• Title/Summary/Keyword: Period of support

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Relationship of Hemodynamic Changes during Off-Pump Coronary Bypass Grafting and Their Effects on Postoperative Outcome (심폐바이패스 없이 시행하는 관상동맥 우회수술 중의 혈역학적 변수들의 변화양상 및 수술 후 결과에 미치는 영향)

  • 허재학;장지민;김욱성;장우익;이윤석;정철현
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.576-582
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    • 2003
  • During the Off-Pump Coronary Arterial Bypass surgery (OPCAB), the manipulation of the heart can depress cardiac contractility and cause hemodynamic instability. In this study, hemodynamic parameters were measured during operation and the laboratory and clinical data were investigated to evaluate their effects on postoperative outcome. Material and Method: From March 2001 to August 2002, 50 consecutive patients who underwent OPCAB were included in this study. During the same period, total number of CABG was 71 The blood pressure, pulmonary artery pressure, mixed venous oxygen saturation, and cardiac index were measured before manipulation, after application of stabilizer, and at the end of anastomosis. Postoperatively, we measured the cardiac enzymes such as CK-MB, troponin 1 and checked the amount of inotropes required, chest tube drainage, the amount of transfusion, duration of ventilator support, and duration of ICU stay. Result: The number of mean distal anastomoses was 2.8$\pm$0.9 per patient. On elevation and stabilization of the heart, systolic blood pressure was depressed and pulmonary artery pressure was elevated significantly, but during each anastomosis no significant changes were detected. The peak level of cardiac markers was 29.2$\pm$46.7 for CK-MB, 0.69$\pm$0.86 for troponin 1 on postoperative day f. Among the intraoperative hemodynamic parameters, the ischemic change of EKG and bolus injection of inotropes significantly affected the posteroperative cardiac enzymes. But, no difference other than the level of cardiac enzymes between the two groups with or without the ischemic change of EKG and bolus injection of inotropes was noticed. Conclusion: The significant hemodynamic changes occurred when the heart was elevated and stabilized, however during anastomoses there were no significant changes. Serum cardiac enzymes rose significantly in the group that showed the ischemic charge of EKG or needed the bolus injection of inotropes for maintaining hemodynamic stability intraoperatively, but it did not affect the postoperative outcome. In conclusion, the ischemic change of EKG and the need for bolus injection of intropes during operation may be very indicative for probable ischemia.

A Study on the Florence Renaissance and the Medici's Libraries (피렌체 르네상스와 메디치가 도서관 연구)

  • Yoon, Hee-Yoon
    • Journal of Korean Library and Information Science Society
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    • v.53 no.3
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    • pp.73-94
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    • 2022
  • Florence is the cradle of the Italian Renaissance. It is the result of a combination of medieval humanists' exploration of ancient Greek and Roman knowledge and culture, the leadership of great monarchs and priests, patronage of the Medici family, etc., free-thinking and creativity of artists, and critical consciousness and cultural needs of citizens. However, the Florentine Renaissance could not have blossomed unless the Medici family had collected ancient manuscripts and translations, and built libraries to preserve and provide literature. Based on this logical basis, this study outlined the Florentine renaissance and historic libraries, analyzed the collection and composition of favorite books of the Medici family, and traced the architectural characteristics and metaphors of the Medici libraries, The San Marco Library (Michelozzo Library), Library of Badia Fiesolana, and the San Lorenzo Library (Laurentian Library) were the priming and birthplace of the Florentine Renaissance despite of many difficulties, including earthquake, fire, restoration, transfer, seizure, and closure. In particular, the San Marco Library, which was opened in 1444 based on the financial support of Cosimo de' Medici, Michelozzo's design, and Niccoli's private collections was the first common library in the Renaissance period. And the architectural highlight of the Laurentian Library, which opened in 1571 under the leadership of Giulio (Papa Clemente VII), is Michelangelo's staircase, which symbolizes 'from ignorance to wisdom', and the real value of the content is the ancient manuscripts and early printed books, which were collected by the humanist Niccoli and the Medici family. In short, when discussing the Florentine Renaissance, Medici's collection and historic libraries are very important points. The reason is that the ancient collections were not stuffed products, but syntactic semiotics, and the libraries are telescopes that view the history of human knowledge and culture and microscopes that create knowledge and wisdom. If records dominate memories, libraries accumulate records. Therefore, long breathing and time capsule strategies are also required for the development and preservation of retroactive books in domestic libraries with a relatively long history.

