system had a significant effect on the reduction of logistical costs. Fourth, in testing a hypothesis that both the linkage between logistical activities and logistical organization structure would interact with each other and would have an effect on the logistical performance, it was shown that their interaction at a normalized level was significant concerning only the reduction of logistical costs, while there was I10 its significance in the customer service. In proving a hypothesis that the linkage between logistical activities and logistical strategy patterns would interact with each other and would have an effect on the logistical performance, it was shown in a differentiated, aggressive investment one among variously patterned logistical strategies that the customer linkage had a significant effect on the reduction of logistical costs, and in the improvement of customer service that the supplier linkage had a remarkable impact. It also was shown that in case of the cost reduction and offensive control strategy, the customer linkage had a remarkable effect, and th at in the improvement of customer service the intra-company and customer linkage had a significant effect. In the marketing and customer service strategy, finally, there was no any significant influence while the customer linkage had a significant impact in the improvement of customer service. Accordingly, whether or not individual companies utilize the logistical information system's functional utilization levels well will have an effect on their logistical performance, and how their supply chain management is well-linked will affect their logistical performance.

• Journal of the Korean Institute of Gas
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• v.5 no.4 s.16
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• pp.1-7
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• 2001

This paper presents a 'consequence analysis' for vapor cloud explosions caused by heavy gas leakages from commercially used storage tanks at petrochemical plants. Particularly, this paper emphasizes on evaluating the results of various vapor cloud explosion accidents from Butane storage tanks. Also this paper analyses the impact of variables on the accidents in order to acquire the optimum conditions for variables. $SuperChems^{TM}$ Professional Edition was applied to analyse the impact (If atmospheric and other variables in the situation where vapor cloud continuously disperses from the ground level. Under the assumption that practical operating conditions are selected as a standard condition, and Butane leaks from the storage tank for 15 minutes, the results show that the maximum distance of LFL (Lower Flammable Limit) was 52 meters and overpressure by the vapor cloud explosion was 1 psi at 128.2 meters. It is observed that the impact of the variables on accidental Butane storage tank leakage mainly varied upon atmospheric stability, wind velocity, pipe line size, visible length, etc., and changes in the simulation result occurred as the variables varied. The maximum distance of the LFL (Lower Flammable Limit) increased as the visible length became shorter, the size of the leak became larger, the wind velocity was decreased, and the climatic conditions became more stable. Thus, by analysing the variables that influence the simulation results of explosions of Butane storage tanks containing heavy gases, I am presenting the most appropriate method for 'consequence analysis' and the selection of standards for suitable values of variables, to obtain the most optimal conditions for the best results.

• The Journal of the Korea Contents Association
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• v.10 no.9
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• pp.267-275
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• 2010

Quality management of an x-ray unit drastically differs according to the type of establishment of medical institutions. Many primary medical institutions have it, but they do not pay much attention to quality management. In the study, Gyeongbuk area has been divided into four zones from January 4, 2010 to September 3, 2010, and four places were designated by city. Among medical institutions located at a total of 16 sites, the target was 8 places with X-ray emission equipment 10 years or more in use as well as 8 places with X-ray emission equipment less than 10 years in use. The 5 essential items of quality control were tested. In the test that checked for equipment it was found that sites with X-ray emission equipment 10 years or more in use didn't have ground connection (6.25%) while all of them passed the current leak test. In the exposure dose reproducibility test 4 sites with X-ray emission equipment 10 years or more in use (25%) and 1 site with X-ray emission equipment less than 10 years in use didn't pass the test. In the KVp accuracy test 5 sites with X-ray emission equipment 10 years or more in use (31.25%) and 2 sites with X-ray emission equipment less than 10 years in use (12.5%) didn't pass the test. In the tube current and tube current amount test 3 sites with X-ray emission equipment 10 years or more in use (18.75%) and 1 site with less than 10 years in use (6.25%) didn't pass the test. According to the findings of the present research, quality control at medical institutions with X-ray equipment 10 years or more in use was poorer than medical institutions with X-ray equipment less than 10 years in use. In this regard, administrative and technical measures need to be taken as soon as possible. In addition, owners of medical clinics or unit managers need to raise awareness, and it is necessary to revise a regular test cycle every year or every two years if they have old equipment or if the equipment is not used on a frequent basis. And it is also important to provide regular educational programs for quality management.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.979-985
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• 1997

