• Journal of Chest Surgery
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• v.42 no.3
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• pp.350-354
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• 2009

Background: Complicated pleural space occupying lesions (SOL) have been treated by thoracentesis, closed thoracotomy drainage (CTD) or surgical intervention with using a video thoracosocpe or open thoracotomy depending on the extent of the disease. With the development of video assisted thoracoscopic surgery (VATS), VATS pleural adhesiolysis and decortication have revealed good results as compared to those for open thorcotomy. To assess the effectiveness of VATS pleural adhesiolysis and decortication, we retrospectively analyzed the medical record and radiologic findings of the patients with complicated pleural SOL and who were treated by this surgery. Material and Method: From May 1996 to April 2006, 64 patients (mean age: 41.8 years) with complicated pleural SOL underwent 65 VATS. To analyze the surgical outcome, we classified the postoperative findings on the simple chest X-rays into 4 classes as Class I: no or minimal pleural lesion, Class II: blunting of the cardiophrenic angle and mild pleural thickening, Class III: an elevated diaphgram or persistent lung collapse and Class IV: complicated or recurrent effusion. Result: Before VATS, the patients underwent the diagnostic or therapeutic procedures: single or repeat diagnostic tapping for 41, thoracoscotomy drainage for 11, pigtail catheter drainage for 10 and intrapleural fibrinolytics for 10. The mean duration between the onset of symptom and surgery was 18.4 days. There was neither mortality nor severe complications. The surgical outcomes were class 1 for 28, class 2 for 13, class 3 for 19 and class 4 for 5. There were statistically significant differences between the symptom duration and the classes, and between the operation time and the classes. Conclusion: VATS pleural adhesiolysis and decortication are effective, safe treatments for managing complicated pleural SOL, and an earlier operation is needed for obtaining a better surgical outcome.

• Progress in Medical Physics
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• v.21 no.3
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• pp.253-260
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• 2010

Most brachytherapy treatment planning systems employ a dosimetry formalism based on the AAPM TG-43 report which does not appropriately consider tissue heterogeneity. In this study we aimed to set up a simple Monte Carlo-based intracavitary high-dose-rate brachytherapy (IC-HDRB) plan verification platform, focusing particularly on the robustness of the direct Monte Carlo dose calculation using material and density information derived from CT images. CT images of slab phantoms and a uterine cervical cancer patient were used for brachytherapy plans based on the Plato (Nucletron, Netherlands) brachytherapy planning system. Monte Carlo simulations were implemented using the parameters from the Plato system and compared with the EBT film dosimetry and conventional dose computations. EGSnrc based DOSXYZnrc code was used for Monte Carlo simulations. Each $^{192}Ir$ source of the afterloader was approximately modeled as a parallel-piped shape inside the converted CT data set whose voxel size was $2{\times}2{\times}2\;mm^3$. Bracytherapy dose calculations based on the TG-43 showed good agreement with the Monte Carlo results in a homogeneous media whose density was close to water, but there were significant errors in high-density materials. For a patient case, A and B point dose differences were less than 3%, while the mean dose discrepancy was as much as 5%. Conventional dose computation methods might underdose the targets by not accounting for the effects of high-density materials. The proposed platform was shown to be feasible and to have good dose calculation accuracy. One should be careful when confirming the plan using a conventional brachytherapy dose computation method, and moreover, an independent dose verification system as developed in this study might be helpful.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.27-35
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• 2002

