• Journal of Chest Surgery
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• 제19권4호
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• pp.644-662
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• 1986

Seventy cases of open heart surgery were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje College, from Oct. 1985 to Oct. 1986. And the results were summarized as follows. 1. Among the 70 cases, there were 48 cases of congenital heart anomalies and 22 cases of acquired rheumatic valvular heart diseases. Age range of the congenital patients was 7 months to 31 years with the mean age of 10 years, and the acquired patients was 18 to 62 years with the mean age of 40 years. 2. The heart-lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 5 of membrane type and 65 of bubble type. For all cases GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 48 congenital anomalies, there were 12 cases of ASD group, 29 of VSD group, 3 of ECD, 3 of TOF and one of PDA + MR, and to all of which the appropriate radical operations were applied. 4. Among the 22 acquired valvular diseases, there were 11 cases of mitral valve diseases [MS; 4, MSr; 3, MRs; 4], 3 cases of aortic valve diseases [AR:1, ARs;1, ASr;1], 4 cases of double valve diseases [MRs+TR; 3, MRs+ARs; 1] and 4 cases of triple valve diseases [MSr+ASr+TR; 3, MSr+Ar+TR; 1]. To all the diseased mitral and aortic valves, artificial valve replacement was applied except one [As], in which valve plication was applied. And to all the diseased tricuspid valve, DeVega annuloplasty was applied. 5. The number of replaced artificial valves were 29 in 25 patients [congenital; 3, acquire; 22]. In MVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 15 of tissue valves [Carpentier-Edward valve; 11, lonescu-Shiley valve; 4] were used. In AVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 2 of tissue valves [Carpentier-Edward valve; 2] were used. 6. Postoperative complications were occurred in 12 cases. Among them 11 cases were recovered with intensive cares, but one patient [VSD + Fistula of Valsalva sinus] was expired with low cardiac out put syndrome.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.760-762
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• 2005

Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.

• 대한두경부종양학회지
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• 제10권2호
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• pp.91-101
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• 1994

Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

• Journal of Chest Surgery
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• 제30권8호
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• pp.815-818
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• 1997

인공판막심내막염은 드물지만 합병증으로 판막주위가 감염으로 파괴되고 농양이 형성되는 경우가 있어 높 은 사망율을 가져온다. 그러나 적절한 항생제의 사용, 심장초음파 검사에 기초를 둔 조기 진단,수술시 효과적인 심근보호. 그리고 수술경험의 축적으로 인공판막심내막염에 있어서 보다좋은 장단기 결과를 얻을 수 있다. 35세 남자 환자가 94년 8월에 대동맥판막, 승모판막대치술과 함께 삼첨판륜성형술을 받은후 특별한 증상 없이 지내다가 갑자기 시작된 실어증, 양안구의 좌측편위, 고열로 입원하여 심장초음파 검사를 시행한 결과 인공판막 심내막염 소견을 보여 6주간의 항생제 치료후 수술을 시행하였다. 수술소견상 대동맥 판륜을 따라 증식물 소견과 판막 주위의 누출, 농양주머니가 형성되어 있었고 승모판막은 비교적 건강해 보였다. 수술은 감염된 조직의 전체적인 제거와 냉동저장된 대동맥 동종이식편을 이용하여 재대치 수술을 시행했다. 환자는 수술후 63일째 퇴원했으며 퇴원후 7개월 동안 외래 추적 관찰결과 특별한 이상소견 없이 지내고 있다.

