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Clinical Results Following Early Tailoring Thoracoplasty in Patients Undergoing Pulmonary Resection (폐의 부분절제수술를 시술받은 환자에서 조기 변형식 흉곽성형수술에 따른 임상결과)

  • Choi, Soon-Ho;Cha, Byung-Ki;Lee, Mi-Kyung;Park, Kwon-Jae;Lee, Sam-Youn;Choi, Jong-Bum
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.485-491
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    • 2007
  • Background: Thoracoplasty has become a rarity in current clinical practice, although it has been widely employed for well over a century as a procedure for reducing the capacity of the thoracic cavity. Yet we have perform tailoring thoracoplasty following or concomitant with pulmonary resection in 20 patients. The aim of this study is to evaluate the early and late clinical results and also the significance of tailoring thoracoplasty. Material and Method: From March 1995 to June 2005, modified thoracoplasty following or concomitant with pulmonary resection was performed in 20 patients out of a total of 298 pulmonary resections for closing air leaks and for treating persistent pleural space following pulmonary resections, and to tailor the thoracic cavity to accept a diminished lung volume. Of the 20 patients, 14 patients had tailoring thoracoplasty performed concomitant with pulmonary resection, and the remaining 6 patients also had tailoring thoracoplasty performed following pulmonary resection. The subjects ages ranged from 24 to 77 (mean $59.1{\pm}6.4$) and a male preponderance was noted (17 : 3); the number of left and right surgeries was equal. The preoperative primary underlying diseases were lung cancer in 7 patients, pneumothorax with giant bullous change in 6 patients, bronchiectasis in 2 patients, previous pulmonary tuberculosis associated with aspergilloma in 2 patients, empyema with fibrothorax in 2 patients and multiple lung abscesses & destruction due to previous trauma in 1 patient. The operative methods were apicolysis and subperiosteal removal of the 2nd, 3rd and 4th ribs (the costochondral junction to the posterior portions of the ribs) with preservation of the first rib and compression of the anterior chest via cotton bags and elastic bandages. Result: The mean duration of the air leaks after thoracoplasty was $1.6{\pm}0.2$ days (range: $0{\sim}7$ days) and the mean duration of an indwelling chest tube was 7 days (range: $5{\sim}11$ days); the mean duration of hospitalization was $19.2{\pm}2.8$ days (range: $8{\sim}47$ days). The postoperative complications were wound infection (2) and pneumonia (2); reoperation was done due to bleeding (1) in one patient who underwent concomitant thoracoplasty and there was 1 case of wound infection (1) after postresection thoracoplasty. The mortality was 1 patient in the early phase and 4 patients in the late phase. Conclusion: We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural spaces and to accommodate the diminished lung volume with acceptable cosmetic results when this procedure is combined with pulmonary resection in selected patients.

A Comparative Study on the Curriculum of Nursing Education in America and Korea (한.미 간호 교육과정의 비교 연구 -간호대학과정을 중심으로-)

