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Surgical Treatment of Left Main Coronary Artery Diseases (좌주관동맥협착의 외과적 치료)

  • 안병희;장원채
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1323-1328
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    • 1996
  • The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.

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Acute Renal Failure after On-pump Coronary Artery Bypass Surgery (체외순환하 시행한 관상동맥우회술 후 발생한 급성신부전증)

  • Jin, Ung;Jo, Min-Seop;Park, Chan-Beom;Sa, Young-Jo;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.416-422
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    • 2004
  • Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

Dynamics of Technology Adoption in Markets Exhibiting Network Effects

  • Hur, Won-Chang
    • Asia pacific journal of information systems
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    • v.20 no.1
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    • pp.127-140
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    • 2010
  • The benefit that a consumer derives from the use of a good often depends on the number of other consumers purchasing the same goods or other compatible items. This property, which is known as network externality, is significant in many IT related industries. Over the past few decades, network externalities have been recognized in the context of physical networks such as the telephone and railroad industries. Today, as many products are provided as a form of system that consists of compatible components, the appreciation of network externality is becoming increasingly important. Network externalities have been extensively studied among economists who have been seeking to explain new phenomena resulting from rapid advancements in ICT (Information and Communication Technology). As a result of these efforts, a new body of theories for 'New Economy' has been proposed. The theoretical bottom-line argument of such theories is that technologies subject to network effects exhibit multiple equilibriums and will finally lock into a monopoly with one standard cornering the entire market. They emphasize that such "tippiness" is a typical characteristic in such networked markets, describing that multiple incompatible technologies rarely coexist and that the switch to a single, leading standard occurs suddenly. Moreover, it is argued that this standardization process is path dependent, and the ultimate outcome is unpredictable. With incomplete information about other actors' preferences, there can be excess inertia, as consumers only moderately favor the change, and hence are themselves insufficiently motivated to start the bandwagon rolling, but would get on it once it did start to roll. This startup problem can prevent the adoption of any standard at all, even if it is preferred by everyone. Conversely, excess momentum is another possible outcome, for example, if a sponsoring firm uses low prices during early periods of diffusion. The aim of this paper is to analyze the dynamics of the adoption process in markets exhibiting network effects by focusing on two factors; switching and agent heterogeneity. Switching is an important factor that should be considered in analyzing the adoption process. An agent's switching invokes switching by other adopters, which brings about a positive feedback process that can significantly complicate the adoption process. Agent heterogeneity also plays a important role in shaping the early development of the adoption process, which has a significant impact on the later development of the process. The effects of these two factors are analyzed by developing an agent-based simulation model. ABM is a computer-based simulation methodology that can offer many advantages over traditional analytical approaches. The model is designed such that agents have diverse preferences regarding technology and are allowed to switch their previous choice. The simulation results showed that the adoption processes in a market exhibiting networks effects are significantly affected by the distribution of agents and the occurrence of switching. In particular, it is found that both weak heterogeneity and strong network effects cause agents to start to switch early and this plays a role of expediting the emergence of 'lock-in.' When network effects are strong, agents are easily affected by changes in early market shares. This causes agents to switch earlier and in turn speeds up the market's tipping. The same effect is found in the case of highly homogeneous agents. When agents are highly homogeneous, the market starts to tip toward one technology rapidly, and its choice is not always consistent with the populations' initial inclination. Increased volatility and faster lock-in increase the possibility that the market will reach an unexpected outcome. The primary contribution of this study is the elucidation of the role of parameters characterizing the market in the development of the lock-in process, and identification of conditions where such unexpected outcomes happen.

Study on Improvement of Family Assistance System for Victim's Family of Air Traffic Accident (항공사고 피해자 가족지원 제도개선 연구)

