• Title/Summary/Keyword: 기능성의 확장

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Aprotinin Therapy for Cardiac Operation in Adult -Full dose regimen- (개심술에서 아프로티닌의 효과 (고용량 요법))

  • 장운하;오태윤;김미혜
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.358-363
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    • 1999
  • Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

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Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

Health Improvement; Health Education, Health Promotion and the Settings Approach (건강 향상: 건강 교육, 건강 증진 및 배경적 접근)

  • Green, Jackie
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.111-129
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    • 2004
  • This paper develops the argument that the 'Healthy Cities Approach' extends beyond the boundaries of officially designated Healthy Cities and suggests that signs of it are evident much more widely in efforts to promote health in the United Kingdom and in national policy. It draws on examples from Leeds, a major city in the north of England. In particular, it suggests that efforts to improve population health need to focus on the wider determinants and that this requires a collaborative response involving a range of different sectors and the participation of the community. Inequality is recognised as a major issue and the need to identify areas of deprivation and direct resources towards these is emphasised. Childhood poverty is referred to and the importance of breaking cycles of deprivation. The role of the school is seen as important in contributing to health generally and the compatibility between Healthy Cities and Health Promoting Schools is noted. Not only can Health Promoting Schools improve the health of young people themselves they can also develop the skills, awareness and motivation to improve the health of the community. Using child pedestrian injury as an example, the paper argues that problems and their cause should not be conceived narrowly. The Healthy Cities movement has taught us that the response, if it is to be effective, should focus on the wider determinants and be adapted to local circumstances. Instead of simply attempting to change behaviour through traditional health education we need to ensure that the environment is healthy in itself and supports healthy behaviour. To achieve this we need to develop awareness, skills and motivation among policy makers, professionals and the community. The 'New Health' education is proposed as a term to distinguish the type of health education which addresses these issues from more traditional forms.

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Improving Memorial Services for Sustainable Forest Burials (지속가능한 수목장림을 위한 추모 서비스 개선방안)

  • Lee, JeungSun;Cha, Seong-Soo
    • Journal of Service Research and Studies
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    • v.14 no.2
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    • pp.37-47
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    • 2024
  • Currently, social interest in post-cremation funerals is growing due to the establishment of cremation culture. In addition, as awareness of nature-friendly funeral methods spreads in modern times, the demand for tree burial grounds and tree groves, which are representative natural burial methods, is increasing. However, if the current method of relying on trees is used, the forest burial may damage the forest and turn it into another cemetery. The tree decoration is a funeral method that contains the temporal meaning of humans returning to the space of nature that we have, and the philosophical meaning that humans return in compliance with nature. Like this, there are quite a few concerns. Even though tree burials are not the traditional burial facilities we are familiar with, many of the facilities and operating systems adopt the standards of park cemeteries and have stricter standards and restrictions than natural burials under the law. This rigidity is intended to preserve the forest, but the reality is that it limits the expansion and operation of tree plantations. To this end, this study seeks to find specific improvement measures for sustainable tree plantation operation. To this end, we look at the types of natural fields in foreign countries and find directions for tree planting that can be effectively applied and established in accordance with the sentiments of the people. Specific improvement measures include an enshrinement method that does not rely on memorial trees, the operation of anonymous or anonymous tree planting, a change in the method of visiting and commemorating, and various mountaineering methods, thereby suggesting alternatives to sustainable tree planting in Korea. The place where tree planting is implemented is the forest, that is, the forest itself. I should be a place where the spirit of natural return, which is the essence of the deceased, can be celebrated through the forest, not a funeral facility. By doing so, it will be possible to provide the public value of the forest, that is, the social function of the forest, in the name of an eco-friendly funeral service.

The Effect of Pulmonary Rehabilitation in Patients with Chronic Lung Disease (만성 폐질환 환자에서의 호흡재활치료의 효과)