Surgical Treatment of Patients with Abdominal Aortic Aneurysm (복부 대동맥류에 대한 수술)

  • Ryu, Kyoung-Min;Seo, Pil-Won;Park, Seong-Sik;Ryu, Jae-Wook;Kim, Seok-Kon;Lee, Wook-Ki
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.331-336
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    • 2009
  • Background: Open surgical repair of abdominal aortic aneurysms was initiated by Dubost in 1952. Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized for curative intent. We retrospectively analyzed surgical outcome, complications, and mortality-related factors for patients with abdominal aortic aneurysms over a 6 year period. Material and Method: We analyzed 18 patients who underwent surgery for abdominal aortic aneurysms between March 2002 and March 2008. The indications for surgery were rupture, a maximal aortic diameter >60 mm, medically intractable hypertension, or pain. Result: The mean age was $66.6{\pm}9.3$ years (range, $49\sim81$ years). Twelve patients (66.7%) were males a 6 patients were females. Extension of the aneurysm superior to the renal artery existed in 6 patients (33.3%), and extension to the iliac artery existed in 13 patients (72.2%). Five patients (27.8%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $72.2{\pm}12.9$ mm (range, $58\sim109$ mm). Surgery was performed by a midline laparotomy, and 6 patients underwent emergency surgery. The mean total ischemic time from aorta clamping to revascularization was $82{\pm}42$ minutes (range, $35\sim180$ minutes). The mortality rate was 16.7%; the mortality rate for patients with ruptured aneurysms was 60%, and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included one each of renal failure, femoral artery and vein occlusion, and wound infection. The patients who were discharged had a long-term survival of $34{\pm}26$ months (range, $4\sim90$ months). Rupture and emergency surgery had a statistically significant mortality-related factor (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have a high mortality, but unruptured cases are repaired with relative safety. Successfully operated patients had long-term survival. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, aggressive application should be determined with care. Experience and systemic support of each center is important in the treatment plan.

Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants (극소 저출생 체중아에서 경피 중심정맥 도관의 유용성과 합병증)

  • Kim, Hyang;Kim, Sun Hui;Byun, Hyung Suck;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.953-959
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    • 2005
  • Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

Expiration-Day Effects: The Korean Evidence (주가지수 선물과 옵션의 만기일이 주식시장에 미치는 영향: 개별 종목 분석을 중심으로)