  • Jeon, Jong-Jin;Kim, Hui-yang;Yoo, Kwang-Eui
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.315-343
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    • 2018
  • In the event of an air accident, the media and members of the general public pay attention to the victim of the accident and are deeply concerned about their actions and rewards. However, through the accident of Air China(CCA) Flight 129, which occurred in 2002, we were able to confirm that it is a real problem that the victims of the air accident as well as the victims suffer much suffering and serious aftermath. Nevertheless, Korea's system for assistance the families of victims of air accident is very poor. On the other hand, when Trans-World Airlines(TWA) Flight 800 exploded and crashed over the Atlantic Ocean in 1996, the United States enacted a law to assistance the families of the victims of the accident. According to this law, systematic assistance and management of not only the victims of the accident but also their families, minimize the additional damage of victims and victims' families and help them to get rid of the accident after the accident. In particular, the measures taken by the US authorities in response to an accident in which an Asiana Airlines flight(AAR) 214 crashed during a landing at San Francisco International Airport in 2013, made a lot of suggestions for us to assistance the victims and their families in an air accident. The purpose of this paper is to suggest the necessity of improving the system for victims and victim's family assistance in air accident. In this paper, we analyze the domestic and foreign legal systems and related cases in past accidents, identify the deficiencies of the Korean system, and derive the necessity to improve the related system. It is also important to make sure that victims' families are relieved from early psychological and economic shocks and that the results of accident investigations are reliable. Relevant ministries, airlines, and related agencies should recognize that prompt and systematic assistance and cooperation is needed to ensure that victims and families are relieved of the impact and confidence in the investigation, as is the case in the United States. In addition, efforts should be made to supplement the related laws for the assistance of aircraft victims and victims' families, to establish manuals for implementation, to plan and to implement them promptly in the event of an accident. To achieve this, it is necessary to establish regulations for the legal institutionalization of the roles and responsibilities of national and state agencies on victims of aviation accidents and family assistance. And the victim and family assistance plan that the airline has to submit to it, as specified in the current law, need to specify that item. In addition, new and supplemented contents should be integrated into a single clause or proposed as a separate special law for the purpose of applying a clear law.

Analysis of Ice Velocity Variations of Nansen Ice Shelf, East Antarctica, from 2000 to 2017 Using Landsat Multispectral Image Matching (Landsat 다중분광 영상정합을 이용한 동남극 난센 빙붕의 2000-2017년 흐름속도 변화 분석)

  • Han, Hyangsun;Lee, Choon-Ki
    • Korean Journal of Remote Sensing
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    • v.34 no.6_2
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    • pp.1165-1178
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    • 2018
  • Collapse of an Antarctic ice shelf and its flow velocity changes has the potential to reduce the restraining stress to the seaward flow of the Antarctic Ice Sheet, which can cause sea level rising. In this study, variations in ice velocity from 2000 to 2017 for the Nansen Ice Shelf in East Antarctica that experienced a large-scale collapse in April 2016 were analyzed using Landsat-7 Enhanced Thematic Mapper Plus (ETM+) and Landsat-8 Operational Land Imager (OLI) images. To extract ice velocity, image matching based on orientation correlation was applied to the image pairs of blue, green, red, near-infrared, panchromatic, and the first principal component image of the Landsat multispectral data, from which the results were combined. The Landsat multispectral image matching produced reliable ice velocities for at least 14% wider area on the Nansen Ice Shelf than for the case of using single band (i.e., panchromatic) image matching. The ice velocities derived from the Landsat multispectral image matching have the error of $2.1m\;a^{-1}$ compared to the in situ Global Positioning System (GPS) observation data. The region adjacent to the Drygalski Ice Tongue showed the fastest increase in ice velocity between 2000 and 2017. The ice velocity along the central flow line of the Nansen Ice Shelf was stable before 2010 (${\sim}228m\;a^{-1}$). In 2011-2012, when a rift began to develop near the ice front, the ice flow was accelerated (${\sim}255m\;a^{-1}$) but the velocity was only about 11% faster than 2010. Since 2014, the massive rift had been fully developed, and the ice velocity of the upper region of the rift slightly decreased (${\sim}225m\;a^{-1}$) and stabilized. This means that the development of the rift and the resulting collapse of the ice front had little effect on the ice velocity of the Nansen Ice Shelf.

A Study on Seeking a Multilateral Cooperation Framework for the Inter-Korean Exchange of Intangible Cultural Heritage - Through a Multinational Nomination of a Representative List of Intangible Cultural Heritage of Humanity - (남북 무형유산 교류 협력의 다자간 협력 틀 모색 - 유네스코 인류무형문화유산 남북 공동 등재 사례 -)

