• 제목/요약/키워드: Operative strategy

검색결과 92건 처리시간 0.028초

게임이론과 한반도를 둘러싼 수산자원의 협력적 관리체계에 관한 연구 (Game Theory and a Study on Fishery Co-operation System in the Seas Surrounding Korea)

  • 강준석
    • 수산경영론집
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    • 제49권3호
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    • pp.49-65
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    • 2018
  • The main purpose of this study is to explain fishery relation in the seas surrounding Korea and how the Prisoner's Dilemma (PD), within game theory is applied to the region and suggest possible co-operative approaches in the region. The seas surrounding Korea are very productive fishing grounds with abundant fisheries resources because of the favourable marine environment, including its geographical features and physical oceanography. Nevertheless, Fishery relations among the coastal states in the region have been historically characterized by conflict rather than co-operation. Based on the PD game where there is always an incentive to do better by not co-operating, in order to ensure a share of the short-run benefits, fishing countries in the region have so far pursued the non-co-operative strategy of 'don't fish responsibly' rather than the co-operative strategy of 'fish responsibly'. Considering rapidly deteriorating situations in terms of fishery resources, regional co-operation among coastal states is urgently required to eliminate overfishing and increase fish stocks to sustainable levels. The West Sea/East China Sea and the East Sea, semi-enclosed seas, have unitary ecosystems, and many migratory fish species are shared between coastal states. Therefore, one countries' efforts alone cannot effectively manage and conserve the fishery resources and close co-operation among coastal states is required. The 1982 UN Convention and other international instruments emphasize the role of RFOs in managing and conserving capture fisheries and encourage states to establish Regional Fishery organizations (RFOs) or strengthen existing RFOs to facilitate conservation and management for fish stocks. Therefore, an international regime is worthy of serious consideration in that it provides fundamental advantages for the conservation of fish stocks for the fishery characteristic of the region.

Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital

  • Baek, Jeong Kook;Lee, Young Ho;Kim, Min Bom;Baek, Goo Hyun
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.105-115
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    • 2016
  • Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

슬래브축열의 최적제어방책에 관한 연구 -평가요소로 복사열의 고려 유무에 의한 차이- (A Study on the Optimal Control Strategy of Air-Conditioning System with Slab Thermal Storage - The Difference by the Presence of Radiant Heat as a Criterion Factor -)

  • 정재훈;신영기
    • 설비공학논문집
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    • 제18권4호
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    • pp.287-296
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    • 2006
  • In this paper, optimal control strategy of the air-conditioning system with slab thermal storage was investigated based on the optimal control theory. An optimal heat output to the plenum chamber and the air-conditioned room was determined based on two kinds of criterion functions. The first one requires small deviation in room air temperature from a set-point value and low energy consumption. It is shown that the optimized control is to store heat through the whole storage time and to increase storage rate gradually with time. As the second case, a criterion that both a deviation of operative temperature from a set-point temperature and the energy consumption should be minimized was adopted. The room air temperature was a little high and the cooling load during storage time was reduced, compared with the results when a criterion function considering only the room air temperature is used.

급성 족근과 골절 환자에서 시행한 컴퓨터 단층촬영 영상의 유용성 (Usefulness of Computed Tomography in Patients with Acute Malleolar Fracture)

  • 전숙하;배서영;안수형;정형진;우승훈
    • 대한족부족관절학회지
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    • 제19권4호
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    • pp.156-160
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    • 2015
  • Purpose: We compared plain radiographs with computed tomography (CT) images to evaluate the usefulness of preoperative CT in acute ankle malleolar fracture in terms of accuracy of diagnosis and planning of operative strategy. Materials and Methods: A retrospective analysis was conducted on 210 cases of malleolar fracture treated at our institute for which plain radiograph and CT were obtained preoperatively. Observers had reviewed plain radiographs and recorded fracture classification, anatomical diagnosis, extent and configuration of fractures and then subsequently reviewed CT images. Records from each image were compared and information regarding the differences in fractures was assessed. Results: Fractures were notably changed in appearance in 88 cases (41.9%) and diagnosis changed in 30 cases (14.3%). According to the change of diagnosis and fracture appearances, the operative strategy was changed in 15 cases (7.1%) including incision, order of reduction, and target of fixation. Conclusion: CT could be a useful adjunctive imaging tool in addition to the plain radiograph in planning of operative treatment for acute malleolar fracture in terms of estimating exact configuration, extent of fractures and even newly revealed hidden fractures.

