• Title/Summary/Keyword: failure risk

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Characteristics of Small Business Start-Up and Effect of Preparation of Small Business Start-up on Business Performance -Focusing on Mediating Effect of Self-Efficacy (소상공인 창업자특성과 창업준비과정이 창업성과에 미치는 영향에 관한 연구 : 자기효능감 매개효과를 중심으로)

  • Kang, Young-Uk;Ha, Kyu-Soo
    • Journal of Digital Convergence
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    • v.10 no.9
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    • pp.239-251
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    • 2012
  • This study aims to seek the policies and the plans for the successful small business start-up through an exploratory study about the factors affecting the success rate of small business start-up. To measure the performance of the start-up business(sales revenue, net profit, and outcome expectancy), the characteristics of founders (experience, psychological characteristics) and the preparation of small business start-up were measured as independent variables and the self-efficacy was measured as a parameter. 427 small business owners were targeted and structured self-administered questionnaires were collected from them. For the data process, a multiple regression analysis by SPSS 18.0 was conducted. The findings demonstrated the experience in the same business, the need for achievement, the risk-taking propensity, the preparation period for business start-up had a significant effect on self-efficacy, and experience of failure and the ratio of net worth had a significant effect on sales revenue and net profit, and the locus of control had a significant effect on outcome expectancy through the self-efficacy, a parameter. It was also noted the self-efficacy of small business owners and the business performance varied depending on the characteristics of them and the preparation process of the business start-up. Based on the those findings, the theoretical and practical implications were discussed and the suggestions about the limits of the study, future policies and studies were made.

Decreased inward rectifier and voltage-gated K+ currents of the right septal coronary artery smooth muscle cells in pulmonary arterial hypertensive rats

  • Kim, Sung Eun;Yin, Ming Zhe;Kim, Hae Jin;Vorn, Rany;Yoo, Hae Young;Kim, Sung Joon
    • The Korean Journal of Physiology and Pharmacology
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    • v.24 no.1
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    • pp.111-119
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    • 2020
  • In vascular smooth muscle, K+ channels, such as voltage-gated K+ channels (Kv), inward-rectifier K+ channels (Kir), and big-conductance Ca2+-activated K+ channels (BKCa), establish a hyperpolarized membrane potential and counterbalance the depolarizing vasoactive stimuli. Additionally, Kir mediates endothelium-dependent hyperpolarization and the active hyperemia response in various vessels, including the coronary artery. Pulmonary arterial hypertension (PAH) induces right ventricular hypertrophy (RVH), thereby elevating the risk of ischemia and right heart failure. Here, using the whole-cell patch-clamp technique, we compared Kv and Kir current densities (IKv and IKir) in the left (LCSMCs), right (RCSMCs), and septal branches of coronary smooth muscle cells (SCSMCs) from control and monocrotaline (MCT)-induced PAH rats exhibiting RVH. In control rats, (1) IKv was larger in RCSMCs than that in SCSMCs and LCSMCs, (2) IKv inactivation occurred at more negative voltages in SCSMCs than those in RCSMCs and LCSMCs, (3) IKir was smaller in SCSMCs than that in RCSMCs and LCSMCs, and (4) IBKCa did not differ between branches. Moreover, in PAH rats, IKir and IKv decreased in SCSMCs, but not in RCSMCs or LCSMCs, and IBKCa did not change in any of the branches. These results demonstrated that SCSMC-specific decreases in IKv and IKir occur in an MCT-induced PAH model, thereby offering insights into the potential pathophysiological implications of coronary blood flow regulation in right heart disease. Furthermore, the relatively smaller IKir in SCSMCs suggested a less effective vasodilatory response in the septal region to the moderate increase in extracellular K+ concentration under increased activity of the myocardium.

Efficacy of minimal invasive cardiac output and ScVO2 monitoring during controlled hypotension for double-jaw surgery

  • Kim, Seokkon;Song, Jaegyok;Ji, Sungmi;Kwon, Min A;Nam, Dajeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.353-360
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    • 2019
  • Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO2) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO2 monitoring did not present with sufficient benefits over the risk and cost.

The Clinical Experience of The Descending Thoracic and Thoracoabdominal Aortic Surgery (하행대동맥 및 흉복부 대동맥 수술의 임상적 경험)

  • 조광조;우종수;성시찬;최필조
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.584-589
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    • 2002
  • Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.

