• Title/Summary/Keyword: Operative strategy

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Nursing Managemant, Strategies for its success (간호관리자 역할의 성공적 수행을 위한 연구)

  • Kim, So-In
    • The Korean Nurse
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    • v.29 no.5
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    • pp.46-53
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    • 1991
  • In the past, management had been done over nurses rather than nursing and this brought the existence of general manager and as a result, nurse-manager's position and role are being threatend. For the up-bringing of nursing to firm professional recognition in the 21st century, it is firmly believed that nursing managers are to be in the position to play the role of general manager with professional qualifications; personal qualities and exact understandings on the role and function of each tier group under her/his management. 124 top(3 nursing superintendents), middle-range(23 supervisors) and unit managers(98 head-nurses) from 3 university hospitals in Seoul were interviewed in order to investigate their belief in the role, professional qualifications, personal qualities as well as the strategy for the development of their leadership qualities. The frame of reference for the interview were developed by the researcher in reference to relevant literatures. It was the common belief that qualifications o[ top-managers and mid-managers require an educational background of master's preparation or higher and clinical career for at least 15 years for top-managers and 5 -10 years for mid-managers. The personal qualities required by nurse managers include; leadership, initiative, judgement, self-confidence, flexibility, open-mindedness and strong motivation. Achievment-orientedness would greatly help them become excellent managers. On the other hand, [or more effective management, managers of each teir group are to fully understand their role and perform "their job responsibilities ie. Top managers are supposed to study with emphasis on organization, function and conceptual s~ill while mid-managers concentrate their effort on the development of skills for direction, guidance and human relationship. Unit managers also supposed to have abilities to manage their function with emphasis on development of clinical performance skill, for direction on operative aspects. The strategies for the development of leadership qualities include program-planning at individual instutional level as well as local, national and international level. Nurse-managers are to be motivated and encouraged to participate in the programs in order to effectively communicate within tier groups.oups.

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Transventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation

  • Song, Ji-Hye;Kong, Doo-Sik;Seol, Ho-Jun;Shin, Hyung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.415-419
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    • 2010
  • Objective : It is usually difficult to perform the neuroendoscopic procedure in patients without hydrocephalus due to difficulties with ventricular cannulation. The purpose of this study was to find out the value of navigation guided neuroendoscopic biopsy in patients with peri- or intraventricular tumors without hydrocephalus. Methods : Six patients with brain tumors without hydrocephalus underwent navigation-guided neuroendoscopic biopsy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by chemotherapy and/or radiotherapy as the first line treatment, or establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy. Results : Under the guidance of navigation, targeted lesion was successfully approached in all patients. Navigational tracking was especially helpful in entering small ventricles and in approaching the third ventricle through narrow foramen Monro. The histopathologic diagnosis was established in all of 6 patients : 2 germinomas, 2 astrocytomas, 1 dysembryoplastic neuroepithelial tumor and 1 pineocytoma. The tumor biopsy sites were pineal gland (n = 2), suprasellar area (n = 2), subcallosal area (n = 1) and thalamus (n = 1). There were no operative complications related to the endoscopic procedure. Conclusion : Endoscopic biopsy or resection of peri- or intraventricular tumors in patients without hydrocephalus is feasible. Image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of ventriculomegaly in patients with brain tumor may not be served as a contraindication to endoscopic tumor biopsy.

Ahmed Valve Implantation for Early Glaucoma Treatment in Dogs (개의 초기 원발성 녹내장안에서 Ahmed valve 이식술의 적용)

  • Park, Shin-Ae;Jeong, Man-Bok;Park, Young-Woo;Kim, Won-Tae;Kim, Se-Eun;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.385-390
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    • 2008
  • The purpose of this study was to compare the long term prognosis of Ahmed valve implantation and medical therapy in dogs with early primary glaucoma. The medical records of dogs with early primary glaucoma from the Veterinary Medical Teaching Hospital of Seoul National University between January 2005 and May 2008 were reviewed. Five dogs underwent Ahmed valve implantation and medical therapy was performed in six dogs. Breeds of the dogs included Shih Tzu(n = 7), American cocker spaniel(n = 2), and miniature poodle(n = 2). Adequate intraocular pressure(IOP) was better maintained in the Ahmed valve implantation group than in the medical treatment group throughout the follow-up period. Mean time for vision loss to develop after treatment in the Ahmed valve implantation group($198.0{\pm}115.4$ days) was significantly longer than that in medical treatment group($43.2{\pm}30.4$ days, p < 0.05). Post-operative complications included occlusion of the tube by fibrin in the anterior chamber (n = 1), fibrous capsule about the episcleral base of the device(n = 1), and dislocation of the valve body(n = 1). It is considered that Ahmed valve implantation is more effective strategy to control IOP and maintain vision than medical treatment in early glaucomatous dogs.

