With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.
Purpose : To assess the early complication of laparoscopic peritoneal dialysis catheter implantation in children. Methods : Medical record review was carried out on 21 laparoscopic and 16 conventional peritoneal dialysis catheter implantations which were performed in 31 children under 18 years of age between 2002 and 2006. All medical records were retrospectively analyzed. The patients were followed until 2 months after catheter placement. Patient characteristics and catheterrelated complications, such as significant bleeding, leakage, obstruction, migration, insertion site infection and peritonitis during the first 60 days after implantation were recorded. Results : After conventional operation, dialysate leakage occurred in 2 of 16 cases and all cases improved after conservative management. In 1 case, significant bleeding occurred and re-operation was performed. Three cases of obstruction due to migration were reported, 2 cases underwent reoperation and 1 case improved without intervention. After laparoscopic surgery, outflow obstruction occurred in 1 out of 21 cases, which was caused by adhesion after several reinsertions of the catheter and recurrent peritonitis. No migration was noted after laparoscopic surgery. There was no significant difference in the complication rate between the two groups. Conclusion : Laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups, with at least equivalent functional results compared to conventional surgery. The additional advantage of laparoscopic catheter insertion is the option to identify and eliminate anatomical risk factors, such as intra-abdominal adhesions, and to perform partial omentectomy without additional incisions.
Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber
Asia-Pacific Journal of Business Venturing and Entrepreneurship
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v.13
no.4
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pp.197-209
/
2018
Recently, many start-up failures occur as the number of attempts to start a business increases in a social atmosphere that encourages start-up. In particular, young entrepreneurs have a lower survival rate than general entrepreneurs because young entrepreneurs are challenging just with a simple idea to overcome the difficulties of employment while lacking prior knowledge and experience of business. Therefore, the reason for the failure of start-up is lack of preparation for start-up and lack of entrepreneurship. The purpose of this study is to develop a measurement tool to build a basic framework for entrepreneurship development and start - up preparation activities for young people. To develop an entrepreneurship measurement tool, researchers developed a preliminary question through qualitative research methods such as literature research, focus group interview, and expert verification. After that, researchers surveyed 102 entrepreneurs using quantitative research method and to verify the construct validity of the measurement tool, the final entrepreneurship measurement tool was completed through exploratory factor analysis and confirmatory factor analysis. The entrepreneurship measurement tool developed through this research process consists of 7 components and 15 measurement items. First, in the step of 'confirming entrepreneurial intention', two items of 'self-analytic competence', three items of 'ability of establishing start-up philosophy'are contained. Second, in the step of 'drawing up a start-up model', two items are contained in each category such as, 'ability of eliciting entrepreneurial idea,' 'ability of analyzing idea validity,' 'competence of planning a venture start-up model'. Third, in the step of 'planning the venture start-up,' two items are contained in each category such as, 'business-plan presentation competency,' 'ability of implementing organizational system.'. The measurement tool of entrepreneurship is meaningful as it could help young entrepreneur find out their lacking competence in preparing their start-ups and strengthen necessary competences by measuring their own entrepreneurship. Rather in the entrepreneurship education, basic data that can diagnose the entrepreneurship of young entrepreneurs is provided.
Purpose : Tumor hypoxia can be overcome with hypoxic cytotoxin. In mouse tumor, tirapazamine's efficacy of the potentiating radiation effect was tested by the tumor oxygenation status combined with hype facti on ated rad iotherapy .:The control and hypoxic mouse tumors we established by inoculation of RIF-1 tumor cells into the normal or previously irradiated back and thigh of C3H mice. When the tumors reached a proper size, both the control and hypoxic tumors were given hypefractionated treatments (8fractions/4 days) with saline (0.02 ml/g), tirapazamin (0.08 mM/0.02 ml/kg), irradiation (2.5 Gy), irradiation combined with tirapazamine given 30 minutes prior to each irradiation. The response was evaluated by the growth delay assay by measuring tumor size from day 0 (12 hrs prior to the first fractionation) to the day when the volume had 4-fold increase or cross sectional area had 2-fold increase. Results : Overall growth pattern showed that tirapazamine Potentiated radiation effect in back and thigh tumors grew in the normal and preirradiated tumor bed. With growth delay assay using reference point of initial tumor volume or cross sectional area, tirapazamine potentiated radiation effect 1.9 times for the control and 2.4 times for the hypoxic tumors in back, and 1.85 times for the control and 1.6 times for the hypoxic tumors. With reference of 4-fold increase of the initial volume or 2-fold increase of the cross sectional area, tirapazamine potentiated radiation effect 1.48 times for the control and 2.02 times for the hypxic tumors in back, and 1.85 times for the control and 1.6 times for the hypoxic tumors. Conclusions : Present result indicated that radiation response of hypoxic tumors was potentiated by tirapazamine in the back or thigh tumors grew in the control or preirradiated tumor bed, and potentiation of the hypoxic tumors was eDual to or greater than that of the control tumors in the back or thigh.
