• Title/Summary/Keyword: 학제성

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The Present and Future for the Protection, Management and Planning of Landscape in the Country - A Perspective from Holism - (국토경관 보호·관리·계획의 현재와 미래 - 전체론의 관점을 중심으로 -)

  • Ryu, Je-Hun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.4
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    • pp.166-175
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    • 2015
  • Nowadays, in the European countries, landscape is spoken of its importance as often as environment, by those who are engaged in such fields as politics, administration, research and civil society. In Korea, while recognizing such an international trend, academics and administrators have made a series of efforts to reflect landscape concept on a variety of policies. However, it is recognized that the effects of these policies have not been satisfactory. Under these circumstances, this paper aims to examine the complex values and multiple meanings in the landscape, which have been discussed by landscape experts in the European countries. Then, it aims to the explore the future direction of policy and research on the landscape to be pursued in Korea, where there is relatively less interest in the issues of landscape. It is argued that landscape should be approached and understood from a holistic perspective, because it is a very complex concept with multiple meanings that have been coined differently depending on the situation. All the academic fields, involved in the landscape research, should try in co-operation to develop the comprehensive approach rather than the inter- and multi-disciplinary approach to the landscape study. In Korea, moreover, it is also necessary in the legislation to recognize the fact that degradation and retreat in the quality of landscape would make a negative effect on the quality of human daily life. Natural and cultural heritages contained in the rural landscape are also now in danger of disappearing. These heritages, therefore, should become an important subject for research and policy on landscape before the countryside is completely evacuated after the aging population die out. To make this happen, it is very urgent that evaluation and classification of landscape character should be undertaken from the holistic perspective, which is equipped with a methodology overcoming as well as encompassing the boundaries of academic fields. It is also equally very urgent that education on landscape should be provided to the politicians, citizens and students as well as the officials dealing with landscape matters. Finally, government should strive to make the landscape concept penetrate deeply as well as widely into the spatial planning and legislation process while designing and implementing a comprehensive landscape policy at the national level.

Institutional approaches in geography -Institutional changes in the Korean financial system- (지리학에서 제도적 접근법에 관한 연구 -한국금융부문의 제도적 변 화를 사례로-)

  • Choi, Jae Heon
    • Journal of the Korean Geographical Society
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    • v.30 no.4
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    • pp.364-388
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    • 1995
  • Even though rarely recognized as a separate approach, the institutional approach in geography is defined as an attempt to seek an explanation of the phenomena of geographical interest through focusing on the effects of institutional structure and actions. It can provide interdisciplinary links with other works and can offer complementary explanations for geographical interests. The concerns for institutions in geography can be found in early studies, the study of the state, the managerial approach, and the regulation approach. The Korean financial systems can provide good examples to apply institutional concepts into creating spatial outcomes, as it has been regarded as a useful tool to promote Korean economic development. Behind the current spatial pattern of financial systems, four different stages of institutional changes are identified in Korea. Each stage has different institutional features reflecting unique spatial implication.

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The Clinical Results of Heart Valve Replacements (심장 판막 치환술의 임상 성적)