  • Choe, Kang Hyeon;Park, Young Joo;Cho, Won Kyung;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.736-745
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    • 1996
  • Background : It is known that pulmonary rehabilitation improves dyspnea and exercise tolerance in patient with chronic lung disease, although it does not improve pulmonary function. But there is a controversy whether this improvement after pulmonary rehabilitation is due to increased aerobic exercise capacity. We performed this study to evaluate the effect of pulmonary rehabilitation for 6 weeks on the pulmonary function, gas exchange, exercise tolerance and aerobic exercise capacity in patients with chronic lung disease. Methods : Pulmonary rehabilitations including education, muscle strengthening exercise and symptom-Umited aerobic exercise for six weeks, were performed in fourteen patients with chronic lung disease (COPD 11, bronchiectasis 1, IPF 1, sarcoidosis 1 ; mean age $57{\pm}4$ years; male 12, female 2). Pre- and post-rehabilitaion pulmonary function and exercise capacity were compared. Results: 1) Before the rehabilitation, FVC, $FEV_1$ and $FEF_{25-75%}$ of the patients were $71.5{\pm}6.4%$. $40.6{\pm}3.4%$ and $19.3{\pm}3.8%$ of predicted value respectively. TLC, FRC and RV were $130.3{\pm}9.3%$, $157.3{\pm}13.2%$ and $211.1{\pm}23.9%$ predicted respectively. Diffusing capacity and MVV were $59.1{\pm}1.1%$ and $48.6{\pm}6.2%$. These pulmonary functions did not change after pulmonary rehabilitation. 2) In the incremental exercise test using bicycle ergometer, maximum work rale ($57.7{\pm}4.9$) watts vs. $64.8{\pm}6.0$ watts, P=0.036), maximum oxygen consumption ($0.81{\pm}0.07$ L/min vs. $0.96{\mu}0.08$ L/min, P=0.009) and anaerobic threshold ($0.60{\pm}0.06$ L/min vs. $0.76{\mu}0.06$ L/min, P=0.009) were significantly increased after pulmonary rehabilitation. There was no improvement in gas exchange after rehabilitation. 3) Exercise endurances of upper ($4.5{\pm}0.7$ joule vs. $14.8{\pm}2.4$ joule, P<0.001) and lower extremity ($25.4{\pm}5.7$ joule vs. $42.6{\pm}7.7$ joule, P<0.001), and 6 minute walking distance ($392{\pm}35$ meter vs. $459{\pm}33$ meter, P<0.001) were significantly increased after rehabilitation. Maximum inspiratory pressure was also increased after rehabilitation ($68.5{\pm}5.4$ $CmH_2O$ VS. $80.4{\pm}6.4$ $CmH_2O$, P<0.001). Conclusion: The pulmonary rehabilitation for 6 weeks can improve exercise performance in patients with chronic lung disease.

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The Status of North Korean Airspace after Reunification (북한 공역의 통일 후 지위)

  • Kwon, Chang-Young
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.1
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    • pp.287-325
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    • 2017
  • Considering the development of aerospace, military science and technology since the 20th century, the sky is very important for the nation's existence and prosperity. The proverb "Whosoever commands the space commands the world itself!" emphasizes the need for the command of the air. This essay is the first study on the status of airspace after reunification. First, the territorial airspace is over the territory and territorial sea, and its horizontal extent is determined by the territorial boundary lines. Acceptance of the present order is most reasonable, rather than attempting to reconfigure through historical truths about border issues, and it could be supported by neighboring countries in the reunification period. For peace in Northeast Asia, the reunified Korea needs to respect the existing border agreement between North Korea and China or Russia. However, the North Korean straight baselines established in the East Sea and the Yellow Sea should be discarded because they are not available under United Nations Convention on the Law of the Sea. It is desirable for the reunified Korea to redefine the straight baselines that comply with international law and determine the territorial waters up to and including the 12-nautical mile outside it. Second, the Flight Information Region (hereinafter "FIR") is a region defined by the International Civil Aviation Organization (hereinafter "ICAO") in order to provide information necessary for the safe and efficient flight of aircraft and the search and rescue of aircraft. At present, Korea is divided into Incheon FIR which is under the jurisdiction of South Korea and Pyongyang FIR which is under the jurisdiction of North Korea. If North Korea can not temporarily exercise control of Pyongyang FIR due to a sudden change of circumstances, it is desirable for South Korea to exercise control of Pyongyang FIR, and if it is unavoidable, ICAO should temporarily exercise it. In reunified Korea, it is desirable to abolish Pyongyang FIR and integrate it into Incheon FIR with the approval of ICAO, considering systematic management and control of FIR, establishment of route, and efficiency of management. Third, the Air Defense Identification Zone (hereinafter "ADIZ") is a zone that requires easy identification, positioning, and control of aircraft for national security purposes, and is set up unilaterally by the country concerned. The US unilaterally established the Korea Air Defense Identification Area (KADIZ) by the Declaration of Commitment on March 22, 1951. The Ministry of Defense proclaimed a new KADIZ which extended to the area including IEODO on December 13, 2013. At present, North Korea's military warning zone is set only at maritime boundaries such as the East Sea and the Yellow Sea. But in view of its lack of function as ADIZ in relations with China and Russia, the reunified Korea has no obligation to succeed it. Since the depth of the Korean peninsula is short, it is necessary to set ADIZ boundary on the outskirts of the territorial airspace to achieve the original purpose of ADIZ. Therefore, KADIZ of the reunified Korea should be newly established by the boundary line that coincides with the Incheon FIR of the reunified Korea. However, if there is no buffer zone overlapping with or adjacent to the ADIZs of neighboring countries, military tensions may rise. Therefore, through bilateral negotiations for peace in Northeast Asia, a buffer zone is established between adjacent ADIZs.