A Study on the Continuity of Volunteering in Urban Park (도시공원 자원봉사행동의 지속성 연구 -서울시 자원봉사단체를 사례로-)

  • 이준미;이규목
    • Journal of the Korean Institute of Landscape Architecture
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    • v.32 no.2
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    • pp.1-10
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    • 2004
  • Urban parks provide good services to the community, and they are enhanced by citizen participation. For that especially, organizational and continued volunteering can be a key strategy. The purpose of this study is to establish factors on promoting the continuity of volunteering in voulatary associations of urban parks. Variables of continuity are continual will, continual time, and psychological continuance motive. To add to this, this study is intended to inquiry about recognition and compensation that volunteers want to receive. The major findings are as follows: First, The main participantes were housewives with high education. Second, Continual will was influenced by gender, profession, the satisfactory degree for individual pursuit an ideal, and the degree of confidence with members. Third, Continual time was influenced by profession and individual network in community. Forth, Continual motive was influenced by individual network in community, the result-analysis behavior of related government organ, the degree of confidence and the degree of ties with members. Finally, Volunteers wanted to receive the volunteering expenses, the compensation about accident, and emotional recognitions. In sum : to ensure the continuity of volunteering, first, recruiting of volunteers is demanded to select a major target group in the community. Second, a voulatary association helps to make confidence and ties with members. Third, the related government organ strives for volunteers to have a positive recognition of the organ's attitudes, for the volunteer association to have a clearly distinguished area of action from the organ's one, and a co-operative system. Finally, an institution needs to be established to give emotional recognitions as well as volunteering expenses and acompensation for accidents.

Clinical Features and Surgical Treatment of Bacterial Brain Abscess

  • Jo, Sung-Dae;Kim, Eal-Maan;Lee, Chang-Young;Kim, In-Soo;Son, Eun-Ik;Kim, Dong-Won;Yim, Man-Bin
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.391-396
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    • 2007
  • Objective : This study was performed to review the clinical characteristics and operative results of brain abscess in order to define the therapeutic strategy for this disease. Methods : We reviewed the medical records and radiology images of brain abscess patients treated in our hospital during the last 16 years. A total of 35 cases included 23 males and 12 females, with the mean age of 48 years old. We excluded cases of postoperative, post traumatic, and fungal abscess. All patient underwent at least one surgical treatment such as stereotactic aspiration or craniotomy with excision. Results : Twenty seven [77.1%] patients presented with symptoms of increased intracranial pressure. The frontal lobe was the most common anatomical place, and streptococcal species were the most frequently encountered pathogens. The chronic pulmonary diseases and chronic otitis media are common underlying condition. Eighteen patients underwent stereotactic aspiration and 17 patients had excision of their abscess as an initial treatment. Seven patients had a repeated surgery, 6 of them had been treated with aspiration initially. At discharge, 60.0% patients showed a favorable outcome. Conclusion : The stereotactic drainage would be more suitable for the brain abscess located in deep and eloquent area. A large, solitary, and well-encapsulated lesion of superficial location could be best treated with complete excision, and this procedure was more definite because it is associated with less repeated surgery and showed more favorable outcome compared to aspiration surgery.

C-Engineering Based Industry 4.0 Innovation Networks Sustainable Development

  • Omelyanenko, Vitaliy;Braslavska, Oksana;Biloshkurska, Nataliia;Biloshkurskyi, Mykola;Kliasen, Natalia;Omelyanenko, Olena
    • International Journal of Computer Science & Network Security
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    • v.21 no.9
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    • pp.267-274
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    • 2021
  • The article deals with problems of innovation development on a network basis, which require effective mechanisms of innovation communications. In research the organizational aspects of ICT infrastructure development for innovation networks sustainable development based on cooperative marketing principles is considered. The proposed research idea is based on the idea that ICT implementation is based not only on the operational approach for innovation management as a factor of efficiency of internal communications, but also on knowledge economy and post-industrial economy trends. Therefore, the purpose of study is to develop an ICT model of innovation infrastructure to improve its effectiveness (strategic character) and efficiency (operative character) through increasing the efficiency of network communication interactions. Creation of information space and communication tools to support innovation network sustainable development and cooperation activities in research is proposed to be solved with the help of specialized ICT platform. It is shown, that ICT platform of innovation cooperation innovation network is important tool for common work of participants. ICT platform is considered as an integrated information system designed to automate business processes related to the sustainable development of innovation network, segment management and integration with HEI information systems and industrial cooperation. The main factors that determine the need to use a special ICT platform for innovation network cooperation were considered. The main issues of concurrent engineering (C-technology) application in high-technology industries and innovation cooperation for integrated product development were studied.