  • Park Sung Min;Son Hosung;Shin Jaesung;Sohn Young-sang;Sun Kyung;Choi Young Ho;Kim Kwan Taik;Lee In Sung;Kim Hackje;Kim Hyung Mook
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.204-213
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    • 2005
  • In spite of the improvement in the quality of artificial heart valves and surgical techniques, the incidence of the complications following valve replacement is still high. We reviewed the clinical results of the valve replacements peformed in Korean University Anam Hospital during the last 26 years. Material and Method: The data of 571 patients who received valve replacement between December 1976 and December 2003 were reviewed. Result: There were 304 cases of MVR which was the most common procedure performed. There were 122 cases of AVR, and 111 cases of AVR with MVR. Among the 47 patients who received redo operation 38 cases were redo cases including 31 cases of MVR. $32.5\%$ of the patients who had tissue valve replacement had second valve replacement with 10.2 $\pm$ 3.9 years interval. $24.3\%$ (139/571) of the patients developed valve related complications and cerebral infarction was the highest in frequency. Atrial fibrillation was related with increased complication rates and the mechanical valve replaced group had higher hemorrhagic complication rate than tissue valve replaced group. The operative mortality was $3.68\%$ and the most common cause of the failure was low output syndrome. The operative mortality was higher in the patient group who had valve replacement before the year 1990. The patient group who had mechanical valve replacement had higher operative mortality rate th;3n the tissue valve group. The 5-year survival rate was $92.2\%$ and 10 year survival rate was $85.7\%$. Conclusion: The operative mortality of valve replacement has been improved. The mechnical valve replaced patients had higher hemorrhagic complication rate than the tissue valve replaced patients and more tissue valve replaced patients received redo valve replacement.

Coronary Artery Bypass Graft Surgery in the Elderly (고령환자의 관상동맥 우회로 조성술)

  • 김학제;황재준;김현구;신재승;손영상;최영호
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.715-721
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    • 1999
  • Background:The number of old patients receiving coronary artery bypass grafting(CABG) is increasing. With the more recent advances in operative techniques, the age at which CABG is indicated has also increased. This study evaluated the risk factors associated with the hospital mortality and the morbidity following CABG in elderly patients. Material and Method: Between March 1991 and June 1998, we retrospectively reviewed 45 consecutive patients aged 65 years or older who underwent CABG. We compared the data with the results of 179 patients under the age 65 years operated during the same period. Result: Mean age was 68${\pm}$1.41 years(range 65 to 74 years). Emergency surgery was required in 4, and elective surgery in 41 patients. The mean number of distal anastomosis per patient was 3.62 ${\pm}$0.81 and mean aortic cross-cramp time was 69.84${\pm}$18.5 minutes. Thirty patients had Canadian class III or IV preoperatively, but 43 patients had class I or II postoperatively. The left ventricular ejection fraction increased significantly from 54.23${\pm}$10.62% preoperatively to 58.14${\pm}$9.88% postoperatively(p<0.05). Postoperative complication was pneumonia in 2 patients, acute renal failure in 2 patients, sternal wound infection in 1 patient, and postoperative myocardial infarction in 1 patient. There were two postoperative deaths. The causes of deaths were low output syndrome in one patient, and sepsis due to pneumonia in the other patient. The hospital mortality was higher in the elderly group(4.4 versus 2.86%) but was not statistically significant(p>0.05). Incremental risk factors for hospital deaths in the elderly were emergent operation, preoperative PTCA, postoperative use of IABP and postoperative ARF(p<0.05). The duration of hospital stay after operation was significantly longer for the elderly group than the younger group(19.27${\pm}$12.51 vs 15.55${\pm}$6.99 days; p< 0.05). Follow-up was complete for 34 of the hospital survivors and ranged from 1 to 73 months(mean: 23.58${\pm}$19.56 months). There was no late mortality of cardiac origin. Conclusion: Age is an important factor in selecting optimal management for elderly patients with coronary compromise, but age alone should not dictate the choice of therapy. Coronary artery bypass surgery in the elderly is associated with acceptable early mortality and excellent long-term results.

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Report for Development of Korean Portable Cardiopulmonary Bypass II. Experimental Study of Portable Cardiopulmonary Bypass for Emergency Cardiopulmonary Resuscitation after Cardiac Arrest in Normal Dogs (한국형 이동식 심폐소생기 개발 보고 II. 응급소생술을 위한 이동식 심폐소생기의 동물 실험 연구)

  • Kim, Hyoung-Mook;Lee, In-Sung;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Lee, Hye-Won;Lee, Kyu-Back;Chang, Jun-Kuen;Kim, Chong-Won;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1147-1158
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    • 1998
  • Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