  • 김정자
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.60-82
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    • 1977
  • The purpose of this study is first, to analyse the present nursing education and the curriculum in Korea in view of the changes and the new tendency of nursing education and second, to compare our curriculum with that of America, where nursing activities are actively earring on and, third, to try to find out what we should reconsider and improve in our nursing education. The object of this study is the educational program and the curriculum from 1973 to 1976 by selecting each five from colleges and department of nursing in Korea and America. The results of the study were as fellows : . 1. The aim of nursing education puts impassion the role of leader, knowledge and technology of nursing, welfare of society and service of community in both the America and Korea. In Korea nursing is mainly restricted to the treatment of diseases, while in the America the items of the aim of nursing are mainly extended to the capacity for Self- realization of nurse, in Korea they are restricted to the treatment of diseases. 2. In Korea the rate of credit of the curriculum of nursing education is the highest in professional education, next in general education, next in supporting science and educational subject, while in America the rate of the credit is the highest in general education, next professional education and then supporting Science and educational subject isn′t included in the curriculum. 3. In both Korea and America the role of the animal credit allotment in general education, is the highest in the first year and the rate in supporting science is the highest in the second year. In Korea professional subjects are concentrated in the third year while in America there is a tendency that they are increasing in number in the grade order. 4. There is a tendency that the rate of the credit allotment of the main professional subjects in curriculum is higher in Korea than in America : that is, in Korea the rate of the allotment of the credit is the highest in medical - surgical nursing, next maternal - child nursing, next community - health nursing and the psychiatric nursing and there in a great difference in the rate of the allotment of each credit. While in America the rate of the allotment of the credit is the highest in community - health nursing, next in medical- surgical nursing, next in maternal - child nursing, and then in psychiatric nursing and there is little difference in the rate of tile allotment of each credit. 5. From general education, supporting science and professional education, they have considered the continuity and sequence in the structure of nursing curriculum of Korea and America. While in Korea we have partly made integration in tile content of the subjects. Most of the school in America, they have made integration in the content of subjects especially in all subjects, but in Korea we haven't made it in all subjects. 6. In the system and form of nursing education Problem solving method, Dialectical method and operational method are introduced in some America schools and in others there is a tendency that the whole nursing education has the system based on Preventive frame - work or Health -illness frame work ; while only one college has an attempt for Health - Illness continue in Korea. 7. In Korea nursing education, as the importance of health- nursing and team nursing, the aim which is also comparatively emphasized is about health management and service of collective community. The subject pertaining to the aim is the studies of community health nursing, which are more in number in America. 8. When we consider the association between the social, general aims ?f the nursing education and the formation of the curriculum in Korean nursing school the courses of study concerning "the role of leadership and cooperative personal relation": "nursing care for the group": dynamic nursing care": and "the system of the public health nursing associated with the understanding of the regional community" are insufficient as compared with those of America. Especially, the lack of the behavioral science including the nursing care connected with the care for the group, the basic science on the clinical and developmental psychology, anthropology in known to be a prominent issue.

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A Study on the Effect of the Bidding Stage Factors of Logistics Outsourcing Service on Trust, Cooperation and Service Satisfaction (물류아웃소싱 서비스의 입찰단계 요인이 신뢰, 협력 및 서비스 만족도에 미치는 영향에 관한 연구)

  • Lee, Nam-Seung;Song, Sang-Hwa
    • Journal of Korea Port Economic Association
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    • v.36 no.2
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    • pp.19-36
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    • 2020
  • The bidding phase for logistics outsourcing services is critical for both shippers and logistics companies. According to the logistics bidding phase, the shipper should provide logistics operation information to logistics companies to resolve uncertainty. In addition, the logistics company can win the contract volume that was placed in the bid by expressing their experience and know-how, and proposing to share the risks and benefits of the shipper's logistics operation. Therefore, it is necessary to examine the factors that can be identified during the bidding phase for logistics outsourcing and how these factors affect the satisfaction of logistics outsourcing services. Based on the factors identified in the preceding studies on logistics outsourcing partnership factors and those on logistics outsourcing determinants, a survey was conducted on experts engaged in logistics companies, performing logistics for domestic shippers and analyzed using Smart-PLS. This study presents the following implications. First, in the logistics bidding phase, the shipper should provide its logistics operation information to logistics firms to resolve uncertainties. Details An in-depth explanation of the operation details will be presented via the bidding presentation, and on-site tours of manufacturing plants and logistics centers should also be carried out if necessary. Second, in the bidding phase, logistics companies should appeal through proposals to their competitiveness, such as experience and knowledge of the logistics of the shipper, and also consider alliances with other logistics companies to supplement their insufficient logistics services. Third, logistics companies should make proposals to share profits and risks through logistics outsourcing during the bidding phase, propose accepting risks from environmental uncertainties of the shipper within its capacity to an acceptable extent, and share the benefits of carrying out the shipper's logistics.