• 산업경영시스템학회지
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• 제40권4호
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• pp.87-95
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• 2017

This study aims to configure what dimensions make up for smart phone after service quality, and how this service quality affects customer satisfaction and customer loyalty. Smart phone market is a market of the device leading the digital convergence as well as positioning itself as one of the national growth driving industry. To survive in this matured market, companies should have to respond actively to radical changes and customers needs in the so-called Smart Revolution environment. Lately, however, the smart phone market is prospected to move from growth phase to mature phase by the scholars. In order to proactively respond to the change in such market condition, companies need to provide absolute advantage in customer loyalty over their competitors by revolutionizing the after-sales service quality. Qualified A/S will lead to service satisfaction and achieve customer loyalty. The empirical analysis results obtained through A/S quality are as follows : First, human quality (attitude, expertise, problem-solvability), environment quality (handling agility, convenience, comfort), service policy quality (quality guarantee, additional service operation) are dimensions that make up for A/S quality. Second, A/S quality dimension showed a significant positive influence on service satisfaction and A/S satisfaction showed a positive influence on customer loyalty as well. Based on this empirical study, we propose some implications for A/S quality improvement. First, human quality dimension has relatively higher influence on A/S satisfaction in case of free A/S, so companies need to solve the product problem completely when consumer's first visit by continual employee education. Second, in case of paid A/S, the service policy quality-especially A/S Warranty period- has higher influence on A/S satisfaction.

• 한국환경과학회지
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• 제22권7호
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• pp.863-871
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• 2013

Dielectric discharges are an emerging technique in environmental pollutant degradation, which that are characterized by the production of hydroxyl radicals as the primary degradation species. For practical application of the plasma reactor, reactor that can handle large amounts of water are needed. Plasma research to date has focused on small-scale water treatment. This study was carried out basic study for scale-up of a single DBD (dielectric barrier discharge) plasma reactor. The degradation of N, N-Dimethyl-4-nitrosoaniline (RNO, indicator of the generation of OH radical) was used as a performance indicator of multi-plasma reactor. The experiments is divided into two parts: design parameters [effect of distance of single plasma module (1~14 cm), arrangement of ground electrode (single and multi), rector number (1~5) and power number (1~5)]; operation parameter [effect of applied voltage (60~220 V), air flow rate (1~5 L/min), electric conductivity of solution ($1.4{\mu}S/cm$, deionized water)~18.8 mS/cm (addition of NaCl 10 g/L) and pH (5~9)]. Considering the electric stability of the plasma reactor, optimum spacing between the single plasma module was 2 cm. Multi discharge electrodes - single ground electrode array was selected. Combination of power 3-plasma module 5 was the optimal combination for maximum RNO degradation. The optimum 1st voltage and air flow rate for RNO degradation were 180 V and 4 L/min, respectively. The pH and conductivity of the solution was not influencing the RNO degradation.

• Imaging Science in Dentistry
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• 제32권4호
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• pp.195-200
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• 2002

Purpose: To evaluate the computed tomographic appearances of post-operative maxillary sinuses. Materials and Methods: 33 asymptomatic cases of post-operative maxillary sinus without evidence of any pathologic changes and clinical symptoms were selected. CT images were classified as opacification, soft tissue shadow, anterior wall depression, naso-antral communication, and compartmentalization. The relationships between the CT image and the age of patients at the time of operatation, and between the CT image and the duration of time elapsed since the surgical procedure were evaluated. Results: The most commonly presented radiological characteristics that occurred after the Caldwell-Luc procedure were opacification and soft tissue shadow. Anterior wall depression and naso-antral communication were radiographic indications that a Caldwell-Luc operation had been carried out. The age of patients when they had been first operated on, and the duration between the surgical procedure and the time of evaluation had no effect on the CT appearances of normal changes. In cases involving a longer time interval between the antral surgery and evaluation, the anterior wall depression with bony healing was more commonly observed than soft tissue healing. Conclusion: The radiographic information regarding the normal healing state using computed tomography can distinguish post-operative changes from inflammatory and cystic disease in patients who have undergone a Caldwell-Luc type of radical maxillary antrostomy.

