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A Qualitative Study for the Psychological Characteristics Affecting Never married Choice (비혼 선택에 영향을 미치는 심리적 특성 탐색을 위한 질적 연구)

  • Jeongha Lee;Jeongyoon Park;Nana Yoon
    • Korean Journal of Culture and Social Issue
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    • v.23 no.2
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    • pp.183-214
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    • 2017
  • The purpose of this study was to examine the psychological characteristics of affecting never married men and women through analyzing the content of in-depth interviews about the idea of marriage and the reason for never married choice. For achieving this purpose, the in-depth interview was conducted with 9 men and women aged mid-20s to late 30s who said to choose never married life for a long time, and then the content of interview was analyzed using consensual qualitative research. As a result of analyzing the content of in-depth interview, it was derived into 2 areas, 10 sub-areas, and 25 categories. The results of the study were as follows. Firstly, it was found that research participants negatively recognized the marriage and had unrealistic expectation rather than no expectation for marriage. Secondly, most of the research participants felt negative feelings about their parents' patriarchal role, and they did not want to live like their parents. They also reported that they did not see their marriage separated from their parents. Thirdly, most of the research participants felt difficulty in forming relationships with intimate person, and it became more difficult to have expectations about spouses and marriage due to repeated relationship conflict patterns. Fourthly, the research participants showed psychological aspect of experiential avoidance and seeking for individuality in terms of never married choice. Most of the research participants predicted the failure of married life, and reported that they were trying to prevent uncomfortable feelings and sufferings by choosing never married life. Also they reported that individuality considered more important than connection with others(togetherness) and individual value considered more important than collective value. Participants in this study showed negative evaluation or had negative influences on the marriage life of parents and acquaintances. This is more likely to be a passive factor in never married choice, so future research should examine the characteristics of active factors in never married choice.

The Exploration of New Business Areas in the Age of Economic Transformation : a Case of Korean 'Hidden Champions' (Small and Medium Niche Enterprises (경제구조 전환기에서 새로운 비즈니스 영역의 창출 : 강소기업의 성공함정과 신시장 개척)

  • Lee, Jangwoo
    • Korean small business review
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    • v.31 no.1
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    • pp.73-88
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    • 2009
  • This study examines the characteristics of 24 Korean hidden champions such as key success factors, core competences, strategic problems, and desirable future directions. The study categorized them into 8 types with Danny Miller's four trajectories and top manager's decision making style(rationality and passion). Danny Miller argued in his book, Icarus paradox, that outstanding firms will extend their orientations until they reach dangerous extremes and their momentum will result in common trajectories of decline. He suggested four very common success types: Craftsmen, Builders, Pioneers, Salesmen. He also suggested common trajectories of decline:Focusing(from Craftsmen to Tinkers), Venturing(from Builders to Imperialists), Inventing(from Pioneers to Escapists), Decoupling(from Salesmen to Drifts). In Korea, successful startups appear to possess three kinds of drive: Technology-drive, Vision-drive, Market-drive. Successful technology-driven firms tend to grow as craftsmen or pioneers. Successful vision-driven and market-driven ones tend to grow as builders and salesmen respectively. Korean top managers or founders seem to have two kinds of decision making style: Passion-based and Rationality-bases. Passion-based(passionate) entrepreneurs are biased towards action or proactiveness in competing and getting things done. Rationality- based ones tend to emphasis the effort devoted to scanning and analysing information to better understand a company's threats, opportunities and options. Consequently this study suggested 4*2 types of Korean hidden champions: (1) passionate craftsmen, (2) rational craftsmen, (3) passionate builders, (4) rational builders, (5) passionate pioneers, (6) rational pioneers, (7) passionate salesmen, (8) rational salesmen. These 8 type firms showed different success stories and appeared to possess different trajectories of decline. These hidden champions have acquired competitive advantage within domestic or globally niche markets in spite of the weak market power and lack of internal resources. They have maintained their sustainable competitiveness by utilizing three types of growth strategy; (1) penetrating into the global market, (2) exploring new service market, (3) occupying the domestic market. According to the types of growth strategy, these firms showed different financial outcomes and possessed different issues for maintaining their competitiveness. This study found that Korean hidden champions were facing serious challenges from the transforming economic structure these days and possessed the decline potential from their success momentum or self-complacence. It argues that they need to take a new growth engine not to decline in the turbulent environment. It also discusses how firms overcome the economic crisis and find a new business area in promising industries for the future. It summarized the recent policy of Korean government called as "Green Growth" and discussed how small firms utilize such benefits and supports from the government. Other implications for firm strategies and governmental policies were discussed.