Background: A perioperative myocardial infarction(PMI) is one of the major complications after CABG. Among diagnostic methods of PMI, CK-MB activity assays have been increasingly replaced by CK-MB mass assays, which have more sensitive, simple measurement. Also, new cardiac-specific and -sensitive marker, cardiac troponin I(cTnl), has been shown to be a marker of myocardial infarction. We report our evaluation of clinical significance of CK-MB mass and cTnl as a marker of PMI after CABG. Material and Method: We studied 32 patients who underwent CABG at Kangdong Sacred Hospital between April 2000 and April 2001. Postoperative serum CK-MB activity level, serum CK-MB mass, cTnl, electrocardiogram, echocardiogram, and clinical data were recorded prospectively The diagnosis of PMI was defined as positive 2 among 3 or all of the following , by a new Q wave on the electrocardiogram, by serum CK-MB activity higher than 200 lU/L within 72 hours after operation, and by new regional wall motion abnormality on the echocardiogram. Result: After CABG, 3 patients had sustained a PMI according to current diagnostic criteria. As serum CK-MB activity time course, a level of CK-MB activity 12 hours after CABG had very linear correlated significance with serum CK-MB mass 24hours(R=0.946) and cTnl 48 hours(R=0.933) after CABG(p=0.000). As we used a receiver operating characteristics curve(ROC curve) for a diagnostic cutoff value in patients with PMI, serum CK-MB mass levels higher than 30.05 ug/L 24 hours after CABG detected the presence of PMI with an area under the ROC curve of 1.0, a sensitivity of 100%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 100%. Also serum cTnl levels higher than 17.15 ug/L 48 hours after CABG detected the presence of PMI with an area under the ROC curve of 0.98, a sensitivity of 100%, a specificity of 96.6%, a positive preclictive value of 75%, and a negative predictive value of 100% Conclusion: We concluded that both the measurement of CK-MB mass and cTnl are the easier, accurate methods as a diagnostic marker of PMT after CABG, also as a proposal of diagnostic cutoff value enables to an early detection of PMI. However, a 1arger number of patient will be needed because of statistic limitation that a small number of participating patients, a small number of PMI.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.290-295
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• 2002

Backgroud: Pneumonectomy carries the possibility of numerous dangerous complications as well as the vast effect the operation itself has on the cardiopulmonary function. Most of operations are done with the insertion of the chest tubes upon completion, but because of the high incidence of pyothorax as its complications, we have tried to analyze and compare the cases without inserting the chest tubes. Material and Method: During a 5 year period from January, 1996 to December 2000, 100 cases, which were operated at the Hanyang University Hospital, were selected using the patient's charts. The age, gender, indication of operation, associated diseases, and operation site(left or right) were classified accordingly and the postoperative complications and mortality were statistically analyzed using the $\chi$ 2-test. After resecting the lung, the intrathoracic pressure was set at -15 ~ -20cm $H_2O$ using the nelaton catheter, and the thoracotomy site was then closed. The gradual collection of the fluid and blood in the thorax of the operated side, as well as the mediastinum location, were observed carefully for 4~5 days postoperatively with the aid of the simple chest x-rays. Result: Of the 100 cases, 16 cases of pulmonary tuberculosis(16%), 81 cases of lung tumor(81%), 2 cases of bronchiectasis(2%), and 1 case of aspergilloma associated bronchiectasis were noted. There were 8 mortality cases(8%), and of the 34 cases(34%), 44 complications were noted. The age, sex, and operation site(left or right) were not statistically significant with the complications. 7 of the 16 cases of pulmonary tuberculosis(44%) and 27 of the 81 cases of lung tumor(33%) had complications, but they were found not to be statistically significant. The increase of the complication rate in the pulmonary tuberculosis patients was 3.86. The evidence of postoperative bleeding was observed in 6 cases with the 3 cases being the pulmonary tuberculosis patients and the 3 cases were others. This shows that the increase in postoperative bleeding in the pulmonary tuberculosis is statistically significant(p=0.019). Of the 100 cases, there were 8 mortality cases(8%), with 5 cases from the 81 cases of the lung tumor group(6.1%), 3 cases from the 16 cases of pulmonary tuberculoses group(18.7%).

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.181-190
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• 2005

The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1063-1069
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• 1998

Background: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. Materials and methods: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. Results: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis(8 cases) or chest tube drainage(10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases(42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, α-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1∼4(mean 1.78±1.00). Operating time was relatively short, about 55∼140 mins(mean 102.8±30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3∼42 days(mean 11.4±11.5) and 6∼36 days(mean 12.9±8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3∼6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. Conclusions: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.

