• Journal of Chest Surgery
• /
• v.20 no.1
• /
• pp.112-127
• /
• 1987

Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
• /
• v.15 no.4
• /
• pp.83-96
• /
• 2020

Traditionally social problems had been largely left to be handled by non-profit organizations, not because of lack of interests in social causes but mostly because of lack of innovative ideas to solve them in commercially viable ways. This market failure has recently been fixed by social enterprises, which manage to provide both solutions for social issues and commercially viable business models. As a result, we have been witnessing a sudden spike of public interests in these social enterprises as well as a call for empirical investigation on social enterprises by prior studies. However, empirically investigating a social enterprise has been a challenging endeavor mostly due to the insufficient number of successful social enterprises. Answering to the call in this study, we empirically investigate Goyohan Taxi, a successful social enterprise that partners with visually impaired cabdrivers and offers a taxi service, by both longitudinally interviewing the founder and adopting in vivo observation throughout the entrepreneurial journey of Goyohan Taxi. Based on the single case study method, we find that Goyohan Taxi adopts two distinctive decision-making mechanisms, the de-escalation of commitment and the orthogonality of commercial and social goals. Although generalizability of the our finding is minimal due to the limitation of single case study method, our finding contributes to the research of social entrepreneurship by offering new avenue of research in decision-making process of social entrepreneurs.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.753-758
• /
• 1996

From January 1987 to December 1994, twenty five patients with cancer of the esophagus were t eated surgically at the department of Thoracic and Cardiovascular Surgery, Tae Jeon Eul ll General Hospital. Among them, male was 24 cases, female was 1 case, with age ranged from 40 to 74 years, mean age was 60.4 years. The most common symptoms were dysphagia 92.0%, general weakness 28.0%, subsiernal pain 16.0%, weight loss 16.0 oyo , The tumor locations were the upper third in 2, middle third in 17, lower third in 6. Surgical treatment was done with transthoracic esophagectomy and esophagogastrostomy 1~4 cases, transthoracic esophagectomy and esophagocologastrostomy 5 cases, Transthoracic esophagectomy and jeT junal interposition 2 cases, palliative feeding gastrostomy 4 cases. The postoperative complications included anstomotic leakage in 3 cases, empyema in 3 cases, wound in- fection in 2 cases, atelectasis in 2 cases, pleural effusion in 1 case, hoarseness in 1 case, pneumothorax in 1 case, necrosis of jejunal loop in 1 case, aspiration pneumonia in 1 case. The operative mortal ty were 3 cases (12.0 %) and causes of death were aspiration pneumonia 1 case. sepsis and respiratory failure in each 1 . The mean survival period was 9.75 months. Recurrence of cancer revealed in 3 cases.

• Journal of the Korean Society of Safety
• /
• v.32 no.4
• /
• pp.34-39
• /
• 2017

Typical flow regime of overflow at barrier or weir constructed in mid and small streams becomes as the submerged flow during most flood events. One of major causes of barrier failure has been reported as the levee-scour near the conjuction node between barrier and levee. However, most related design guidelines in Korea have not mentioned about the protection of levee around barrier or weir in detail. Furthermore, most previous researches have focused on the flow characteristics of overflow around several types of weirs but they did not have considered the material properties of levee itself. In this study, local scour near barrier was investigated with different material properties of levee under the submerged overflow condition which is assumed to reenact a flood event. Based on results from Fritz et al. and Mavis et al., a theoretical formula was also proposed in initial stage of laboratory experiments. And hydraulic experiments were carried out for the verification of the proposed formula. Levee was installed in the prismetic trapezoidal open channel and most parts were made of concrete except for movable section in which scour was expected to occur for the efficiency of experimental procedure. Each compaction of movable section in levee was followed by the basis of the KS F 2312. Further, after performing the experiments to find the optimum water content for each sediment, the specific amount of water was injected before flowing water. The difference between the proposed theoretical formula and experiment results was not much but considerable, which might be caused by the effect of compaction. For theoretical approach, it seemed that the formula did not take into account the compaction of levee, thus the correction coefficient for levee compaction determined in the literature was considered. Finally, the formula for the length of scour around barrier or weir was proposed, which can be useful to predict a levee in the reference design of revetment in mid and small streams. As shortly future study, scour length of levee around barrier or weir under different flow conditions such as perfect overflow condition will be studied and it will be able to contribute to suggest the design formula or criteria under all overflow conditions near barrier or weir.

