• Journal of Chest Surgery
• /
• v.37 no.1
• /
• pp.43-49
• /
• 2004

Background: Acute thoracic aortic dissections involving the aortic arch differ in diagnosis, surgical procedures, and operative results compared to those that do not involve the aortic arch. In general cerebral perfusion under deep hypothermic circulatory arrest (HCA) is performed during the repair of the aortic arch dissection. Here, we report our surgical results of the aortic arch dissection repair using retrograde cerebral perfusion (RCP) and its safety. Material and Method: Between January 1996 and June 2002, 22 consecutive patients with aortic arch dissection underwent aortic arch repair. In 20 of them RCP was performed under HCA. RCP was done through superior vena cava in 19 patients and by systemic retrograde venous perfusion in 1, in whom it was difficult to reach the SVC. When the patient's rectal temperature reached 16 to 18$^{\circ}C$, systemic circulation was arrested, and the amount of RCP amount was 481.1 $\pm$292.9 $m\ell$/min with perfusion pressure of 20∼30 mmHg. Result: There were two in-hospital deaths (4.5%) and one late death (9.1%). Mean circulatory arrest time (RCP time) was 54.0$\pm$ 13.4 minutes (range, 7 to 145 minutes). RCP time has no correlation with the appearance of consciousness, recovery of orientation, or ventilator weaning time (p=0.35, 0.86, and 0.92, respectively). Ventilator weaning was faster in patients with earlier recovery of consciousness and orientation (r=0.850, r=926; p=0.000, respectively). RCP of more than 70 minutes did not affect the appearance of consciousness, recovery of orientation, ventilator weaning time, exercise time, or hospital stay (p=0.42, 0.57, 0.60, 0.83, and 0.51, respectively). Conclusion: Retrograde cerebral perfusion time under hypothermic circulatory arrest during repair of aortic arch dissection may not affect recovery of orientation, ventilator weaning time, neurologic complications, and postoperative recovery.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.29 no.2
• /
• pp.159-167
• /
• 2002

The purpose of this study was to evaluate the efficacy and safety depending on the route of flumazenil, as an antagonist against midazolam. The subjects of this study were 15 volunteers of $22{\sim}24$ years old. They were sedated with midazolam 0.2mg/Kg intranasal spray, and then 40 minutes after midazolam administration, they were given flumazenil 0.2mg intranasal spray for their reversal. For evaluation of the efficacy and safety of intranasal spray for flumazenil, they were monitored with pulse-oxymeter(Nellcor symphony N-3000, Nellcor Puritan CO. USA) and electric sphygmomanometer (Heartcare 200, National CO. Japan), and were assessed themselves using visual analogue scale(VAS) for tranquilization, sleep, fatigue and attitude. All of these subjects were reduced completely without any undesired situations. The results from this study can be summarized as follows ; 1. Nasaly administered flumazenil using spray device produced much more rapid reduction than intravenously administered flumazenil, but soon after fell in more deep sedated state than intravenously administered flumazenil. 2. There were no considerable side effects or bad influence on vital signs of both nasaly administered flumazenil and intravenously administered flumazenil. These results suggested that the flumazenil administered nasaly using spray device for reversal, we could treat patients safely and effectively under conscious sedation using midazolam administration. But, We will have to research about its optimal dosages for flumazenil, used as intranasal spray for reversal agents against the midazolam by evaluating the blood plasma concentration of midazolam and flumazenil.

• Journal of agricultural medicine and community health
• /
• v.43 no.2
• /
• pp.108-113
• /
• 2018

