• Title/Summary/Keyword: 조기가동

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Do the Rotating Hinge-Flexible Intramedullary Nail Composites Alleviate Junctional Osteolysis in Megaprothesis Reconstruction for Bone Tumor? (탄력성 있는 골수강 내고정물과 회전경첩형 슬관절 전치환물을 조합한 종양인공관절로 자가골의 골 용해를 감소시킬 수 있는가?)

  • Song, Won-Seok;Cho, Wan-Hyeong;Cho, Sang-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.96-104
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    • 2007
  • Purpose: The authors investigated whether 35 flexible nail-rotating hinge composite reconstructions around knee joint minimize junctional osteolysis of host bone. Material and Method: The reconstructive technique was as follows: 1) en bloc tumor resection, 2) filling of the host bone marrow cavity with multiple Ender nails, 3) assembling the Ender nails and an Endo-Link type total knee component with wire and bone cement. Result: Mean follow-up was 53 months (ranged 30~79). At final follow-up, 29 patients retained a mobile joint. Resection of more than 40% of bone showed a positive relationship with junctional hypertrophy (p=0.028). Eight patients showed nail breakage and eight prostheses were removed due to early or late infection. The cumulative prosthetic survival rate was 33% at 6 year. Average functional score according to the MSTS criteria was 26.8. Conclusion: Mid-term evaluations showed that results were fair. The revision process was straightforward. Junctional hypertrophy observed appears to give some clues as to how to minimize osteolysis at the prosthesis-host junction after modular prosthesis fixation.

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Case Study on Design, Manufacture and Application of Customized Assistive Device for the ADL of Person with Brain Lesions (뇌병변장애인의 일상생활을 위한 맞춤형 보조기구의 설계·제작·적용 사례 연구)

  • Lee, J.H.;Choi, M.N.;Yim, S.B.;Rhee, G.M.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.4 no.1
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    • pp.81-86
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    • 2010
  • This paper is case study on design, manufacture and application of customized assistive device for the ADL of person with brain lesions. The study had carried out from October 2010 to November 2010 and 2 clients from Assistive device case management demonstration project which is performed by Daegu assistive and rehabilitation center had participated. Case A, a 47-year-old man with brain lesions, stays only on the floor and could not get close to the usual toilet by himself because of the poor low extremities muscle strength and function. The moveable-toilet and customized ramp had applied to Case A. He clambers up the ramp and reach to the toilet easily. Case B, a 8-year-old boy with brain lesions, had difficulties with self-feeding because of his clumsy hand. Several existing feeding aids were applied but not appropriated. A customized feeding aid was designed and manufactured out of regard of Case A's ROM and right hand size. And his occupational therapist works together continuously to make him feed himself in the near future. Already-made assistive devices were not appropriate to Case A and B and to solve this problem, customized assistive devices were applied. The importance and needs of design and manufacture of assistive device were recognized through these case study.

A study on the standard of effective fire facilities for the Atrium (아트리움 공간의 효과적인 방화설비 기준연구)

  • Choi, Don-Mook;Kim, Jae-Woon;Min, Se-Hong
    • Journal of Korean Institute of Fire Investigation
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    • v.6 no.1
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    • pp.49-66
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    • 2005
  • The purpose of this study is to present reference data to be considered in designing fur the fire safety of atrium buildings. This study deals with the characteristics of atrium buildings in the fire safety aspect, analysis of fire examples and foreign fire codes of atrium space. And con-crete factors to be consigning fur the fire facilities of atrium buildings are presented. Recently many atrium spaces have been built in Korea. They provide new experience of space with resident and pedestrians. However, because of the lack of knowledge in design principle and disaster prevention, large loss of lives is expected in an emergency situation. cion. Therefore safety ensuring from the case is urgently needed. The following is the summary on the standard of effective fire facilities for the atrium. 1. The smoke control. inside atrium must use the machine ventilation in the atrium. 2. It is desirable to divide the section between atrium and nearby living room by anti-smoke screen in order to prevent damage by smoke when fire break out. 3. It is desirable to instill an excellent fire detector like infrared light detector as a replacement of old one. 4. It is desirable to transfer from closed operating sprinkler to fire-cycle sprinkler equipment or ablative sprinkler when the height is lower than 20m.

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Postoperative Pulmonary Vein Stenosis (PVS) in Patients with TAPVR (전 폐정맥 환류 이상의 수술 후 폐정맥 협착에 대한 분석)

  • Jung Sung-Ho;Park Jeong-Jun;Yun Tae-Jin;Jhang Won-Kyoung;Kim Young-Hwue;Ko Jae-Kon;Park In-Sook;Seo Dong-Man
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.347-353
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    • 2006
  • Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.

Middle and Long Term Results of 34 Cases of Emergency Coronary Artery Bypass Graft Surgery (응급 관상동맥 우회술 34예의 중장기 성적)

  • 손정환;김응중;지현근;신윤철;김건일;최광민;이원진;이원용
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.741-747
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    • 2003
  • Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

Emergency Coronary Artery Bypass Operation for Card iogen ic Shock (심인성 쇼크에 대한 응급 관상동맥 우회술)

  • 김응중;이원용
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.966-972
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    • 1997
  • Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.

