• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.28 no.1
• /
• pp.25-33
• /
• 2024

Backgrounds/Aims: Parenchymal-sparing anatomical hepatectomy (Ps-AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps-AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α-Fetoprotein was 25.2 ng/mL. All cases (100%) had Child-Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien-Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions: Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.

• Clinical Endoscopy
• /
• v.55 no.2
• /
• pp.215-225
• /
• 2022

Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them. Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables. Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039). Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

• Korean Circulation Journal
• /
• v.54 no.7
• /
• pp.409-421
• /
• 2024

Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.

• Journal of the Korean Society of Radiology
• /
• v.85 no.4
• /
• pp.714-726
• /
• 2024

Researchers have developed various algorithms utilizing artificial intelligence (AI) to automatically and objectively diagnose patterns and extent of pulmonary emphysema or interstitial lung diseases on chest CT scans. Studies show that AI-based quantification of emphysema on chest CT scans reveals a connection between an increase in the relative percentage of emphysema and a decline in lung function. Notably, quantifying centrilobular emphysema has proven helpful in predicting clinical symptoms or mortality rates of chronic obstructive pulmonary disease. In the context of interstitial lung diseases, AI can classify the usual interstitial pneumonia pattern on CT scans into categories like normal, ground-glass opacity, reticular opacity, honeycombing, emphysema, and consolidation. This classification accuracy is comparable to chest radiologists (70%-80%). However, the results generated by AI are influenced by factors such as scan parameters, reconstruction algorithms, radiation doses, and the training data used to develop the AI. These limitations currently restrict the widespread adoption of AI for quantifying pulmonary emphysema and interstitial lung diseases in daily clinical practice. This paper will showcase the authors' experience using AI for diagnosing and quantifying emphysema and interstitial lung diseases through case studies. We will primarily focus on the advantages and limitations of AI for these two diseases.

• The Journal of the Convergence on Culture Technology
• /
• v.10 no.5
• /
• pp.445-452
• /
• 2024

Through the pandemic, the topography of dining culture is rapidly changing due to the advancement of the food delivery market. Competition in the domestic market is intensifying as Coupang Eats recently surpassed Yogiyo and jumped to second place, and Baedal Minjok(Baemin), the industry's No. 1 company, is also preparing to introduce a subscription system. While the growth of the delivery market is slowing, the use of takeout and pick-up services is increasing due to rising delivery costs and food prices. From Generation Z's perspective, the main factors influencing the active use of app services were identified through prior research as usability and convenience, cost sensitivity, and hedonic motivation. While, they are leading the trend of minimizing spending through 'stepping stone consumption' and delivery pot process instead of choosing a subscription system. Accordingly, we aim to provide customers with a better experience and help strengthen competitiveness by proposing ways to improve and revitalize new delivery apps that reflect the characteristics of Gen.Z. As a result of the expert Delphi survey, we will receive impact evaluation scores in the following order: direct view of accumulated discounts, addition of family benefits, coupon reinforcement, SNS promotion, pick-up walk, in-store promotion, and discount rate display, and review their application to practice. It presents academic and policy implications regarding the food tech market.

• Journal of Korean Medical classics
• /
• v.9
• /
• pp.555-652
• /
• 1996

Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

• Research in Community and Public Health Nursing
• /
• v.11 no.1
• /
• pp.127-145
• /
• 2000

The objectives of this study are to identify health behaviors and health problems. and the relations between health behaviors and health problems of female workers in the retail business. The number of subjects were 200 female workers of 6 department stores in Seoul and Kyonggi area, whose jobs last more than 6 months as retail employees. The data was collected during 2 months from July 1 to August 30, 1998. The Cornell Medical Index Health Questionnaire(CMI) was used to measure their health problems, while health behaViorn were investigated in terms of 'smoking', 'alcohol', exercise', 'diet', and 'sleeping'. The data were analyzed with frequency. percentage, t-test, ANOVA test, and $X^2-test$ by SPSS PC+ program. The results of this study are as follows: 1. Out of health problems. Digestive symptoms occupied the highest percent number. nervous ones the second and cardiovascular ones the third among physical health problems of retail female workers. The most frequent mental health problem was 'adequacy' and the next, 'tension' and 'anger', 2, Health problems according to general characteristics of subjects were shown that the younger or the unmarried complained more than the older or the married, especially in the items of 'eye and ear', 'respiratory system', 'cardiovascular system', 'digestive tract', 'nervous system', 'adequacy', and 'depression'. The longer working duration they have had, the more they complained of 'respiratory system' and 'adequacy'. The lower academic careers complained of 'nervous' than the higher ones with statistical significance. 3. The analysis of daily health clinic notes showed that respiratory complaints were the highest percent, successively followed by digestive tract, nervous one, external injury, musculoskeletal system, urinary-reproductive system and others. 4. The level of their health practice was generally low in smoking, diet habit and alcohol intake, exercise, sleeping, very low especially in smoking, diet, alcohol intake, and exercise among them all. 5. Present smokers and ones with past experience complained of physical and mental health problems of 'respiratory system', 'digestive tract', 'skin', 'nervous', 'urinary-reproductive system', 'fatigability', adequacy', 'depression', 'anxiety', 'anger' and 'tension', than non smokers, with statistical difference. Workers without having breakfast and with irregular diet had more complaints on 'digestive tract', 'adequacy' and 'tension', than those who had regular dietary habit. The less the subjects slept, the more they complained of eye and ear, cardiovascular system. The subjects who drank alcohol complained more digestive problem. However, whether they exercise or not did not affect physical and mental health problems in a significant manner. 6. The subjects' age and marital status were statistically significant relating to health behaviors, as the younger or unmarried recorded a low level of health practice in smoking, drinking, dietary habit. Based on the results, the suggestions are made as follows: 1. Health education program on smoking, alcohol intake, diet habit is needed to improve health problems and health behavior of female retail workers. 2. The unmarried workers of late teen and twenties, who are transitional period from teenagers to adulthood are important targets for health promotion program especially for maternal health. 3. Better working environment with sufficient time and facilities for workers to relax is required to promote female sales workers' health. 4. Further research is required to identify the relation between workers' visual fatigue and intense lights for the display of goods.