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The Analysis of the Trend of Research on Gastric Cancer Reported in Professional Journals in the Field of Surgery in Korea (국내 전문 학술지에 의한 위암 외과의 연구 경향에 대한 분석)

  • Oh, Cheong-Ah;Kim, Dae-Hoon;Oh, Seung-Jong;Cho, Hyun-Jin;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Bae, Jae-Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.186-192
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    • 2009
  • Purpose: The aim of this study was to analyze the trend of the literature reported in the Journal of Korean Gastric Cancer Association (JKGCA) and the Journal of Korean Surgical Society (JKSS) in order to suggest new directions for the future studies on gastric cancer. Materials and Methods: The papers published in the Journal of Korean Gastric Cancer Association (JKGCA) and the Journal of Korean Surgical Society (JKSS) between 2001 and 2008 were compared and summarized in terms of the following categories, retrospective study, prospective study, case report, biomolecular study, genetic study, tumor marker study, review article, and report. Results: For recent 8 years, while the number of review articles in JKSS had initially increased, gradually fallen down and recently increased again, only a few (only 6 publications) in JKGCA have been published. The number of case reports in JKSS has gradually increased and fallen down. On the other hand, a few of case reports (1~3 publications) has been annually published in JKSS. Uniquely, reports were published only in JKGCA with the noticeable increase during the period from 2004 to 2005. For retrospective studies, in JKGCA the number started off very high and decreased, and finally increased again (U-shaped), whereas it had a bell-shaped trend in JKSS. The number of prospective studies in JKGCA had a bell-shaped trend, but the one in JKSS continued to decrease. Few papers of molecular biologic study, tumor marker study and genetic study had been published in both journals. Conclusion: We concluded that the transition from retrospective studies to prospective studies as well as a comprehensive multi-disciplinary team management of a clinical research would represent a desirable strategy in gastric cancer research.

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Effect of Global Ischemic Preconditioning After Cardioplegic Arrest -Langendorff Isolated Heart Study- (단기간의 심근허혈이 심근보호에 미치는 영향 -적출 쥐 심장의 연구-)

  • Cheon, Young-Jin;Lee, In-Sung;Kim, Yeon-Soo;Choi, Young-Ho;Kim, Kwang-Taik;Kim, Hyoung-Mook;Kim, Hark-Jei;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.95-101
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    • 1998
  • Ischemic preconditioning is known to have protective effect on myocardial function at prolonged ischemic insult but the mechanism of the effect is not clearly known. The effect of the preconditioning on the global ischemia using cardioplegic solution is not well known. To evaluate the effect of global myocardial preconditioning on the functional recovery after cardioplegic arrest and two hours of hypothermic storage, we used the isolated rat heart and two hours cardioplegic arrest time at $0^{\circ}C$. In the experimental group(n=10), after baseline functional data was obtained, ischemic preconditioning was induced with 1 min of global normothermic ischemia for three times before the arrest period. In the control group(n=10), hearts underwent no ischemic precondi- tioning. After 2 hrs of cardioplegic arrest and storage in the $0^{\circ}C$ cardioplegic solution reperfusion was done and hemodynamic data were collected at post-reperfusion 20 min. Heart with ischemic preconditioning showed improved functional recovery at post reperfusion 20 min in peak developed pressure and dP/dT. In percent change of the peak pressure, preconditioning group showed 93.20$\pm$15.7% recovery rate compared to baseline data, and control group showed 67.3$\pm$15.6% recovery rate. In percent change of the dP/dT, control group showed 54.7$\pm$18.2% recovery rate and preconditioning group showed 78.1$\pm$15.1% recovery rate. Percent changes in heart rate and coronary flow showed no significant difference between two groups and there was no significant differences in amount of cardioplegic delivery between groups. Our data suggest ischemic preconditioning may have protective effect on recovery state after cardioplegic arrest and 2 hr ischemic storage of isolated rat heart and its mechanism is not related to the amount of the cardioplegic delivery amount.