A Study on Way to Revitalize the Service Delivery System in the Hinterland Villages in Non-Urbanized Area (비도시지역 배후마을 서비스전달체계 활성화방안 연구)

  • Haechun Jung;Heeseung Yang
    • Journal of Environmental Impact Assessment
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    • v.32 no.6
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    • pp.533-544
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    • 2023
  • The Ministry of Agriculture, Food and Rural Affairs has been promoting policies to strengthen the functions of rural centers (culture, welfare, economy, education, etc.) and to ensure that services from the centers are delivered to and connected to hinterland villages. For this policy purpose, the rural center revitalization project and the basic living base creation project within the rural development projects are being promoted. However, in the process of carrying out the actual project, as the focus is on strengthening the functions of rural centers, service delivery and connection with hinterland villages are not being actively promoted. therefore, in this study, we analyze the projects previously carried out in Jeoksang-myeon, Muju-gun and the regional status, analyze the reasons why hinterland village services were not connected and activated, and propose a direction for the second phase of the basic living base creation project to be carried out in the future. As a result of analyzing the reasons for the failure of hinterland village services to be activated, problems such as disadvantages in accessing services due to dispersed residence in rural areas and limitations in topographical structure, and the lack of a service delivery system to develop demand in hinterland areas were found to be problems. Improvement measures were derived as follows. First, it is a stepping stone construction plan proposed to overcome topographical limitations. Establish a stepping base that will function as a service intermediate terminal to ensure efficient service delivery. Second, for a rational decision-making structure, we proposed a plan for deploying communication channels that could closely collect local opinions by operating various small-scale communities along with the efficient composition of a resident committee that includes residents of the central and hinterland villages and various classes. Third, it is a virtuous cycle of local manpower training plans that train local residents into professional instructors. We aim to complete a sustainable, resident-led service supply system by nurturing the most important service deliverers, that is, activists, in service delivery.

A Study on the Effects of Entrepreneurial Marketing Orientation on the Management Performance: Mediated Effect of Organizational Marketing Capabilities (창업자의 앙트레프레니얼 마케팅 지향성이 경영성과에 미치는 영향: 조직내 마케팅역량의 매개효과)

  • Byun, Hong Joo;Byun, Chung Gyu;Ha, Hwan Ho
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.4
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    • pp.87-100
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    • 2022
  • Early start-up companies have an inherent limitation of lack of resources. Despite these limitations, in order to survive, the entrepreneur's personal ability to efficiently use limited resources is required. In the marketing field, various studies are needed to reduce the business failure rate through establishing growth strategies and innovation. Accordingly, it is necessary to apply the concept of entrepreneurial marketing, which has been researched and developed overseas for 30 years, to fit the domestic reality. According to the flow of this study, an empirical study should be preceded to clarify the influence relationship between entrepreneurial marketing orientation, marketing competency, and management performance, along with a theoretical theorem on entrepreneurial marketing that is suitable for early start-ups and small and medium-sized enterprises(SMEs) and can respond innovatively to changes. The establishment of entrepreneurial marketing orientation and the processes from which this concept leads to business performance through the organization's marketing capabilities and its effects will be empirically verified. For an empirical survey, a survey was conducted on founders of 220 companies, and path analysis using structural equations was used for hypothesis verification. The findings are as follows. First, it was found that the entrepreneurial marketing orientation had a positive effect on both the organization's marketing capabilities and management performance. Second, it was found that the organization's marketing capabilities also had a positive effect on management performance. Third, as a result of empirical analysis of the mediating effect of the organization's marketing capabilities on the relationship between entrepreneurial marketing orientation and management performance, it was found that marketing capabilities showed a greater mediating effect on non-financial performance than financial performance. On the other hand, it was confirmed that marketing performance had a stronger mediating effect on financial performance than non-financial performance. By confirming and presenting the concept and constituent factors of entrepreneurial marketing orientation of domestic start-ups, which were academic gaps for the purpose of this paper, the academic research is differentiated in that they were verified as six components of entrepreneurial marketing. The practical implications of the research results will be that the entrepreneurial marketing-oriented mindset of small and medium-sized companies will optimize market analysis capabilities, network with various stakeholders, and increase the organization's ability to demonstrate marketing capabilities.