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High-Resolution Numerical Simulations with WRF/Noah-MP in Cheongmicheon Farmland in Korea During the 2014 Special Observation Period (2014년 특별관측 기간 동안 청미천 농경지에서의 WRF/Noah-MP 고해상도 수치모의)

  • Song, Jiae;Lee, Seung-Jae;Kang, Minseok;Moon, Minkyu;Lee, Jung-Hoon;Kim, Joon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.17 no.4
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    • pp.384-398
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    • 2015
  • In this paper, the high-resolution Weather Research and Forecasting/Noah-MultiParameterization (WRF/Noah-MP) modeling system is configured for the Cheongmicheon Farmland site in Korea (CFK), and its performance in land and atmospheric simulation is evaluated using the observed data at CFK during the 2014 special observation period (21 August-10 September). In order to explore the usefulness of turning on Noah-MP dynamic vegetation in midterm simulations of surface and atmospheric variables, two numerical experiments are conducted without dynamic vegetation and with dynamic vegetation (referred to as CTL and DVG experiments, respectively). The main results are as following. 1) CTL showed a tendency of overestimating daytime net shortwave radiation, thereby surface heat fluxes and Bowen ratio. The CTL experiment showed reasonable magnitudes and timing of air temperature at 2 m and 10 m; especially the small error in simulating minimum air temperature showed high potential for predicting frost and leaf wetness duration. The CTL experiment overestimated 10-m wind and precipitation, but the beginning and ending time of precipitation were well captured. 2) When the dynamic vegetation was turned on, the WRF/Noah-MP system showed more realistic values of leaf area index (LAI), net shortwave radiation, surface heat fluxes, Bowen ratio, air temperature, wind and precipitation. The DVG experiment, where LAI is a prognostic variable, produced larger LAI than CTL, and the larger LAI showed better agreement with the observed. The simulated Bowen ratio got closer to the observed ratio, indicating reasonable surface energy partition. The DVG experiment showed patterns similar to CTL, with differences for maximum air temperature. Both experiments showed faster rising of 10-m air temperature during the morning growth hours, presumably due to the rapid growth of daytime mixed layers in the Yonsei University (YSU) boundary layer scheme. The DVG experiment decreased errors in simulating 10-m wind and precipitation. 3) As horizontal resolution increases, the models did not show practical improvement in simulation performance for surface fluxes, air temperature, wind and precipitation, and required three-dimensional observation for more agricultural land spots as well as consistency in model topography and land cover data.

The Short-and Long-term Employment Effects of reduced Working Hours in a Putty-Clay-Model (법정근로시간 단축의 단기 및 중·장기적 고용효과 : Putty-Clay-Approach)

  • Lee, Sang-Mok
    • Journal of Labour Economics
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    • v.24 no.3
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    • pp.13-38
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    • 2001
  • The question about whether a shorter workweek may increase employment has been a serious issue and been furiously debated among collective bargainers. The advocators recommend publicly that a reduction in standard working hours will provide benefits to the unemployed through the provision of new jobs, and also can improve the quality of life workers. The opponents argue that a shorter workweek will increase labor costs and induce firms to reduce their production levels, and consequently cut back their demand for labor. Although the debate is still continuing, considerable has been made toward achieving the goal workweek reduction. The analytical framework of this paper is a Putty-clay-model, in which the short-and long-term impacts of changes in working time on the employment associated with the interrelations of wages, prices, hourly labour productivity, the firm's labor demand, business cycle and economic growth etc. must be analyzed.

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The Changes of Cerebral Metabolic Parameters, Serum Levels of Neuron-Specific Enolase and S-100$\beta$ Protein During Retrograde Cerebral Perfusion Under Profound Hypothermic Total Circulatory Arrest (초저체온하 완전순환정지 시에 이용되는 역행성 뇌관류의 시간에 따른 뇌대사 지표, 혈청 내 neuron-specific enolase, 및 S-100 베타단백의 변화)

  • 김경환
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.653-661
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    • 2001
  • Background: Retrograde cerebral perfusion(RCP) is one of the methods used for brain protection during aortic arch surgery. The author previously published the data, however, for the safety of it, there still remains many controversies. The author performed RCP and checked various parameters to clarify the possibility of early detection of cerebral injury. Material and Method: The author used pigs(Landrace species) weighing 25 to 30kg and performed RCP for 120 minutes. After weaning of cardiopulmonary bypass, we observed pigs for another 120 minutes. Rectal temperature, jugular venous oxygen saturation, central venous pressure were continuously monitored, and the hemodynamic values, histological changes, and serum levels of neuron-specific enolose(NSE) and S100$\beta$ protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. Result: Flow rates(ml/min) during RCP were 224.3$\pm$87.5(20min), 227.1$\pm$111.0(40min), 221.4$\pm$119.5(60min), 230.0$\pm$136.5(80min), 234.3$\pm$146.1(100min), and 184.3$\pm$50.5(120min). Serum levels of NSE did not increase after retrograde cerebral perfusion. Serum levels of S100$\beta$ protein(ng/ml) were 0.12$\pm$0.07(induction of anesthesia), 0.12$\pm$0.07(soon after CPB), 0.19$\pm$0.12(20min after CPB), 0.25$\pm$0.06(RCP 20min), 0.29$\pm$0.08(RCP 40min), 0.41$\pm$0.05(60min), 0.49$\pm$0.03(RCP 80min), 0.51$\pm$0.10(RCP 100min), 0.46$\pm$0.11(RCP 120min), 0.52$\pm$0.15(CPBoff 60min), 0.62$\pm$0.15(60min after rewarming), 0.76$\pm$0.17(CPBoff 30min), 0.81$\pm$0.20(CPBoff 60min), 0.84$\pm$0.23(CPBoff 90min) and 0.94$\pm$0.33(CPBoff 120min). The levels of S100$\beta$ after RCP were significantly higher than thosebefore RCP(p<0.05). The author could observe the mitochondrial swellings using transmission electron microscopy in neocortex, basal ganglia and hippocampus(CA1 region). Conclusion: The author observed the increase of serum S100$\beta$ after 120 minutes of RCP. The correlation between its level and brain injury is still unclear. The results should be reevaluated with longterm survival model also considering the confounding factors like cardiopulmonary bypass.

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