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20-Year Experience of Surgical Treatment for Postpneumonectomy Empyema (전폐절제술 후 사강에 발생한 농흉의 치료)

  • 김형렬;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.542-547
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    • 2002
  • Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

Early and Midterm Results of Cabrol Technique in the Aortic Root Replacement (대동맥 근부치환술에 있어 Cabrol술식의 중단기 성적)

  • 곽기오;최강주;류지윤;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.547-551
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    • 2000
  • Background; The purpose of this study was to analyze the early and midterm results of Cabrol technique to assist in making future decisions on a more adequate technique for repairing aortic root diseases. Material and Method; From August 1993 to July 1999, we performed Cabrol technique in 18 patients ; 12 annuloaortic ectasia, 6 Stanford type A aortic dissection. Male and female ratio was 11;7, mean age was 46.9$\pm$12.3 years and mean follow up period was 22.5$\pm$21.5 months. We analysed the factors influencing postoperative complications and early mortality. The factors were old age(>60 years), high NYHA(>III), preoporative concomitant disease, urgency of operation, concomitant procedure, long pump preoperative concomitant disease, urgency of operation, concomitant procedure, long pump time(>200 minute), and hospital stay time (>30 days). Result; Operative mortality was 11.1%, late mortality was 11.1%, and overall mortality was 22.2%. The causes of operative death were a heart failure and an arrhythmia. The causes of late death were an acute myocardial infarction and an unknown etiology. Postoperative complications were bleeding, wound infection, toxic hepatitis, acute renal failure, and cerebral infarction. The factors influencing postoperative complications were hihg MYHA Fc(>III) (p=0.044), concomitant disease (p=0.044), long pump time(>200 minute)(p=0.015), and concomitant procedure(p=0.004). There were no significant factors influencing early mortality. Conclusion; The lower postoperative bleeding rate and no complication related to tension of anastomosis after Cabrol technique warrant its consideration in patients requiring aortic root replacement, especially without feasible mobilization of coronary arteries. However, to confirm the graft thrombosis, a more detailed study including periodic angiography will be required.

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A Quality Assurance Study for the Application of Cook/Chill System in School Foodservice Operation (II) - Pork Bulgogi (Broiled Sliced Pork with Sauces) - (학교급식에 Cook/Chill System 적용을 위한 품질보증연구(II) - 돼지불고기 -)

  • Kwak, Tong-Kyung;Moon, Hye-Kyung;Park, Hye-Won;Hong, Wan-Soo;Ryu, Kyung;Chang, Hye-Ja;Kim, Sung-Hee;Choi, Eun-Jung
    • Journal of Food Hygiene and Safety
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    • v.13 no.4
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    • pp.319-331
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    • 1998
  • The purposes of this study were to develop Hazard Analysis Critical Control Point plan applicable to cook/chilled Pork Bulkogi (broiled sliced pork with sauces) in school foodservice operations and to establish reasonable shelf-life limits by assessing food quality during chilled storage period of 5 days. During the product flow, time-temperature profile was recorded and microbiological analyses including mesophilic and psychrotrophic total plate counts, coliform, and fecal coliform and qualitative analyses of Salmonella and Listeria monocytogenes were done. Chemical analyses (pH, acid value, total volatile basic nitrogen), sensory evaluation, and quantitative analysis of thiamin were conducted for 5 days of chilled storage. The number of mesophiles in raw pork ($4.26{\pm}0.11\;Log\;CFU/g$), seasoning mixture ($5.97{\pm}O.04\;Log\;CFU/g$) and marinated pork ($5.56{\pm}0.21\;Log\;CFU/g$) were below the microbial standards for "requires further cooking" food items. Listeria monocytogenes was detected in seasoning mixture. After heating, the number of mesophiles ($5.17{\pm}0.04\;Log\;CFU/g$) were slightly reduced but it did not meet the microbial guidelines of $5\;Log\;CFU/g$ for "ready-to-eat" foods. No other microbes including pathogens were detected. By reheating the menu item after chilled storage, the number of mesophiles were reduced in every phase of 1st day ($4.62{\pm}0.22\;Log\;CFU/g$), 3rd day ($4.55{\pm}0.20\;Log\;CFU/g$) and 5th day ($4.25{\pm}0.16\;Log\;CFU/g$) of chilled storage, and the number of microbes was below the standard limits for "ready-to-eat" foods. At the fifth day of chilled storage, pH (p<0.05), acid value (p<0.01) and TVBN (p<0.05) showed significant increases. Sensory evaluation results did not show any significant change for 5 days of chilled storage. Thiamin content showed a decrease for 5 days of chilled storage. Consequently, the ideal shelflife recommended for Pork Bulkogi was within 3 days of chilled storage. CCPs for Pork Bulkogi were purchasing and receiving of raw meat and some seasoning ingredients, heating, chilling, chilled storage, reheating, and distribution.