문제중심학습과 신업체 현장실습 연계를 통한 효과적인 PLM 교육에 관한 연구 (A Study on the Problem-Based Learning with Industry Co-operative Program for Effective PLM Education)

  • 채수진;노상도
    • 한국CDE학회논문집
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    • 제13권5호
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    • pp.362-371
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    • 2008
  • Generally, a PLM education program in university consists of lectures of theory, software lab and software development raining as an advanced subject. Most industries want more than these, such as practical problem solving capabilities, teamwork skills and engineering communications including human relationship, rhetoric, technical writing, presentation and etc. Problem-Based Learning is a problem-stimulated and student-centered teaming method, and an innovative education strategy for collaborative and self-directed learning by applying real world problems. Education paradigm changes from "teaching" to "learning" accomplished by team working, and students are encouraged to develop, present, explain and defense their ideas, suggestions or solutions of a problem, and the "cooperative teaming" proceeds spontaneously during team operations. Co-operative education program is an into-grated academic model and a structured educational program combining classroom learning with productive work experience in a field related to a student's academic or career goals. Based on the partnership between academic institutions and industries, students are engaged in real and productive "work" in the industry, in contrast with merely observing. In this paper, PBL with Co-op program is suggested as an effective approach for PLM education, and we made and operated a PBL-based education course with industry co-op program. The Co-op education in industry accompanied with the PBL course in university can improve practical problem solving capabilities of students, including modeling and management of P3R(Product, Process, resource and Plant) using commercial PLM software tools. By the result, we found this to be an effective strategy for helping students, professors and industries succeed in engineering education, especially PLM area.

Influence of Clinically Significant Portal Hypertension on Hepatectomy for Hepatocellular Carcinoma: a Meta-analysis

  • Tang, Yun-Hao;Zhu, Wen-Jiang;Wen, Tian-Fu
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권4호
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    • pp.1649-1654
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    • 2014
  • Background: Clinically significant portal hypertension (PHT) is considered as a contraindication for hepatectomy according to the guidelines of the European Association for Study of Liver and the American Association for Study of Liver Diseases. However, this issue remains controversial. Here we performed a metaanalysis to evaluate the impact of PHT on the results of hepatectomy for hepatocellular carcinoma (HCC). Methods: Cohort studies evaluating the impact of clinically significant PHT, defined as oesophageal varices and/or splenomegaly associated with thrombocytopenia, on the results of hepatectomy for HCC were identified using a predefined search strategy. Summary risk ratios (RRs) and 95% confidence intervals (95% CIs) for PHT and outcomes after hepatectomy for HCC were calculated. Results: Seven cohort studies which including 574 cases with PHT and 1,354 cases without PHT were considered eligible for inclusion. The meta-analysis showed that, in all patients, pooled RRs of post-operative liver failure, post-operative ascites, peri-operative blood transfusion, operative mortality, 3- and 5-year overall survival associated with PHT were 2.23 (95% CI: 1.48-3.34, P=0.0001), 1.77 (95% CI: 1.19-2.64, P=0.005), 1.23 (95% CI: 1.03-1.49, P=0.03), 2.58 (95% CI: 1.12-5.96, P=0.03), 0.82 (95% CI: 0.75-0.88, P<0.00001) and 0.76 (95% CI: 0.69-0.85, P<0.00001), respectively. In subgroup analysis, similar results were found in Child-Pugh class A patients. Conclusion: This meta-analysis suggests that presence of oesophageal varices and/or splenomegaly associated with thrombocytopenia is associated with higher rates of post-operative complications and poor long-term survival after hepatectomy for HCC.

