• Journal of Chest Surgery
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• v.31 no.10
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• pp.939-944
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• 1998

Background: The sugical results of the Cox-Maze procedure (CMP) for lone atrial fibrillation(AF) have proven to be exellent. However, those for AF associated with mitral valve(MV) disease have been reported to be a little inferior. Materials and methods: To assess the efficacy and safety of the CMP as a combined procedure with MV operation, we studied retrospectively our experiences. Between April 1994 and October 1997, we experienced 70 (23 males, 47 females) cases of CMP concomitantly with MV operation. Results: The etiologies of MV disease were rheumatic in 67 and degenerative in 3 cases. The mean duration of AF before sugery was 66$\pm$70 months. Fifteen patients had the past medical history of thromboembolic complications, and left atrial thrombi were identified at operation in 24 patients. Twelve cases were reoperations. Aortic cross clamp (ACC) time was mean 151$\pm$44 minutes, and cardiopulmonary bypass (CPB) time was mean 246$\pm$65 minutes. Concomitant procedures were mitral valve replacement (MVR) in 19, MVR and aortic valve replacement (AVR) in 14, MVR and tricupid annuloplasty (TAP) in 8, MVR with AV repair in 3, MV repair in 11, MVR and coronary artery bypass grafting (CABG) in 2, MVR and AVR and CABG in 1, redo-MVR in 10, redo-MVR and redo-AVR in 2 patients. The rate of hospital mortality was 1.4%(1/70). Perioperative recurrence of AF was seen in 44(62.9%), and atrial tachyarrhythmias in 10(14.3%), low cardiac output syndrome in 4(5.7%), postoperative bleeding that required mediastinal exploration in 4(5.7%) patients. Other complications were acute renal failure in 2, aggravation of preoperative hemiplegia in 1, and transient delirium in 1 patient. We followed up all the survivors for 16.4 months(3-44months) on an average. Sinus rhythm has been restored in 65(94.2%) patients. AF has been controlled by operation alone in 73.9% and operation plus medication in 20.3%. Two patients needed permanent pacemaker implantation; one with sick sinus syndrome, and the other with tachycardia- bradycardia syndrome. Only two patients remained in AF. We followed up our patients with transthoracic echocardiography to assess the atrial contractilities and other cardiac functions. Right atrial contractility could be demonstrated in 92% and left atrial contractility in 53%.We compared our non-redo cases with redo cases. Although the duration of AF was significantly longer in redo cases, there was no differences in ACC time, CPB time, postoperative bleeding amount and sinus conversion rate. Conclusions: In conclusion, the CMP concomitant with MV operation demonstrated a high sinus conversion rate under the acceptable operative risk even in case of reoperation.

• Korean Security Journal
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• no.9
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• pp.69-98
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• 2005

The security industry for civilians (Private Security), was first introduced to Korea via the US army's security system in the early 1960's. Shortly after then, official police laws were enforced in 1973, and private security finally started to develop with the passing of the 'service security industry' law in 1976. Korea's Private Security industry grew rapidly in the 1980's with the support of foreign funds and products, and now there are thought to be approximately 2000 private security enterprises currently running in Korea. However, nowadays the majority of these enterprises are experiencing difficulties such as lack of funds, insufficient management, and lack of control over employees, as a result, it seems difficult for some enterprises to avoid the low production output and bankruptcy. As a result of this these enterprises often settle these matters illegally, such as excessive dumping or avoiding problems by hiring inappropriate employees who don't have the right skills or qualifications for the jobs. The main problem with the establishment of this kind of security service is that it is so easy to make inroads into this private service market. All these hindering factors inhibit the market growth and impede qualitative development. Based on these main reasons, I researched this area, and will analyze and criticize the present condition of Korea's private security. I will present a possible development plan for the private security of Korea by referring to cases from the US and Japan. My method of researching was to investigate any related documentary records and articles and to interview people for necessary evidence. The theoretical study, involves investigation books and dissertations which are published from inside and outside of the country, and studying the complete collection of laws and regulations, internet data, various study reports, and the documentary records and the statistical data of many institutions such as the National Police Office, judicial training institute, and the enterprises of private security. Also, in addition, the contents of professionals who are in charge of practical affairs on the spot in order to overcomes the critical points of documentary records when investigating dissertation. I tried to get a firm grasp of the problems and difficulties which people in these work enterprises experience, this I thought would be most effective by interviewing the workers, for example: how they feel in the work places and what are the elements which inpede development? And I also interviewed policemen who are in charge of supervising the private escort enterprises, in an effort to figure out the problems and differences in opinion between domestic private security service and the police. From this investigation and research I will try to pin point the major problems of the private security and present a developmental plan. Firstly-Companies should unify the private police law and private security service law. Secondly-It is essential to introduce the 'specialty certificate' system for the quality improvement of private security service. Thirdly-must open up a new private security market by improving old system. Fourth-must build up the competitive power of the security service enterprises which is based on an efficient management. Fifth-needs special marketing strategy to hold customers Sixth-needs positive research based on theoretical studies. Seventh-needs the consistent and even training according to effective market demand. Eighth-Must maintain interrelationship with the police department. Ninth-must reinforce the system of Korean private security service association. Tenth-must establish private security laboratory. Based on these suggestions there should be improvement of private security service.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.241-250
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• 1999

Background: Persistent nonproductive cough is a major adverse effect encountered with ACE inhibitor treatment and the most frequent reason for withdrawal of the drug. The mechanism of cough was postulated to be associated with accumulation of bronchial irritants which are substrates of ACE. It has been speculated that occurrence of this adverse effect is genetically predetermined ; in particular, variants of the genes encoding ACE. To investigate this relationship, we determined ACE gene Insertion/Deletion polymorphism in subjects with and without a history of ACE inhibitor-induced cough. Methods: Among the 339 patients with ACE inhibitor treatment, subjects who developed cough that resolved when not taking medication were designated to cough group and other subjects who did not complain cough were designated to non-cough group. Clinical characteristics of the patients were collected by review of medical records. ACE genotypes were determined by PCR amplification of DNA from peripheral blood and agarose gel electrophoresis. Results: 37 patients complained of dry cough(cough group) and 302 patients did not complained of cough(non-cough group). The incidence of ACE inhibitor induced dry cough was 10.9%. There was a preponderance of females in the cough group (M : F=24.3% : 75.7%) compared to the non-cough group (M : F=49.7% : 50.3%, p=0.004). There was no significant difference in mean age, underlying diseases, and kinds and frequencies of ACE inhibitors and their mean dosage between the both groups. ACE genotypic frequencies were I/I : I/D : D/D=16.2% : 18.9% : 64.9% in the cough group and 18.9% : 18.2% : 62.9% in the non-cough group which showed no significant difference between the both groups(p=0.926). Allelic frequencies were I : D = 25.7% : 74.3% and 28.0% : 72.0% in the cough and non-cough group respectively and the difference was not significant(p = 0.676). Conclusion: The incidence of ACE inhibitor-induced cough are 10.9%, and women are more susceptible to ACE inhibitor-induced cough. ACE inhibitor-induced dry cough is not associated with ACE gene Insertion/Deletion polymorphism.