목적 글루포시네이트암모늄은 비선택성 제초제로 1984년 일본에서 개발되었으며, 급성 중독시에는 위장관계 증상뿐만 아니라 의식변화, 경련, 호흡부전 및 기억소실 등과 같은 다양한 임상증상을 보이는 것으로 알려져 있다. 한국에는 1994년 소개된 이후로 널리 사용되고 있으며, 사용량의 증가와함께 음독환자가 점점 증가하여 사회적 문제가 되고 있다. 저자들은 최근 글로포시네이트 중독 환자에서 초기치료 후 지연성 악화를 보였던 2례를 문헌고찰과 함께 보고하고자 한다. 방법 및 결과 첫 번째 증례는 62세의 남자환자로 음주상태에서 글루포시네이트암모늄 음독 후 의식 저하 상태로 발견되어 응급실로 이송되었다. 응급 위세척을 시행 후 보존적 치료 및 집중모니터링을 유지하였고, 의식수준은 6시간 후에 거의 명료한 상태로 호전되었다. 지연성 악화의 가능성에 대해설명하고 지속적인 경과관찰 및 치료를 위해 집중치료실 입원이 필요함에 대해 설명하였으나, 환자와 보호자는 타상급병원으로의 전원을 원하였다. 환자는 이송 중에 발생한 심폐정지로 심폐소생술을 시행하였으나, 회복되지 못하고 사망하였다. 두 번째 증례는 54세의 남자 환자로 글루포시네이트암모늄 음독 후 발생한 의식 변화로 응급실로 이송되었다. 내원시 의식은 혼미한 상태였으며 앞의 증례와 같이 응급 위세척을 시행하였다. 본 환자는 초기치료 후 본원 집중치료실에서 지속적인 혈액 및 생화학적 검사를 시행하였으며, 집중모니터링 및 치료를 유지하였다. 입원 2일째 혈액검사 소견은 호전 중이었으나, 경련이 발생하였으며 의식은 혼미한 상태가 지속되었다. 신경과 협진하여 뇌파검사를 시행 후 항경련제를 증량한 후로 경련은 발생하지 않았다. 입원 7일째에는 의식 수준은 거의 명료한 상태까지 호전되었다. 입원 13일째 혈액 및 생화학검사에서 약간의 혈색소 감소 외에는 정상소견을 보였으며, 뚜렷한 신경학적 합병증 없이 퇴원하였다. 결론 급성 글루포시네이트중독 환자는 매우 다양한 임상증상을 보이며 초기치료 후에 상태가 안정적이더라도 지연성으로 임상적 또는 신경학적 악화가 발생할 가능성이 있으므로 치료에 유의하여야 한다.

• Korean Journal of Social Welfare
• /
• v.56 no.2
• /
• pp.145-166
• /
• 2004

The purpose of this study is to offer information needed in developing mental health service programs which can help mental patients to improve their self-esteem. For that purpose, the difference and the interrelation between mental patients' characteristics, and their self-esteem, group consciousness and consciousness of right were examined. And also, in practice, I observed 374 patients suffering from mental problem, who live in Busan and in Kyeong Nam province. As the result, the several facts which could be got from this theoretical examination and practical observation are as follows: First, it is shown that what is meaningfully related to mental patients' self-esteem are their educational level, the families' monthly earnings, a feeling of satisfaction to family relationship, the time spending together with their friends, or a feeling of satisfaction to their friends Second, it is appeared that there was a significant interaction between group consciousness of mental patients, and whether they have got married and the time spending together with their friends. Third, it is found out that their feeling of satisfaction to family relationship and the time spending together with their friends have meaningful relation to consciousness of right which mental patients have. Finally, speaking of interaction among self-esteem, group consciousness and consciousness of right, it is understood that self-esteem has significant effect of group consciousness, and that group consciousness has confidential effect on consciousness of right.

• Journal of the Korean association of regional geographers
• /
• v.22 no.3
• /
• pp.483-498
• /
• 2016

This study investigated the conceptualization and application of new concept of regional resilience with case study in Korea in order to promote more sustainable regional development strategies, while problematizing dominant regional competitiveness concept in the current regional development circle under the condition of stagnant growth and ever-existing crisis in these days. Through literature review, this paper found out that regional resilience is a useful concept both to understand dramatic regional changes and to promote new regional development strategies. Furthermore, the study formulated basic research topics and issues for regional resilience through reviewing existing research outcomes on the measurement and factors of regional resilience. Through case study of two macro city-regions in Korea, this study also found out that regional resilience patterns and processes are differentiated according to the place and its scale and that both regional industrial structure formed in a path-dependent way and regional competitive characteristics are all significant to understand the regional resilience patterns and processes.

• Proceedings of the Korea Contents Association Conference
• /
• 2012.05a
• /
• pp.83-84
• /
• 2012

현대사회 환경의 변화와 개인생활의 복잡 다양화는 시민의 안전한 삶을 위협하는 요인들로 특히 범죄피해를 당하게 되면 피해당사자는 정신적 물질적으로 회복이 힘들고 피해의식과 두려운 기억에 의한 원만한 대인관계의 불가능이나 가족과 친지에게도 큰 상처를 남기게 된다. 경찰의 국민보호는 기본 임무이며, 주요 임무 중 하나인 수사도 국민보호의 차원에서 이루어지고 있는 활동임에도 이러한 경찰활동은 피해자의 신뢰와 협력 없이는 목적을 이룰 수 없으므로 이들 범죄피해자를 위하여 경찰에서도 적극적인 노력을 기울여야 한다. 본 연구에서는 경찰의 범죄피해자 보호 실태와 문제점의 주된 내용을 살펴보고, 그에 대한 대책을 살펴보도록 한다.