Development of a Climate Change Vulnerability Index on the Health Care Sector (기후변화 건강 취약성 평가지표 개발)

  • Shin, Hosung;Lee, Suehyung
    • Journal of Environmental Policy
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    • v.13 no.1
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    • pp.69-93
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    • 2014
  • The aim of this research was to develop a climate change vulnerability index at the district level (Si, Gun, Gu) with respect to the health care sector in Korea. The climate change vulnerability index was esimated based on the four major causes of climate-related illnesses : vector, flood, heat waves, and air pollution/allergies. The vulnerability assessment framework consists of six layers, all of which are based on the IPCC vulnerability concepts (exposure, sensitivity, and adaptive capacity) and the pathway of direct and indirect impacts of climate change modulators on health. We collected proxy variables based on the conceptual framework of climate change vulnerability. Data were standardized using the min-max normalization method. We applied the analytic hierarchy process (AHP) weight and aggregated the variables using the non-compensatory multi-criteria approach. To verify the index, sensitivity analysis was conducted by using another aggregation method (geometric transformation method, which was applied to the index of multiple deprivation in the UK) and weight, calculated by the Budget Allocation method. The results showed that it would be possible to identify the vulnerable areas by applying the developed climate change vulnerability assessment index. The climate change vulnerability index could then be used as a valuable tool in setting climate change adaptation policies in the health care sector.

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A Study on the Activation Factors of Voluntary Community Activities in Neighborhood Parks - Based on the People Who Love Chamsaem in Sejong City - (근린 생활권 공원에서의 자발적 공동체 활동의 활성화 요인에 관한 연구 - 세종시 '참샘을 사랑하는 모임'을 대상으로 -)

  • Kim, Woo-Joo;Lee, Cha-Hee;Sung, Jong-Sang
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.2
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    • pp.37-51
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    • 2018
  • Recently, urban parks are required to actively participate with residents in order to strengthen social functions and maintain sustainable management. This study analyzed the formation process of volunteer resident groups (Chamsamo) in the neighborhood parks in which local residents can participate in an ongoing basis based on the solidarity of a daily living space. The important factors in the activation of resident activity are derived from 5 aspects including resources, local area, resident group capacity, resident group role, and public support. The results of the study are as follows. 1) Life-friendly resources: It was important to find life-friendly resources such as 'Chamsaem' in the park. The combined resources of continuous human activities provided various benefits to the residents. This has led to stronger attachment and community activities to continue to utilize attractive resources in the park. 2) Sharing Common Daily Spaces and Expansion: As the Chamsamo activities were centered around the neighborhood, the network of activists in the local community expanded. This led to continued resident interest and favorable participation as well as to the regional expansion of Chamsamo activities. 3) Park management as part of everyday life: Park management became a part of everyday life, and pleasant park management was facilitated by utilizing the talents of the residents, who carried out diverse activities and constantly streamlined their hard labor. 4) Chamsamo's Leadership Linking Residents and the Public Sector through Leading Park Management Activities: Chamsamo served as a middle leader in linking the public sector and its users. 5) Role and Support of the Public Sector: In order to be able to sustain the activities of residents, the government's willingness to support the resident-led activities of the park in planning and operating the public sector was required. In the public management system of the park, support for residents' activities such as financing, education, and consulting was necessary.

The Current Status and Problems of Tobacco Control Programs of Public Health Centers in Korea (보건소 금연사업의 현황과 문제점 분석을 통한 개선방안)

  • Park, Soon-Woo;Lee, Ju-Yul
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.87-100
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    • 2009
  • Objectives: This study was conducted to suggest the way to improve the tobacco control program of public health centers in Korea. Methods: A survey with a self-administered questionnaire was conducted among 246 persons in charge of tobacco control work in public health centers nationwide in December, 2006. Frequency analysis was performed with a final sample of 212 respondents with SPSS 12.0 for Windows. Results: The duration of engagement in tobacco control work was less than 3 years among 86.7% of respondents, and 87.3% of respondents had other duties besides tobacco control. Almost all public health centers conducted a campaign with posters or leaflets, and smoking prevention education among adolescents. The actual priority for programs was based on the community diagnosis in only 33.5% of the cases. Only 1.9% of respondents complained lack of budget, on the other hand, 44.7% of respondents appealed insufficient number of personnel. The route of knowledge and skill was largely dependent on self-learning or information from colleague. Collaboration with other related department was done well in 39.5% of the cases. The majority of respondents was satisfied with the general support from central government. Conclusions: To improve the tobacco control program of public health centers, it is needed the reinforcement of capacity and specialty among personnel, priority setting and performance of programs based on the scientific evidence, induction of community participation, utilization of community human resources, development of education and training course for practical skill, effective networking among departments.