• Proceedings of the Korean Institute Of Construction Engineering and Management
• /
• autumn
• /
• pp.115-122
• /
• 2002

There is various points that should be improved in Fairness such as our contract practice to propose construction projects, project managing and the stakeholders' way of thinking and culture. We consider that the revision of construction related provisions and systems is required but even more, an overall change in business management through the implementation of Integrated Construction Information Management System that will enable the owner, which drives the project, and contractor sharing construction information is required. To mange construction related information in an integrated manner, designing information should be smoothly transferred to purchasing information, and changes are required in order to move ahead to process-oriented work system. Finally information created from various construction organizations should be delivered in an aligned and standardized manner as well. The domestic Nuclear Power Plant Construction has been accepting various technology transfers from U.S, France, Canada and UK, which enabled us to self-support technology and recently even proceeded to the phase exporting our technology to others. However, continuous effort is required to improve internal business efficiency and to respond to external environmental change such aselectricity market deregulation. Recently, in accordance with the result in number of CEO's intention to make progress in IT and improve business efficiency, the number of enterprises introducing Enterprise Resource Planning is increasing. ERP is an innovative tool which changes the way of performing work from organization and department orientation to process-orientation in order to optimize the resources, such as human and material resources, through out the Enterprise by performing BPR which will maximize overall business efficiency of the enterprise, such includes not only construction management, but also business management. KHNP continued to performing large scaled construction projects such as nuclear power plant construction for past 30 years and took the initiatives of large scale project management and Quality management ability in domestic industry by having independent capability of over all construction planning, purchasing and, construction and start up management etc. To maintain our leading position of improving construction management technology based on our accumulated project management experience and technology, KHNP included construction into our ERP project in purpose of innovating construction business. We would like to discuss the characteristics of nuclear construction business, project management system, information system infrastructure and information sharing system among construction related entities, and implementation practices for information system, and consider how to resolve our practice that should be improved in this thesis.

• 대한공업교육학회지
• /
• v.38 no.1
• /
• pp.105-124
• /
• 2013

This study aims to analyze the teaching and learning methods realities and needs in the subjects 'The basis of the Invention Patent'. To this end, research and analysis of the subjects 'The basis of the Invention Patent' the teacher and take advantage of their current teaching and learning methods, 'The basis of the Invention Patent' subject teachers to recognize the most desirable teaching and learning methods, subjects 'The basis of the Invention Patent' of teaching and learning and the operating requirements of the difficult matters. Survey of 48 schools across the country in high school teachers to teach the subjects 'The basis of the Invention Patent' was conducted, the results of this study are as follows. First, a high percentage of theoretical learning activities, teaching methods, such as 'lectures' and take advantage of the higher percentage. Module was to conduct classes such as 'project', 'lab experiments', 'discussion', 'investigation' by taking advantage of the high proportion of practice learning activities. Second, Higher requirements for the experience and practice of student-centered 'lab experiments', 'project', 'Case Studies', 'field trips' and theory-driven rather than 'lectures'. Third, 'The basis of the Invention Patent' subjects 'Teaching and learning important when operating requirements for the degree' as a whole was highly recognized. in particular, operating requirements for teaching and learning in accordance with the former college of education of education than non-group differences were higher overall response. Fourth, 'The basis of the Invention Patent' subjects 'Teaching and learning difficult when operating your degree' as a whole was highly recognized. In particular, was recognized by difficult questions, such as lack of preparation classes due to excessive work, educational facilities and equipment shortage, lack of prior knowledge about the subject, individual differences of the students considering the difficulties, student's

• Journal of Nutrition and Health
• /
• v.51 no.2
• /
• pp.153-167
• /
• 2018

Purpose: This study was conducted to identify differences in dietary behaviors, dietary life consumer education related situation competencies, and dietary lifestyles between baby-boom and echo generations by gender. Methods: Data were drawn from the 2016 Food Consumption Behavior Survey, and 2,474 subjects (baby-boom generation 1,304; echo generation 1,170) were selected. Results: The baby-boom generation more frequently ate meals at home with family than the echo generation, whereas the echo generation had meals more frequently at cafeterias, cafes, bakeries, convenience stores and with friends or colleagues than the baby-boom generation. However, no significant differences in dietary life related consumer education were observed between generations, and experience with food related consumer education and food related promotional/events was very low in general. Baby-boomers received their primary dietary information from surrounding people, whereas the echo generation received it from broadcasting. The information use competence was lower for the baby-boom generation (3.29) than echo generation (3.35), although this difference was not significant. Healthy dietary life competence did not differ significantly, whereas the baby-boom generation showed a higher level of practice competence than the echo generation. Additionally, the baby-boom generation was more likely to pursuit health and less likely to be concerned with convenience and taste quality than the echo generation. Conclusion: The frequencies of meal eating places, drinking, and eating-out differed significantly between the two generations, while the participation ratios of food related consumer education/events, attitudes toward education, and information use competence did not. Additionally, knowledge regarding healthy dietary life competencies did not differ, whereas practice level showed significant differences between generations. Among dietary lifestyles, the baby-boom generation showed higher pursuit of health and lower pursuit of convenience and taste quality than the echo generation.