• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.538-544
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• 2005

Background: Pulmonary artery banding (PAB) is an initial palliative procedure for a diverse group of patients with congenital cardiac anomalies and unrestricted pulmonary blood flow. We proved the usefulness of PAB through retrospective investigation of the surgical indication and risk analysis retrospectively. Material and Method: One hundred and fifty four consecutive patients (99 males and 55 females) who underwent PAB between January 1986 and December 2003 were included. We analysed the risk factors for early mortality and actuarial survival rate. Mean age was $2.5\pm12.8\;(0.2\sim92.7)$ months and mean weight was $4.5\pm2.7\;(0.9\sim18.0)\;kg$. Preoperative diagnosis included functional single ventricle $(88,\;57.1\%)$, double outlet right ventricle $(22,\;14.2\%)$, transposition of the great arteries $(26,\;16.8\%)$, and atrioventricular septal defect $(11,\;7.1\%)$. Coarctation of the aorta or interrupted aortic arch $(32,\;20.7\%)$, subaortic stenosis $(13,\;8.4\%)$ and total anomalous pulmonary venous connection $(13,\;8.4\%)$ were associated. Result: The overall early mortality was $22.1\%\;(34\;of\;154)$, The recent series from 1996 include patients with lower age $(3.8\pm15.9\;vs.\;1.5\pm12.7,\;p=0.04)$ and lower body weight $(4.8\pm3.1\;vs.\;4.0\pm2.7,\;p=0.02)$. The early mortality was lower in the recent group $(17.5\%;\;16/75)$ than the earlier group $(28.5\%;\;18/45)$. Aortic arch anomaly (p=0.004), subaortic stenosis (p=0.004), operation for subaortic stenosis (p=0.007), and cardiopulmonary bypass (p=0.007) were proven to be risk factors for early death in univariate analysis, while time of surgery (<1996) (p=0.026) was the only significant risk factor in multivariate analysis. The mean time interval from PAB to the second-stage operation was $12.8\pm10.9$ months. Among 96 patients who survived PAB, 40 patients completed Fontan operation, 21 patients underwent bidirectional cavopulmonary shunt, and 35 patients underwent biventricular repair including 25 arterial switch operations. Median follow-up was $40.1\pm48.9$ months. Overall survival rates at 1 year, 5 years and 10 years were $81.2\%\;65.0\%,\;and\;63.5\%$ respectively. Conclusion: Although it improved in recent series, early mortality was still high despite the advances in perioperative management. As for conventional indications, early primary repair may be more beneficial. However, PA banding still has a role in the initial palliative step in selective groups.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.181-190
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• 2005

The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

• Proceedings of the KOSOMBE Conference
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• v.1992 no.05
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• pp.27-47
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• 1992

Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

• Journal of Biomedical Engineering Research
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• v.19 no.1
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• pp.69-80
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• 1998

This research was designed to investigate how the exercise program affects paraplegic standing and walking employing functional electrical stimulation(FES). Emphasis was also given to fatigue of major lower extremity muscles induced by different types of electrical stimulation. We applied continuous and intermittent rectangular pulse trains to quadriceps of 10 normal subjects and 4 complete paraplegic patients. The frequencies were 20Hz and 80Hz, and the knee angle was fixed at 90$^{\circ}$and 150$^{\circ}$to investigate how muscle fatigue is related to muscle length. The knee extensor torque was measured and monitored. We have been training quadriceps and gastrocnemius of a male paraplegic patient by means of electrical stimulation for the past two year. FES standing was initiated when the knee extensors became strong enough to support the body weight, and then the patient started FES walking utilizing parallel bars and a walker. We used an 8-channel constant-voltage stimulator and surface electrodes. The experimental results indicated that paralyzed muscles fatigued rapidly around the optimal length contrary to normal muscles and confirmed that low frequency and intermittent stimulation delayed fatigue. Our exercise program increased muscle force by approximately 10 folds and decreased the fatigue index to half of the initial value. In addition, the exercise enabled the patient to voluntarily lift each leg up to 10cm, which was of great help to the swing phase of FES walking. Both muscle force and resistance to fatigue were significantly enhanced right after the exercise was applied every day instead of 6 days a week. Up to date, the patient can walk for more than two and half minutes at 10m/min while controlling the on/off time of the stimulator by pushing the toggle switch attached to the walker handle.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.16 no.2
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• pp.70-80
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• 2011

