• Journal of Chest Surgery
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• v.31 no.12
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• pp.1172-1182
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• 1998

Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.

• Korean journal of applied entomology
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• v.48 no.2
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• pp.123-158
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• 2009

An attempt was made to stimulate future research by providing exemplary information, which would integrate published knowledge to solve specific pest problem caused by resistance. This review was directed to find a way for delaying resistance development with consideration of chemical(s) nature, of mixture, rotation, or mosaics, and of insecticide(s) compatible with the biological agents in integrated pest management (IPM). The application frequency, related to the resistance development, was influenced by insecticide activity from potentiation, residual period, and the vulnerability to resistance development of chemical, with secondary pest. Chemical affected feeding, locomotion, flight, mating, and predator avoidance. Insecticides with negative cross-resistance by the difference of target sites and mode of action would be adapted to mixture, rotation and mosaic. Mixtures for delaying resistance depend on each component killing very high percentage of the insects, considering allele dominance, cross-resistance, and immigration and fitness disadvantage. Potential disadvantages associated with mixtures include disruption of biological control, resistance in secondary pests, selecting very resistant population, and extending cross-resistance range. The rotation would use insecticides in high and low doses, or with different metabolic mechanisms. Mosaic apply insecticides to the different sectors of a grid for highly mobile insects, spray unrelated insecticides to sedentary aphids in different areas, or mix plots of insecticide-treated and untreated rows. On the evolution of pest resistance, selectivity and resistance of parasitoids and predator decreased the number of generations in which pesticide treatment is required and they could be complementary to refuges from pesticides To enhance the viability of parasitoids, the terms on the insecticides selectivity and factors affecting to the selectivity in field were examined. For establishment of resistant parasitoid, migration, survivorship, refuge, alternative pesticides were considered. To use parasitoids under the pressure of pesticides, resistant or tolerant parasitoids were tested, collected, and/or selected. A parasitoid parasitized more successfully in the susceptible host than the resistant. Factors affecting to selective toxicity of predator are mixing mineral oil, application method, insecticide contaminated prey, trait of individual insecticide, sub-lethal doses, and the developmental stage of predators. To improve the predator/prey ratio in field, application time, method, and formulation of pesticide, reducing dose rate, using mulches and weeds, multicropping and managing of surroundings are suggested. Plant resistance, predator activity, selective insect growth regulator, and alternative prey positively contributed to the increase of the ratio. Using selective insecticides or insecticide resistant predator controlled its phytophagous prey mites, kept them below an economic level, increased yield, and reduced the spray number and fruits damaged.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.186-193
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• 2005

Purpose: To improve the management of a medical linear accelerator, the records of operational failures of a Varian CL2l00C over a ten year period were retrospectively analyzed. Materials and Methods: The failures were classified according to the involved functional subunits, with each class rated Into one of three levels depending on the operational conditions. The relationships between the failure rate and working ratio and between the failure rate and outside temperature were investigated. In addition, the average life time of the main part and the operating efficiency over the last 4 years were analyzed. Results: Among the recorded failures (total 587 failures), the most frequent failure was observed in the parts related with the collimation system, including the monitor chamber, which accounted for $20\%$ of all failures. With regard to the operational conditions, 2nd level of failures, which temporally interrupted treatments, were the most frequent. Third level of failures, which interrupted treatment for more than several hours, were mostly caused by the accelerating subunit. The number of failures was increased with number of treatments and operating time. The average life-times of the Klystron and Thyratron became shorter as the working ratio increased, and were 42 and $83\%$ of the expected values, respectively. The operating efficiency was maintained at $95\%$ or higher, but this value slightly decreased. There was no significant correlation between the number of failures and the outside temperature. Conclusion: The maintenance of detailed equipment problems and failures records over a long period of time can provide good knowledge of equipment function as well as the capability of predicting future failure. Wore rigorous equipment maintenance Is required for old medical linear accelerators for the advanced avoidance of serious failure and to improve the qualify of patient treatment.

• Journal of the Korean Society of Marine Environment & Safety
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• v.23 no.1
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• pp.26-32
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• 2017

Enlargement and speed-up of a ship and diversification of ship's type have served to greatly increase the importance of marine transport means. It's reported that accident occurrence frequency of collision is high next to engine damage among the ship accident types, and that the accident ratio according to human factors is also high. In addition, ship accidents come to occur caused by complex cause factors rather than a sole cause factor, it is necessary to investigate the cause factors through the written verdict. This study proposed the cause factors of collision ship accident on the basis of human factors in collision ship accident among the written verdicts provided by the Korean Maritime Safety Tribunal, and inquired into the cause factor and effect through the correlation analysis of accident occurrence factors. Also, this study predicted the collision accident through analyzed the major cause factor of the occurrence at the zero minute when collision on the basis of the time taken from the time point of detecting collision of ships to the time point of collision occurrence. This study used commercial software-Statistical Package for Social Sciences (SPSS Ver21.0) to do correlation analysis. For time analysis, this study analyzed the cause factor and time by analyzing the time taken from the time point of detected ships to the time point of collision occurrence on the basis of the written verdicts. The study analysis showed that there were many cases of collision ship accidents occurrence caused by more than two sorts of cause factors, and that the case (zero minute) where there is no time to spare for collision avoidance accounted for 36.1 %, and negligence in guard or surveillance of the other ship, and sailing while drowsy, or drinking was a contributor to an accident. Poor watch keeping is very strong relationship with pool ready for sail.

• Journal of the Korean Institute of Landscape Architecture
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• v.48 no.4
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• pp.1-7
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• 2020

This study quantified annual uptake and storage of carbon by urban greenspace in institutional lands and suggested improvement of greenspace structures to enhance carbon reduction effects. The study selected a total of five study cities including Seoul, Daejeon, Daegu, Chuncheon, and Suncheon, based on areal size and nationwide distribution. Horizontal and vertical greenspace structures were field-surveyed, after institutional greenspace lots were selected using a systematic random sampling method on aerial photographs of the study cities. Annual uptake and storage of carbon by woody plants were computed applying quantitative models of each species developed for urban landscape trees and shrubs. Tree density and stem diameter (at breast height) in institutional lands averaged 1.4±0.1 trees/100 ㎡ and 14.9±0.2 cm across the study cities, respectively. Of the total planted area, the ratio of single-layered planting only with trees, shrubs, or grass was higher than that of multi-layered structures. Annual uptake and storage of carbon per unit area by woody plants averaged 0.65±0.04 t/ha/yr and 7.37±0.47 t/ha, which were lower than those for other greenspace types at home and abroad. This lower carbon reduction was attributed to lower density and smaller size of trees planted in institutional lands studied. Nevertheless, the greenspace in institutional lands annually offset carbon emissions from institutional electricity use by 0.6 (Seoul)~1.9% (Chuncheon). Tree planting in potential planting spaces was estimated to sequester additionally about 18% of the existing annual carbon uptake. Enhancing carbon reduction effects requires active tree planting in the potential spaces, multi-layered/clustered planting composed of the upper trees, middle trees and lower shrubs, planting of tree species with greater carbon uptake capacity, and avoidance of the topiary tree maintenance. This study was focused on finding out greenspace structures and carbon offset levels in institutional lands on which little had been known.