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Surgical treatent of esophageal atresia with tracheo-esophageal fistula (기관 식도루를 동반한 선천성 식도 폐쇄증의 외과적 치료)

  • 김동원
    • Journal of Chest Surgery
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    • v.27 no.7
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    • pp.603-609
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    • 1994
  • Esophageal atresia is a rare congenital anomaly and it usually associated with tracheo-esophgeal fistula and other congenital anomalies. The first report of esophageal atresia with tracheo-esophageal fistula was done by Thomas Gibson in 1696. In 1941, Haight performed the first successful primary anastomosis for esophageal atresia. These accomplishments opened the gateway for clinical studies that have resulted in reinforcements and improvement in the care of infants born with this anomaly. From January 1986 to April 1994, 14 cases of esophgeal atresia with tracheo-esophgeal fistula were diagnosed in Kyung Hee Uinv. Hospital. There were 9 male and 5 female infants. 12 infants were Gross classification type C and 2 infants were type A. The average body weight was 2.7$\pm$0.4kg and Waterson Category A contained 4 infants, B contained 3 infants and C contained 7 infants. Among these infants, 9 infants were underwent anastomosis procedures. We performed retropleural approach in 6 infants, transpleural approach in 2 infants and 1 infant was performed colon interposition through substernal space.By the method of anastomosis, end-to-side anastomosis was performed in 5 infants, end-to-end anastomosis in 3 infants and esophagocologastrostomy in 1 infant.The former 8 infants were Gross classification type C and the latter was type A. Among the type C infants, 6 infants were anastomosed with one layer interrupted suture and 2 infants with 2 layer interrupted suture. Post- operative death was in 1 infant and 8 infants were discharged with good result and have been in good condition.

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Analysis of Drug Utilization after the Mandatory Application of the DRG Payment System in Korea (포괄수가제 당연적용 후 의약품 사용현황 분석)

  • Kang, Hee-Jeong;Kim, Ji Man;Lim, Jae-Young;Lee, Sang Gyu;Shin, Euichul
    • Korea Journal of Hospital Management
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    • v.23 no.2
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    • pp.18-27
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    • 2018
  • Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.

Effects of Static Softening on Hot Workability of $SiC_P$/A1-Si COmposites ($SiC_P$/A1-Si 복합재료의 정적연화가 열간가공성에 미치는 영향)

  • 고병철;전정식;유연철
    • Proceedings of the Korean Society for Technology of Plasticity Conference
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    • 1995.10a
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    • pp.172-180
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    • 1995
  • Isothermal interrupted deformation behavior of 10vol.%SICp/AI-Si composites was investigated by hot torsion test at the temperature ranges from 27$0^{\circ}C$ to 43$0^{\circ}C$ and at strain rate range of 1.26X10-2~2.16X10-1/sec. With increasing pass strain, flow stresses were high compared to continuous deformation condition. Fractional softening was increased with temperature imterruption time and pass strain. Fractional softening of 10vol.%SiCp/AI-Si composites was lower than that of AI-Si matrix at 37$0^{\circ}C$. However at high temperature of 43$0^{\circ}C$, SiC particle promoted static softening, diminishing the dislocation density at the interface of AI-Si matrix and reinforcements, then this resulted in higher fractional softening in composites. Both of failure strain improved reducing the fracture of SiC particle and Si precipitates above 32$0^{\circ}C$, however at low temperature of 27$0^{\circ}C$, the softening effect by interrupted deformation was found to be negligible.

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Pre-school Children′s Privacy Needs in the Residential Space (주거공간 내에서의 유아의 프라이버시 욕구)

  • Lee, In-Soo
    • Journal of the Korean housing association
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    • v.15 no.5
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    • pp.1-11
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    • 2004
  • This study has been performed to review pre-school children's needs for privacy within normal residential space. In this study, there were three circumstances in which children need to stay alone without being interrupted by their parents; First, they strongly want to be stay quiet until relieving their anger or fear, shortly after disciplined and impugned by their parents. Second, infant children need to obtain their own territory in order to demonstrate ownership and dignity in their sley space. Third, there are also special circumstances of privacy needs among families with intrusive parents such as alcoholics and heavy smokers, or for the children of disability. In Korea, it is presumed that more than 60 percent the pre-school children aging three to six are in deficit of privacy for relieving their emotional disturbance, but no research has been documented for the case of disabled or interrupted children. Therefore in this study, it was primarily proposed that empirical studies need to be peformed among Korean preschoolers, in order to evaluate privacy needs in the perspectives of ordinary family lives, individual household behaviors, and special conditions of disability or offensive family members.

Factors Related to the Desire of Married, "Career-interrupted" Women to be Re-employed (경력 단절 기혼 여성의 재취업 욕구 관련 요인)

  • Kwon, Hee-Kyung
    • Journal of Families and Better Life
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    • v.28 no.1
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    • pp.87-98
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    • 2010
  • The purpose of the present study was to examine the desire of married women to be re-employed and the factors related to this desire. The study gathered information from 240 women who gave up their jobs and careers after marriage. Information included their career history, current psycho-social condition, and family situation. Multiple regression and covariation structure analyses indicated that the desire of married women to go back to paid work was influenced by family economic condition, psycho-social condition, and child care situation. Specifically, the study found that family's monthly income and the age of the last child were negatively related to the women's desire for re-employment. On the other hand, economic pressure and achievement motivation were positively related to the women's desire. Finally, the study found that socio-economic background and external social support were not significantly related to the women’s wish to go back to the workforce.