  • Choe, Hyuk;Eom, Yun-Sung
    • The Korean Journal of Financial Management
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    • v.24 no.2
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    • pp.41-79
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    • 2007
  • This study examines the expiration-day effects of stock index futures and options in the Korean stock market. The so-called 'expiration-day effects', which are the abnormal stock price movements on derivatives expiration days, arise mainly from cash settlement. Index arbitragers have to bear the risk of their positions unless they liquidate their index stocks on the expiration day. If many arbitragers execute large buy or sell orders on the expiration day, abnormal trading volumes are likely to be observed. If a lot of arbitragers unwind positions in the same direction, temporary trading imbalances induce abnormal stock market volatility. By contrast, if some information arrives at market, the abnormal trading activity must be considered a normal process of price discovery. Stoll and Whaley(1987) investigated the aggregate price and volume effects of the S&P 500 index on the expiration day. In a related study, Stoll and Whaley(1990) found a similarity between the price behavior of stocks that are subject to program trading and of the stocks that are not. Thus far, there have been few studies about the expiration-day effects in the Korean stock market. While previous Korean studies use the KOSPI 200 index data, we analyze the price and trading volume behavior of individual stocks as well as the index. Analyzing individual stocks is important for two reasons. First, stock index is a market average. Consequently, it cannot reflect the behavior of many individual stocks. For example, if the expiration-day effects are mainly related to a specific group, it cannot be said that the expiration of derivatives itself destabilizes the stock market. Analyzing individual stocks enables us to investigate the scope of the expiration-day effects. Second, we can find the relationship between the firm characteristics and the expiration-day effects. For example, if the expiration-day effects exist in large stocks not belonging to the KOSPI 200 index, program trading may not be related to the expiration-day effects. The examination of individual stocks has led us to the cause of the expiration-day effects. Using the intraday data during the period May 3, 1996 through December 30, 2003, we first examine the price and volume effects of the KOSPI 200 and NON-KOSPI 200 index following the Stoll and Whaley(1987) methodology. We calculate the NON-KOSPI 200 index by using the returns and market capitalization of the KOSPI and KOSPI 200 index. In individual stocks, we divide KOSPI 200 stocks by size into three groups and match NON-KOSPI 200 stocks with KOSPI 200 stocks having the closest firm characteristics. We compare KOSPI 200 stocks with NON-KOSPI 200 stocks. To test whether the expiration-day effects are related to order imbalances or new information, we check price reversals on the next day. Finally, we perform a cross-sectional regression analysis to elaborate on the impact of the firm characteristics on price reversals. The main results seem to support the expiration-day effects, especially on stock index futures expiration days. The price behavior of stocks that are subject to program trading is shown to have price effects, abnormal return volatility, and large volumes during the last half hour of trading on the expiration day. Return reversals are also found in the KOSPI 200 index and stocks. However, there is no evidence of abnormal trading volume, or price reversals in the NON-KOSPI 200 index and stocks. The expiration-day effects are proportional to the size of stocks and the nearness to the settlement time. Since program trading is often said to be concentrated in high capitalization stocks, these results imply that the expiration-day effects seem to be associated with program trading and the settlement price determination procedure. In summary, the expiration-day effects in the Korean stock market do not exist in all stocks, but in large capitalization stocks belonging to the KOSPI 200 index. Additionally, the expiration-day effects in the Korean stock market are generally due, not to information, but to trading imbalances.

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An Effect of Rhythmic Movement Therapy for Adaptation State in Mastectomy Patients (율동적 운동요법이 유방절제술 환자의 퇴원후 적응상태에 미치는 영향)

  • Lee Myung-Hwa
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.67-85
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    • 1995
  • The purpose of this study was to determine the effects of rhythmic movement therapy for adaptation state in mastectomy patients. The quasi-experimental study was designed using nonequivalent control group pretest-posttest design within the framework of Laszarus & Folkman's stress-adaptation model. The subjects of the study were composed thirty-two mastectomy patients, of these fifteen were assigned to the experimental group and seventeen to the control group. Rhythmic movement therapy was carried out twice a week for thirty-five, minutes or forty minutes for six weeks period from August 22 to September 30 in 1994. Data was collected before and after the experimentation. Collected data was analyzed by mens of chi-square test, t-test, two-way ANOVA, Pearson's correlation coefficient with $SPSS/PC^+$. The results were summarized as follows : 1. Physical symptom score in the experimental group and control group was not significant difference. 2. Joint Movement Parameter in the experimental group and control group was significant difference. 3. Depression score in the experimental group and contrl group was significant difference. 4. Body image score in the experimental group and control group was significant difference. 5. Stress perception score in the experimental group and control group was significant difference. 6. Social adjustment score in the experimental group and control group was significant difference. 7. Each adaptational level in the experimental group and control group according to type of Health Locus of Control were partially significant difference. Depression score and social adjustment score between the experimental group and control group according to others Health Locus of control were significant difference. This data suggest that rhythmic movement therapy was more effective in the group of Others health Locus of Control. 8. Each adaptational level between the experimental group and control group according to amount of spouse support were not significant difference. 9. The significant positive correlation between physical symptom score and body image, between body image and social adjustment, were observed. The significant negative correlation between stress perception score and social adjustment, between depression and body image, between depression and social adjustment, were observed. This data suggest that the more physical symptom score increased, the more body image increased and the more body image, the more social adjustment. And then the more stress perception score decreased, the more social adjustment increasded and the more depression score, the more body image and social adjustment. Thus it is concluded that the rhythmic movement therapy was a useful nursing intervention for adaptation of mastectomy patients.