• Journal of Service Research and Studies
• /
• v.7 no.4
• /
• pp.109-126
• /
• 2017

Designing cost-effective service recovery strategies mix has been recognized one of important issues by both service researchers and practitioners. In spite of the rising interest in them, there has been scarce studies on them. In this paper, we try to find cost-effective service recovery strategies mix via game-theoretic modeling. Especially, we focus on the possible incentives such as voucher type reward and service re-performance which have different cost structure. We investigated three questions about the topics as follows:(1) Should the service firm use the possible incentive scheme such as voucher and service re-performance for service recovery?, (2) How much voucher and service re-performance is adequate for service recovery under diverse service failure severity level?, (3) How much voucher and service re-performance is adequate for service recovery under diverse threshold level to make the customer repurchase? The results are as follows:(1) The use of both voucher and service re-performance for service recovery results in greater surplus for the service firm. (2) The higher gets the service failure severity level, the higher total incentives are required in the equilibrium. As service failure severity level gets higher, higher level of discount might be more useful to the service firm. However, service re-performance should be cut down above some critical level of service failure severity in the equilibrium. (3) The higher gets the threshold level to make the customer repurchase, the higher incentives are required in the equilibrium, and the higher portion of voucher incentive is required relative to that of service re-performance in the equilibrium.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.7 no.2
• /
• pp.222-238
• /
• 2000

The purpose of this study was to demonstrate the effect of music therapy as a nursing intervention on changes in recovery of consciousness and vital signs for postoperative patients in the recovery room. The subject for this study were fifty three of postoperative patients who were transferred from the OR to the RR at Kwangju Christian Hospital in Kwangju City. Thirty of them were assigned to the experimental group, and twenty three, to the control group. The age of the subject was between twenty and sixty years of age. The subject had a general anesthesia without any special complications, and they were not completely awake. The data were collected for six months from July 1999 to February 2000. The method used was to compare the condition of the subjects in each group at the beginning and at certain times repeatedly. The features observed were the level of consciousness, the frequency of complaints of pain, and vital signs of the subject before and 15 minutes, 30 minutes, and 60 minutes after hearing their favorite music for 30 minutes. The results are as follows 1. The recovery of consciousness was revealed through significant changes in facial expression, facial color, and grip strength in the experimental group more strongly than in the control group. No significant changes were shown in verbal order. The differences in recovery of consciousness in the pre-post music therapy between the two groups was not significant in verbal order, facial expression, or grip strength. However, significant changes were seen in facial color. 2. There were no significant differences between the two groups in changes in the frequency of pain complaints after music therapy. However, a significant difference was shown in the pre-post music therapy scres. 3. Vital signs did not show a significant difference between the two groups. However, the $SPO_2$ of the experimental group was significantly elevated after 60 minutes. The difference pre-post to the music therapy in the vital signs between two groups was significant only in body temperature. This study showed that the effect of music therapy given to postoperative patients is that it promotes changes in facial expression, facial color, and grip strength helping recovery of consciousness, stabilizing vital signs, elevating levels of $SPO_2$. and reducing complaints of pain. It is recommended that if the patient wants it music therapy be given right after surgery in the recovery room as a nursing intervention.

• International Commerce and Information Review
• /
• v.14 no.4
• /
• pp.109-130
• /
• 2012

In recent years, the volume of global fair trade has been increased rapidly. As the quality of life improves, consumers are increasingly concerned about fairness and environment and show positive attitudes toward ethical products. Fair trade is a social movement that aims to set fair prices for products, alleviate poverty, and assist producers marginalized by the traditional economic model. The study attempt to investigate empirically fair trade products purchase intention, so consumers attitude toward fair trade product purchase, normative belief, fairness restoration expectation, ethical responsibility are defined and their impacts on the purchase intention were analyzed. The statistical method used to test the hypotheses was multi-regression using SPSS 18 for window. The results of this study are follows. Purchase attitudes toward fair trade products and ethical responsibility had a significant effect on the purchase intention. The Effectiveness of the ethical responsibility had greater than that of the purchase attitudes. The result of the empirical study provides important implications for the fair trade related organizations and businesses.

• Journal of Digital Convergence
• /
• v.14 no.9
• /
• pp.485-493
• /
• 2016

This study analyzes the collision occurring in the daily life of the United States where diverse ethnicities live side by side, as portrayed in the film 'crash'. The analysis is followed by a counseling method necessary for a diverse society. To analyse the essence of conflict in the film, a convergence psychological analysis was conducted based on desire theory. The result was that the desire to survive and innovate always collided with frustration. This is because of the obstacles in real life that suppresses desire. The process of frustrated desires and their distortion was structurized. In the conclusion, a counseling method and theory with 'a recovery model that promotes change' was presented for problematic personalities that are entrenched widely in the United States about pain by conflict.