• Title/Summary/Keyword: Case Review

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Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

A Case Study - IT Outsourcing of the Korea Development Bank (산업은행: 금융 IT 아웃소싱 - 공동협력으로 안전한 문을 연다)

  • Kang, Ju-Young;Lee, Jae-Kyu
    • Information Systems Review
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    • v.7 no.2
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    • pp.229-255
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    • 2005
  • The Korea Development Bank promoted a total outsourcing for IT operation in 1999 for the first time in the banking industry. The Korea Development Bank became the center of public attention because the most banks were unwilling to take an outsourcing with external sources for the reason of financial operation accidents, securities, and threats of strikes. After the introduction of the total IT outsourcing, the Korea Development Bank has continuously diagnosed the problems of the IT outsourcing and adopted various proper complements for the enhancement of the IT outsourcing. As the result of the enhancement, the IT outsourcing of the Korea Development Bank marched into the joint liability operation period after going through the outsourcing operation period and the co-operation period. The joint liability operation which is the most leading outsourcing system which is adopted by the Korea Development Bank for the first time in the banking industry. Through the joint liability operation, the Korea Development Bank could accept the most up-to-date IT, concentrate internal manpower on the core capability, and secure flexibility of manpower. Also, the bank changed the relationship between the bank and the external sources from the one-sided relationship between a producers and a consumer to the joint liability relationship on which both sides are responsible for the operation, and could integrate the internal capacity with the professional know-how of the external IT outsourcing company. In this paper, we testified the soundness and validity for the worries of banks about the total IT outsourcing with external sources. And, we arranged the advantages and outcomes of the total IT outsourcing with external sources compared to the IT outsourcing with internal sources. Moreover, we expect that we can improve the closed financial IT outsourcing industry structure and raise the world competitive power of domestic IT outsourcing companies by correcting wrong ideas on the IT outsourcing with external sources.

Digital painting: Image transfonnation, simulation, heterologie and transfonnation (현대회화에서의 형태와 물질 -Digital Transfiguration에 관한 연구-)

