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Early Surgical Revascularization for Acute Myocardial Infarction (급성 심근 경색후 관상 동맥 우회술의 조기 적용)

  • 지현근;이원용
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1077-1082
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    • 1997
  • To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

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The Legal Theory on the Civil Execution against Aircraft (항공기 집행에 관한 법리)

  • Kwon, Chang-Young
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.83-153
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    • 2015
  • As our economy grows and the number of aircraft increase, the number of civil execution against aircraft cases are likely to increase as well in the future. The purpose of this article is to present the legal theory on the civil execution against aircrafts by drawing on the legal theory on the civil execution against vessels which constitute a relatively large number of cases thus observed. The provisions of the civil execution against immovables or vessel, shall basically apply mutatis mutandis to the civil execution against aircraft or light aircraft. The civil execution against ultra-light flying devices or a foreign aircraft shall be executed in conformity with the civil execution against movables. There are a compulsory auction, an auction to execute a security right to aircraft, and an auction under the right of retention, etc. in the civil execution against an aircraft. A compulsory execution against an aircraft means an execution carried out by a creditor against a debtor's aircraft to obtain satisfaction of claims for the purpose of payment of money. The court of execution of a compulsory execution against an aircraft shall be the district court having jurisdiction over the airport of stoppage or storage of such aircraft at the time of seizure. The forums of execution of a compulsory execution against an aircraft shall be exclusive forums. When a court has rendered an order on commencing an auction, it shall order an execution officer to receive a certificate of the aircraft's registration and other documents as required for its operation, and to submit them to the court. A court may revoke the procedures for a compulsory auction when an execution officer fails to obtain a transfer of the aircraft's registration certificate, etc. and the location of the aircraft is not evident, not later than an elapse of 2 months from the date on which an order on commencing an auction has been rendered. In the case where it is deemed that there exists a business-related need or other based on proper reasoning, the court may permit the aircraft's operation, upon the motion submitted by the debtor. In this case, there shall be a consent from the creditor, the highest bidder, the next highest bidder and successful bidder. A court may, upon a motion submitted by the creditor, make the dispositions required for observing and preserving the aircraft. When a debtor has submitted the documents under subparagraph 2 or 4 of the Article 49 of the Civil Execution Act, and furnished the guarantee equivalent to the claims of the execution creditors and the creditors demanding a distribution and to the costs for execution, before a declaration of bid, the court shall, upon request, revoke other procedures than those for distribution. The provisions of a obligatory auction against vessel or aircraft and an auction to execute a security right to real estate or vessel, shall apply mutatis mutandis to an auction to execute the security right to aircraft. In an auction to execute the security right to aircraft case, an executive title is not necessary. An executory exemplification is not necessary in an application for an auction to execute the security right to aircraft. A court should examine the existence of security right and claim secured. No order on commencing an auction procedure shall be issued with non-existence or invalidity of the security right and absence or extinguishment of the claim secured. Furthermore, these prohibitions are the reason of a decision on non-permit for sale, the court overlooked these prohibitions, and the decision on a permit for sale became final and conclusive, the successful bidder who paid the price and registered of ownership could not acquire ownership of the aircraft sold. A court may render a ruling to put plural aircrafts up for a blanket auction, only when they are in restraint and related matter (Supreme Court Order 2001Ma3688 dated on August 22, 2001). A righter of retention on aircraft may file a request for an auction against the aircraft. The provisions of an auction to execute a security right to aircraft shall apply mutatis mutandis to the formal auction. Airport facility fee and an aircraft are not in restraint and related matter, so an airport management corporation does not hold the right of retention on the aircraft (Supreme Court Decision 2011Da29291 decided on April 10, 2014). In an auction in accordance with the right of retention, all encumbrances (e.g., mortgages) on the sold aircraft shall be extinguished by a sale under the legal conditions for sale. Not only creditors who have claims for preferential payment but also general creditors could demand for distribution. The precedence of the claim of the right of retention on aircraft and that of general creditor's claims are equal.

Clinical Outcomes of Off-pump Coronary Artery Bypass Grafting (심폐바이패스 없는 관상동맥우회술의 임상성적)