Kim Dae Yong;Ahn Yong Chan;Huh Seung Jae;Choi Dong Rak;Nam Jong Hyun;Lee Jung Il;Park Kwan;Nam Do-Hyun;Kim Moon Kyung
Radiation Oncology Journal
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v.16
no.2
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pp.185-194
/
1998
Purpose : With the development of stereotactic immobilization systems capable of reliable serial repositioning, fractionated stereotactic radiation therapy (FSRT) offers the Potential for an improved treatment outcome by excellent dose delivery, and dose distribution characteristics with the favorable radiobiological properties of fractionated irradiation. We describe our initial experience using FSRT for the treatment of intracranial benign tumor. Materials and Methods : Between August 1995 and December 1996. 15 patients(7 males and 8 females aged 6-70 years) were treated with FSRT. The patients had the following diagnosis pituitary adenoma(10) including one patient who previously had received radiotherapy, craniopharyngioma (2), acoustic neurinoma (1), meningioma (2). Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2Gy was irradiated at 90% to 100% isodose surface of the isocenter The collimator sizes ranged from 26mm to 70mm. Results : In all patients except one follow-up lost, disease was well-controlled. Acute complication was negligible and no patient experienced cranial nerve neuropathies and radiation necrosis. In overall patient setup with scalp measurements, reproducibility was found to have mean of $1.1{\pm}0.6mm$ from the baseline reading. Conclusion : Relocatable stereotactic system for FSRT is highly reproducible and comfortable. Although the follow-up period was relatively short. FSRT is considered to be a safe and effective radiation technique as the treatment of intracranial tumor. But the fractionation schedule(fraction size, overall treatment time and total dose) still remains to be solved by further clinical trials.
Kim, Kil-Ja;Kim, Da-Mi;An, Ho-Sub;Choi, Jin-Kyung;Kim, Seon-Gon
Journal of Mushroom
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v.17
no.4
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pp.211-217
/
2019
Currently, cultivation of mushrooms using the Information and Communication Technology (ICT)-based smart farming technique is increasing rapidly. The main environmental factors for growth of mushrooms are temperature, humidity, carbon dioxide (CO2), and light. Among all the mentioned factors, currently, only temperature has been maintained under automatic control. However, humidity and ventilation are controlled using a timer, based on technical experience.Therefore, in this study, a Pleurotus eryngii first-generation smart farm model was set up that can automatically control temperature, humidity, and ventilation. After installing the environmental control system and the monitoring device, the environmental condition of the mushroom cultivation room and the growth of the fruiting bodies were studied. The data thus obtained was compared to that obtained using the conventional cultivation method.In farm A, the temperature during the primordia formation stage was about 17℃, and was maintained at approximately 16℃ during the fruiting stage. The humidity was initially maintained at 95%, and the farm was not humidified after the primordia formation stage. There was no sensor for CO2 management, and the system was ventilated as required by observing the shape of the pileus and the stipe. It was observed that, the concentration of CO2 was between 700 and 2,500 ppm during the growth period. The average weight of the mushrooms produced in farm A was 125 g, and the quality was between that of the premium and the first grade.In farm B. The CO2 sensor was in use for measurement purposes only; the system was ventilated as required by observing the shape of the pileus and the stipe. During the growth period, the CO2 concentration was observed to be between 640 and 4,500 ppm. The average weight of the mushrooms produced in farm B was 102 g.These results indicate that the quality of the king oyster mushroom is determined by the environmental conditions, especially by the concentration of CO2. Thus, the data obtained in this study can be used as an optimal smart farm model, where, by improving the environmental control method of farm A, better quality mushrooms were obtained.
Korean Journal of Agricultural and Forest Meteorology
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v.6
no.2
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pp.107-117
/
2004
If doubtlessly contributes much to agriculture and rural development. The roles can be summarized as; 1. to activate rural areas and to provide more comfortable and safe rural life with equivalent services to those in urban areas, facilitating distance education, tole-medicine, remote public services, remote entertainment etc. 2. To initiate new agricultural and rural business such as e-commerce, real estate business for satellite officies, rural tourism and virtual corporation of small-scale farms. 3. To support policy-making and evaluation on optimal farm production, disaster management, effective agro-environmental resource management etc., providing tools such as GIS. 4. To improve farm management and farming technologies by efficient farm management, risk management, effective information or knowledge transfer etc., realizing competitive and sustainable farming with safe products. 5. To provide systems and tools to secure food traceability and reliability that has been an emerging issue concerning farm products since serious contamination such as BSE and chicken flu was detected. 6. To take an important and key role for industrialization of farming or lam business enterprise, combining the above roles.
Kim, Young-Soon;Lee, Chang-Geol;Lee, Kyoung-Ok;Kim, Ok-Kyum;Kim, In-Hye;Kim, Mi-Jeong;Hwang, Ae-Ran;Lee, Won-Hee
Journal of Hospice and Palliative Care
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v.7
no.2
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pp.200-213
/
2004
Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.
The sustainable urban development has emerged as a new paradigm of urban studies in recent years. A review of the literature of land use and transport policies in relation to sustainable development reveals a consensus that the main objectives of sustainable strategy should decrease the numbers and length of journeys, and change the land use pattern towards mixed use and high density. However, there is a lack of empirical research as to what types of policies might influence effectively the reduction in the energy consumption and emission of $CO_2$. in order to sustain urban development. This paper tries to construct the conceptual structure of the PSS(planning support system), which is designed to the simulation of the probable effects of policies and planning of different kinds in cities, and evaluate the sustainablilty level according to construct the structure of the PSS(planning support system), which is designed to the simulation of the probable effects of policies and planning of different kinds in cities, and evaluate the sustainablilty level according to the alternative scenarios. The PSS is composed of three components (input-modeling-output). The core of PSS is integrating land use-transport-environment modeling. The advantages of integrating land use-transport-environment modeling are well known, but there are very few such integrated modeling packages in practice. So this paper tries to apply TRANUS software, which is an integrated land use and transport model. The TRANUS system was calibrated to city of Yongin for the base year. The purpose of the application of TRANUS to Yongin is to examine the operability of TRANUS system in Korea. From the outputs and results of operating the system, TRANUS may be effectively used to evaluate the effects of alternative sustainable urban development policies, since sustainablilty indicators can be extracted from several aspects such as land use consumption, total trips, distance and cost, energy consumption, ratio of transport split.
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