• The Journal of the Korea Contents Association
• /
• v.16 no.10
• /
• pp.435-442
• /
• 2016

Obesity extends the global economic burden and it causes that the failure of a reduction of physical activity, and diet management. In this work, nutritional information and personalized diet based on calorie supply system and is discriminatory utilized the obesity-related SNP information in order to recommend a personalized functional foods. This study performed a GWAS analysis for the excavation of a Korean-specific and obesity-related SNP, which utilizes genetic information were recommended by entering a personalized diet in accordance with the SNP genotype-phenotype information. In addition, we integrated Database with relation of nutrient for utilizing the USDA Food information and it was applied to recommend with Sickdanome. As a result, the obesity-related SNP information was confirmed in the sample which has the normal value BMI. In this study, we have recognized that the phenotype information related obesity, BMI is inconsistent with the SNP genotype information. This result is shown that it is necessary to provide the personalized dietary SickdanOme recommendation based on the both pheotype-genotype information.

• Journal of Biomedical Engineering Research
• /
• v.19 no.5
• /
• pp.503-511
• /
• 1998

In this study, the stress distribution for different tibial components was observed In order to Investigate the load transfer and potential failure mechanism of the tibial components subjected to dynamic impact loading and also to evacuate the effect of bone-implant bonding conditions on the implant system. The 3-dimensional finite element models included an intact tibia, cemented metal-backed tibial component, uncemented metal-blocked tibial component, cemented all-polyethylene tibial component, and metal-backed component with a debonded bone/stem interface. The results showed that the cemented metal-hocked component Induced slightly higher peak stress at stem tip than the uncemented component. The peak stress of the all-polyethylene tibia1 component at stem trip showed about half thats of metal-backed tibial components. The all-polyethylene component showed a similar dynamic response to intact tibia. In case of debonded bone/stem interface, the peak stress below the metal tray was three times Higher than that of the fully bonded interface and unstable stress distribution at the stem tip was observed with time, which causes another adverse bone apposition and implant loosening. Thus, the all-polyethylene tibial component bonded fully to the surrounding bone might be most desirable system under an impact loading.

• Journal of Biomedical Engineering Research
• /
• v.28 no.4
• /
• pp.569-576
• /
• 2007

Ventricular Assist Device(VAD) has switched its goal from a short-tenn use for bridge-to-transplantation to a long-tenn use for destination therapy, With this goal, the importance of long-tenn reliability gets more interests and importances, H-VAD is an portable extracorporeal biventricular assist device, and adopts an electro-pneumatic driving mechanism. The pneumatic pressure to pump out blood is generated with compression of bellows, and is transmitted in a closed pneumatic circuit through a pneumatic line. The existing pneumatic VAD adopts a air compressor which can generate stable pressures but has defects such as a noise and a size problem. Thus, it is not suitable for being used as a portable device, These problems are covered with adopting a closed pneumatic circuit mechanism with a bellows which has a small size and small noise generation, but it has defects that improper pneumatic setting causes a failure of adequate flow generation. In this study, the pneumatic pressure regulation system is developed to cover these defects of a bellows-type pneumatic VAD. The optimal pneumatic pressure conditions according to various afterload conditions for an optimal flow rate were investigated and the afterload estimation algorithm was developed, The final pneumatic regulation system estimates a current afterload and regulate the pneumatic pressure to the optimal point at a given afterload condition. The afterload estimation algorithm showed a sufficient performance that the standard deviation of error is 8.8 mmHg, The pneumatic pressure regulation system showed a sufficient performance that the flow rate was stably governed to various afterload conditions. In a further study, if a additional sensor such as ultrasonic sensor is developed to monitor the direct movement of diaphragm in a blood pump part, the reliability would be greatly increased. Moreover, if the afterload estimation algorithm gets more accuracy, it would be also helpful to monitor the hemodynamic condition of patients.