• Journal of Gastric Cancer
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• 제4권2호
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• pp.75-81
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• 2004

Recently detection of early gastric cancer (EGC) has been increasing and the treatment strategies for gastric cancer have been changing. The purpose of this study was to compare clinical outcomes between laparoscopically assisted (LADG) and hand-assisted laparoscopic gastrectomy (HALDG) and open distal gastrectomy for early gastric cancer. This review is directed toward providing gastric surgeons with recent advances in the treatment of EGC. We investigated the English language literature for the past 12 years through computer searches which focused on : 1) Patient demographics, 2) Operation time, 3) Intra-operative blood loss, 4) Depth of invasion, 5) CBC, 6)Weight loss, 7) Analgesic requirement, 8)Time NPO, 9) Length of hospital stay, 10) Tumor stage, 11) Lymph node (LN) dissection, 12) Position of LN resected, 13) Complications. Improved operative techniques and surgical instrumentation have facilitated the development of minimally invasive gastric cancer surgery. The short-term benefits of laparoscopic gastrectomy included less surgical trauma, less pain, rapid return of gastrointestinal function, and shorter hospital stay, with no change in operative outcome. Laparoscopic gastrectomy was better accepted by the patients as a good procedure and promptly brought the patients back to their previous lifestyle and activities of daily living. But the advantages of HALDG for gastric cancer, extended lymph node dissection and intracorporeal anastomosis are feasible and easier with the presence of the internal hand. The hand-assisted laparoscopic (HALDG) method reported the best results in lymph node dissection.This method is an alternative to total laparoscopic radical gastrectomy. LADG and HALDG, when compared with conventional open gastrectomy, have several advantages. When performed by a skilled surgeon, LADG and HALDG are safe and useful techniques for patients with early-stage gastric cancer. Their appropriateness for gastric cancer surgery require further study.

• 한국병원경영학회지
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• 제4권1호
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• pp.1-20
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• 1999

Since the late 1980s, there have been radical changes in the managerial environment of Y University Medical Center(YUMC). Externally, the competition among hospitals has intensified due to the establishment of universal health insurance in 1939 and the entrance of large enterprises into the health care industry in the early 1990s. In addition, government regulation of medical institution is becoming stricter. Also, consumer groups have continued to demand the respect for patient rights and improvement of the quality of medical services. Internally, the financial condition of YUMC has worsened, not only because weak control and poor mediation in its large-scale structure have made its operation inefficient, but also because the rates of increase in the prices of goods and labor have grown faster than any increases in revenues. This study on materials management at YUMC presents a way for YUMC to reduce costs and increase its productivity, thereby overcoming its financial difficulties and dealing with external pressures. This study utilized the case studies of the materials purchasing and medical supply management in the United States and the comparative analysis of management to suggest short-term and long-term alternatives for innovation in YUMC. The goals of the short-term alternatives for innovation are to centralize the purchasing and supply departments and to simplify the decision-making processes. Through these attempts, it is estimated that YUMC's costs could be reduced by $600,000 per year. In the long-term, it is necessary to consider introducing a Supply Processing Distribution(SPD) system and setting up a centralized electronic system for supply and inventory management, although it is difficult to estimate the effect of cost-cutting because of the lack of analysis data. Thus, YUMC should thoroughly analyze initial investment costs and economical efficiency generated from long-term alternatives.

• Journal of Gastric Cancer
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• 제7권3호
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• pp.174-179
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• 2007

진단의 발달과 치료의 발전으로 위암의 치료 성적은 괄목한 성장이 이루어졌으나 근치적 위전절제술 후 암의 발생, 즉 문합부 재발암과 전이 그리고 이시성암이 발생되었을때 외과적 치료에 대한 보고와 결과는 많지 않으며, 특히 문합부에만 국소적으로 발생된 암은 흔치 않다. 근치적 위전절제술 후 문합부에만 국소적으로 발생된 암에 대하여 적극적인 수술을 함으로써 생존이 연장되었다는 보고가 있다. 연구자들은 위선암으로 근치적 위전절제술 후 발생한 문합부 국소재발 1예, 이시성 편평상피암 1예, 림프종 1예에 대하여 원격전이가 없음을 확인한 후 수술을 시행하여 모두 좋은 결과를 얻어 이에 문헌 고찰과 함께 보고하는 바이다.