• Asia pacific journal of information systems
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• v.17 no.4
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• pp.207-228
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• 2007

Measuring Information Technology(IT) organizations' activities have been limited to mainly measure financial indicators for a long time. However, according to the multifarious functions of Information System, a number of researches have been done for the new trends on measurement methodologies that come with financial measurement as well as new measurement methods. Especially, the researches on IT Balanced Scorecard(BSC), concept from BSC measuring IT activities have been done as well in recent years. BSC provides more advantages than only integration of non-financial measures in a performance measurement system. The core of BSC rests on the cause-and-effect relationships between measures to allow prediction of value chain performance measures to allow prediction of value chain performance measures, communication, and realization of the corporate strategy and incentive controlled actions. More recently, BSC proponents have focused on the need to tie measures together into a causal chain of performance, and to test the validity of these hypothesized effects to guide the development of strategy. Kaplan and Norton[2001] argue that one of the primary benefits of the balanced scorecard is its use in gauging the success of strategy. Norreklit[2000] insist that the cause-and-effect chain is central to the balanced scorecard. The cause-and-effect chain is also central to the IT BSC. However, prior researches on relationship between information system and enterprise strategies as well as connection between various IT performance measurement indicators are not so much studied. Ittner et al.[2003] report that 77% of all surveyed companies with an implemented BSC place no or only little interest on soundly modeled cause-and-effect relationships despite of the importance of cause-and-effect chains as an integral part of BSC. This shortcoming can be explained with one theoretical and one practical reason[Blumenberg and Hinz, 2006]. From a theoretical point of view, causalities within the BSC method and their application are only vaguely described by Kaplan and Norton. From a practical consideration, modeling corporate causalities is a complex task due to tedious data acquisition and following reliability maintenance. However, cause-and effect relationships are an essential part of BSCs because they differentiate performance measurement systems like BSCs from simple key performance indicator(KPI) lists. KPI lists present an ad-hoc collection of measures to managers but do not allow for a comprehensive view on corporate performance. Instead, performance measurement system like BSCs tries to model the relationships of the underlying value chain in cause-and-effect relationships. Therefore, to overcome the deficiencies of causal modeling in IT BSC, sound and robust causal modeling approaches are required in theory as well as in practice for offering a solution. The propose of this study is to suggest critical success factors(CSFs) and KPIs for measuring performance for IT organizations and empirically validate the casual relationships between those CSFs. For this purpose, we define four perspectives of BSC for IT organizations according to Van Grembergen's study[2000] as follows. The Future Orientation perspective represents the human and technology resources needed by IT to deliver its services. The Operational Excellence perspective represents the IT processes employed to develop and deliver the applications. The User Orientation perspective represents the user evaluation of IT. The Business Contribution perspective captures the business value of the IT investments. Each of these perspectives has to be translated into corresponding metrics and measures that assess the current situations. This study suggests 12 CSFs for IT BSC based on the previous IT BSC's studies and COBIT 4.1. These CSFs consist of 51 KPIs. We defines the cause-and-effect relationships among BSC CSFs for IT Organizations as follows. The Future Orientation perspective will have positive effects on the Operational Excellence perspective. Then the Operational Excellence perspective will have positive effects on the User Orientation perspective. Finally, the User Orientation perspective will have positive effects on the Business Contribution perspective. This research tests the validity of these hypothesized casual effects and the sub-hypothesized causal relationships. For the purpose, we used the Partial Least Squares approach to Structural Equation Modeling(or PLS Path Modeling) for analyzing multiple IT BSC CSFs. The PLS path modeling has special abilities that make it more appropriate than other techniques, such as multiple regression and LISREL, when analyzing small sample sizes. Recently the use of PLS path modeling has been gaining interests and use among IS researchers in recent years because of its ability to model latent constructs under conditions of nonormality and with small to medium sample sizes(Chin et al., 2003). The empirical results of our study using PLS path modeling show that the casual effects in IT BSC significantly exist partially in our hypotheses.