The Politics of Scale: The Social and Political Construction of Geographical Scale in Korean Housing Politics (스케일의 정치: 한국 주택 정치에서의 지리적 스케일의 사회적.정치적 구성)

  • Ryu, Yeon-Taek
    • Journal of the Korean Geographical Society
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    • v.42 no.5
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    • pp.691-709
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    • 2007
  • This paper investigates the social and political construction of geographical scale in conjunction with Korean housing politics. Recently, attention has been drawn to the issue of the social and political construction of geographical scale. Spatial scales have increasingly been regarded as socially constructed and politically contested rather than ontologically pregiven or fixed. The scale literature has paid attention to how different spatial scales can be used or articulated in social movements, with an emphasis on 'up-scaling' and 'scales of activism' rather than 'down-scaling' and 'scales of regulation.' Furthermore, the scale literature has focused on the aspect of empowerment. However, it is worthwhile to examine how scale-especially 'down-scaling' and 'scales of regulation'-can be used not only for marginalizing or excluding unprivileged social groups, but also for controlling the (re)production of space, including housing space. Under a regulatory regime, the Korean central government gained more control over the (re)production of housing space at geographical multi-scales by means of 'jumping scales,' specifically 'down-scaling.' The Korean central government has increasingly obtained the capacity to 'jump scales' by using not only multiscalar strategies for housing developments, but also taking advantage of various scales of institutional networking among the central and local governments, quasi-governmental institutions, and Chaebols, across the state. Traditionally, scale has been regarded as an analytical spatial unit or category. However, scale can be seen as means of inclusion(and exclusion) and legitimation. Choosing institutions to include or exclude cannot be separated from the choices and range of spatial scale, and is closely connected to 'scale spatiality of politics.' Facilitating different forms of 'scales of regulation,' the Korean central government included Chaebols and upper- and middle-income groups for the legitimization of housing projects, but excluded local-scale grassroots organizations and unprivileged social groups as decision-makers.

Analysis of Linkage between Official Development Assistance (ODA) of Forestry Sector and Sustainable Development Goals (SDGs) in South Korea (국내 임업분야 공적개발원조(ODA)사업과 지속가능발전목표(SDGs)와의 연관성 분석)

  • Kim, Nahui;Moon, Jooyeon;Song, Cholho;Heo, Seongbong;Son, Yowhan;Lee, Woo-Kyun
    • Journal of Korean Society of Forest Science
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    • v.107 no.1
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    • pp.96-107
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    • 2018
  • This study analyzed the linkage between the Forestry sector Official Development Assistance (ODA) Project in South Korea and the Sustainable Development Goals (SDGs) of United Nations (UN), Suggested direction of ODA project focusing on the implementation of the SDGs. Forestry sector ODA project data in South Korea have collected from Economic Development Cooperation Fund (EDCF) statistical inquiry system developed by The Export-Import Bank of Korea. According to the analysis result, Forestry sector ODA project in South Korea have been actively implemented in the fields of forestry development, forestry policy and administration. In both fields, Korea Forest Service and Korea International Cooperation Agency (KOICA) carried out the most projects. The Forestry sector ODA project data in South Korea are classified technical development, capacity building, construction of infrastructure and afforestation based on their objectives and contents. SDGs emphasizes the importance of national implementation assessment and this study analyze linkage between ODA activity content in each classification item and 2016 Korea Forest Service Performance Management Plan indicator. Analyzed the 2016 Korea Forest Service Performance Management Plan indicator and SDGs target and SDGs indicator were identified. finally, SDGs goals were recognized. In conclusion, Forestry sector ODA project in South Korea are associated with the SDGs Goal 1 (No Poverty), Goal 2 (Zero Hunger), Goal 6 (Clean Water and Sanitation), Goal 13 (Climate Action), Goal 15 (Life on Land) and Goal 17 (Partnership for The Goals). Therefore, With the launch of the SDGs, This study analyzed the linkage among the Forestry sector ODA Project in South Korea, the 2016 Korea Forest Service Performance Management Plan and the SDGs. it presented the limitations of Forestry sector ODA Project in South Korea and made proposals for the implementation of the SDGs.