  • Kim, Deoksoon
    • Korean Journal of Heritage: History & Science
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    • v.52 no.3
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    • pp.252-269
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    • 2019
  • Since the inauguration of the Kim Jong-un regime in 2012, the safeguarding and management system of cultural heritage in the Democratic People's Republic of Korea (DPRK) has been changing to a form similar to that of a democratic country's legal system. In addition, the National Authority for the Protection of Cultural Heritage (NAPCH) has continuously recorded and cataloged intangible cultural heritage elements in the DPRK, listing Arirang, kimchi-making, and ssireum on the UNESCO Intangible Cultural Heritage Representative List. In particular, the multinational nomination of ssireum in October 2018 is symbolic in terms of inter-Korean exchanges and cooperation for peace and reconciliation, raising expectations for the further multinational nomination of the two Koreas' intangible cultural heritage. Currently, South Korea lists 20 items on its Representative List of the Intangible Cultural Heritage of Humanity, three of which are shared by various countries with multinational nominations such as falconry, tug-of-war, and ssireum. However, when comparing the process of applying for multinational nomination in the three elements that follow, it is necessary to discuss whether these cases reflect the nature of multinational nomination. In particular, in the case of ssireum, without a working-level consultation between the two Koreas to prepare an application for a multinational nomination, each applied for a single registration; these applications were approved exceptionally as a multinational nomination by the Intergovernmental Committee under the leadership of the Secretary-General of UNESCO, and no bilateral exchanges have taken place until now. This is symbolic, formal, and substantially similar to the individual listings in terms of the spirit of co-listing on the premise of mutual exchange and cooperation. Therefore, the only way to strengthen the effectiveness of the multinational nomination between the two Koreas and to guarantee the spirit of multinational nomination is to request multilateral co-registration, including the two Koreas. For this, the Korean government needs a strategic approach, such as finding elements for multilateral co-listing; accumulating expertise, capabilities, and experience as a leading country in multilateral co-listing; and building cooperative governance with stakeholders. Besides, to reduce the volatility of inter-Korean cultural exchanges and cooperation depending on political situations and the special nature of inter-Korean relations, measures should be taken toward achieving inter-Korean cultural heritage exchanges and cooperation under a multilateral cooperation system using UNESCO, an international organization.

A comparative analysis of Leadership Competency Education System in Korea, US and UK (한국·미국·영국의 유아교육기관 원장 리더십역량 교육체계 비교분석)

  • Park, Soo-Jin;Kim, Mi-Kyung
    • Korean Journal of Comparative Education
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    • v.27 no.4
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    • pp.255-283
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    • 2017
  • The purpose of this study is to analyze the comtent of the education system of US and the UK in order to build an integrated system that can develop the leadership competency of preschool principle. Based on this, the implications are as follows. First, competencies can developed through learning rather than fixed. Therefore, re-conceptualization of leadership competence appropriate to the characteristics and organization of the individual as the presiding authority of the preschool can be considered as ability to show visible knowledge and skills, invisible self concept. Therefore, it is necessary to establish a capacity development plan based on this. Second, the introduction and implementation of continuous and systematic training programs such as the training system that strengthens the capacity of the directors and principals of the United States and the United Kingdom is necessary. To do this, we must introduce a system that renews certification every five years, like the United States, rather than a system that acquires and maintains certification with a single training. Third, various training methods should be carried out. In the case of the US and the UK, we think it is desirable to train in various ways in the training period, the university, the teacher center, and the private organization or association. Therefore, it is necessary to build a cooperation system with various institutions such as training institutes, universities, teacher centers, educational information research institutes, and private organizations in each province, and strengthen them in various ways. Fourth, the contents and methods of qualification training and future job training of the director of the preschool should be deviated from the uniform level. Therefore, the systematic research that reflects the knowledge and contents of the administration required in the field should be given priority by the university or research organization that is in charge of the training.

Study on Hay Preparation Technology for Alfalfa Using Stationary Far-Infrared Dryer (정치식 원적외선 건조기를 이용한 알팔파 건초 조제 기술 연구)

  • Kim, Jong Geun;Kim, Hyun Rae;Jeong, Eun Chan;Ahmadi, Farhad;Chang, Tae Kyoon
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.42 no.2
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    • pp.73-78
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    • 2022
  • This experiment was conducted to establish the technology for artificial hay preparation in Korea. Using far-infrared heater, a device that can control temperature, airflow, and far-infrared radiation was produced and conducted on the fourth harvested alfalfa. The drying conditions were carried out by selecting a total of four conditions. For each condition, the radiation rate was set to around 40% (33-42%), and the temperature was set at 58~65℃, and the speed of the airflow was fixed at 60m/s. The overall drying time was set to 30 min in the single and 60 min (30-30 min) and 90 min (30-30-30 min) in the complex condition, and the radiation rate and temperature were changed by time period. In the case of drying condition 1, the final dry matter (DM) content was 46.26%, which did not reach a DM suitable for hay. However, all of the alfalfa corresponding to the remaining drying conditions 2 to 7 showed a DM content of 80% or more, resulting in optimal alfalfa hay production. In power consumption according to the drying conditions, the second drying condition showed the lowest at 4.7 KW, and the remaining drying conditions were as high as 6.5 to 7.1 KW. The crude protein content was found to be high at an average of 25.91% and it showed the highest content in the 5th drying condition (26.93%) and the lowest value in the 6th drying condition (25.16%). The digestibility showed a high value with an average of 84.90%, and there was no significant difference among treatments (p>0.05). Considering the above results, it was judged that drying condition 2 was the most advantageous.