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Entrepreneurship Competency-Based Education Research: EntreComp (Entrepreneurship Competence) Frame for Advancement of University Startup Education (기업가정신역량기반 교육 연구: 대학 창업교육 고도화를 위한 EntreComp(Entrepreneurship Competence) Frame 도출)

  • Bian, Jhi-Yoo;Lee, Jang-Hee
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.6
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    • pp.189-207
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    • 2020
  • The government has achieved quantitative growth in university start-up education while supporting start-up education. However, it failed to systematize start-up education from an academic, policy, and practical perspective and to reveal the relationship between education and achievements in supporting start-ups. Therefore, there is a lack of interest and effort to promote effective education. In Europe, in-depth research has already been done over many years to establish an EntreComp system. Competences create values for others and attempt to apply them to education, viewing them as the people's lifelong competitiveness. On the other hand, it is urgent to improve the education system as domestic university start-up education is mainly focused on cultural level start-up skills and easy-to-access education from a business administration perspective. Based on this, the entrepreneurship competence-based start-up education system was designed. Next, eight EntreComp frames were drawn for university students through the Focus Group Interview (FGI) and Delphi survey methods, as well as domestic and international prior studies on EntreComp. In 2018, 919 start-up education programs of 42 start-up leading universities were conducted to derive the status of education by EntreComp. Prior studies of 25 entrepreneurship competences, including data from Bacigalupo et al.(2016), which studied EntreComp in the EU, were investigated and reflected the frequency of research and the importance of education and start-up perspectives. Based on the purpose of the university start-up education presented in this study, the entrepreneurship competence frame consisting of a total of eight, including spotting opportunities, value creation, self improvement, mobilising resources, technology application, strategic management, relationship, and learning through experience, was derived through expert verification. It also investigated the current status of education by competence, the degree of reflection of competence education, and the relationship with the results of support for start-ups that reflect the number of students enrolled in each university. Through this, it was suggested that future start-up education at universities could be improved from the EntreComp perspective. It has a differentiation in research in that it conducted a thorough survey using the data on start-up courses operated by leading startup universities for a certain period. However, it is difficult to generalize because the number of samples of leading startup universities is limited. Nevertheless, this study proposes the educational goal of advancing university start-up education from the perspective of entrepreneurial competence, cultivating future required competences, and fostering entrepreneurial talents that create value for others. In addition, it is meaningful in that it presents a clear direction for subsequent research by preparing a framework for research from a more essential perspective on the entrepreneurship competence frame.

Studies on the Propagation of the Freshwater Prawn, Macrobrachium nipponense (De Haan) Reared in the Laboratory (담수산 징거미새우, Macrobrachium nipponense (De Haan)의 증${\cdot}$양식에 관한 생물학적 기초연구 1. 생식생태에 관한 연구)