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Comparison of Pork Quality by Different Berkshire Line (버크셔 계통조성돈의 육질 특성비교)

  • Park, Beom-Young;Cho, Soo-Hyun;Kim, Jin-Hyoung;Seong, Pil-Nam;Kang, Geun-Ho;Jeong, Da-Woon;Kim, Chul-Wook;Park, Hwa-Chun;Jeong, Jong-Hyun;Choi, Jong-Soon;Kim, Dong-Hun
    • Food Science of Animal Resources
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    • v.30 no.5
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    • pp.867-871
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    • 2010
  • Objective of this study was to develop a Korean Berkshire line produced using organized management techniques. A total of 448 pigs divided into five line groups were slaughtered and analyzed for their meat quality. $pH_{45}$ values were significantly higher in lines 1~4 (pH 6.08). However, $pH_{24}$ values were lower in line 1 (pH 5.69) and line 3 (pH 5.65) (p<0.05) than in the other lines. Moisture contents were significantly higher in line 5, and the intramuscular fat contents (3.07%) were significantly higher in the other four lines. Water holding capacity (WHC) was higher for line 3 (58.36%) while Warner-Bratzler shear force (WBS) values were significantly higher for line 4 (2.84 kg/$0.5inch^2$) than in the other lines (p<0.05). For meat color properties, L values (CIE L) were 51.59 for line 5, and this value was higher than the other lines. There were no significant differences in $a^*$ values and $b^*$ values among the five lines (p>0.05). Therefore, line 5 was selected as the growth type, whereas line 4 was selected as the Korean Berkshire line that produced pork significantly higher in pH and significantly lower in meat color (lightness), drip loss, and WBS.

Dependency of Compatibility Termination Criteria on Prehydration and Bentonite Quality for Geosynthetic Clay Liners (사전투수 및 벤토나이트 품질에 따른 GCL의 투수종결기준에 미치는 영향평가)

  • Lee Jae-Myung;Shackelford Charles D.;Choi Jae-Soon;Jung Moon-Kyung
    • Journal of the Korean Geotechnical Society
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    • v.20 no.7
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    • pp.141-158
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    • 2004
  • The dependency of criteria used to terminate compatibility tests on the prehydration and quality of bentonite in geosynthetic clay liners (GCLs) is evaluated based on permeation with chemical solutions containing 5, 10, 20, 50, and 100 mM calcium chloride ($CaCl_2$). The hydraulic conductivity tests are not terminated before chemical equilibrium between the effluent and the influent chemistry has been established, resulting in test durations ranging from < 1 day to > 900 days, with longer test durations associated with lower $CaCl_2$ concentrations. The evaluation includes both physical termination criteria (i.e., volumetric flow ratio and steady hydraulic conductivity based on ASTM D 5084, ${\ge}2$ pore volumes of flow, constant thickness of specimen) and chemical termination criteria requiring equilibrium between influent and effluent chemistry (viz., electrical conductivity, pH, and $Ca^{2+}\;and\;Cl^-$ concentrations). For specimens permeated with 5, 10, and 20 mM $CaCl_2$ solutions, only the criterion based on chemical equilibrium in $Ca^{2+}$ concentration correlates well with equilibrium in hydraulic conductivity, regardless of prehydration or quality of bentonite. However, all of the termination criteria, except for the volumetric flow ratio and 2 pore volumes of flow for the prehydrated specimens, correlate well with equilibrium in hydraulic conductivity regardless of prehydration or quality of bentonite when permeated with 50 and 100 mM $CaCl_2$ solutions. The results illustrate the uniqueness of the termination criterion based on solute concentration equilibrium between the effluent and the influent with respect to both prehydration and quality of bentonite in the GCLs.