Heat transfer characteristics of fin and tube heat exchangers with various interrupted surface for air conditioning application (다양한 형태의 단속표면을 갖는 공조기용 핀-관 열교환기의 열전달 특성)

  • Yun, Jeom-Yeol;Lee, Gwan-Su
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.20 no.12
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    • pp.3938-3948
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    • 1996
  • This study is related with the experimental investigation on the heat transfer and pressure drop characteristics of the fin-and-tube heat exchangers with three different interrupted fins and a plane fin for air-conditioning application. Experiments were conducted accordingly following the appropriate development process. Geometry similitude experiment was introduced to predict the performance of fins, and prototype experiment was also performed to confirm the validity of geometry similitude experimental results. However, these experimental results were limited to the sensible heat transfer characteristics of the heat exchangers. Hence, additional experiment was performed using refrigerant to investigate the latent heat transfer characteristics. This paper presents an appropriate process for the development of a new type heat exchanger. Sensible and latent heat transfer characteristics for each fin configuration is also provided along with the optimal fin configuration.

Analysis of Gendered Job Sequence through Optimal Matching (최적일치법을 이용한 남녀간 직업 배열의 분석)

  • Han, Joon
    • Journal of Labour Economics
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    • v.24 no.1
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    • pp.149-176
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    • 2001
  • This paper analyzes job sequences of men and women using optimal matching in order to find patterns of intra-generational mobility in Korean society. Men and women differ in their job careers: men show long-lasting job sequences with few gaps, while women either have short careers or have interrupted careers with long gaps. Long gaps in men's career are limited to those cases in which men move from agricultural to other job. The results from a combination of optimal matching and cluster analysis show that men's job sequences cluster around major occupations while women's cluster in terms of sequence length. The interrupted careers characteristic of women are considered to be consequent on the burdens of house keeping and child raising together with the discrimination against women pursuing careers.

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One case report of mid-thoracic esophageal diverticulum (식도중간부 식도게실: 1 수술 치험례)

  • Sun, Kyung;Choi, Young-Ho;Chae, Sung-Soo;Kim, Hark-Jei;Kim, Hyong-Mook
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.447-450
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    • 1982
  • A 45 year old male officer was admitted due to upper substernal pain for 1 month, which was aggravated by swallowing. On past and family history, there was no specific history except heavy drinking. Simple chest x-ray revealed no specific abnormal findings. Preoperative esophagofiberscopy and Barium study showed midesophageal diverticulum, pulsion type, at about 2 cm below the left main bronchus. The opening of the diverticulum was located at the left posterolateral aspect of esophagus. Midesophageal false diverticulum, measuring 2 x 2 x 1 .S cm in size, was noted at about 5 cm under the aortic arch protruding through a slit-like muscular defect. After inversion of diverticular sac, interrupted sutures with 3-0 silks were done on muscular defect site, and mediastinal pleura was reinforced on the lesion with interrupted sutures. On 4th postoperative day, esophagography revealed no diverticulum or stenosis. Also esophagofiberscopy showed smooth mucosal tag without disturbance of passage. On 14th postoperative day, the patient was discharged uneventfully, and follow-up for 3 months after discharge revealed nothing abnormal symptoms. The authors report one case of midesophageal, pulsion type, false diverticulum.

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Distal Type of Aortopulmonary Septal Defect with Aortic Origin of Right Pulmonary Artery and Interruption of the Aortic Arch - A Case of Successful Surgical Report -

  • Jeong, Yun-Seop;Song, Myeong-Geun
    • Journal of Chest Surgery
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    • v.24 no.7
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    • pp.693-700
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    • 1991
  • A rare case of the association of distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and interrupted aortic isthmus in a 40-day-old infant is reported. The infant was suffered from two operations with an interval of nine days. At the first operation a 10mm polytetrafluoroethylene prosthesis was inserted instead of the interrupted aortic isthmus and ductus was ligated via the left posterolateral thoracotomy. But the patient could not be weaned from the respirator because of large amount of left-to-right shunt. So the total correction was subsequently performed after an interval of nine days. At the second operation, tunneling of the right pulmonary artery to the main pulmonary artery through the aortopulmonary septal defect was performed using the Dacron patch via a longitudinal transaortic approach and a separate autologous pericardial patch was applied to the longitudinally incised margins of the anterior wall of the ascending aorta. The second postoperative course was relatively uneventful except some respiratory distress and nutritional problems. Now he is at 6 months of age and thrives well without any symptom. Because the success of the surgical repair of this complex anomalies depends upon the accurate diagnosis and meticulous design of each step of procedure prior to operation these problems are also discussed.

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A Novel Spectrum Access Strategy with ${\alpha}$-Retry Policy in Cognitive Radio Networks: A Queueing-Based Analysis

  • Zhao, Yuan;Jin, Shunfu;Yue, Wuyi
    • Journal of Communications and Networks
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    • v.16 no.2
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    • pp.193-201
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    • 2014
  • In cognitive radio networks, the packet transmissions of the secondary users (SUs) can be interrupted randomly by the primary users (PUs). That is to say, the PU packets have preemptive priority over the SU packets. In order to enhance the quality of service (QoS) for the SUs, we propose a spectrum access strategy with an ${\alpha}$-Retry policy. A buffer is deployed for the SU packets. An interrupted SU packet will return to the buffer with probability ${\alpha}$ for later retrial, or leave the system with probability (1-${\alpha}$). For mathematical analysis, we build a preemptive priority queue and model the spectrum access strategy with an ${\alpha}$-Retry policy as a two-dimensional discrete-time Markov chain (DTMC).We give the transition probability matrix of the Markov chain and obtain the steady-state distribution. Accordingly, we derive the formulas for the blocked rate, the forced dropping rate, the throughput and the average delay of the SU packets. With numerical results, we show the influence of the retrial probability for the strategy proposed in this paper on different performance measures. Finally, based on the trade-off between different performance measures, we construct a cost function and optimize the retrial probabilities with respect to different system parameters by employing an iterative algorithm.