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Leukocyte count and hypertension in the health screening data of some rural and urban residents (일부 농촌과 도시의 건강선별조사 자료로 본 백혈구수와 고혈압과의 관계)

  • Lee, Choong-Won;Yoon, Nung-Ki;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.363-372
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    • 1991
  • We used the health screening data of some rural and urban residents to examine the cross-sectional association between leukocyte count and hypertension. The 206 male and 203 female rural residents were selected by multi-stage cluster sampling method in Kyungsan-Kun area of Kyungbuk province in 1985 and 600 urban residents were selected by the same sampling method as the rural residents in Daegu city of the same province in 1986 compatible with age-sex distribution of Daegu city of 1985 census, but of whom 384 actually responded. The rest of 600 were replaced by age and sex with those who were members of the medical insurance plan visiting the health management department of the university hospital to get the biannual preventive medical checkups. Excluded in the analysis were those having hypertensive history, diseases and extreme outlying values of the screening tests, leaving 373 rural and 571 urban residents. Leukocyte count was measured with ELT-8 Laser shadow method and the unit $cells/mm^3$, Blood pressures were determined with an aneroid sphygmomanometer with pre-standardized method and hypertensives were defined as those showing systolic blood pressure more than 140mmHg and/or diastolic blood pressure more than 90mmHg. Total residents pooled (N=944) showed a significant difference between hypertensives and normotensives ($6965.93{\pm}1997.01\;vs\;6490.61{\pm}1941.32,\;P=0.00$) and in rural residents was noted the similar significant difference (P=0.03). None of significant differences were noted in any stratum stratified by residency and sex. Compared to the lowest quintile of WBC, 2/5 quintile showed odds ratio 0.99 (95% Confidence interval, Ci 0.62-1.59), 3/5 quintile 1.41 (95% CI 0.90-2.21), 4/5 quintile 1.76 (95% CI. 1.14-2.72), and highest quintile 1.80 (1.15-2.82) in the total residents. Likelihood ratio test for linear trend for it indicated a significant trend ($X^2_{trend}=5.53,\;df=1,\;P<0.05$). There were no other significant odds ratios compared to the lowest quintile of WBC in strata stratified by residency and sex. The odds ratios in total residents which had showed significant odds ratios became nonsignificant and of reduced magnitude after controlling age, frequency of smoking and drinking with multiple logistic. regression. In each stratum, it changed magnitudes of odds ratios slightly and unstably. None of the trend tests showed any significant trend. These results suggest that the Friedman et al's finding of association between leukocyte count and hypertension may be due to an statistical type I error resulting from the data dredging in an exploratory study, in which more than 800 variables were screened as possible predictors of hypertension.

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Reoperations on the Aortic Root and Ascending Aorta (대동맥근부 혹은 상행대동맥의 재수술)