  • Kwon Chin-Soo;Lee Bok-Kyu
    • Journal of Aquaculture
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    • v.4 no.1
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    • pp.31-66
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    • 1991
  • This paper deals with the reproductive ecology e.g., number of the pre-spawning moults, morphological characteristics of the pre-spawning moult the common moult, daily ration druing a molting cycle mating behavior, structures of spermatozoa and spermatophore, structure of vas deferens, mechanisms of the oviposition and brooding into the egg-chambers, a suitable time for the artificial mating and fertilization, time sequence of the oviposition and brooding into egg-chambers from the copulation, responses to temperature and chlorinity on the egg development and hatching, effect of temperatures on duration of egg development, physical mechanism of the egg hatching, to make an attempt for the artificial spawning and brooding to establish a suitable system of the artificial seedling-production for the aquaculture. 1. Females molted commonly $8{\~}10$ times at an interval of $17{\~}18$ days at $28^{\circ}C,\;3.26\~4.35\%_{\circ}$ while the prespawning moltings were $4{\~}5$ times at an interval of $13{\~}14$ days. The suitable state for artificial copulation was within 14 hours elapsed from the prespawning moltings (most suitable state was within 8 hours). Males discharged a gelatinous spermatophore and placed it on the females sternum during copulation. Oviposition was seen $6{\~}17$ hours after copulation. External fertilization was considered to take place at oviposition. Fertilized eggs held in egg-chambers forming between pleopods were about $5000{\~}6000$ in females those sizes about 6.5 cm in body length. 2. Eggs immediately after oviposition were elliptic shape, measuring $0.58{\times}0.48$ mm up to hatching. Their sizes increased with egg development and finally reached $0.85{\times}0.54$ mm up to hatching. The relationship between the long axis of the egg(Y in U) and days elapsed(X) was expressed as Y= 5.60194 + 0.007358X. The eggs performed superficial cleavage and their cleavage furrows became visible at the 4-daughter-nucleus stage. The eggs showed normal development up to hatching at water temperature range of $22{\~}30^{\circ}C$ (optimum temperature : $26{\~}28^{\circ}C$) and at chlorinity range of $0.00\~6.64\%_{\circ}$ (optimun chlorinity : $2.21{\%}_{\circ}$). The relationship between incubation period (Y in days) and water temperature(X in $^{\circ}C$) could be expressed as Y= 50.803-1.3555X. The eggs hatched $12{\~}13$ days after oviposition at $28.0{\~}28.6^{\circ}C$ 3. The pre-spawning moltings were appreciably different in the morphologic structure from those of common moltings. Breeding setae and dresses were formed on the thoracic regions, abdominal epimerae and the bases of the first to fourth pleopods in order to prepare and support oviposition, transfering and supporting eggs in egg-chambers up to hatching. These supplementary breeding organs were observed only at reproductive seasons.

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Autonomic Nervous Response of Female College Students with Type D Personality during an Acute Stress Task: Heart Rate Variability (Type D 성격 여대생의 급성 스트레스에 따른 자율신경계 반응 : 심박률 변동성을 중심으로)

  • Ko, Seon-Young;Kim, Myung-Sun
    • Korean Journal of Health Psychology
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    • v.14 no.2
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    • pp.277-292
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    • 2009
  • This study investigated the responses of the autonomic nervous system of individuals with Type D personality during an acute stressful situation. Twenty-three female students of Type D personality and 23 female students with non-Type D personality. Stroop Color-Word Task was used to induce a stressful situation, heart rate variability (HRV) was used to measure the responses of the autonomic nervous system during the baseline, acute stress, recovery periods. To analyze the data, the repeated measures analysis of variance was used to compare the autonomic nervous system of the Type D group to that of the non-Type D group. Regression analysis is used to determine if the Type D scale and stress vulnerability predicted the activities of the autonomic nervous system during the baseline period. The results of this study demonstrated that the Type D group's normalized low frequency (LF norm) and ratio of low frequency to high frequency (LF/HF ratio) were higher than those for the non-Type D group, while its normalized high frequency (HF norm) was lower than that for the non-Type D group in all three periods. There were no statistically significant differences among the three periods in terms of LF norm, HF norm, and LF/HF ratio in the Type D group. The study demonstrated that the total scores of the Type DS-14 and scores of social inhibition and negative affect were independent predictors of LF norm and HF norm during the baseline. The Type D group showed increased activation of the sympathetic nervous system and/or decreased activation of the parasympathetic nervous system. These results support the hypothesis that the Type D personality is vulnerable to the stress. Also, the highly activated sympathetic and/or lowly activated parasympathetic nervous systems, which were observed in the Type D group during the baseline, indicated that the Type D individual is susceptible to psychosomatic disorders.

The Significance of the Early Electroencephalographic Findings in Severely Asphyxiated Newborn Infants (중증 주산기 가사 환아에서 시행한 초기 뇌파 검사의 임상적 의의)

  • Lee, Jong Uk;Choi, Won Joung;Kim, Chun Soo;Lee, Sang Lak;Kim, Jun Sik
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.784-788
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    • 2003
  • Purpose : Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. Methods : Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of ${\leq}3$ and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. Results : Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst-suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). Conclusion : Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.