• The Korean Journal of Physiology and Pharmacology
• /
• v.13 no.6
• /
• pp.437-442
• /
• 2009

A non-steroidal anti-inflammatory drug (NSAID) has many adverse effects including cardiovascular (CV) risk. Diclofenac among the nonselective NSAIDs has the highest CV risk such as congestive heart failure, which resulted commonly from the impaired cardiac pumping due to a disrupted excitationcontraction (E-C) coupling. We investigated the effects of diclofenac on the L-type calcium channels which are essential to the E-C coupling at the level of single ventricular myocytes isolated from neonatal rat heart, using the whole-cell voltage-clamp technique. Only diclofenac of three NSAIDs, including naproxen and ibuprofen, significantly reduced inward whole cell currents. At concentrations higher than $3\;{\mu}M$, diclofenac inhibited reversibly the $Na^+$ current and did irreversibly the L-type $Ca^{2+}$ channels-mediated inward current $(IC_{50}=12.89\pm0.43\;{\mu}M)$ in a dose-dependent manner. However, nifedipine, a well-known L-type channel blocker, effectively inhibited the L-type $Ca^{2+}$ currents but not the $Na^+$ current. Our finding may explain that diclofenac causes the CV risk by the inhibition of L-type $Ca^{2+}$ channel, leading to the impairment of E-C coupling in cardiac myocytes.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.3
• /
• pp.673-680
• /
• 2017

sump pump is a system that draws in water that is stored in a dam or reservoir. They are used to pump large amounts of water for cooling systems in large power plants, such as thermal and nuclear plants. However, if the flow and sump pump ratio are small, the flow rate increases around the inlet port. This causes a turbulent vortex or swirl flows. The turbulent flow reduces the performance and can cause failure. Various methods have been devised to solve the problem, but a correct solution has not been found for low water level. The most efficient solution is to install an anti-vortex device (AVD) or increase the length of the sump inlet, which makes the flow uniform. This paper presents a computational fluid dynamics (CFD) analysis of the flow characteristics in a sump pump for different sump inlet lengths and AVD types. Modeling was performed in three stages based on the pump intake, sump, and pump. For accurate analysis, the grid was made denser in the intake part, and the grid for the sump pump and AVD were also dense. 1.2-1.5 million grid elements were generated using ANSYS ICEM-CFD 14.5 with a mixture of tetra and prism elements. The analysis was done using the SST turbulence model of ANSYS CFX14.5, a commercial CFD program. The conditions were as follows: H.W.L 6.0 m, L.W.L 3.5, Qmax 4.000 kg/s, Qavg 3.500 kg/s Qmin 2.500 kg/s. The results of analysis by the vertex angle and velocity distribution are as follows. A sump pump with an Ext E-type AVD was accepted at a high water level. However, further studies are needed for a low water level using the Ext E-type AVD as a base.

• Journal of Chest Surgery
• /
• v.31 no.12
• /
• pp.1165-1171
• /
• 1998

Background: All currently available mechanical and bioprosthetic valves are associated with various types of deterioration leading to dysfunction and/or valvular complications. Reoperation on prosthetic heart valves is increasingly under consideration for both clinical and prophylactic indications. This review was conducted to determine the factors affecting the risk of reoperation for prosthetic valve replacement. Material and method: From January 1985 to July 1996, 124 patients underwent reoperation on prosthetic heart valves, and 3 patients had a second valve reoperation. The causes of reoperation were prosthetic valve failure(96 cases, 77.4%), prosthetic valve thrombosis(16 cases, 12.9%), prosthetic valve endocarditis(7 cases, 5.6%) and paravalvular leak(5 cases, 4.1%). This article is based on the analysis of the experience with particular emphasis on the preoperative risks affecting the outcome of the reoperation. Result: Overall hospital mortality rate was 8.9%(11/124). Low cardiac output was the most common cause of death(70.6%). Left ventricular systolic dimension(p=0.001), New York Heart Association functional class IV(p=0.003) and serum creatinine level(p=0.007) were the independent risk factors, but age, sex and cardiothoracic ratio did not have any influence on the operative mortality. Follow-up period was ranged from 3 to 141 months (mean, 50.6 months). A late mortality rate was 1.8%. Conclusion: The surgical risk of reoperation on heart valve prostheses in the advanced NYHA class patients is higher, therefore reoperation is recommended before the hemodynamic impairment become severe.