  • Baek, Man-Jong;Na, Chan-Young;Kim, Woong-Han;Oh, Sam-Se;Kim, Soo-Cheol;Lim, Cheong;Ryu, Jae-Wook;Kong, Joon-Hyuk;Kim, Wook-Sung;Lee, Young-Tak;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.188-198
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    • 2002
  • Background: Reoperations on the aortic root or the ascending aorta are being performed with increasing frequency and remain a challenging problem. This study was performed to analyze the results of reoperations on the ascending aorta and aortic root. Material and Method: Between May 1995 and April 2001, 30 patients had reoperations on the ascending aorta and aortic root and were reviewed retrospectively. The mean interval between the previous repair and the actual reoperation was 56 months(range 3 to 142 months). Seven patients(23.3%) had two or more previous operations. The indications for reoperations were true aneurysm in 7 patients(23.3%), prosthetic valve endocarditis in 6(20%), false aneurysm in 5(16.7%), paravalvular leak associated with Behcet's disease in 4(13.3%), malfunction of prosthetic aortic valve in 4(13.3%), aortic dissection in 3(10%), and annuloaortic ectasia in 1(3.3%). The principal reoperations performed were aortic root replacement in 17 patients(56.7%), replacement of the ascending aorta in 8(26.7%), aortic and mitral valve replacement with reconstruction of fibrous trigone in 2(6.6%), patch aortoplasty in 2(6.6%), and aortic valve replacement after Bentall operation in 1 (3.3%). The cardiopulmonary bypass was started before sternotomy in 7 patients and the hypothermic circulatory arrest was used in 16(53.3%). The mean time of circulatory arrest, total bypass, and aortic crossclamp were 20$\pm$ 12 minutes, 228$\pm$56 minutes, and 143$\pm$62 minutes, respectively Result: There were three early deaths(10%). The postoperative complications were reoperation for bleeding in 7 patients(23.3%), cardiac complications in 5(16.7%), transient acute renal failure in 2(6.6%), transient focal seizure in 2(6.6%), and the others in 5. The mean follow-up was 22.8 $\pm$20.5 months. There were two late deaths(7.4%). The actuarial survival was 92.6$\pm$5.0% at 6 years. One patient required reoperation for complication of reoperation on the ascending aorta and aortic root(3.7%). The 1- and 6-year actuarial freedom from reoperation was 100% and 83.3$\pm$15.2%, respectively. One patient with Behcet's disease are waiting for reoperation due to false aneurysm, which developed after aortic root replacement with homograft. There were no thromboembolisms or anticoagulant related complications. Conclusions: This study suggests that reoperations on the ascending aorta and aortic root can be performed with acceptable early mortality and morbidity, and adequate surgical strategies according to the pathologi conditions are critical to the prevention of the reoperation.

Musical Analysis of Jindo Dasiraegi music for the Scene of Performing Arts Contents (연희현장에서의 올바른 활용을 위한 진도다시래기 음악분석)

  • Han, Seung Seok;Nam, Cho Long
    • (The) Research of the performance art and culture
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    • no.25
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    • pp.253-289
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    • 2012
  • Dasiraegi is a traditional funeral rite performance of Jindo located in the South Jeolla Province of South Korea. With its unique stylistic structure including various dances, songs and witty dialogues, and a storyline depicting the birth of a new life in the wake of death, embodying the Buddhism belief that life and death is interconnected; it attracted great interest from performance organizers and performers who were desperately seeking new contents that can be put on stage as a performance. It is needless to say previous research on Dasiraegi had been most valuable in its recreation as it analyzed the performance from a wide range of perspectives. Despite its contributions, the previous researches were mainly academic focusing on: the symbolic meanings of the performance, basic introduction to the components of the performance such as script, lyrics, witty dialogue, appearance (costume and make-up), stage properties, rhythm, dance and etc., lacking accurate representation of the most crucial element of the performance which is sori (song). For this reason, the study analyzes the music of Dasiraegi and presents its musical characteristics along with its scores to provide practical support for performers who are active in the field. Out of all the numbers in Dasiraegi, this study analyzed all of Geosa-nori and Sadang-nori, the funeral dirge (mourning chant) sung as the performers come on stage and Gasangjae-nori, because among the five proceedings of the funeral rite they were the most commonly performed. There are a plethora of performance recordings to choose from, however, this study chose Jindo Dasiraegi, an album released by E&E Media. The album offers high quality recordings of performances, but more importantly, it is easy to obtain and utilize for performers who want to learn the Dasiraegi based on the script provided in this study. The musical analysis discovered a number of interesting findings. Firstly, most of the songs in Dasiraegi use a typical Yukjabaegi-tori which applies the Mi scale frequently containing cut-off (breaking) sounds. Although, Southern Kyoung-tori which applies the Sol scale was used, it was only in limited parts and was musically incomplete. Secondly, there was no musical affinity between Ssitgim-gut and Dasiraegi albeit both are for funeral rites. The fundamental difference in character and function of Ssitgim-gut and Dasiraegi may be the reason behind this lack of affinity, as Ssitgim-gut is sung to guide the deceased to heaven by comforting him/her, whereas, Dasiaregi is sung to reinvigorate the lives of the living. Lastly, traces of musical grammar found in Pansori are present in the earlier part of Dasiraegi. This may be attributed to the master artist (Designee of Important Intangible Cultural Heritage), who was instrumental in the restoration and hand-down of Dasiaregi, and his experience in a Changgeuk company. The performer's experience with Changgeuk may have induced the alterations in Dasiraegi, causing it to deviate from its original form. On the other hand, it expanded the performative bais by enhancing the performance aspect of Dasiraegi allowing it to be utilized as contents for Performing Arts. It would be meaningful to see this study utilized to benefit future performance artists, taking Dasiraegi as their inspiration, which overcomes the loss of death and invigorates the vibrancy of life.