Estuarine ecosystem responds sensitively to natural and anthropogenic perturbations. lt is necessary to identify the direction of the change when the perturbation occurs as well as to understand the structure and functioning of estuarine ecosystem for a proper management of the area. In this study, the estuarine habitats were classified into different ecological districts so as to the switch from one district to another district could be related to the environmental change due to the perturbations. Total 16 ecological districts was defined according to the presence of barrage, salinity and vegetation characteristics. The defined ecological districts were applied to small estuaries in Goseong bay, south sea of Korea (Baedun, Guman, Maam, Goseong) to distinguish different regions which might have characteristic bottom topography, inclinations of river bottom, sediment characteristics, salinity structure and area of vegetation. Total 7 out of 16 ecological district was identified in this region; NFB (natural, fresh, bare), NHB (natural, high salinity, bare), NLV (natural, low salinity, vegetated) in natural (without barrage) estuaries and CFB (closed, fresh, bare), CFV( closed, fresh vegetated), CLV (closed, low salinity, vegetated), CHB (closed, high salinity, bare) in closed (with barrage) estuary. A comparison of environmental factors and biota between CHB and CLV demonstrated the effect of barrage on estuarine ecosystem. The height and sediment characteristics of CHB and CLV were similar but the average salinity was lower in CLV than in CHB due to the barrage, which produced favorable condition for the Phragmites australis in CLV. Information regarding the ecological districts in various sizes and location could be useful for predicting the ecosystem change due to natural and anthropogenic perturbations and for preparing management actions.

• Journal of Global Scholars of Marketing Science
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• v.17 no.4
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• pp.1-22
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• 2007

Customer satisfaction is important in an increasingly competitive and global marketplace. This implies that customer service is a critical factor for many organizations. In service encounter context, customer satisfaction is affected by employees' attitudes and behaviors. Accordingly, service firms have been focusing on selecting high quality of service employees, which resulted the ability to identify and select quality service- or customer- oriented employees to become critical for an organization's success. It was suggested that customer service orientation links to performance and subsequent organizational revenue. Moreover, it was found that service encounter failures were among the major reasons for customers' service switch. Therefore, the selection of customer service oriented employees is a key factor in establishing customer service - a potential source of sustained competitive advantage. However, the measurement of employee service orientation is more confusing than that of definitive answers. The difficulty of measuring service orientation is attributed to the use of broad versus narrow measures of personality. Advocates for the broad perspective prefer using basic personality constructs, such as the Big Five personality traits. On the contrary, the latter prefer a construct-oriented approach of personality research that provides a better measure of job performance because it requires the specification of the relationship of the personality traits with multiple dimensions of job performance. The customer service orientation was defined as "a set of basic individual predispositions and an inclination to provide service, to be courteous and to be helpful in dealing with customers and associates." Similarly, it is a fact that the Big five personality traits are predictors of customer orientation, and employee's self- and supervisor performance. They propose that basic personality traits may be too far removed from focal service behaviors to be able to predict specific service behaviors (customer orientation) and service worker performance. Also, customer orientation is defined as "an employee's tendency or predisposition to meet customer needs in an on-the-job context." This means that people who have job-relevant personality traits such as concern, empathy, and conscientiousness will be more adept at customer service than people who do not possess these traits. However, little attention has been given to the exploration of the service orientation of customer-contact employees who play a key role in creating satisfactory service encounters in the hospitality industry except for Kim, McCahon, & Miller (2003)'s study, especially in family restaurants context. Thus, the purposes of this study are to examine and validate the customer service orientation of customer-contact employees using the instrument developed by Donavan (1999) in Korean family restaurants, because the scale was developed to measure the personality traits related job behaviors. And this study explores the relationships between customer service orientation, job satisfaction, organizational commitment, and self service performance using structural equation modeling (SEM). And this study explores the relationships between customer service orientation, job satisfaction, organizational commitment, and self service performance using structural equation modeling (SEM). For these purposes the author developed several hypotheses as follows: H1: Employee's service orientation is associated with service performance. H2: Employee's service orientation is positively associated with job satisfaction. H3: Employee's service orientation is positively associated with organizational commitment. H4: Service performance is positively associated with job satisfaction. H5: Service performance is positively associated with organizational commitment. H6: Job satisfaction is negatively associated with organizational commitment. The data were collected from 278 employees in 5 deluxe hotels located in Pusan, Korea. The researcher contacted the manager of the restaurants, and managers consented to administer surveys to their employees. The survey was executed during one month period in the October of 2007. The data were analyzed with structural equation modeling with LISREL 8.7 W. The result of the overall model analysis appeared as follows: $X^2$=122.638 (p = 0.00), df=59, GFI=.936, AGFI=.901, NFI=.948, CFI=.971, RMSEA=.0625. Since the result of the overall model analysis demonstrated a good fit, we could further analyze our data. The findings can be summarized as follows: First, the greater the employee service orientation, the greater the service performance. Second, the greater the employee service orientation, the greater the job satisfaction. Third, the greater the employee service orientation, the greater the organizational commitment. Fourth, the greater the service performance, the greater the job satisfaction. Fifth, the greater the service performance, the greater the organizational commitment. Finally, the greater the job satisfaction, the greater the organizational commitment. Seventh, the greater the customer satisfaction, the greater the customer loyalty.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.225-270
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• 2008