  • Jeong, Suk-Yeong
    • Journal of Science of Art and Design
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    • v.10
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    • pp.161-181
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    • 2006
  • The words which appeared in my theoretical study and work are image transformation to digital painting, simulation, heterologie and transfiguration, etc. Firstly, let's look into 'digital era' or 'new media era'. Nowadays, the image world including painting within the rapid social and cultural change, which is called as digital era, is having the dramatic change. Together with the development of scientific technology, large number of events which was deemed to be impossible is happening as real in image world Moreover, these changes in image world is greatly influencing to our life. The word which compresses this change of image world and shows is 'digital'. Digit, which means fingers in Latin, indicates separately changing signal, and to be more narrow, it indicates the continual signal of '0' and ' 1' in computer. The opposite word is 'analogue'. As analogue is the word meaning 'infer' or 'similarity', it indicates the signal or form which continuously changes along the series of time when it is compared to digital. Instead of analogue, digital is embossed as a major ruler along the whole area of our current culture. In whole culture and art area, and in whole generalscience, digital is appearing as it has the modernism and importance. The prefix, 'digital', e.g. digital media, digital culture, digital design, digital philosophy, etc, is treated as the synonym of modernism and something new. This advent of digital results the innovative change to the image world, creates the new beauty experience which we could not experience before, and forecasts the formation of advanced art and expansion of creative area. Various intellectual activities using computer is developing the whole world with making the infrastructure. Computer in painting work immediately accomplishes the idea of painters, takes part in simulation work, contingency such as abrupt reversal, extraction, twisting, shaking, obscureness, overlapping, etc, and timing to stimulate the creativity of painters, and provides digital formative language which enables new visual experience to the audience. When the change of digital era, the image appeared in my work is shown in 'transfiguration' like drawing. The word, 'transfiguration' does not indicate the completed and fixed real substance but indicate endlessly moving and floating shape. Thus, this concept is opposite to the substantial consideration, so that various concepts which is able to replace this in accordance with the similar cases are also exist such as change, deterioration, mutation, deformity of appearance and morphing which is frequently used in computer as a technical word. These concepts are not clearly classified, and variably and complicatedly related. Transfiguration basically means the denial of "objectivity' and '(continual) stagnation' or deviation from those. This phenomenon is appeared through the all art schools of art ever since the realism is denied in the 19th century. It is called as 'deformation' in case of expressionism, futurism, cubism, etc, in the beginning of the century, which its former indication is mostly preserved within the process of structural deviation and which has the realistic limit which should be preserved. On the contrary, dramatic transfiguration which has been showing in the modern era through surrealism is different in the point that dramatic transfiguration tends to show the deterioration and deviation rather than the preservation of indicated object. From this point, transfiguration coming out from morphing using computer deteriorates and hides the reality and furthermore, it replaces the 'reality'. Moreover, transfiguration is closely approached to the world of fake or 'imaginary' simulation world of Baudrillard. According to Baudrillard, the image hides and deteriorates the reality, and furthermore, expresses 'not existing' to 'imaginary' under the name of transfiguration. Certain reality, that is, image which is absent from the reality is created and overflowed, so that it finally replaces the reality. This is simulation as it is said by Baudrillard. In turn, Georges Bataille discusses about the image which is produced by digital technology in terms of heterologie. Image of heterologie is the visual signal which is established with the media. Image of media is to have the continuous characteristics of produce, extinction, and transformation, and its clear boundary between images becomes meaningless. The meaning of composition, excess, violation, etc of digital image is explained to heterological study or heteologie suggested as important meaning of Georges Bataille who is a heretic philosopher. As the form and image of mutation shows the shape in accordance with mechanical production, heterologie is introduced as very low materialism (or bas materialisme), in this theory. Heterologie as low materialism which is gradually changing is developing as a different concept and analysis because of the change of time in the late 20s century beside high or low meaning. Including my image, all images non-standardizes and transforms the code. However, reappearance and non-standardization of this code does not seem to be simple. The problem of transformation caused by transfiguration which appears in my digital drawing painting, simulation, heterologie, etc, are the continual problems. Moreover, the subject such as existence of human being, distance from the real life, politics and social problems are being extended to actual research and various expressing work. Especially, individual image world is established by digital painting transfiguration technique, and its change and review start to have the durability. The consciousness of observers who look at the image is changing the subject. Together with theoretical research, researchers are to establish the first step to approach to various image change of digital era painting through transfiguration technique using our realistic and historical image.

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Cytopathologic Diagnosis of Bile Obtained by Percutaneous Biliary Drainage (담즙의 세포병리학적 진단에 관한 연구)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.3 no.1
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    • pp.1-11
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    • 1992
  • From the one hundred forty eight patients with evidence of biliary tract obstruction, 275 bile samples were obtained from percutaneously placed biliary drainage catheters. Of the 148 patients, ova of Clonorchis sinensis were demonstrated in 17 patients (11.5%), with the epithelial cells. Among them, one case also demonstrated coexisting adenocarcinoma. In 105 patients, the medical records were available for review and the clinical diagnoses were malignancy in 99 patients and benign lesion in 6 patients. Of the 99 patients in which clinico-radiologic diagnosis were malignant, cytologic results were positive in 23.2%. Dividing the patients Into two groups, the ones with tumor of bile duct origin (group I) and the others with tumors producing extrinsic compression of bile duct, such as periampullary carcinoma, pancreas head carcinoma or metastatic carcinoma in lymph nodes from tumors of adjacent organs (group II), the cytologic results were positive in 37% and 11.6%, respectively. In patients with histologic confirmation, the positive correlation was found in 50% and 20% in group I and group II, respectively, with remarkable difference between two groups. There were no false positives in cytologic diangosis. The overall concordance rate of cytologic diagnosis with diagnosis of clinical investigation in both benign and malignant lesions was 27.6% and the diagnostic specificity was 100%.