Between October 1991 and May 1995, 256 "New Duromedics Valve"(Edward TEKNA Bileaflet Valve) were implanted in 208 adult patients(171 mitral, 82 aortic and 3 tricuspid) with age ranging from 18 years to 70 years(mean 48.2$\pm$ 11.6 years). Postoperative complication rates were 12.2%, but there was none valve related one. Overall early mortality rate were 1.4%(1.6% for MVR, 2.1% for DVR, and none for AVR or TVR) respectively. Follow-up was 99% completed ranging in duration from 2 months to 46 months. There were 6 valve-related late complications(2.9%) with 2 patients with upper gastrointestinal bleeding, 2 with cerebral thxomtioembolism, 1 with valve thrombosis and 1 with valve endocarditis. Freedom from these valve-related major complications were 89.9% at 40 months. There were 5 late deaths(2.4%). one of these late deaths was considered valve-related. Overall actuarial survival rates at 40 months were 95.5%, 96.8% for mitral, 97.1% for aortic, 100% for tricuspid, and 92.0% for double valve replacement respectively. Preoperative New York Heart Association functional class were 2.9, and 1.3 in post-operative state. We have been trying to keep the international normalized ratio(INR) with range of 2.5 to 3.0. The INR of 4 patients of 5 with anticoagulant ralated complications was beyond the range. To reduce the rate of anticoagulant related complications, we felt very strongly that the INR should be kept between 2.5 and 3.0. In our cases, there was no structural failure or significant hemolysis in the absence of periprosthetic leak. This experience encourages us to continue using the "New Duromedics Valve".omedics Valve".uot;.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.488-494
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• 2005

Purpose : To outline the aspects of extubation by birth weight and find the predictors for success/failure at the first extubation in extremely low birth weight infants. Methods : One hundred thirteen extremely low birth weight infants(<1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought to be related with extubation success or failure were compared with the success and the failure of the first extubation. Results : As the birth weight decreased, extubation success day was significantly delayed : $16{\pm}3day(d)$ in 900-999 g; $20{\pm}3d$ in 800-899 g; $35{\pm}4d$ in 700-799 g; $37{\pm}9d$ in 600-699 g; $49{\pm}12d$ in ${\leq}599g$. 25 out of 113 infants(22%) failed the first extubation. Preterm premature rupture of membrane was associated with extubation success, and air leak was associated with extubation failure, with a borderline significance. Postnatal and corrected age and body weight at the first extubation, nutritional status, and ventilator settings were not associated with extubation success or failure. Extubation success day was significantly delayed, and the incidence of late-onset sepsis and mortality was significant higher in the failure of the first extubation. Conclusion : We could not find significant predictors for success/failure at the first extubation. The failure of the first extubation had an increased risk of late-onset sepsis and death. Further studies are needed to find the predictors for extubation success/failure.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1309-1315
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• 2000

Objectives : We performed an in vivo experiment to investigate the effect of $^{166}Holmium$ and $^{166}Holmium$-chitosan complex($^{166}Ho$-CHICO) on the normal brain of rats and to determine the sublethal dose of $^{166}Ho$-CHICO. Materials and Methods : $^{166}Ho$ is a beta and gamma ray emitter. $^{166}Ho$-CHICO is a novel radio-pharmaceutical complex with chitosan to facilitate the transport of $^{166}Ho$ obtained from Korea Atomic Energy Research Center(Taejon, Korea). It is in acidic form and becomes gel state at alkaline pH. One hundred and seventy consecutive rats were divided into four groups : $^{166}Ho$ treated(n＝50), $^{166}Ho$-CHICO treated(n＝57), saline treated(n＝5) and chitosan treated(n＝5) groups. $^{166}Ho$ and $^{166}Ho$-CHICO were injected into the rat brain stereotactically with various doses of 0.1mCi/$20{\mu}l$, 0.2mCi/$20{\mu}l$, 0.3mCi/$20{\mu}l$, and 0.4mCi/$20{\mu}l$ using an automated microinjector. Nuclear imaging, histopathological and hematological studies were performed in 10 rats in each group at 1 day, 3days, 7 days, 1 month and 3 months after the injections. Results : An infiltration of inflammatory cells and necrotic changes were noted in $^{166}Ho$ treated group at 1 week after the injection. A wedge-shaped tissue defect due to necrosis, lined with infiltrated glial cells in $^{166}Ho$ treated group and a cystic defect lined with reactive astroglial cells in $^{166}Holmium$-CHICO treated group at 3 months after the injection were observed. $^{166}Ho$ alone without chitosan leaked out and caused necrotic lesion on the cerebral surface but $^{166}Holmium$-CHICO treated group did not show this feature. As the dose of $^{166}Ho$ increased, the mortality rates were also increased. The mortality rate of the $^{166}Holmium$-CHICO group was higher than the $^{166}Ho$ treated group at a dose of 0.4mCi/$20{\mu}l$/300g. There was no detectable radioactivity due to the leakage or extravasation from the injected site of the brain on the scintigraphy performed at 1 hour, 24 hours and 48 hours after the injection. There was also no detectable activity of $^{166}Holmium$-CHICO in other organs including spleen, liver and kidney. Conclusions : $^{166}Ho$-CHICO did not leak out to the critical cortical surface of the brain from the injection site and induced radiation changes of the parenchyma around the injection site without cortical damage. The sublethal dose of $^{166}Ho$-CHICO for the normal brain in rats was determined to be 0.2mCi/$20{\mu}l$/300g.