Empirical Survey for the Evaluation of Content Relevance in the 7th Technology & Home Economics Subject (제7차 기술$\cdot$가정 교육내용 적정성 평가 - 가정과교육 영역을 중심으로 -)

  • Wang Seok-Soon
    • Journal of Korean Home Economics Education Association
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    • v.17 no.4 s.38
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    • pp.133-156
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    • 2005
  • This study clarifies the concept of the education content relevance in order to evaluate the content relevance of Technology & Home Economics in a secondary school, and design its standards based on the preceding study. In other words, four standards such as the amount of studying content, the degree of difficulty, the validity of contents and the sequence of contents are established. Also, a survey on the current status of nationwide units targeting students, teachers, and professors was conducted to collect actual data about relevance evaluation. The results are as follows. First, as for the evaluation in terms of the amount of studying content, the majority of respondents answered that it decreased by about $30\%$ when compared to the 6th Technology & Home Economics Curriculum However, middle school teachers pointed out that the number of classes is not enough considering the fact that it's an activity-oriented subject. So, they acknowledged that the amount of study time during a Technology Sl Home Economics class is 'quite a lot.' Second, the evaluation in the degree of difficulty is divided into two responses. Teachers responded that it's reasonable overall, but according to students, it's difficult. Especially, the chapters that students don't understand well including 'The Elements of Draftsmanship,"' 'Understanding of Machinery,' 'Electronics & Electricity Technology,' and 'Energy & Transportation Technology.' In the Home Economics area, 'The Design of Home Life' is the only chapter that students don't understand well. Third, as for the validity of contents, the chapters that were not considered as important considering the objective of Technology Sl Home Economics Curriculum include 'The Elements of Draftsmanship,' 'Computer & Processing,' and 'The Management of Resources and Environment.' Fourth, as for the sequence of contents, the survey was conducted including the name of the course asone of the survey items. The majority of teachers wanted it as it is, but the Professors of education colleges who wanted the 3rd name to connect the course with the elementary school course was a little more $(50.5\%)$ than the ones who don't want any changes $(45.5\%)$. The follow-up study should correct and complement the standards that this study suggested through analytic and critical review according to the character & goal of the subject. Based on such standards, the evaluation of content relevance should be continued to realize the quality control of the curriculum systematically.

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Social Contribution and Future Direction of Home Economics Education (가정교육학의 사회적 기여와 미래 방향)

  • Chae, Jung-Hyun;Lee, Soo-Hee;Yoo, Tae-Myung
    • Journal of Korean Home Economics Education Association
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    • v.22 no.4
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    • pp.139-154
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    • 2010
  • The purpose of this study was to put forth of a future vision from examining of social contribution, future direction, and theoretical framework of home economics education and its cases of practice in educational setting. This study was carried with literature review, and results of study were as follows: First, home economics education should contribute to society through (1) educating individuals suffering from family tiredness to maintain autonomous lives free from distorted family ideology by being critically conscious of them in individual dimension, (2) educating individuals to develop a competence as a citizen to be critical of family ego-centric ideas and to participate and support communal life in family-social dimension, and (3) educating female and male students gender sensitivity and management of family life to be critical of gender discrimination ideology in gender dimension. Second, future home economics education should reinforce all round character education which let students develop their creativity and problem solving ability and foster students' wisdom of life with honesty and morality rather than merely acquiring knowledge in individual dimension. Third, this study employed Brown and Paolucci's conceptual scheme as a theoretical framework which focuses on the role of home economics education leading individuals and families as a changing agent. This framework let individuals and families to critically examine the social character and ideas provided by existing social, economical, and political systems, and to transform social character and ideas to build an ideal societal condition when there are any problems in them. Fourth, this study examined sample classroom instruction of Japan and FCCLA of United States of America to see how they educate students to become a changing agent. In conclusion, future vision of home economics education is to accomplish family revolution to sustain happy family relation and their family lives in which they feel pampered from achievement and free from distorted family ideology. For home economics to accomplish family revolution, it should strengthen education for empowerment, enlightenment, and autonomy. This study calls for immediate paradigm shift not as an occupational but as a practical-critical praxis subject matter for family revolution through home economics education.