Analysis of the Anatomy of the Venae Comitantes Related to the Digital Artery (손가락동맥과 동반정맥 구조에 대한 해부학적 연구)

  • Choi, Hwan-Jun;Shim, Byung-Kwan;Kim, Cheol-Han;Tark, Min-Seong;Kim, Jun-Hyuk;Jung, Sung-Gyun;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.122-128
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    • 2010
  • Purpose: Many descriptions of the digital arterial anatomy including skin territory of the finger have been published. Relatively few studies on venous architecture of the finger have been performed in this area, in part, attributable to the technical difficulties encountered in dissecting small vessels. The purpose of this study is to present the precise microsurgical anatomy of the vein related to the digital artery and venae comitantes of the components. Methods: Arterial and venous anatomy of their relation to the fingers were examined in 38 specimens of two fresh cadavers and 36 clinical cases. All specimens were evaluated grossly, surgical microscopically, or / and light microscopically to observe the three & two-dimensional structure of the artery and joining vein, evidence of the venae comitantes, and venous valve. Results: No longitudinal venae comitantes along the digital artery were found in any specimens. The size of the venae comitantes of each digital artery was much smaller than other vein, but always existed any level of digital artery. One or two venae comitantes in the digital artery ran spiral, oblique, helical, fibrillar, or irregular branched shape. The authors also found the vein of the finger, that had bicuspid valves, but not in venae comitantes. Conclusion: Recently, venous outflow problem rather than arterial circulation is the most common cause tissue failure after microvascular surgery in the hand. Sometimes, if it is not recognized early, there is an increased risk of tissue damage and loss. The authors concluded that this study presents a useful knowledge for the characterization of the venous structure and evidence for venae comitantes like a venule in the digital artery at varying levels of the finger.

Early Result of Coronary Artery Bypass Surgery (관상동맥 우회술의 조기성적)

  • Park, Jae-Hyeong;Lee, Won-Yong;Kim, Eung-Jung;Hong, Gi-U
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.158-163
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    • 1997
  • From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years (range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction hi tory. Five patients had preoperative left ventricular ejection fraction of 40% or less, The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases.21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery,)1, radial artery; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).

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The Clinical and Laboratory Features of Kawasaki Disease with Nonresponsibility to the Acute Antiinflammatory Treatment (급성기 항염치료에 반응하지 않은 가와사끼병의 임상양상과 검사소견)

  • Kim, Eun-Jung;Hong, Myung-Eun;Lee, Chang-Woo;Oh, Yeon-Geun;Kim, Jong-Duk;Yoon, Hyang-Suk
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.500-504
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    • 2003
  • Purpose : To assess the clinical features and laboratory findings in Kawasaki patients with nonresponsibility to the acute antiinflammatory treatment, and identify the risk factors for the nonresponsibility, we reviewed the medical records of patients with Kawasaki disease. Methods : A retrospective study of 177 patients with Kawasaki disease at Wonkwang University Medical Center from June, 1997 to June, 2002, was performed. High dose intravenous immune globulin(IVIG) and aspirin were all used for the initial acute antiinflammatory treatment. Two groups, group A(n=19) of initial nonresponders and group B(n=158) of initial responders were compared clinically and laboratorically. Results : Nineteen(10.7%) of 177 patients hardly responded to the initial antiinflammatory treatment. Patients with failure to respond to initial treatment(group A) did not differ from the control group in terms of age, sex, WBC count, coronary abnormalities, and evidence of pyuria. Compared with initial responders(group B), the patients who were retreated(group A) had a significantly shorter feveradmission interval(P=0.041), and a higher level of both AST/ALT(P=0.011) and ASO titier(P=0.000). Conclusion : Among Kawasaki disease patients studied, retreatment group with initial nonresponders had significantly shorter fever-admission interval, and higher both AST/ALT level and ASO titer, than the initial response group.

Analysis on the Credit Guarantee System for Creative Economy in Korea (창조경제 활성화를 위한 금융지원 방안에 대한 연구 : 신용보증제도를 중심으로)

  • Yoo, Kyeongwon;Kim, Kyungkeun;Bae, Sang Hoo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.6
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    • pp.47-64
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    • 2014
  • Considering the network externality and spill-over effects, this paper constructs the theoretical model for analyzing the financial policies focusing on the credit guarantee system for Creative Economy, which has been set as the new policy paradigm for the Korean Economy. The analytical results show that it is as much as important to improve the efficiency of the financial markets and construct the infrastructure for reducing the information asymmetry problem which would be more serious in the creative finance. Although it is important to fill the gap due to the market failure it is also crucial to construct the appropriate financial schemes for the various stages of the innovative firms growth. Without these, the impacts of current public funding policies may crowd out the amount of private market funds for the innovative firms or reduce the possibility of commercialization of new technologies in these firms. Based on the evaluation of current related public policies from the perspectives of creative finance, we imply that the current financial policies appear to be quantity oriented not the quality based. Although the policy goals would be appropriately set for vitalizing the Creative Economy in Korea, they appear to be still unsuccessful to address the information asymmetry issue which is the major concern in vitalizing the creative economy. Thus we emphasize the market friendly policies, risk-sharing between the various market participants, revitalizing the relationship banking and efficient management of credit guarantee system in Korea based on the analytical model as well as the evaluation of related policies regarding the creative economy.