• Journal of Environmental Policy
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• v.9 no.2
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• pp.185-205
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• 2010

Climate change vulnerability assessment based on local conditions is a prerequisite for establishment of climate change adaptation policies. While some studies have developed a methodology for vulnerability assessment at the national level using statistical data, few attempts, whether domestic or overseas, have been made to develop methods for local vulnerability assessments that are easily applicable to a single city. Accordingly, the objective of this study was to develop a conceptual framework for climate change vulnerability, and then develop a general methodology for assessment at the regional level applied to a single coastal city, Mokpo, in Jeolla province, Korea. We followed the conceptual framework of climate change vulnerability proposed by the IPCC (1996) which consists of "climate exposure," "systemic sensitivity," and "systemic adaptive capacity." "Climate exposure" was designated as sea level rises of 1, 2, 3, 4, and 5 meter(s), allowing for a simple scenario for sea level rises. Should more complex forecasts of sea level rises be required later, the methodology developed herein can be easily scaled and transferred to other projects. Mokpo was chosen as a seaside city on the southwest coast of Korea, where all cities have experienced rising sea levels. Mokpo has experienced the largest sea level increases of all, and is a region where abnormal high tide events have become a significant threat; especially subsequent to the construction of an estuary dam and breakwaters. Sensitivity to sea level rises was measured by the percentage of flooded area for each administrative region within Mokpo evaluated via simulations using GIS techniques. Population density, particularly that of senior citizens, was also factored in. Adaptive capacity was considered from both the "hardware" and "software" aspects. "Hardware" adaptive capacity was incorporated by considering the presence (or lack thereof) of breakwaters and seawalls, as well as their height. "Software" adaptive capacity was measured using a survey method. The survey questionnaire included economic status, awareness of climate change impact and adaptation, governance, and policy, and was distributed to 75 governmental officials working for Mokpo. Vulnerability to sea level rises was assessed by subtracting adaptive capacity from the sensitivity index. Application of the methodology to Mokpo indicated vulnerability was high for seven out of 20 administrative districts. The results of our methodology provides significant policy implications for the development of climate change adaptation policy as follows: 1) regions with high priority for climate change adaptation measures can be selected through a correlation diagram between vulnerabilities and records of previous flood damage, and 2) after review of existing short, mid, and long-term plans or projects in high priority areas, appropriate adaptation measures can be taken as per this study. Future studies should focus on expanding analysis of climate change exposure from sea level rises to other adverse climate related events, including heat waves, torrential rain, and drought etc.

• Journal of the Korean Society of Costume
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• v.41
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• pp.95-105
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• 1998

SOO-BAL(Hair Style) is a method Which match hair style to face and clothes with using hair covering and protecting the head. Also SOO-BAL includes personal ornaments using to avoid one's hair be disheveled. In a standpoint of beauty and spirit, etiquette SOO-BAL is a very important thing as one being dressed up. Until now, since just a form of hair style have been studied, hair styling process is nothing to be known and studied. Time after time, our unique traditional SOO-BAL is forgotten with clothes and then this th-esis will be classified hair styling form follow-ing a form of hair style in royal palace of the C-hosun dynasty. According to the record of HAE DONG HISTORY, it shows the same of attire between Ko-rean and chinese style in ae of the chosun. The reason in that there were no any certain boundary border and the interaction of culture between two countries was happened spontaneously at ancient time like the GOCHO-SUN age. Until the period of the three states, the korean attire be changed had gone with chinese one s-imilarly. The chinese form gave to influence on the EONJIN MEURI·POON-GI-MYEONG MEURI·JJO-CJIN MEURI·MOOK-EUN GOONG-BAL MEURI·OL-LIN MEURI·SSANGSANG-TU ME-URI be drawn wall painting in the KOKUR-YU. And a gold chignon accesso-ry unearthed in a MOO-RYOUNG royal mausoleum is proof of the korean attrire be changed with chinese. In the shilla dynasty at three years after Cjin-Deuk(A.D. 649) reign. It was recorded that the dynasty let women wear the form of chinese attire. Also in the koryo dyn-asty, a rod-like hairpin (BIN-YEU) and DANG-GI employing EON-JIN MEURI was used. The SOO-BAL based on the Confucianism had lots of regulations which limited to use ornaments with classes of society in the CHOSUN dynasty. Until YOUNG CHO and CHUNG CHO period. EONJIN MEURI be decorated GACHAE was announced by dynasty as ind-ulging in luxury. Women of yangban used a rod-like hairpin and a chignon accessory made by jewerly. And 1-owly women weared a rod-like hairpin made of born and wood to perfom EONJIN MEURI with PUNCHAE. Most unmarried women decorated with DDA-AH-NEULIN MEURI, GUI-MIT MEURI, specially in palace with SAE-ANG MEURI. At palace, one put on a full dress with KEUN MEURI, and a simple dress with ER-YEO MEURI be decorated DDERL-JAM The CHOP-JI MEURI manifested social rank, class. Kids at CHO-SUN age had BA-DUK-PANMEURI and JONG-JONG MEURI. The ornament things are GACHE, DDERL JAM with EON-JIN M-EURI, and all kinds of rod-like hairpin and chignon accessory used in JJOK MEURI. IN DANGGE, JE-BI-BURI DANGGI used by ummarried women. DO-TOO-RAK DANGGI and AP DANGGI on a dress suit, and BE-SSI DANGGI used by 3∼4 years ungrown kids etc. were used. And at palace, kinds of CHUPJI used with JJOK MEURI showed social rank. In CHOSUN age, women want to keep shiny hair washed at TA-NO festival day, a treatment of bald hair used a forked remedy. In CHOSUN age, woman Soo-Bal hair style has DAE-SOO·DDEU-KOO-JI MEURI·CHO-P-GI MEURI·EON-JIN MEURI·SAE-ANG MEURI· and so on. We could find out Soo-Bal was developed very well by these variety hair styles. I attatched all of the hair style pictures step by step, and also explained detail my research foll owing these pictures.

