• 한국실내디자인학회논문집
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• 제19권6호
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• pp.188-196
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• 2010

The Commercial space are changed gradually large scalized and complexed to introduce different culture exchanges and experience. However, the mass-complex commercial space are limited as of their complexed space composition or degree of space depth, which may become factors causing people to get tired easily. Thus, having a design strategy is important to create economical effectiveness in order to overcome these limitations and for the people to stay longer and do their consumption activities through more experiences and social interchanges. Recently, Jerde Partnership's who designed many complex commercial spaces made a commercial success by their unique design strategy to setup a new space and lead the interaction between space and people. The purpose of this study is based on Jerd's design concept to analyze Jerd Partnership's design strategy and space related structure to propose their space construction and design method for mass-complex commercial spaces. The results are as follows. (1)Jerde Partnership's causes the abundant space experience of the user through mass and space constitution to have a theme and a story. (2)They builds an excursion type line of flow system with an organic curve, and a non-daily experience by the change of the space scale and the application of various programs is enabled and guides the stay for the long time. (3)They builds the doorway of various courses and a circulation system through the open space and controls depth of the space. In addition, various events are performed in the center of such a circulation system, and this event makes a unique place.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.28-33
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• 2014

Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.

• Journal of Chest Surgery
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• 제33권8호
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• pp.630-637
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• 2000

Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.

• Journal of Gastric Cancer
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• 제4권2호
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• pp.75-81
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• 2004

Recently detection of early gastric cancer (EGC) has been increasing and the treatment strategies for gastric cancer have been changing. The purpose of this study was to compare clinical outcomes between laparoscopically assisted (LADG) and hand-assisted laparoscopic gastrectomy (HALDG) and open distal gastrectomy for early gastric cancer. This review is directed toward providing gastric surgeons with recent advances in the treatment of EGC. We investigated the English language literature for the past 12 years through computer searches which focused on : 1) Patient demographics, 2) Operation time, 3) Intra-operative blood loss, 4) Depth of invasion, 5) CBC, 6)Weight loss, 7) Analgesic requirement, 8)Time NPO, 9) Length of hospital stay, 10) Tumor stage, 11) Lymph node (LN) dissection, 12) Position of LN resected, 13) Complications. Improved operative techniques and surgical instrumentation have facilitated the development of minimally invasive gastric cancer surgery. The short-term benefits of laparoscopic gastrectomy included less surgical trauma, less pain, rapid return of gastrointestinal function, and shorter hospital stay, with no change in operative outcome. Laparoscopic gastrectomy was better accepted by the patients as a good procedure and promptly brought the patients back to their previous lifestyle and activities of daily living. But the advantages of HALDG for gastric cancer, extended lymph node dissection and intracorporeal anastomosis are feasible and easier with the presence of the internal hand. The hand-assisted laparoscopic (HALDG) method reported the best results in lymph node dissection.This method is an alternative to total laparoscopic radical gastrectomy. LADG and HALDG, when compared with conventional open gastrectomy, have several advantages. When performed by a skilled surgeon, LADG and HALDG are safe and useful techniques for patients with early-stage gastric cancer. Their appropriateness for gastric cancer surgery require further study.

• 한국콘크리트학회:학술대회논문집
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• 한국콘크리트학회 2008년도 춘계 학술발표회 제20권1호
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• pp.237-240
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• 2008

현재 우리나라 고속도로의 일부 도로와 교량들은 이미 노후화가 진행 중이며, 또한 증가하는 교통량을 소화하기 위해 교량의 보수 및 보강, 신축, 확장이 필요한 구간이 많은 실정이다. 이러한 교량 공사는 공사가 진행되는 동안 야기되는 사회적 민원이나 그 밖의 손실, 교통통제에 따른 우회차량의 경제적 손실등과 밀접하며 점점 중요한 문제로 부각되고 있다. 이러한 영향으로 교량 공사의 현장작업 최소화를 위해 다양한 프리캐스트 부재와 공법 등이 개발되고 있으며 새로운 소재를 적용하기 위한 연구 또한 진행 중이다. 본 연구에서는 프리캐스트형(形) CFFT 개발을 위해 축소모형 실험을 수행하였고, 결과 비교를 위해 동일한 제원의 현장타설형(形) RC교각과 현장타설형(形) CFFT 교각의 축소모형 실험도 수행하였다. 각 실험체의 하중-변위 곡선을 얻어 내하력을 비교하였고, 변위연성도를 구하여 내진성능을 비교해 보았다.