  • Shin, Je-Kyoun;Kim, Jeong-Won;Jung, Jong-Pil;Park, Chang-Ryul;Park, Soon-Eun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.34-40
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    • 2008
  • Background: Off-pump coronary artery bypass grafting (OPCAB) shows fewer side effects than cardiopulmonary by. pass, and other benefits include myocardial protection, pulmonary and renal protection, coagulation, inflammation, and cognitive function. We analyzed the clinical results of our cases of OPCAB. Material and Method: From May 1999 to August 2007, OPCAB was performed in 100 patients out of a total of 310 coronary artery bypass surgeries. There were 63 males and 37 females, from 29 to 82 years old, with a mean age of $62{\pm}10$ years. The preoperative diagnoses were unstable angina in 77 cases, stable angina in 16, and acute myocardial infarction in 7. The associated diseases were hypertension in 48 cases, diabetes in 42, chronic renal failure in 10, carotid artery disease in 6, and chronic obstructive pulmonary disease in 5. The preoperative cardiac ejection fraction ranged from 26% to 74% (mean $56.7{\pm}11.6%$). Preoperative angiograms showed three-vessel disease in 47 cases, two-vessel disease in 25, one-vessel disease in 24, and left main disease in 23. The internal thoracic artery was harvested by the pedicled technique through a median sternotomy in 97 cases. The radial artery and greater saphenous vein were harvested in 70 and 45 cases, respectively (endoscopic harvest in 53 and 41 cases, respectively). Result: The mean number of grafts was $2.7{\pm}1.2$ per patient, with grafts sourced from the unilateral internal thoracic artery in 95 (95%) cases, the radial artery in 62, the greater saphenous vein in 39, and the bilateral internal thoracic artery in 2. Sequential anastomoses were performed in 46 cases. The anastomosed vessels were the left anterior descending artery in 97 cases, the obtuse marginal branch in 63, the diagonal branch in 53, the right coronary artery in 30, the intermediate branch in 11, the posterior descending artery in 9 and the posterior lateral branch in 3. The conversion to cardiopulmonary bypass occurred in 4 cases. Graft patency was checked before discharge by coronary angiography or multi-slice coronary CT angiography in 72 cases, with a patency rate of 92.9% (184/198). There was one case of mortality due to sepsis. Postoperative arrhythmias or myocardial in-farctions were not observed. Postoperative complications were a cerebral stroke in 1 case and wound infection in 1. The mean time of respirator care was $20{\pm}35$ hours and the mean duration of stay in the intensive care unit was $68{\pm}47$ hours. The mean amounts of blood transfusion were $4.0{\pm}2.6$ packs/patient. Conclusion: We found good clinical outcomes after OPCAB, and suggest that OPCAB could be used to expand the use of coronary artery bypass grafting.

Interpretation and Meaning of Celadon Inlaid with Sanskrit Mantras in the late Goryeo Dynasty (고려 후기 범자 진언명 상감청자의 해석과 의미)

  • Lee Jun-kwang
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.104
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    • pp.70-100
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    • 2023
  • The celadon made in the Goryeo era, a time when Buddhism was flourishing in Korea, naturally contains many elements of Buddhist culture. Among them, inlaid celadon with Sanskrit inscriptions bears a close relationship with esoteric Buddhism. However, the research on deciphering the Sanskrit inscriptions has made little progress due to the small number of extant examples. However, the four recent excavations at the No. 23 kiln site in Sadang-ri, Gangjin have yielded new materials that allow the existing materials to be categorized into several types. The results obtained through the reading and interpretation of the inscriptions are as follows: First, the Sanskrit characters inlaid on the celadon were parts of mantras. Inscriptions where only one character is apparent cannot be deciphered, but scholars have revealed that others are written in the manner of a wheel mantra represent the "Mantra for Purifying the Dharma-Realm," "Six-Syllable Mantra of the Vidyaraja," "Sweet Dew Mantra," "Jewel Pavilion Mantra," "Mantra of the Savior Bodhisattva," "Dharani of the Mind of the Budha of Infinite Life," and "Mantra for Extinguishing Evil Rebirth." Each mantra was written in Siddham script. Second, they are believed to have been produced during the thirteenth and fourteenth centuries based on the arrangement of the inscriptions and the way the "Sweet Dew Mantra" is included in the "40 Hands Mantra." In particular, the celadon pieces with a mantra inlaid in a concentric manner are dated to the late thirteenth and early fourteenth centuries based on their production characteristics. Third, the interpretation of the inlaid mantras suggests that they all refer to the "Shattering Hell" and "Rebirth in the Pure Land." Based on this, it can be concluded that some of these inlaid celadon wares with mantras may have been used in Buddhist rituals for the dead, such as the ritual for feeding hungry ghosts (施餓鬼會). Also, because the Sadang-ri No. 23 kiln site and the "ga" area of the site are believed to have produced royal celadon, it is likely that these rituals were performed at the royal court or a temple under its influence. Fourth, this inlaid Goryeo celadon with Sanskrit mantras was not a direct influence of the ceramics of Yuan China. It emerged by adopting Yuan Chinese Buddhist culture, which was influenced by Tibetan Buddhism, into Goryeo Korea's existing esoteric practices. Fifth, the celadon wares inlaid with a Sanskrit mantra reveal a facet of the personal esoteric rituals that prevailed in late Goryeo society. Changes in esotericism triggered by the desire for relief from anxieties can be exemplified in epitaph tablets and coffins that express a shared desire for escaping hell and being born again in paradise. Sixth, the inlaid celadon with Sanskrit mantras shares some common features with other crafts. The similarities include the use of Siddham Sanskrit, the focus on Six-Syllable Mantra of the Vidyaraja, the correspondence with the contents of the mantras found on Buddhist bells, wooden coffins, and memorial tablets, and their arraignment in a similar manner with rooftiles. The major difference between them is that the Mantra for Extinguishing Evil Rebirth and the Sweet Dew Manta have not yet been found on other craftworks. I believe that the inscriptions of Sanskrit mantras are found mainly on inlaid celadon vessels due to their relatively low production cost and efficiency.