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Vesicoureteral Reflux and Renal Scar (방광요관역류와 신반흔)

  • Nam, Hee-Young;Shin, Joon-Heon;Lee, Jun-Ho;Choi, Eun-Na;Park, Hye-Won
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.201-212
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    • 2006
  • Purpose : Vesicoureteral reflux(VUR) is the major risk factor of urinary tract infection(UTI) in children and may result in serious complications such as renal scarring and chronic renal failure. The purpose of this study was to evaluate the relationship between VUR and renal scar formation, the usefulness and correlation of various imaging studies in reflux nephropathy, and the spontaneous resolution of VUR. Methods : We retrospectively reviewed 106 patients with VUR with no accompanying urogenital anomalies in the Department of Pediatrics, Bundang CHA Hospital during the period from Jan. 1996 to Mar. 2005. Ultrasonography and $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan were performed in the acute period of UTI. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. Follow-up DMSA scan was performed 4 to 6 months after treatment and a follow-up VCUG was performed every 12 months. Results : The mean age at detection of VUR was $13.8{\pm}22.2$ months and the male to female ratio was 2:1. The incidence of renal scarring showed a tendency of direct correlation between severity of VUR(P<0.001) and abnormal findings of renal ultrasonography(P<0.01). 63.2%(24 of 38 renal units) of renal parenchymal defects present in the first DMSA scan disappeared on follow-up DMSA scans. Follow-up DMSA scans detected renal scars in 7(14%) of 50 renal units with ultrasonographically normal kidneys. Meanwhile, ultrasonography did not show parenchymal defects in 7(36.8%) of 19 renal units where renal scarring was demonstrated on a follow-up DMSA scan. The spontaneous resolution rate of VUR was higher(75%) in cases with low grade(I to III) VUR(P<0.01). Conclusions : The presence and severity of VUR and abnormal findings of renal ultrasonography significantly correlated with renal scar formation. DMSA scan was useful in the diagnosis of renal defects. Meanwhile renal ultrasonography was an inadequate method for evaluating renal parenchymal damage. Therefore, follow-up DMSA scans should be performed to detect renal scars even in children with low-grade VUR and normal renal ultrasonography.

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Comparison of the Outcomes between Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Replacement in Patients Aged above 80

  • Lee, Jeong-Woo;Kim, Jihoon;Jung, Sung-Ho;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.255-262
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    • 2017
  • Background: Transcatheter aortic valve replacement (TAVR) has been suggested as a less invasive treatment for high-risk patients with aortic valve disease. I n this study, we compared the outcomes of conventional surgical aortic valve replacement (AVR) and TAVR in elderly patients aged over 80. Methods: A total of 108 patients aged 80 years or older who underwent isolated AVR (n=35) or TAVR (n=73) from 2010 through 2015 at Asan Medical Center were identified. Early and late clinical outcomes, including echocardiographic findings, were evaluated in both groups. The mean follow-up duration was $766.4{\pm}528.7days$ in the AVR group and $755.2{\pm}546.6days$ in the TAVR group, and the average timing of the last follow-up echocardiography was at $492.6{\pm}512.5days$ in the AVR group and $515.7{\pm}526.8days$ in the TAVR group. Results: The overall early mortality was 2.8% (0 of 35, 0% in the AVR group vs. 3 of 73, 4.1% in the TAVR group). Permanent pacemaker insertion was significantly more common in the TAVR group (p=0.010). Renal failure requiring dialysis and new-onset atrial fibrillation was more frequent and the length of hospital stay was longer in the AVR group; however, this difference did not reach statistical significance. In the TAVR group, 14 patients (19.2%) were rehospitalized due to cardiac problems, and 13 patients (17.8%) had developed significant paravalvular leakage by the time of the last follow-up echocardiography. Conclusion: TAVR could be a good alternative to conventional surgical AVR in elderly patients. However, TAVR has several shortcomings, such as frequent significant paravalvular leakage or readmission, which should be considered in decision-making.