The Effects of Technological Competitiveness by Country on The Increase of Unicorn Companies (국가별 기술경쟁력이 유니콘기업 증가에 미치는 영향에 관한 연구)

  • Kyu Hoon Cho;Dong Woo Yang
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.55-73
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    • 2024
  • Unicorn companies are attracting attention around the world as they are recognized for their high corporate value in a short period of time as an innovative business models. Their growth process presents good lessons for the startup ecosystem and have a positive impact on national economic development and job creation. However, previous studies related to unicorn companies are focused on 'event studies' and 'case studies' such as characteristics of founders, environmental factors, business models and success/failure cases of companies already recognized as unicorns rather than a multifaceted approach. The occurrence of unicorn companies and Macroscopic analysis of related factors is lacking. Against this background, this study are considering the characteristics of unicorns examined through previous research and the current status unicorns with a high proportion of technology companies, the purpose was to analyze the impact of the country's technological competitiveness, such as 'technology human resource index', 'R&D index', and 'technology infrastructure index', on the increase in unicorn companies. For statistical analysis, data published by various international organizations, the Bank of Korea, and Statistics Korea from 2017 to 2020 and unicorn company data compiled by CB Insights were used as panel data for 44 countries to be tested by multiple regression analysis. As a result of the study, it was confirmed that the number of science majors had a positive (+) effect on the increase of unicorn companies in the case of technology human resource index, and in the case of R&D index, the total amount of R&D investment had a positive (+) effect on the increase of unicorn companies, while the number of Triad Patents Families and the number of scientific and technological papers published had a negative (-) effect on the increase of unicorn companies. Finally, in the case of technology infrastructure index, it was confirmed that the number of the world's 500th-ranked universities had a positive (+) effect on the increase of unicorn companies. This study is the first to reveal the causal relationship between national technological competitiveness and unicorn company growth based on country-specific and time-series empirical data, which were insufficiently covered in previous studies. and compared to the UN's ranking of the global industrial competitiveness index and the OECD's total R&D investment by country, Korea is considered to have technological and growth potential, while the number of unicorn companies driving growth as leaders of the innovative economy is relatively small, so the research results can be used when establishing policies to discover and foster unicorn companies in the future.

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An Empirical Study on the Influencing Factors for Big Data Intented Adoption: Focusing on the Strategic Value Recognition and TOE Framework (빅데이터 도입의도에 미치는 영향요인에 관한 연구: 전략적 가치인식과 TOE(Technology Organizational Environment) Framework을 중심으로)