• Journal of Nutrition and Health
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• v.41 no.5
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• pp.381-390
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• 2008

Present study was conducted to investigate the effects of exercise and cholesterol diet on plasma and liver lipids, platelet aggregation, erythrocyte Na efflux and liver index such as GOT and GPT using Sprague Dawley rats. Forty rats were divided into four groups and fed control or 0.5% cholesterol diet with and without treadmill for six weeks. The final body weight of group fed cholesterol diet with exercise was somewhat decreased compared with group fed cholesterol diet without exercise. L.W/B.W ratio was significantly increased in groups fed cholesterol diet (p < 0.01), but exercise tended to decrease this ratio. Plasma total cholesterol was significantly increased and HDL-cholesterol was decreased in groups fed cholesterol diet (p < 0.01). Plasma triglyceride was significantly decreased in groups fed cholesterol diet compared with groups fed control diet (p < 0.01). Plasma triglyceride of groups with exercise was significantly decreased compared with their non exercising counterparts regardless diet (p < 0.05). Liver total cholesterol and triglyceride was significantly increased in groups fed cholesterol diet (p < 0.01), but exercise did not affect on these levels. Na-K ATPase was somewhat decreased in groups fed cholesterol diet, and exercise tended to recover the reduced Na-K ATPase. Na passive transport was significantly decreased in group fed control diet without exercise and significantly increased in group fed cholesterol diet with exercise, there were significant differences between groups (p < 0.05). There were no differences in total Na efflux and intracellular Na among groups, and total Na efflux was not correlated with intracellular Na. Hematocrit was significantly lower (p < 0.05) in group fed cholesterol diet without exercise compared with other groups. Platelet aggregation in the initial slope and the maximum was increased in groups fed cholesterol diet, but not statistically significant. Exercise especially increased the initial slope of aggregation. Plasma GOT and GPT was significantly increased in groups fed cholesterol diet (p < 0.01), and exercise in group fed cholesterol diet significantly decreased both GOT and GPT compared with the non exercising counterpart (p < 0.01). This study showed that cholesterol diet increases plasma and liver lipids and GOT and GPT, and exercise improves plasma and liver lipid profile and liver index of GOT and GPT preventing fatty liver.

• Journal of Korean Society of Environmental Engineers
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• v.31 no.11
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• pp.997-1006
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• 2009

Organic removal efficiency and methane production rate, a feasibility of power generation from biogas, and the optimum conditions for membrane operation were evaluated for the pilot scale (5 tons/day) two-phase anaerobic digestion coupled with ultra filtration (TPADUF) system fed with garbage leachate. The TPADUF system is consisted of a thermophilic acidogenic reactor, a mesophilic methanogenic reactor, and an UF membrane. When garbage leachate with 150 g/L of TCOD was fed to the TPADUF up to organic loading rate (OLR) of 11.1 g COD/L/d, the effluent TCOD was lower than 6 g/L and the average removal efficiencies of TCOD and SCOD were higher than 95%. The methane composition of the gas was 65%, and the methane yield was 39 $m^3/m^3$ garbage leachatefed, 260 $m^3$/tons $COD_{added}$, or 270 $m^3$/tons $COD_{removed}$, even there was some gas leak. The power production per consumed gas was 0.96 kWh/$m^3$ gas or 1.49 kWh/$m^3$ methane. This lower power production efficiency mainly due to the small capacity of gas engine (15 kW class). The membrane was operated at the average flux of 10 L/$m^2$/hr. When the flux decreased, washing with water and chemical (NaOCl) was conducted to restore the flux. In the TPADUF system, optimum pH could be maintained without alkali addition by recycling the membrane concentrate or mixed liquor of the methanogenic digester to the acidogenic reactor. Also, partial production of methane in the acidogenic reactor had a positive effect on lowering the OLR of the methanogenic reactor.