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Optimization of Biotransformation Process for Sodium Gluconate Production by Aspergillus niger (Aspergillus niger를 이용한 글루콘산 나트륨 생산 생변환 공정의 최적화)

  • 박부수;조병관;이상윤;임승환;김동일;김병기
    • KSBB Journal
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    • v.14 no.3
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    • pp.309-314
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    • 1999
  • In order to produce high concentration of sodium gluconate, optimization of the fermentation conditions, such as glucose concentration, inoculum size, dissolved oxygen concentration and glucose feeding method, was examined. When the glucose concentration was maintained in the range of 30∼50 g/L during the batch fermentation, glucose conversion yield and productivity were 92.2% and 6.0 g/L/hr, respectively. In the case of the low concentration below 30 g/L, the yield decreased by about 25%. As the inoculum size increased above 20%(w/v), lag phase was shortened but the productivity decreased. The dissolved oxygen level of 60∼70% was shown to be the threshold point for 75% of increase in the productivity of sodium gluconate. Finally, optimal glucose feeding rate was determined using various feeding methods such as exponential feeding, feeding based on the average glucose consumption rate and was determined using various feeding methods such as exponential feeding, feeding based on the average glucose consumption rate and on the oxygen uptake rate and etc. Our result shows that glucose feeding, based on the oxygen uptake rate is a very simple, efficient and robust method, especially when oxygen is consumed as a substrate for the bioconversion. Using the above glucose feeding strategy under the optimized condition, 255 g/L of sodium gluconate concentration, 12 g/L/hr of productivity and 95% of glucose conversion yield were achieved with A. niger ACM53.

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Shade comparative analysis of natural tooth measured by visual and spectrophotometric methods (육안과 분광 측정기를 이용한 자연 치아의 색조비교분석)

  • Kim, Bum-Suk;Shin, Soo-Yeon;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.443-454
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    • 2008
  • Statement of problem: A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment. Purpose: This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer. Material and methods: At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed. Results: 1. There was significant difference between visual and spectrophotometric assessment (mean ${\Delta}E$ values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ${\Delta}E$ values). Conclusion: Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems.

GIS-based Market Analysis and Sales Management System : The Case of a Telecommunication Company (시장분석 및 영업관리 역량 강화를 위한 통신사의 GIS 적용 사례)

  • Chang, Nam-Sik
    • Journal of Intelligence and Information Systems
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    • v.17 no.2
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    • pp.61-75
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    • 2011
  • A Geographic Information System(GIS) is a system that captures, stores, analyzes, manages and presents data with reference to geographic location data. In the later 1990s and earlier 2000s it was limitedly used in government sectors such as public utility management, urban planning, landscape architecture, and environmental contamination control. However, a growing number of open-source packages running on a range of operating systems enabled many private enterprises to explore the concept of viewing GIS-based sales and customer data over their own computer monitors. K telecommunication company has dominated the Korean telecommunication market by providing diverse services, such as high-speed internet, PSTN(Public Switched Telephone Network), VOLP (Voice Over Internet Protocol), and IPTV(Internet Protocol Television). Even though the telecommunication market in Korea is huge, the competition between major services providers is growing more fierce than ever before. Service providers struggled to acquire as many new customers as possible, attempted to cross sell more products to their regular customers, and made more efforts on retaining the best customers by offering unprecedented benefits. Most service providers including K telecommunication company tried to adopt the concept of customer relationship management(CRM), and analyze customer's demographic and transactional data statistically in order to understand their customer's behavior. However, managing customer information has still remained at the basic level, and the quality and the quantity of customer data were not enough not only to understand the customers but also to design a strategy for marketing and sales. For example, the currently used 3,074 legal regional divisions, which are originally defined by the government, were too broad to calculate sub-regional customer's service subscription and cancellation ratio. Additional external data such as house size, house price, and household demographics are also needed to measure sales potential. Furthermore, making tables and reports were time consuming and they were insufficient to make a clear judgment about the market situation. In 2009, this company needed a dramatic shift in the way marketing and sales activities, and finally developed a dedicated GIS_based market analysis and sales management system. This system made huge improvement in the efficiency with which the company was able to manage and organize all customer and sales related information, and access to those information easily and visually. After the GIS information system was developed, and applied to marketing and sales activities at the corporate level, the company was reported to increase sales and market share substantially. This was due to the fact that by analyzing past market and sales initiatives, creating sales potential, and targeting key markets, the system could make suggestions and enable the company to focus its resources on the demographics most likely to respond to the promotion. This paper reviews subjective and unclear marketing and sales activities that K telecommunication company operated, and introduces the whole process of developing the GIS information system. The process consists of the following 5 modules : (1) Customer profile cleansing and standardization, (2) Internal/External DB enrichment, (3) Segmentation of 3,074 legal regions into 46,590 sub_regions called blocks, (4) GIS data mart design, and (5) GIS system construction. The objective of this case study is to emphasize the need of GIS system and how it works in the private enterprises by reviewing the development process of the K company's market analysis and sales management system. We hope that this paper suggest valuable guideline to companies that consider introducing or constructing a GIS information system.