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Review of Family Planning / Health Integration Efforts and Evaluation Results in Korea (가족계획과 보건사업의 통합시도 및 평가결과)

  • Bang, Sook
    • Korea journal of population studies
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    • v.10 no.2
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    • pp.58-81
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    • 1987
  • The purpose of this study is to examine major factors that affect patterns of living arrangements of older Korean noncitizens in the United States using the 1990 8% Public Use Microdata Sample(PUMS). In order to do so, I analyzed the effects of four factors including acculturation(English proficiency and Age at migration), economic circumstances(Personal Income and Supplemental Security Income: SSI receipt), health status(Mobility and Personal care limitation), and the ethnic community. The results show that acculturation and economic circumstances play an important role in determining the patterns of living arrangements among older Korean aliens, whereas the health status and the ethnic community do not show consistent effects. Regardless of marital status, the impact of age at migration is positively associated with solitary living of older Korean noncitizens, though, the effect of English proficiency show the opposite direction in accordance with marital status. That is, among nonmarried elders, those who cannot speak English are more likely to live alone. The case is reverse for married elders. The impact of economic feasibility is also positively associated with independent living arrangements. Those who receive SSI are much more likely to live apart from family, and elders whose annual personal income between $5,001 and $10,000 have the greatest propensity of solitary living-a large proportion of their income source is SSI. Individuals who receive SSI are also qualified to collect Medicaid, food stamps, rent subsidies, and other welfare benefits. In a sense, the economic feasibility provided by welfare benefits is the key determinant of independent living of older Korean noncitizens. Therefore, the recent welfare reform which denies legal aliens welfare benefits such as SSI and food stamps will severly affect the present living arrangements of older Korean aliens, and give economic burden to their family member The findings also show that there are significant differences within the elderly Korean Americans in terms of demographics, income, fertility, health status, and patterns of living arrangements by U.S. citizenship status. In particular, after controlling for age at migration as a proxy for acculturation, there is a statistically significant variation in living arrangements between elderly Korean noncitizens and naturalized citizens. For both theoretical and methodological reasons, future research on minority aging needs to investigate the concept of U.S. citizenship status for its impact on patterns of living arrangements among the minority elderly.

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Review of Primary Chest wall Tumors (원발성 흉벽종양의 임상적 고찰)

  • Sohn, Sang-Tae;Chon, Soon-Ho;Shin, Sung-Ho;Kim, Hyuck;Chung, Won-Sang;Kim, Young-Hak;Kang, Chung-Ho;Park, Moon-Hang;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.988-994
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    • 1998
  • Background: Chest wall tumors can classified into soft tissue tumors and bone tissue tumors and can be subclassified into benign and malignant tumors. Materials and methods: We report an analysis of 68 patients with primary chest wall tumors treated at the department of thoracic and cardiovascular surgery at Hanyang University Hospital from January, 1973 to September 1997. Results: Among a total of 68 patients 33(48.5%) were males and 35(51.5%) were females. The ages of the patients ranged from 10 to 79 years with a mean age of 39.3 years. According to the age distribution, 23 patients (33.8%) were from the 4th decade, 12 patients(17.6%) were from the 6th decade, and 10 patients(14.7%) were from the 5th decade. Among the primary chest wall tumors, 53 cases were benign and 15 cases were malignant. Among the benign tumors, 17 cases(32.1%) were in the 4th decade and among the malignant tumors, 6 cases(40%) were in the 4th decade. In both malignant and benign tumors the most common ages were in the 4th decade. The most common tumors were fibrous dysplasia and chondroma, each with a total of 14 cases(26.4%). Osteochondroma and lipoma each had 8 cases(15.1%). Among malignant tumors, osteosarcoma was most common with 8 cases (53.3%). According to location, 49 cases occured in both bone and cartilage tissue, 19 cases occurred in cartilage. Among the presenting symptoms, palpable mass was present in all cases. Fifty-one patients complained of tenderness and among cases with involvement of the lung, 3 patients had complained of respiratory distress. Among the malignant tumors 6 cases underwent a radical operation and 4 cases of benign tumors underwent a radical operation. Postoperativly, there was one case with recurrence from a desmoid tumor. There were no deaths postoperativly and no deaths due to complications(and their postoperative courses were uneventful). Conclusions: Most patients with primary chest wall tumors initially present with mass at admission. Resection is sufficient treatment for benign tumors but in malignant tumors wide resection of the chest wall is needed and mchest wall reconstruction.