• Smart Structures and Systems
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• 제11권4호
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• pp.411-433
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• 2013

Due to its easy operation and wide applicability, the ambient vibration method is commonly adopted to determine the cable force by first identifying the cable frequencies from the vibration signals. With given vibration length and flexural rigidity, an analytical or empirical formula is then used with these cable frequencies to calculate the cable force. It is, however, usually difficult to decide the two required parameters, especially the vibration length due to uncertain boundary constraints. To tackle this problem, a new concept of combining the modal frequencies and mode shape ratios is fully explored in this study for developing an accurate method merely based on ambient vibration measurements. A simply supported beam model with an axial tension is adopted and the effective vibration length of cable is then independently determined based on the mode shape ratios identified from the synchronized measurements. With the effective vibration length obtained and the identified modal frequencies, the cable force and flexural rigidity can then be solved using simple linear regression techniques. The feasibility and accuracy of the proposed method is extensively verified with demonstrative numerical examples and actual applications to different cable-stayed bridges. Furthermore, several important issues in engineering practice such as the number of sensors and selection of modes are also thoroughly investigated.

• Clinical and Experimental Pediatrics
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• 제64권10호
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• pp.531-537
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• 2021

Background: Multisystem inflammatory syndrome in children (MIS-C) is a new hyperinflammatory variant that evolved during the coronavirus disease 2019 pandemic. Although the precise pathophysiology of MIS-C is uncertain, it is thought to be due to immune dysregulation occurring after recovery from acute infection. Purpose: Our study aimed to analyze the clinical spectrum, laboratory parameters, imaging characteristics, treatment strategies, and short-term outcomes of children with a diagnosis of MIS-C. Methods: This retrospective and prospective observational study included children less than 16 years of age who were admitted to the pediatric unit of a tertiary care teaching hospital in south India between August 2020 to January 2021 with a diagnosis of MIS-C according to World Health Organization criteria. Results: Twenty-one children were included in the analysis; all had fever with variable combinations of other symptoms. The mean age was 6.9 years; 71.4% were male. Gastrointestinal (80.9%) and cardiovascular (80.9%) systems were the most commonly affected. The majority of children had elevated inflammatory markers, and 16 (76.2%) had echocardiographic abnormalities mimicking Kawasaki disease. Eleven children (52.4%) required intensive care admission, 3 (14.3%) required supplemental oxygen, and 4 (19%) required inotropes. Nine (42.9%) were treated with intravenous immunoglobulin alone, 6 (28.6%) with steroids alone, and 3 (14.3%) with steroids and immunoglobulin. The median hospital stay was 6 days; there were no fatalities. Overweight/obesity, elevated ferritin, and mucocutaneous involvement were significantly associated with a prolonged hospital stay (≥7 days). Sixteen children (76.2%) were followed up till now and all of them had no clinical concerns. Conclusion: MIS-C is an emerging disease with variable presentation. A high index of suspicion is necessary for its early identification and appropriate management. Further research is essential for developing optimal treatment strategies.

• 한국콘텐츠학회논문지
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• 제19권5호
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• pp.532-541
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• 2019

본 연구는 간호사가 인지하는 외적 환경 요인인 간호업무환경과 내적요인인 직무만족도와 사회적 지지의 관계를 확인하고 재직의도에 영향을 주는 요인과 지속적으로 근무할 수 있는 환경 여건을 형성하고, 효율적인 간호인력 관리 방안을 마련하기 필요한 기초자료를 제공하고자 시도된 서술적 상관관계연구이다. 각 병원의 간호부의 승인을 얻은 후 173명의 간호사를 대상으로 설문조사를 실시하였다. 연구결과 간호근무환경은 평균 2.43점, 직무만족도는 평균 3.04점, 사회적 지지는 평균 3,44점, 재직 의도는 평균 4.3점이며, 재직 의도는 간호근무환경, 직무만족도, 사회적 지지와 정적 상관관계를 나타내었다. 재직의도에 가장 큰 영향을 미치는 요인은 직무만족도이며 설명력은 9.3%였다. 결론적으로 간호사의 직무만족을 높여 재직의도를 향상시키기 위해서는 양질의 간호근무환경을 확보하기 위해서 충분한 인력 및 물질적 자원에 관심을 기울여야 하며, 동료들 간에 정서적으로 신뢰감을 높일 수 있는 새롭고 다양한 방법을 모색하여 오랫동안 근무하도록 유도하는 것이 필요하다.

• 보건행정학회지
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• 제32권2호
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

• Journal of Chest Surgery
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• 제57권3호
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• pp.255-262
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• 2024

Background: Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. Methods: Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG). Results: The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up. Conclusion: The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.