Mobile Camera-Based Positioning Method by Applying Landmark Corner Extraction (랜드마크 코너 추출을 적용한 모바일 카메라 기반 위치결정 기법)

  • Yoo Jin Lee;Wansang Yoon;Sooahm Rhee
    • Korean Journal of Remote Sensing
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    • v.39 no.6_1
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    • pp.1309-1320
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    • 2023
  • The technological development and popularization of mobile devices have developed so that users can check their location anywhere and use the Internet. However, in the case of indoors, the Internet can be used smoothly, but the global positioning system (GPS) function is difficult to use. There is an increasing need to provide real-time location information in shaded areas where GPS is not received, such as department stores, museums, conference halls, schools, and tunnels, which are indoor public places. Accordingly, research on the recent indoor positioning technology based on light detection and ranging (LiDAR) equipment is increasing to build a landmark database. Focusing on the accessibility of building a landmark database, this study attempted to develop a technique for estimating the user's location by using a single image taken of a landmark based on a mobile device and the landmark database information constructed in advance. First, a landmark database was constructed. In order to estimate the user's location only with the mobile image photographing the landmark, it is essential to detect the landmark from the mobile image, and to acquire the ground coordinates of the points with fixed characteristics from the detected landmark. In the second step, by applying the bag of words (BoW) image search technology, the landmark photographed by the mobile image among the landmark database was searched up to a similar 4th place. In the third step, one of the four candidate landmarks searched through the scale invariant feature transform (SIFT) feature point extraction technique and Homography random sample consensus(RANSAC) was selected, and at this time, filtering was performed once more based on the number of matching points through threshold setting. In the fourth step, the landmark image was projected onto the mobile image through the Homography matrix between the corresponding landmark and the mobile image to detect the area of the landmark and the corner. Finally, the user's location was estimated through the location estimation technique. As a result of analyzing the performance of the technology, the landmark search performance was measured to be about 86%. As a result of comparing the location estimation result with the user's actual ground coordinate, it was confirmed that it had a horizontal location accuracy of about 0.56 m, and it was confirmed that the user's location could be estimated with a mobile image by constructing a landmark database without separate expensive equipment.

Fusion of the Guardianship System and Mental Health Law Based on Mental Capacity - Focusing on the Enactment and the Application of the Mental Capacity Act (Northern Ireland) 2016 - (의사능력에 기반한 후견제도와 정신건강복지법의 융합 - 북아일랜드 정신능력법[Mental Capacity Act (Northern Ireland) 2016]의 제정 과정과 그 의의를 중심으로 -)

  • Kihoon You
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.155-206
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    • 2023
  • When a person with diminished mental capacity refuses necessary medical care, normative judgments about when paternalistic intervention can be justified come into question. A typical example is involuntary hospitalization for people with mental disabilities, traditionally governed by mental health law. However, Korean civil law reform in 2011 introduced a new form of involuntary hospitalization through guardianship legislation, leading to a dualized system to involuntary hospitalization. Consequently, a conflict has arisen between the 'best interest and surrogate decision-making' paradigm of civil law and the 'social defense and preventive detention' paradigm of mental health law. Many countries have criticized this dualized system as not only inefficient but also unfair. Moreover, the requirement for the presence of 'mental illness' for involuntary hospitalization under mental health law has faced criticism for unfairly discriminating against people with mental disabilities. In response, attempts have been made to integrate guardianship legislation and mental health law based on mental capacity. This study examines the legislative process and framework of the Mental Capacity Act (Northern Ireland) 2016, which reorganized the mental health care system by fusing guardianship legislation with mental health law based on mental capacity. By analyzing the case of Northern Ireland, which has grappled with conflicts between guardianship legislation and mental health law since the 1990s and recently proposed mental capacity as a single, non-discriminatory standard, we aimed to offer insights for the Korean guardianship and mental health systems.