Segmentation of Intima/Adventitia of IVUS Image using Fuzzy Binarization (퍼지 이진화를 이용한 IVUS 영상의 내막/외막 분할)

  • Kim, Kwang Baek
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.12
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    • pp.1514-1519
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    • 2019
  • IVUS is an intra-operative imaging modality that facilitates observing and appraising the vessel wall structure of the human coronary arteries. IVUS is regularly used to locate the atherosclerosis lesions in the coronary arteries. Auto-segmentation of the vessel structure is important to detect the disorder of coronary artery. In this paper, we propose a simple strategy to extract Intima/Adventitia area effectively using fuzzy binarization from intravascular images. The proposed method apply fuzzy binarization to find the adventitia but apply average binarization to locate the intima since they have different homogeneity of pixel intensity comparing with the environment. In this paper, we demonstrate an effective auto-segmentation method for detecting the interior/exterior of the vessel walls by differentiating the fuzzy binarization result and average binarization result from IVUS image. Important statistics such as Intima-Media Thickness (IMT) or volume of a target area can be easily computed from result.

Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

  • Urabe, Masayuki;Yagi, Koichi;Shiomi, Shinichiro;Toriumi, Tetsuro;Okumura, Yasuhiro;Setoa, Yasuyuki
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.397-404
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    • 2022
  • Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.

Cinnamic acid derivatives as potential matrix metalloproteinase-9 inhibitors: molecular docking and dynamics simulations

  • Mohammad Hossein Malekipour;Farzaneh Shirani;Shadi Moradi;Amir Taherkhani
    • Genomics & Informatics
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    • v.21 no.1
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    • pp.9.1-9.13
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    • 2023
  • Matrix metalloproteinase-9 (MMP-9) is a zinc and calcium-dependent proteolytic enzyme involved in extracellular matrix degradation. Overexpression of MMP-9 has been confirmed in several disorders, including cancers, Alzheimer's disease, autoimmune diseases, cardiovascular diseases, and dental caries. Therefore, MMP-9 inhibition is recommended as a therapeutic strategy for combating various diseases. Cinnamic acid derivatives have shown therapeutic effects in different cancers, Alzheimer's disease, cardiovascular diseases, and dental caries. A computational drug discovery approach was performed to evaluate the binding affinity of selected cinnamic acid derivatives to the MMP-9 active site. The stability of docked poses for top-ranked compounds was also examined. Twelve herbal cinnamic acid derivatives were tested for possible MMP-9 inhibition using the AutoDock 4.0 tool. The stability of the docked poses for the most potent MMP-9 inhibitors was assessed by molecular dynamics (MD) in 10 nanosecond simulations. Interactions between the best MMP-9 inhibitors in this study and residues incorporated in the MMP-9 active site were studied before and after MD simulations. Cynarin, chlorogenic acid, and rosmarinic acid revealed a considerable binding affinity to the MMP-9 catalytic domain (ΔGbinding < -10 kcal/ mol). The inhibition constant value for cynarin and chlorogenic acid were calculated at the picomolar scale and assigned as the most potent MMP-9 inhibitor from the cinnamic acid derivatives. The root-mean-square deviations for cynarin and chlorogenic acid were below 2 Å in the 10 ns simulation. Cynarin, chlorogenic acid, and rosmarinic acid might be considered drug candidates for MMP-9 inhibition.

Long-term Results of Surgical Treatment of Craniopharyngioma : Experience with 100 Adult Patients (성인 두개인두종 연속 100예의 장기 치료 성적)

  • Bang, Jae Seung;Jung, Hee-Won;Kim, Dong Gyu;Gwak, Ho-Shin;Paek, Sun Ha;Chung, Young Seob;Hong, Seung-Koan
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.472-478
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    • 2001
  • Objectives : The authors present a retrospective analysis of 100 consecutive adult patients harboring craniopharyngiomas who underwent microsurgical resection between 1981 and 1999 to assess the long-term outcome of surgical treatment and to determine the most optimal management strategy. Methods : The extent of surgical removal was divided into four categories ; GTR(gross total removal), RSTR(radical subtotal removal), STR(subtotal removal),and PR(partial removal). The median follow-up period was 50 months(4-198). CT scan and/or MR imaging and hormonal status were evaluated to the last follow-up. Results : Visual disturbance was the most common presentation, which was improved in 42 cases and aggravated in 19 cases following the operation. Hypopituitarism was detected in 56 patients preoperatively, 82 during the immediate postoperative period, and 76 at the last follow-up. Improvement of pituitary function was not observed in any of these patients. Twenty of 100 patients showed recurrence at the mean of 27 months(3 to 196). The median progression-free survival(PFS) time of all patients was 145 months and 5-year PFS rate was 74%. Five-year PFS rate of GTR or RSTR group(71%) was significantly higher than that of STR or PR group(30%)(p=0.01). Postoperative radiation therapy significantly prolonged the PFS from 94 months in non-radiation group to 182 months(p=0.002). However, there was no statistical difference in number of patients who required hormonal replacement therapy between radiation and non-radiation group. Conclusion : Visual disturbance can be improved by early diagnosis and surgical decompression. GTR or RSTR in selected patients is considered a proper surgical strategy. Post-operative radiation therapy for residual tumors must be considered, although the ideal timing of radiation therapy is to be determined.

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