• Journal of the Korean Society of Costume
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• v.26
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• pp.175-206
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• 1995

The costume culture of China is as old and varied as her long history. As China is a multiracial nation and consists of fifty-six min-ority races including Han race, there are not only fifty-six different costumes in China but each races' costume habit is very different. Therefore, Chinese penninsula can be considered an enor-mous exhibition center of the costumes. This study undertook on the assumption that the costumes' mainstream of Korea and east-northern Asia as well as that of China could be examined by investigating the minority races' costumes in the east-and west-northern areas of China. The process of evolution of the costume of a particular people, country or area is subject not only to constraints related to geography such as climate, topography or local products but is also affected by numorous environmental influences including cultural, economic, social and even pol-itical ones in terms of the selection of material, styling, color and standard of tailoring. In other words, things like philosophy of life, religious be-lief, aesthetic outlook, moral code, class system, degree of affluence, and cultural exchange will all be reflected directly or indirectly by features of a people's or country's style costume. Of course, there are several factors affecting to the style of costume of the minority people in China. However, the only three factors-geo-graphical and environmental, production method, and religious belef-will be touched in this study. First of all, the geograghical and eenviron-mental factor would be the decisive one because the costume should be designed to overcome the constraints of climate and geographical environ-ments. Accordingly, each race has an unique style of costume. The costume of the minority races in the northern parts are loose and wide, and made of warm furs. For instance, Mongolian robe has the quality of anti-wind, anti-cold and warmness, and the width of a sleeve is narrow and long. Secondly, the costume style can be said to be limited by the production pattern, when the geo-graphical environment was affected to decide the costume style, the production pattern was together affected to it . In case of Mongolian robe, they should satisfy the dual condition as the practical function. One is the condition that they should be fitted to the climate, and the other is the condition that they should be suit-able to the nomadic life. Mongolian robes are suitable to the nomadic peoples because they are designed for not only overcoming the cold wind and weather but being used as the bedquit at night. The costumes of Hoche people was made of the skin of the fish and wild animals because of their main means of living being fishing and hunting. Accordingly, their costumes are dur-able, warm and water-proof. Finally, the style of the costume is affected by the religious belief. In other words, the pattern in fashion is closely related with the religious be-lief or ancestor worship and nature worship. Ac-cordingly, the symbols of these worship are often emerged in the decoration of the costume. The design of costume of the people in the northern areas of China is very simple. It is related with their monotheism. On the other hand, the costumes of twen쇼 minority races in the east-northern parts of China can be devided into three racial groups such as the long robes of Man people and Mongols, Tunics of the peoples in the west-northern areas, and the pants and jackets of Hoche people. The minorority races all has not only the unique costume habit but their costumes are also related with their living style and production means.