• Journal of Food Hygiene and Safety
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• v.29 no.3
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• pp.202-206
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• 2014

In this study, the bacteriological survey was examined on ice creams at manufacturing factories in Korea during the summer season of 2011. The nineteen selected among 166 samples by preliminary test were collected from 11 different manufacturing factories in four major manufacturers in May 2011. Samples from ice milk, ice creams, sherbets, and non milk fat ice creams were tested for the total aerobic bacteria, coliform bacteria, and five food borne pathogens, respectively. The results showed that the coliforms including E. coli O157:H7, Salmonella spp., Staphylococcus aureus, Clostridium perfringens, and Listeria monocytogenes were not detected on all the ice creams. The total aerobic bacteria of the packed samples examined ranged between $2.5{\times}10^3$ and $5.5{\times}10^5cfu/g$. One ice cream, two sherbets, and four ice milk samples exceeded the acceptable limits of total aerobic bacteria according to the Korean standards for ice cream ($1.0{\times}10^5cfu/g$) and others ($5.0{\times}10^4cfu/g$). The levels of these microorganisms from ice creams were higher in three original equipment manufacturers than seven self-manufacturers. Three of ten ice creams (30.0%), three of six ice milks (50.0%), and one of two sherbets (50%) exceeded the acceptable limits of total aerobic bacteria, respectively. The personnel hygiene procedures with chocolate and vanilla chip addition from the manufacturing process were the main sources of the microbial contamination of stick-bar type ice creams when being produced in a factory. Improvement of the hazard analysis critical control points (HACCP) system should be introduced into the ice cream factory to improve the microbial quality of the ice cream products in Korea.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.142-149
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• 2003

To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.889-896
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• 1996

Aggressive revascularization of the ischemic lower extremities in atherosclerotic occlusive diseases or acute embolic arterial occusion due to cardiac valvular disease by thromboembolectomy or an arterial by- pass operation has been advocated by some authors. To evaluate clinical pattern and operative outcome of the ischemic lower extremity, surgical experience in 101 patients who were admitted to Dong-A Univer- sity Hospital between March 1990 and August 1995 was analyzed. The patients were 92 males and 9 females ranging fro 25 to 87 years of age. The underlying causes of arterial occlusive disease were atherosclerotic obliterances in 54 case, Buerger's disease in 20 cases, thromboembolism in 24 cases, vascular trauma in 3 cases and pseudoaneurysm in 3 cases. - The major arterial occlusive sites of atherosclerotic obliterance were femoral artery in 30 cases, iliac artery in 23 cases, popliteal artery in 10 cases, distal aorta in 6 cases and the major arterial occlusive sites of Buerger's disease were posterior tibial artery in 14 cases, anterior tibial artery in 8 cases, popliteal artery in 5 cases. The operative procedures of arterial occlusive disease were bypass graft operation in 61 cases, thromboembolectomy in 21 cases, sympathectomy in 20 cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 61 cases which Included femoro-popliteal bypass in 21 cases, femoro-femoral bypass in 15 cases, axillo-bifemoral bypass in 7 cases, aorto-bifemoral with inverted Y-gr ft In 3 cases, femoro-profundafemoral bypass in 3 cases, popliteo-tibial bypass in 2 cases, aorto-iliad bypass in 1 case Over all postoperative patency rates were 83.6 oyo at 1 year, 75.5% at 3 years and limb salvage rate was 86.8 oyo . Six patients died in the hospital following vascular surgery for ischemic lower extremities, although the causes of death were not directly related to the vascular reconstructive operative proccedures. The leading causes of death were in the order of multiple organ failure, acute renal failure, and sepsis.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.24-34
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• 1996

There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.616-621
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• 2005

Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.

• Journal of the Korean Society for Library and Information Science
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• v.4
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• pp.43-71
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• 1975