  • Ka, Hoi-Kwang;Kim, Jin-soo
    • Asia pacific journal of information systems
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    • v.24 no.4
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    • pp.443-472
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    • 2014
  • To survive in the global competitive environment, enterprise should be able to solve various problems and find the optimal solution effectively. The big-data is being perceived as a tool for solving enterprise problems effectively and improve competitiveness with its' various problem solving and advanced predictive capabilities. Due to its remarkable performance, the implementation of big data systems has been increased through many enterprises around the world. Currently the big-data is called the 'crude oil' of the 21st century and is expected to provide competitive superiority. The reason why the big data is in the limelight is because while the conventional IT technology has been falling behind much in its possibility level, the big data has gone beyond the technological possibility and has the advantage of being utilized to create new values such as business optimization and new business creation through analysis of big data. Since the big data has been introduced too hastily without considering the strategic value deduction and achievement obtained through the big data, however, there are difficulties in the strategic value deduction and data utilization that can be gained through big data. According to the survey result of 1,800 IT professionals from 18 countries world wide, the percentage of the corporation where the big data is being utilized well was only 28%, and many of them responded that they are having difficulties in strategic value deduction and operation through big data. The strategic value should be deducted and environment phases like corporate internal and external related regulations and systems should be considered in order to introduce big data, but these factors were not well being reflected. The cause of the failure turned out to be that the big data was introduced by way of the IT trend and surrounding environment, but it was introduced hastily in the situation where the introduction condition was not well arranged. The strategic value which can be obtained through big data should be clearly comprehended and systematic environment analysis is very important about applicability in order to introduce successful big data, but since the corporations are considering only partial achievements and technological phases that can be obtained through big data, the successful introduction is not being made. Previous study shows that most of big data researches are focused on big data concept, cases, and practical suggestions without empirical study. The purpose of this study is provide the theoretically and practically useful implementation framework and strategies of big data systems with conducting comprehensive literature review, finding influencing factors for successful big data systems implementation, and analysing empirical models. To do this, the elements which can affect the introduction intention of big data were deducted by reviewing the information system's successful factors, strategic value perception factors, considering factors for the information system introduction environment and big data related literature in order to comprehend the effect factors when the corporations introduce big data and structured questionnaire was developed. After that, the questionnaire and the statistical analysis were performed with the people in charge of the big data inside the corporations as objects. According to the statistical analysis, it was shown that the strategic value perception factor and the inside-industry environmental factors affected positively the introduction intention of big data. The theoretical, practical and political implications deducted from the study result is as follows. The frist theoretical implication is that this study has proposed theoretically effect factors which affect the introduction intention of big data by reviewing the strategic value perception and environmental factors and big data related precedent studies and proposed the variables and measurement items which were analyzed empirically and verified. This study has meaning in that it has measured the influence of each variable on the introduction intention by verifying the relationship between the independent variables and the dependent variables through structural equation model. Second, this study has defined the independent variable(strategic value perception, environment), dependent variable(introduction intention) and regulatory variable(type of business and corporate size) about big data introduction intention and has arranged theoretical base in studying big data related field empirically afterwards by developing measurement items which has obtained credibility and validity. Third, by verifying the strategic value perception factors and the significance about environmental factors proposed in the conventional precedent studies, this study will be able to give aid to the afterwards empirical study about effect factors on big data introduction. The operational implications are as follows. First, this study has arranged the empirical study base about big data field by investigating the cause and effect relationship about the influence of the strategic value perception factor and environmental factor on the introduction intention and proposing the measurement items which has obtained the justice, credibility and validity etc. Second, this study has proposed the study result that the strategic value perception factor affects positively the big data introduction intention and it has meaning in that the importance of the strategic value perception has been presented. Third, the study has proposed that the corporation which introduces big data should consider the big data introduction through precise analysis about industry's internal environment. Fourth, this study has proposed the point that the size and type of business of the corresponding corporation should be considered in introducing the big data by presenting the difference of the effect factors of big data introduction depending on the size and type of business of the corporation. The political implications are as follows. First, variety of utilization of big data is needed. The strategic value that big data has can be accessed in various ways in the product, service field, productivity field, decision making field etc and can be utilized in all the business fields based on that, but the parts that main domestic corporations are considering are limited to some parts of the products and service fields. Accordingly, in introducing big data, reviewing the phase about utilization in detail and design the big data system in a form which can maximize the utilization rate will be necessary. Second, the study is proposing the burden of the cost of the system introduction, difficulty in utilization in the system and lack of credibility in the supply corporations etc in the big data introduction phase by corporations. Since the world IT corporations are predominating the big data market, the big data introduction of domestic corporations can not but to be dependent on the foreign corporations. When considering that fact, that our country does not have global IT corporations even though it is world powerful IT country, the big data can be thought to be the chance to rear world level corporations. Accordingly, the government shall need to rear star corporations through active political support. Third, the corporations' internal and external professional manpower for the big data introduction and operation lacks. Big data is a system where how valuable data can be deducted utilizing data is more important than the system construction itself. For this, talent who are equipped with academic knowledge and experience in various fields like IT, statistics, strategy and management etc and manpower training should be implemented through systematic education for these talents. This study has arranged theoretical base for empirical studies about big data related fields by comprehending the main variables which affect the big data introduction intention and verifying them and is expected to be able to propose useful guidelines for the corporations and policy developers who are considering big data implementationby analyzing empirically that theoretical base.

The Role of Tumor Necrosis Factor-$\alpha$ and Interleukin-$1{\beta}$ as Predictable Markers for Development of Adult Respiratory Distress Syndrome in Septic Syndrome (패혈증 증후군환자에서 성인성 호흡곤란 증후군 발생의 예측 지표서의 혈중 Tumor Necrosis Factor-$\alpha$와 Interleukin-$1{\beta}$에 관한 연구)

  • Koh, Youn-Suck;Jang, Yun-Hae;Kim, Woo-Sung;Lee, Jae-Dam;Oh, Soon-Hwan;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.452-461
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    • 1994
  • Background: Tumor necrosis factor(TNF)-$\alpha$ and Interleukin(lL)-$1{\beta}$ are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-$\alpha$ in the pathogenesis of ARDS, including human studies, it has been reported that TNF-$\alpha$ is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-$\alpha$ and IL-$1{\beta}$ as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. Methods: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood samples were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-$\alpha$ and IL-$1{\beta}$ was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. Results: 1) Plama TNF-$\alpha$ levels: Plasma TNF-$\beta$ levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the $mean{\pm}2SD$, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-$\alpha$ levels from patients with ARDS were 10.26pg/mL(median; <10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-$\alpha$ levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (p<0.01). There was no statistical significance between survivors(<10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-$\alpha$ levels. 2) Plasma IL-$1{\beta}$ levels: Plasma IL-$1{\beta}$ levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-$1{\beta}$ levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ngfmL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-$1{\beta}$ levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). Conclusion: Plasma TNF-$\alpha$ and IL-$1{\beta}$ level are not a predictable marker for development of ARDS. But TNF-$\alpha$ is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-$\alpha$ and IL-$1{\beta}$ in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.