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The Incidences and Characteristics of Malignant Pleural Effusions According to Histologic Types (악성 흉막 삼출증의 조직학적 아형에 따른 빈도와 특성)

  • Yim, Jae-Joon;Kim, U-Jin;Lee, Jae-Ho;Yoo, Chul-Gyu;Chung, Hee-Soon;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.565-573
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    • 1998
  • Malignant pleural effusions are most commonly associated with lung cancers, however, it also can be resulted from breast cancers, ovarian cancers, stomach cancers and so on. According to the their histologic types, adenocarcinoma have been known as the most common cell type of malignant pleural effusions and squamous cell carcinoma is rare. We herein present incidences, clinical characteristics and survivals of malignant pleural effusions according to their cell types and primary diseases. The objects are 84 malignant pleural effusion patients diagnosed by pleural fluid cytologic examination or pleural biopsy from Jan. 1992 to May. 1997 in Seoul National University Hospital. A retrospective chart review on their histologic types, biochemical parameters and survivals is described. Among 84 patients, 52 were males and the other 32 were females with 1.6:1 of male and female ratio and their mean age was 57.6 years old. Common symptoms of them wele dyspnea, cough, sputum and pleuritic chest pain. The proportions of bloody nature of effusion, lymphocyte dominant pleural effusion, exudative effusions were 66%, 39% and 93%, respectively. They consisted of 54 cases of adenocarcinoma(33 cases of them were lung cancers), and 10 cases of squamous cell carcinoma (8 cases of them were lung cancers), 10 cases of malignant lymphoma, 8 cases of small cell lung cancer and a case of mesothelioma and leukemia. There was no differences in characteristics of effusions, clinical features and survivals between each histologic cell types. Analyzing them according to primary diseases, no difference except longer survivals in malignant pleural effusions from breast cancer than from other cancers was observed. In conclusion, considering the incidences of histologic types of lung cancers during same period (squamous cell carcinoma; 47%, adenocarcinoma; 33%, small cell lung cancer; 12% and large cell carcinoma; 2%), malignant pleural effusions more likely occurred in adenocarcinoma than other cell types of lung cancers and there was no significant difference of clinical characteristics between histologic types.

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A Study on Visitor Motivation and Satisfaction of Urban Open Space - In the Case of Waterfront Open Space in Seoul - (도시 오픈스페이스 방문동기 및 만족도 연구 - 서울시 하천변 오픈스페이스를 중심으로 -)

  • Zoh, Kyung-Jin;Kim, Yong-Gook;Kim, Young-Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.1
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    • pp.27-40
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    • 2014
  • The functions of urban open space, which embraces community revitalization, are diverse. It is the means of public healthcare, learning centers for children, hub of arts and cultural programs, as well as promoter of urban tourism. However, in-depth discourse and research on the topic of urban open spaces has been limited so far. Hence, this study aims to investigate the motivations and satisfaction of visitation based on four representative waterfront open space in Seoul; Cheongyecheon Waterfront, Seoul Forest Park, Seonyudo Park and Banpo Hangang Park. The methods of study are literature review, observation investigation, and questionnaire survey. The findings are analyzed through the Exploratory Factor Analysis, Reliability Analysis, ANOVA Analysis and Regression Analysis by SPSS 18.0. The results of the study are as follows. First, urban waterfront open spaces in Seoul has 5 factors of visitor motivation; community amenity, nature access, cultural and educational assets, aesthetic enjoyment, and lastly means of escape. Second, factors of recognizing urban waterfront open spaces as community amenity and nature access indicate meaningful differences in visitor's perception by spatial characteristics. Third, distances between the destination and the visitor's residence influence significantly their perceived motivation. Close-range visitors perceived nature access as a principal factor, whilst medium to long-range visitors perceived visitation for aesthetic purposes more importantly. Lastly, the will to escape was shown as the influential factor in visitor satisfaction. Visiting open spaces for the enjoyment of nature and aesthetic purposes were factors that also closely relate to visitor satisfaction. In addition, it was found that there are different visitor motivations that influence visitor satisfaction in accordance with the spatial characteristics of each open space. In summary, it can be said that urban waterfront open space is a hybrid space connected to various types of urban contents beyond daily experiences. It was found that several visitor motivations including community development, design aesthetics, education and culture, entertainment, enjoyment of natural landscape, and relaxation, affect the overall satisfaction of the visiting experience. It is anticipated that the results of the study will be used by the local government in setting up strategies for the creation and management of successful urban waterfront open space, and for those involved in planning and design act as a starting point for spatial programming and amenities arrangement in accordance to the city's tourism and urban marketing approach.