We analyze macroeconomic consequences of pay-as-you-go (PAYGO) public pension system with a simple overlapping generations model. Contrary to large body of existing literatures offering quantitative results based on simulation study, we take another route by adopting a highly simplified framework in search of qualitatively tractable analytical results. The main contribution of our results lies in providing a sound theoretical foundation that can be utilized in interpreting various quantitative results offered by simulation studies of large scale general equilibrium models. We present a simple overlapping generations model with a defined benefit(DB) PAYGO public pension system as a benchmark case and derive an analytical equilibrium solution utilizing graphical illustration. We also discuss the modifications of the benchmark model required to encompass a defined contribution(DC) public pension system into the basic framework. Comparative statics analysis provides three important implications; First, introduction and expansion of the PAYGO public pension, DB or DC, result in lower level of capital accumulation and higher expected rate of return on the risky asset. Second, it is shown that the progress of population aging is accompanied by lower capital stock due to decrease in both demand and supply of risky asset. Moreover, risk premium for risky asset increases(decreases) as the speed of population aging accelerates(decelerates) so that the possibility of so-called "the great meltdown" of asset market cannot be excluded although the odds are not high. Third, it is most likely that the switch from DB PAYGO to DC PAYGO would result in lower capital stock and higher expected return on the risky asset mainly due to the fact that the young generation regards DC PAYGO pension as another risky asset competing against the risky asset traded in the market. This theoretical prediction coincides with one of the firmly established propositions in empirical literature that the currently dominant form of public pension system has the tendency to crowd out private capital accumulation.

• Journal of the Korean association of regional geographers
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• v.6 no.2
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• pp.21-40
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• 2000