Correlation of Tracheal Cross-sectional Area with Parameters of Pulmonary Function in COPD (만성 폐쇄성 폐질환에서 기관의 단면적과 폐기능지표와의 상관관계)

  • Lee, Chan-Ju;Lee, Jae-Ho;Song, Jae-Woo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.628-635
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    • 1999
  • Background : Maximal expiratory flow rate is determined by the size of airway, elastic recoil pressure and the collapsibility of airway in the lung. The obstruction of expiratory flow is one of the major functional impairments of emphysema, which represents COPD. Nevertheless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. Method : We included 20 patients diagnosed as emphysema by radiologic and physiologic criteria from January to August in 1997 at Seoul Municipal Boramae Hospital. Chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were taken from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this corrected area with such parameters of pulmonary function tests as $PaCO_2$, $PaO_2$, airway resistance, lung compliance and so on. Results : Expiratory cross-sectional area of trachea had significant correlation with $PaCO_2$ (r=-0.61, p<0.05), $PaO_2$ (r=0.6, p<0.05), and minute ventilation (r=0.73, p<0.05), but inspiratory cross-sectional area did not (r=-0.22, p>0.05 with $PaCO_2$, r=0.26, p>0.05 with $PaO_2$, and r=0.44, p>0.05 with minute ventilation). Minute ventilation had significant correlation with tidal volume (r=0.45, p<0.05), but it had no significant correlation with respiratory frequency (r=-0.31, p>0.05). Cross-sectional area of trachea had no significant correlation with other parameters of pulmonary function including $FEV_1$, FVC, $FEV_1$/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area was expiratory or inspiratory. Conclusion : Cross-sectional area of trachea narrowed during expiration in emphysema, and its expiratory area had significant correlation with $PaCO_2$, $PaO_2$, and minute ventilation.

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Comparisons in Volumes of Irrigation and Drainage, Plant Growth and Fruit Yield under FDR Sensor-, Integrated Solar Radiation-, and Timer-Automated Irrigation Systems for Production of Tomato in a Coir Substrate Hydroponic System (토마토 코이어 수경재배에서 FDR센서, 적산일사량센서 및 타이머 급액방식에 따른 급배액량, 생육 및 과실수량 비교)

  • Choi, Eun-Young;Kim, Hee-Yong;Choi, Ki-Young;Lee, Yong-Beom
    • Journal of Bio-Environment Control
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    • v.25 no.1
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    • pp.63-70
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    • 2016
  • Water drainage from the open hydroponics often causes significant environmental pollution due to agrochemicals and loss of water and nutrients. The objectives of this study were to show the potential application of an irrigation schedule based on threshold values of volumetric substrate water content for tomato (Solanum lycopersicum L. 'Samsamgu') cultivation in a commercial hydroponic farm during spring to summer cultivation. This study was performed for minimizing effluent from coir substrate hydroponics using a frequency domain reflectometry (FDR) sensor-automated irrigation, as compared with an integrated solar-radiation (IR) and conventional timer-irrigation (TIMER) after transplanting. In results, no significant difference in daily irrigation volume was found among the treatments until 88 days after transplant (DAT). However, during the 88 to 107 DAT, the daily irrigation volume was in the order of IR (2125 mL) > TIMER (2063 mL) > FDR (1983 mL), and during the 108 to 120 DAT, it was in the order of IR (2000 mL) > TIMER (1664 mL) > FDR (1500 mL). The lowest drainage volume was observed in the FDR treatment with the order of IR (12~19%) > TIMER (4~12%) > FDR (0~7%) during the entire growing period. A lower irrigation volume in the FDR treatment after 88 DAT may be due to the sensor's detecting capacity for less water absorption by plant after completing fruit maturity with apical pruning and removal of lower leaves, while a higher irrigation volume in the IR treatment may be due to gradual increase in integrated solar-radiation amount as closer to summer season. There was no significant difference in plant growth and fruit yield among the treatments; however, a 11% and 18% of higher soluble sugar content was observed in the FDR than that of TIMER and IR treatment. respectively.