• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.828-834
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• 2005

Background: Off-pump coronary artery bypass grafting (OPCAB) has shown better outcome in chronic renal failure (CRF) patients by avoiding the effects of cardiopulmonary bypass. We evaluated renal function after OPCAB in CRF patients. Material and Method: 656 patients underwent OPCAB between January, 2001 and December, 2004. Data were collected in 26 CRF patients (Cr > 1.7 mg/dL). Preoperative/postoperative creatinine (Cr) levels, creatinine clearance and postoperative data were evaluated. We divided the patients into group 1 (Cr < 3 mg/dL) and group 2 (Cr $\geq$ 3 mg/dL). Result: Three patients started dialysis after surgery. Preoperative mean creatinine level (4.19$\pm$3.4 mg/dL) was elevated to 4.36$\pm$2.7 mg/dL at the third postoperative day and decreased below Preoperative level at the fifth postoperative day. In group 1 (mean Cr level=1.87$\pm$0.25 mg/dL), Cr level reached its peak level of 2.19$\pm$0.52 mg/dL at the fourth postoperative day (p=0.017), with subsequent decrease. Patients without pre- or postoperative dialysis (n=15) showed peak Cr elevation on postoperative day four (p=0.017) and subsequent decrease (p=0.01). Postoperative creatinine clearance showed reverse correlation with creatinine level. Conclusion: Creatinine level was elevated at third/fourth postoperative day, but decreased 5 days after surgery. Thus, if urgent dialysis is not indicated, postoperative renal replacement therapy in CRF patients may be better to be considered after four days observation.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.170-175
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• 1997

Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.416-422
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• 2004

Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.1895-1904
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• 2014

This study explores the way to improve service quality with the application of Service Blueprint and Analytic Hierarchy Process (hereafter, "AHP") in medical tourism. Service Blueprint has been widely accepted to identify the possible fail points in service delivery system, and AHP analysis has been recognized as beneficial method to rate relative importance in multi-criteria decision making process. We try to understand possible pitfalls to enhance Chinese medical tourists, and propose the priority in the resolution process. In the first step, we reviewed the extant literatures about medical tourism of South Korea, and built initial Service Blueprint. Experts who experienced service delivery process towards Chinese patients participated to review the proposed Service Blueprint in the second step. Thirdly, after extracting the possible fail points from revised Service Blueprint, we asked experts to guess the relative importance of Chinese patient by AHP methodology. Four domains (Arrival and Welcoming, Hospitalization, Process before, operations, and after surgery, Recovery and discharge) were emerged with detail criteria. Results show that operations and treatment is the most important domain not to lose Chinese patient's loyalty with following hospitalization process domain. Also, we suggest the priority among sixteen criteria to prevent service failure.

• KIPS Transactions on Computer and Communication Systems
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• v.9 no.11
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• pp.256-264
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• 2020

Industrial Wireless Sensor Networks (IWSNs) is exploited to achieve various objectives such as improving productivity and reducing cost in the diversity of industrial application, and it has requirements such as low-delay and high reliability packet transmission. To accomplish the requirement, the network manager performs graph construction and resource allocation about network topology, and determines the transmission cycle and path of each node in advance. However, this network management scheme cannot treat mobile devices that cause continuous topology changes because graph reconstruction and resource reallocation should be performed as network topology changes. That is, despite the growing need of mobile devices in many industries, existing scheme cannot adequately respond to path failure caused by movement of mobile device and packet loss in the process of path recovery. To solve this problem, a network management scheme is required to prevent packet loss caused by mobile devices. Thus, we analyse the location and movement cycle of mobile devices over time using machine learning for predicting the mobility pattern. In the proposed scheme, the network manager could prevent the problems caused by mobile devices through performing graph construction and resource allocation for the predicted network topology based on the movement pattern. Performance evaluation results show a prediction rate of about 86% compared with actual movement pattern, and a higher packet delivery ratio and a lower resource share compared to existing scheme.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.479-489
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• 1998

This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1020-1029
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• 1988

The authors evaluated 153 patients who had undergone cardiac valve replacement between October 1979 and July 1988. The results are as follows: l. Out of 153 patients, there were 56 males and 97 females ranging from 15 to 62 years of age with a mean of 37 years. 2. Isolated mitral valve replacement took place in 82 patients, aortic valve replacement[AVR] in 16, double valve replacement[DVR] in 34, AVR combined with open mitral commissurotomy in 19, and tricuspid valve replacement[TVR] was done in 2 patients. 3. 153 patients had 187 prosthetic valves replaced with Ionescu-Shiley valves[16], Carpentier-Edwards[36], Bjork-Shiley[19], St. Jude Medical[108], and Duromedics[8]. 4. Our of 98 patients with atrial fibrillation[ 64% of a total 153 patients ] during the preoperative period, 22 patients recovered NSR[ 22/98, NSR recovery rate 22.4%] after valvular surgery and remaining 76 patients revealed persisting atrial fibrillation[76/153, 49.7% ]. 5. Preoperative episodes of systemic arterial embolization were attained in 9 patients[9/153, 6% ], and left atrial thrombi were confirmed in 22 patients intraoperatively[ 22/153, 14% ]. Of these, only one patient, however, demonstrated the correspondence of preoperative embolization and intraoperative existence of LA thrombi. 6. With mechanical prostheses, anticoagulant therapy was begun 48 hours after operation with sodium warfarin[2.5-5.0mg/day], maintaining the prothrombin time between 16 and 18 seconds or 30 to 50% of control values and continued for life. With tissue prostheses, sodium warfarin was continued for 3 to 6 months and converted into buffered ASA[ 325 mg/day ] for one year. 7. The mean follow-up for the survivors was 30.1 months, with a range from 3 months to 9 years. All suspected or confirmed thromboembolic episodes counted as events and occurred in 4 patients[ 1.04%/patient-year] with mechanical valve replacement. No persistent paralysis or death was noted. Late complications have not yet occurred in the patients with isolated MVR and AVR. 8. There were remarkable structural failures of tissue valves in 3 patients[ 1.9%/patient-year ], while no instance of failure of a mechanical valve. 9. There were 10 operative early deaths[10/153, 6.5%] and 5 late deaths[5/153, 3.3%]. Consequently, overall mortality was 9.8%[ 15/153] during follow-up period. 10. We currently favor using the St. Jude Medical valve in all patients requiring valve replacement except in those who can not take warfarin anticoagulation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.44-54
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• 2018