The retail trades in many countries have changed recently according to the high quality, diversification, and marked individuality of consumer needs. Under the continually competing system of the WTO agreement, corporations based in the USA and the EU try to raise their market share in other countries so it is inevitable for Korean retail enterprises to compete with them. This paper is aimed at contributing to the efficient growth for Korean retail trade from the analysis of the development process in retail trade and its changing locations comparing Korea and the USA. Retailers in the USA have practiced diversified marketing strategies considerably in order to survive in a rapidly changing retailing environment. American retailing, which has the most advanced marketing system in the world, has been of growing concern to marketing strategies in Korea. The following is a brief summary of this study. 1. Speedy and higher quality consumption is needed in accordance with the great increase in the single-family household and the female labor force participation both in Korea and in the USA. Senior citizens have become a new consumer group due to the aging population. In the future the retail trade will switch over to diversified retail formats and internet shopping as countries are transformed into information and communication societies. 2. In Korea, the former retail system characterized by markets and department stores has been greatly changed since the late 1980s with emphasis on high quality and convenience in consumption behaviors, with large domestic enterprises and foreign distribution corporations participating in Korean retailing. In the USA, retailing mergers and takeovers by major retails, bankruptcies, and extra-large shopping centers have emerged since the late 1980s. Recently, the USA retailing formats have been changed from the lower price-oriented discount types to the large scale theme parks. Much emphasis was put on entertainment, resorts, and convention centers. On the other hand, non-store types, such as the internet shopping, the CATV shopping, as well as catalog and mail-order sales are drastically increasing, although the proportion of their sales is low up to now. 3. In Korea, most of the retail facilities are concentrated in Seoul and the Metropolitan Region, and the distribution ratio of facilities came to 52% in 1997. The periodic markets, traditional markets which open on a periodic basis, are located mainly in Chollanam-do and Kyungsangbuk-do. The large-sized discount stores have expanded their locations to the over-crowded apartment complexes in new towns, located in the Metropolitan Region, and the large provincial cities, unlike the suburban locations in the USA. Therefore we needed to give attention to the locational relations in retail facilities between Seoul & the Metropolitan Region and rural settlement areas. In the USA, urban areas grew quickly with the development of the automobile in the 1920s, and the location of stores changed from a dispersed style centering around rural areas to a centralized one in urban areas. There is an accelerated growth for suburban areas, which have grown rapidly since 1950. As the membership warehouse clubs were introduced in the 1970s, the decentralization of location was more intensified. On the other hand, inner cities were revitalized by rearranging existing facilities to cope with suburban areas. And the location-free virtual retailing & TV shopping are also growing every year. 4. In view of the above, the continuous and desirable development devices in Korean retail trade are summarized as follows: First, the countermeasures against economies of scale, increase in retailing sales, and rise of a employment percentage in retailing are in need. Second, a scheme of lowering the proportion of food retail sales, and increasing a ratio of durable goods sales need to be worked out. Third, the original ideas are needed to apply positively information, communication and technology to retailing, to graft the traditional types on modem ones based on the social culture. Fourth, strategies are needed to strengthen the competitiveness of our retail trade through cooperation and chains of smaller retailers, the large enterprises participating in the distribution industry. Fifth, in order to realize the above, the retail industry, the administration, and the academic world should support the retail segment with concern and a practical strategy plan.

• Cartoon and Animation Studies
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• s.6
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• pp.152-171
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• 2002

This study analyses the avatar service, which is recognized as an alternative strategy of animation industry. The research questions of this study are following: (1) How have the avatar services been developed and what are the present dominant types? (2) Which structural characteristics of e-business environment are needed for the success of avatar services? (3) What is the economic characteristics of avatar business model? To solve these research questions, the basic conditions and the structural characteristics of avatar services have been investigated. In the first place, two forms of avatar service are classified. One is the internet service site whole primary service is to provide chatting service based on avatar service. The other is the portal site in which many kinds of products and services are presented as bundles to meet the needs of internet users. So avatar service is one of bundles which those portal sites are providing with. In this study, the big five internet service sites are selected based on the profits they earned through the sales of avatar service. The result of analysis is that the pricing strategy of those big five sites is very different from those of traditional off-line markets. The pricing mechanism are based on the value which internet users endow with the avatar items, not based on the costs of making the products. Avatar is the representative informative goods. The informative goods have the original cost structures, constant fixed costs and zero marginal costs, so the providers of avatar services make much of the subjective values of consumers. The sayclub, which is the most successful avatar service site and earn the average sales of 3 billing won a month, takes the aggressive strategy of pricing avatar items at highest price in the industry. The avatar service providers which make lots of profits are planning of making differentiate the services, introducing well-known brand items and star-named items. Nevertheless, the fact that the members of the sayclub are not decreasing means that the network effect of the site is so strongly manifest. Moreover, the costs the members have paid for the avatar items are so big not as to switch from one site to the other site, it can be very costly. These switching costs are endemic in high-technology industries and digital contents industries. It can be so large that switching suppliers is virtually unthinkable, a situation known as 'lock-in'. When switching costs are substantial, competition can be intense to attract new customers, since, one they are locked in, they can be a substantial source of profit. The consumers of avatar items have switching costs if they subscribe for the new avatar service site. The switching costs can be subscription costs as well as the costs of giving up the items they already paid for. One common example of switching costs involves specialized supplies, as with inkjet printer cartridges. In this example, the switching cost is the purchase of a new printer. The market is competitive ex ante, but since cartridges are incompatible, it is monopolized dx post. So the providers of printer/cartridges set pricing printer so cheap and cartridges expensive. On the contrary, since the avatar service can be successful with the strong network effect, the providers of avatar services have to compete aggressively for new customers. So they allow the subscription at a low price(almost marginal cost) in the early market. The network effect can be maximized when the members are sufficiently growing. The providers which have the monopoly power with sufficient subscribers. begin to raise the prices over the lifetime of the product and make profits.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.532-537
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• 2010

Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.