Operations research has developed rapidly since its origins in World War II. Practitioners of O. R. have contributed to almost every aspect of government and business. More recently, a number of operations researchers have turned their attention to library and information systems, and the author believes that significant research has resulted. It is the purpose of this essay to introduce the library audience to some of these accomplishments, to present some of the author's hypotheses on the subject of library management to which he belives O. R. has great potential, and to suggest some future research directions. Some problem areas in librianship where O. R. may play a part have been discussed and are summarized below. (1) Library location. It is usually necessary to make balance between accessibility and cost In location problems. Many mathematical methods are available for identifying the optimal locations once the balance between these two criteria has been decided. The major difficulties lie in relating cost to size and in taking future change into account when discriminating possible solutions. (2) Planning new facilities. Standard approaches to using mathematical models for simple investment decisions are well established. If the problem is one of choosing the most economical way of achieving a certain objective, one may compare th althenatives by using one of the discounted cash flow techniques. In other situations it may be necessary to use of cost-benefit approach. (3) Allocating library resources. In order to allocate the resources to best advantage the librarian needs to know how the effectiveness of the services he offers depends on the way he puts his resources. The O. R. approach to the problems is to construct a model representing effectiveness as a mathematical function of levels of different inputs(e.g., numbers of people in different jobs, acquisitions of different types, physical resources). (4) Long term planning. Resource allocation problems are generally concerned with up to one and a half years ahead. The longer term certainly offers both greater freedom of action and greater uncertainty. Thus it is difficult to generalize about long term planning problems. In other fields, however, O. R. has made a significant contribution to long range planning and it is likely to have one to make in librarianship as well. (5) Public relations. It is generally accepted that actual and potential users are too ignorant both of the range of library services provided and of how to make use of them. How should services be brought to the attention of potential users? The answer seems to lie in obtaining empirical evidence by controlled experiments in which a group of libraries participated. (6) Acquisition policy. In comparing alternative policies for acquisition of materials one needs to know the implications of each service which depends on the stock. Second is the relative importance to be ascribed to each service for each class of user. By reducing the level of the first, formal models will allow the librarian to concentrate his attention upon the value judgements which will be necessary for the second. (7) Loan policy. The approach to choosing between loan policies is much the same as the previous approach. (8) Manpower planning. For large library systems one should consider constructing models which will permit the skills necessary in the future with predictions of the skills that will be available, so as to allow informed decisions. (9) Management information system for libraries. A great deal of data can be available in libraries as a by-product of all recording activities. It is particularly tempting when procedures are computerized to make summary statistics available as a management information system. The values of information to particular decisions that may have to be taken future is best assessed in terms of a model of the relevant problem. (10) Management gaming. One of the most common uses of a management game is as a means of developing staff's to take decisions. The value of such exercises depends upon the validity of the computerized model. If the model were sufficiently simple to take the form of a mathematical equation, decision-makers would probably able to learn adequately from a graph. More complex situations require simulation models. (11) Diagnostics tools. Libraries are sufficiently complex systems that it would be useful to have available simple means of telling whether performance could be regarded as satisfactory which, if it could not, would also provide pointers to what was wrong. (12) Data banks. It would appear to be worth considering establishing a bank for certain types of data. It certain items on questionnaires were to take a standard form, a greater pool of data would de available for various analysis. (13) Effectiveness measures. The meaning of a library performance measure is not readily interpreted. Each measure must itself be assessed in relation to the corresponding measures for earlier periods of time and a standard measure that may be a corresponding measure in another library, the 'norm', the 'best practice', or user expectations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.301-308
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• 2018

This study explores an analytical mathematical model designed to estimate the optimal debt ratio of the Korean automobile industry, which has a more significant effect on the national economy than that of other industries, and attempts to estimate the optimal debt ratio based on objective data. The analytical model is based on ROA and ROE which uses the debt ratio as an independent variable and employs ROS, TAT, and NFCL as the related parameters. Regarding the NFCL, the optimal debt ratio is usually defined as the debt ratio that maximizes the ROA and ROE and is calculated using analytical procedures, such as by adding an equation that considers the debt ratio and the linearity relationship to the analytical model. This is because the optimal debt ratio can be calculated reliably by making use of an estimated value within a certain range, which is derived from more than two calculations rather than a single estimation starting from one calculation formula. In this study, for the estimation of the optimal debt ratio, the ROA and ROE are expressed as a quadratic equation with the debt ratio as the independent variable. Using this analysis procedure, the optimal debt ratio obtained using the data from the Korean automobile industry over a sixteen year period, which would optimize the profitability of the Korean automobile industry, was found to be 188% of the debt ratio in the ROA and 213% of the debt ratio in the ROE. This result was obtained by overcoming the problem of the reliability of the estimation value in spite of the limitations of the logical theory of this study, and can be interpreted as meaning that maintaining a debt ratio of 188% to 213% can enhance the profitability and reduce the risks in the Korean automobile industry. Furthermore, this indicates that the existing debt ratio of the Korean automobile industry is lower than the optimal value within the estimated range. Consequently, it is necessary for corporations to change their future debt ratio policies, given that the purpose of debt ratio management is to maintain safety and increase profitability, and to take into account the characteristics of the specific industry.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.623-629
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• 2006

Purpose : The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. Methods : One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. Results : The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. Conclusion : Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1065-1070
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• 2008

Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. Results : The mean gestational age (GA) was $26{\pm}2weeks$ (range, 23-32 wk), and the birth weight was $782{\pm}146g$ (range, 430-990 g). The delayed closure group was associated with early GA ($25.7{\pm}1.7wk$ vs $27.1{\pm}2.0wk$, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010). Conclusion : Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.579-587
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• 2006

Background: Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have poor surgical outcome; prolonged pleural drainage, protein losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for prolonged pleural effusion drainage after the Fontan operation. Material and Method: A retrospective review of 96 consecutive patients who underwent the Extracardiac Fontan procedures (median age: 3.9 years) was performed. Fontan risk score (FRS) was calculated from 12 categorized preoperative anatomic and physiologic variables. PVC $(mm^2/m^2{\cdot}mmHg)$ was defined as pulmonary artery index $(mm^2/m^2)$ divided by total pulmonary resistance $(W.U{\cdot}/m^2)$ and pulmonary blood flow $(L/min/m^2)$ based on the electrical circuit analogue of the pulmonary circulation. Chest tube indwelling time was log-transformed (log indwelling time, LIT) to fit normal distribution, and the relationship between preoperative predictors and LIT was analyzed by multiple linear regression. Result: Preoperative PVC, chest tube indwelling time and LIT ranged from 6 to 94.8 $mm^2/mmHg/m^2$ (median: 24.8), 3 to 268 days (median: 20 days), and 1.1 to 5.6 (mean: 2.9, standard deviation: 0.8), respectively. FRS, PVC, cardiopulmonary bypass time (CPB) and central venous pressure at postoperative 12 hours were correlated with LIT by univariable analyses. By multiple linear regression, PVC (p=0.0018) and CPB (p=0.0024) independently predicted LIT, explaining 21.7% of the variation. The regression equation was LIT=2.74-0.0158 PVC+0.00658 CPB. Conclusion: Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.