Stress and fatigue of the distributor, an equipment of the high-pressure evaporator for the HRSG, were evaluated according to ASME Boiler & Pressure Vessel Code Section VIII Division 2. First, from the results of the piping system analysis model, reaction forces of the tubes connected to the distributor were derived and used as the nozzle load applied to the detailed analysis model of the distributor afterward. Next, the detailed model to analyze the distributor was constructed, the distributor being statically analyzed for the design condition with the steam pressure and the nozzle load. As a result, the maximum stress occurred at the bore of the horizontal nozzle, and the primary membrane stress at the shell and nozzle was found to be less than the allowable. Next, for the transient operating conditions given for the distributor, thermal analysis was performed and the structural analysis was carried out with the steam pressure, nozzle load, and thermal load. Under the transient conditions, the maximum stress occurred at the vertical downcomer nozzle, and of which fatigue life was evaluated. As a result, the cumulative usage factor was less than the allowable and hence the distributor was found to be safe from fatigue failure.

• Herbal Formula Science
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• v.25 no.2
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• pp.223-251
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• 2017

Objectives : A lot of experiment results of Yugmijihwangtang(YM) are reported in various kinds of journals. Many of them report on the new effects that are not recorded in the traditional medical texts. So it is necessary to take it into consideration that newly reported effects could be of help to clinical practice, because this process of comparison of Donguibogam and scientific experiment results will have basis to lead into the evidence based medicine. Methods : We compared the effects of in Donguibogam and the experiment results of YM. Results : The effects of YM in Donguibogam are to replenish essence and marrow, and to treat red wen, fatigue, treat hypouresis, urinary sediment, urinary urgency, hematuria, hydrocephalus, speech and movement retardation, yin-deficiency, diabetes mellitus, nonalcoholic fatty liver, melanoma, disability to see near and far sight, tinnitus, hearing loss, alopecia, angiogenesis, cough, cough at night, trachyphonia, and, infantile convulsion. The experiment results of YM since 2000 in both Korea and China are to inhibit atopic dermatitis, renal interstitial fibrosis, anti-oxidant, emphysema, stress, glomerulosclerosis, diabetic nephropathy, chronic glomerulonephritis, hemorrhage, plantar sweating, dermal aging, kidney aging, bone loss, breast cancer, pathological myocardial cell, primary liver cancer, thrombosis, osteoporosis, intrauterine growth retardation, chronic renal failure, IgA nepropathy, slow cerebral development, and hippocampal tissue lesions on the one hand, and to help bone formation, renin-angiotensin- aldosterone system, cerebral recovery, cognitive function and expression, osteoblast proliferation and differentiation, learning and memory, cold-tolerance and oxygen deficit-tolerance and anti-fatigue, endometrial formation, humoral and cell-mediated immunity, immune regulation effect, Hypothalamus-Pituitary-Ovary Axis, and spermatogenesis, on the other hand. Conclusion : When we compared the effects of YM with the experiment results of YM, there existed a considerable gap between them. So, from now on, it is expected that a great effort and consideration are needed to solve these gaps from an academic and clinical point of view.

• Journal of KIISE:Computer Systems and Theory
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• v.36 no.3
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• pp.191-198
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• 2009

The FAT (File Allocation Table) compatible file system has been widely used in mobile devices and memory cards because of its data exchangeability among numerous platforms recognizing the FAT file system. By the way. modern embedded systems have tough demands for instant power failure recovery and superior performance for multimedia applications. The key issue is how to achieve the goals of superior write performance and instant booting capability while controlling compatibility issues. To achieve the goals while controlling compatibility issues. we devised a temporary meta-data journaling scheme for a FAT compatible file system. Benchmark results of the scheme implemented in a FAT compatible file system shows that it really improves write performance of the FAT file system by converting small random write for meta-data update to a large sequential write in journaling area. Also, it provides natural way to implement the instant booting capability. Nevertheless, the file system compatibility is temporarily compromised by the scheme because it stores updated meta-data in the temporary journaling area rather than to their original locations. However, the compatibility can be fully recovered at any time by journal-flushing that copies meta-data in journaling area to their original locations. Generally, the journal-flushing is done before un-mounting a memory card so that it can be used in other mobile devices which recognized FAT file system but not the temporary meta-data journaling scheme.