A Study on Hybrid Characteristics of Public Space in Contemporary Cities Reinterpreted by the Idea of Liminal Space (역공간(Liminal Space) 개념으로 해석한 현대도시 공공공간의 혼성적 특성에 관한 연구)

  • Zoh, Kyung-Jin;Han, So-Young
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.4
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    • pp.49-59
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    • 2011
  • This study is a reinterpretation of characteristics of public space in contemporary cities with a view to liminal space. The conditions of pubic space now cannot be captured through the existing discourses of publicness, and public space. The basic premise of the study is that the idea of liminal space or liminality is useful to grasp the fluid and hybrid attribute of public space in contemporary cities. Liminal space, originally from anthropological studies, is the intermingled stage between two realms and the sustained period of the ritual. The idea has been widely used for various cultural phenomenon and spatial experiences. A literature review on public space and liminal space was carried out. Cases pertaining to public space with a view to liminal space were examined and discussed in detail. Through the careful reading of several public spaces with an angle toward liminal space, the new perspective toward public space will be drawn out. First, we need to emphasize the fluid spectrum of public space rather than the serial stage such as the public, the semi-public, the semi-private, and the private. Second, the idea will contribute to understanding the flexible state depending upon time. What we can learn from case studies is the volatile characteristics in public space as a common phenomenon support its vitality. This interpretation will contribute to the perception of a new horizon of public space. The nature of public space is unpredictable and free. In reality, the spectrum of public space will expand and fluctuate. Ironically, public space can be vitalized through enhancing and activating the private space. The intimate and complicated interface between the two realms is a key issue. The boundary of public space might be redefined to embrace the flexible the fragile nature of changing public space. These research implications will guide the thoughtful design and management of pubic space.

Clinical significance of follow-up laboratory tests, performed at 6 weeks after the onset of Kawasaki disease (가와사끼병에서 발병 6주째에 시행하는 추적검사의 임상적 유용성에 관한 고찰)

  • Oh, Il Ji;Moon, Kyung Hee;Hong, Myung Eun;Kim, Yeon Soon;Lee, Chang Woo;Yoon, Hyang Suk
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.672-676
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    • 2006
  • Purpose : Low dose aspirin is used due to its antiplatelet effect for the subacute phase of Kawasaki disease(KD). It is usually used for 6-8 weeks, then various hematologic laboratory tests and follow up echocardiography for evaluating coronary abnormalities are performed. Our review investigated the usefulness of various follow up laboratory tests performed at 6 weeks after the onset of KD. Methods : Two hundred eighty-two children diagnosed and hospitalized with KD were identified by reviewing patient's charts. Cases which were diagnosed between January 1997 and December 2004 were included in this study. We reviewed laboratory data including leukocytes, platelet counts, antistreptolysin O(ASO), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), aspartate aminotransferase(AST), alanine aminotransferase(ALT), urinalysis, and echocardiograms performed at admission and 6 weeks after the onset of KD. Paired t-test and Fisher's exact test, as well as logistic regression tests, were used for the statistical analysis. Results : At 6th week data, ESR and CRP were still elevated in 35(12.4 percent) and 12(4.3 percent) patients, respectively. Sterile pyuria were all normalized. But, 36 patients(12.8 percent) showed thrombocytosis, 22(7.8 percent) elevated AST, 15(5.3 percent) leukocytosis, and 6(2.1 percent) coronary abnormalities. Coronary abnormalities at the 6th week were only shown in patients with initial abnormalites. Younger age and initial thrombocytosis were risk factors for thrombocytosis at the 6th week. Conclusion : All children with initial coronary abonormalites should have an echocardiogram at 6 weeks after the onset of fever. In view of case-effectiveness, additional echocardiographic studies are justified only if abnormalities are present at admission. ESR, CRP, and urinalysis performed at the 6 weeks after onset of KD is not significant for clinical information of progression. Platelet count should be estimated at 6th week for a judgement of continuous antiplatelet therapy.