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A Study of Clinical Model for Radiation Therapy in Lung Cancer Patients of Busan and South Gyeongnam Province (부산, 경남지역 폐암 환자의 방사선치료 이용에 대한 임상 결정 모델 연구)

  • Son, Jongki;Kim, Yunjin;Jo, Deokyoung
    • Journal of the Korean Society of Radiology
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    • v.9 no.6
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    • pp.393-401
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    • 2015
  • Radiation therapy for lung cancer is an effective treatment during monotherapy or combination therapy. Studies have reported that the optimum utilization rate of radiation therapy is estimated at 61% to 74%. Radiation therapy in Korea has been investigated to be low; further studies are needed. This study was intended to assess the appropriateness of the use of radiation and to reveal the use of radiation therapy-related factors by examining radiation therapy in lung cancer patients of Busan and South Gyeongnam Province. This study was aimed at the population diagnosed with lung cancer in Busan and South Gyeongnam Province. To conduct the study, 1036 patients enrolled in two hospitals were collected and 897 appropriate as subjects were selected. We compared the optimum utilization rate and actual rate of radiation therapy, and revealed the adequacy and related factors for use of radiotherapy. Of 897 patients, 503 (56%) were treated with medical therapy and 394 (44%) were given radiotherapy. The radiotherapy utilization rate of all lung cancer patients was 42%. The proportion of non-small cell lung cancer by histologic type was 33% and that of small cell lung cancer was 90%. Factors related to radiation therapy used in cancer were age, histological type, clinical stage, doctor refereed to, and clinical examination. Compared to radiation utilization by region (site), curative chest therapy was 42%; palliative treatment was 26%. In the comparison of histologic types, utilization of small-cell lung cancer is lower; the lowest especially in the stage III. Utilization of radiation therapy in Busan and South Gyeongnam Province was lower than the reasonable one. Utilization difference could be explained by patient factors, tumor factors, and health service factors. To improve utilization,development ofoutreach service programs and activation of the multidisciplinary team are required.

A Plan for Activating Elderly Sports to Promote Health in the COVID-19 Era (코로나19 시대 건강증진을 위한 노인체육 활성화 방안)

  • Cho, Kyoung-Hwan
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.141-160
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    • 2020
  • The purpose of this study was to devise a specific plan for activating sports to promote health in old age against the prolonged COVID-19 pandemic. Through literature review, it also analyzed the association between health status and COVID-19 in old age, suggested health promotion policies and projects for elderly people, and presented a plan for activating sport to promote health in old age against COVID-19 era. First, it is necessary to revise the relevant laws, including the Sport Promotion Act and the Elderly Welfare Act, partially or entirely, make developmental and convergent legislations for elderly health and sports, and establish an institutional device as needed. Second, it is necessary to build an integrated digital platform for the elderly and make a supporting system that links facilities, programs, information, and job creation as part of a New Deal program in the field of sports on the basis of the Korean New Deal. Third, it is necessary to train elderly welfare professionals. Efforts should be made to establish more departments related to elderly sports in universities and make it compulsory to place elderly sports instructors at elderly leisure and welfare facilities. Fourth, it is necessary to develop contents related to health in old age. This means performing diverse movements by manipulating them through a virtual reality (VR) simulation. Fifth, it is necessary to make a greater investment in research and development related to elderly sports and relevant fields. This means the need to conduct constant research on healthy and active aging in a systematic and practical way through multidisciplinary cooperation. Sixth, it is necessary to establish and operate an elderly management agency (elderly health agency) under the influence of the Office of the Prime Minister. This means the need to secure independence in implementing the functions related to health promotion in old age and make comprehensive operation, which involves all the issues of health promotion in old age, daily function maintenance and rehabilitation, social adjustment, and long-term care, by establishing an elderly management agency in an effort to give lifelong health management to the elderly and cope with the untact, New Normal age.

Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.