The impact of major league baseball on the incidence of operative hand and facial trauma at a level 1 trauma center

  • Ricci, Joseph A.;Vargas, Christina R.;Ho, Olivia A.;Lin, Samuel J.;Lee, Bernard T.
    • Archives of Plastic Surgery
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    • 제46권3호
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    • pp.198-203
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    • 2019
  • Background Professional affiliation between medical centers and professional sports teams can be mutually beneficial in the provision of healthcare and marketing strategy. Anecdotal evidence suggests a link between trauma volume and sporting events; however, there is limited data. This study aims to characterize the incidence of operative hand and facial trauma during professional baseball home games. Methods A retrospective review of surgical cases for traumatic hand or facial injuries at a level 1 center between 1999 and 2012 was performed. Demographic information including date of injury, admission status, and operative repair were collected. Patients were grouped based on whether their trauma occurred on the date of a home game. Results Operative hand and facial trauma occurred at a rate of 33.4 injuries per 100 days with home games, compared to 22.2 injuries per 100 days (incidence rate ratios, 1.50; 95% confidence interval, 1.34-1.69). When home games were played, patients were more likely to present as a result of motorcycle accidents (3.1% vs. 1.5%; P=0.04) or bicycle accidents (5.0% vs. 2.6%; P=0.01). Other mechanisms of trauma were not statistically different. There was an increase incidence of injuries during home games in August; weekly variability showed an increased incidence during the weekends. Conclusions There was an increased rate of operative hand and facial injuries on dates with professional home games. The incidence of injuries during home games was higher in the late summer and on the weekends. Further analysis may allow improved resource allocation and strategies for injury prevention and treatment.

점진적 걷기프로그램이 폐절제술 환자의 신체활동량, 운동능력, 회복력 및 합병증 발생에 미치는 효과 (Effects of a Progressive Walking Program on Physical Activity, Exercise Tolerance, Recovery, and Post-Operative Complications in Patients with a Lung Resection)

  • 김인아;이해정
    • 대한간호학회지
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    • 제44권4호
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    • pp.381-390
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection. Methods: A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0. Results: A higher proportion of patients in the experimental group showed adequate levels of physical activity (p=.001), shorter period of chest tube retention (${\leq}7$ days; p=.011), and shorter stay in the hospital (${\leq}10$ days; p=.036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p=.032) and lower levels of dyspnea (p=.049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications. Conclusion: The findings of this study suggest that the PW could be a useful strategy for improving patients' post-operative health and reducing cost after lung resection.

Management of High-grade Blunt Renal Trauma

  • Lee, Min A;Jang, Myung Jin;Lee, Gil Jae
    • Journal of Trauma and Injury
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    • 제30권4호
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    • pp.192-196
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    • 2017
  • Purpose: Blunt injury accounts for 80-95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80-85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury. Methods: We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high-grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III-V) renal injury patients were included in the analysis. Results: During the eight-year study period, there were 62 AAST grade III-V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade. Conclusions: Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

  • Kim, Seong-Hun;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • 제21권1호
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    • pp.48-55
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    • 2018
  • While non-operative treatment with structured rehabilitation tends to be the strategy of choice in the management of Rockwood type III acromioclavicular joint injury, some advocate surgical treatment to prevent persistent pain, disability, and prominence of the distal clavicle. There is no clear consensus regarding when the surgical treatment should be indicated, and successful clinical outcomes have been reported for non-operative treatment in more than 80% of type III acromioclavicular joint injuries. Furthermore, there is no gold standard procedure for operative treatment of type III acromioclavicular joint injury, and more than 60 different procedures have been used for this purpose in clinical practice. Among these surgical techniques, recently introduced arthroscopic-assisted procedures involving a coracoclavicular suspension device are minimally invasive and have been shown to achieve successful coracoclavicular reconstruction in 80% of patients with failed conservative treatment. Taken together, currently available data indicate that successful treatment can be expected with initial conservative treatment in more than 96% of type III acromioclavicular injuries, whereas minimally invasive surgical treatments can be considered for unstable type IIIB injuries, especially in young and active patients. Further studies are needed to clarify the optimal treatment approach in patients with higher functional needs, especially in high-level athletes.