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A Study on the Stress Distribution of Tooth/Implant Connected with Konus Telescope Denture Using 3-Dimensional Finite Element Method (이중관으로 연결된 자연치와 임플랜트의 악골 내응력분포에 관한 3차원 유한요소분석)

  • Lee, Su-Ok;Choi, Dae-Gyun;Kwon, Kung-Rock;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.4
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    • pp.381-395
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    • 2008
  • Purpoose: For decades dental implants have been used widely in the field of prosthetic dentistry. However there is confusion when establishing treatment plans in cases where some teeth are remained but an insufficient number of implants can be used due to limited anatomical status and ecomomical problems. Many clinicians have tried to connect natural teeth and implants, and it still has controversy. But, there have been few studies on mechanical analysis of connecting natural teeth and implants with konus telescopic removable partial dentures. The purpose of this study was to analyze the stress distribution of prosthesis, abutment and alveolar bone when teeth and implants were connected with the konus telescopic denture, by means of 3-dimensional finite element analysis. Material and methods: The assumption of this study was that there were 2 mandibular canine (11 mm in length, 4 mm in diameter) and 2 implants(10 mm in length, 4 mm in diameter) which are located in the second premolar region. The mandible, teeth, implants, abutments, and connectors are modeled, and analyzed with the commercial software, ANSYS Version 8.1(Swanson, Inc., USA). The control group used implants instead of natural teeth. 21038 elements, 23544 nodes were used in experimental group and 107595 elements, 21963 nodes were used in control group, Stress distribution was evaluated under 150 N vertical load on 3 experimental conditions - between teeth and implants (Load case 1), posterior to implants (Load case 2), between natural teeth (Load case 3). Results: 1. In all load cases, higher von mises stress value was observed in the experimental group. 2. Maximum von miss stress observed in all load cases and all locations were as follows ; a. 929.44 Mpa in the experimental group, 640.044 Mpa in the control group in outer crown and connector - The experimental group showed 1.45 times high value compared with the control group. b. 145,051 Mpa in the experimental group, 142.338 Mpa in the control group in abutment - The experimental group showed 1.02times high value compared with the control group. c. 32.489 Mpa in the experimental group, 25.765 Mpa in the control group in alveolar bone - The experimental group showed 1.26times higher value compared with the control group. 3. All maximum von mises stress was observed in load case 2, and maxim von mises stress in alveolar bone was 32.489 Mpa at which implant failure cannot occur. 4. If maximum von mises stress is compared between two groups, the value of the experimental group is 1.02 times higher than the control group in abutment, 1.26 times higher than the control group in alveolar bone. Conclusion: If natural teeth and implants are connected with the konus telescopic denture, maximum stress will be similar in abutment, 1.26 times higher in alveolar bone than the control group. With this result, there may be possible to make to avoid konus telescopic dentures where natural teeth and implants exist together.

Initial Experience of the Emergency Bypass System ($EBS^{(R)}$) for the Patients with Cardiogenic Shock due to an Acute Myocardial Infarction (급성 심근경색으로 인한 심인성 쇼크 환자에 대한 경피적 순환 보조장치($EBS^{(R)}$) 적용의 초기경험)

  • Ryu, Kyoung-Min;Kim, Sam-Hyun;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon;Kim, Young-Hwa;Park, Seong-Sik
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.329-334
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    • 2008
  • Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

Application of a Single-pulsatile Extracorporeal Life Support System for Extracorporeal Membrane Oxygenation -An experimental study - (단일 박동형 생명구조장치의 인공폐 적용 -실험연구-)

  • Kim, Tae-Sik;Sun, Kyung;Lee, Kyu-Baek;Park, Sung-Young;Hwang, Jae-Joon;Son, Ho-Sung;Kim, Kwang-Taik;Kim. Hyoung-Mook
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.201-209
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    • 2004
  • Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.