• Journal of Chest Surgery
• /
• v.38 no.10 s.255
• /
• pp.680-684
• /
• 2005

Background: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. Material and Method: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patiency was evaluated in 9 patients by multi-slice computed tomography. Result: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was $15.9\pm4.4(8\~20hrs)$ hrs and mean ICU stay was $2.9\pm0.8(2\~4 days)$ days. Mean hospital day was $21.6\pm14.3(13\~56 days)$ days. Postoperative mean CK-MS was $11.3\pm14.1\;ng/mL$. Early postoperative graft patency rate was $100\%(24/24)$. Follow-up was completed in all patients. In this time, there was no patients with angina or death. Conclusion: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.

• Journal of Chest Surgery
• /
• v.38 no.1 s.246
• /
• pp.56-62
• /
• 2005

Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

• Journal of Sericultural and Entomological Science
• /
• v.17 no.2
• /
• pp.141-149
• /
• 1975

Silkworm is known to be damaged under the unfavorable environmental conditions. Recently, it has been often argued that nicotine is a main factor to affect the silkworm nutritional balance and to result in decrease of quantitative characters, and unbalance of larval nutrition. Especially in spring season, there is tendency to produce nicotine damage to silkworm fed with the mulberry leaf near to tobacco field early cultivated in mulching system. In these connections, the trial was made in the different pots placing by the different distance 10rn, 20m, 40m, and 60m in the direction of east-north from the tobacco field. Location of pot near to the tobacco fold is 40m below the tobacco Held and gradually higher than the tobacco field by 10 degree of slope. In addition, when the mulberry field is divided into two areas from the east-south to west-north, southern east zone is lowering down below 10 degree of slope and has 36％ of east-south wind, 21％ of south-east wind and 16％ of south wind, etc. Pots are left on the mulberry field from the completion of lower part leaf harvest to just before upper part leaf harvest is completed for 32 days. Then silkworm at 4th-5th stage was fed with the leaf grown during the period and larval characters are statistically analyzed. The results are summarized as follows： 1. 10-40m distant pot statistically at the same level has the longest larval duration and 60m distant pot is. not significant at 5％ level. Whole larval duration has same tendency as in the 5th larval duration. 2. Percentage of delayed molting larvae at the 5th stage is increased in 10m distant pot and there is no significance statistically in other pots, as compared with that of control. 3. It is not showed that there is no damage to mortality of the old larvae in 60m distant pot. 4. 10-20m distant pot produces a low pupation and others are at the same level statistically at 5％ significance, 5. It is showed that nicotine damage is occurred in single cocoon freight and cocoon shell weight up to 60m distant pot, rather higher damage in cocoon shell weight than in single cocoon weight. 6. It is showed that cocoon yield from 10, 000 molted larvae including double cocoon is decreased up to 40m distant pot far from the tobacco field in which 40％ of cocoon yield in 10m distant pot by 7kg, 26％ of cocoon yield in 20m distant pot by 3.9kg, 24％ of cocoon yield in 40m distant pot by 3.6kg, and 12％ of cocoon yield in 60m distant pot by 1.8kg, as compared with control. However, there is no significance statistically at 5％ level in 60m distant pot. With these above results, it is concluded that nicotine da mage could be occurred in cocoon yield and cocoon quality up to 60m distant far from the tobacco field.

• Journal of Chest Surgery
• /
• v.32 no.4
• /
• pp.368-372
• /
• 1999

Background: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. Material and Method: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. Result: The proportion of the skin incision length to the sternal length was 63.1${\pm}$3.9%(5.2∼11cm, mean 7.3cm) in children, and 55.0${\pm}$3.5%(10∼13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. Conclusion: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.

• Journal of Intelligence and Information Systems
• /
• v.23 no.4
• /
• pp.57-76
• /
• 2017

Recently, consumer needs are diversifying as information technologies are evolving rapidly. A lot of IT devices such as smart phones and tablet PCs are launching following the trend of information technology. While IT devices focused on the technical advance and improvement a few years ago, the situation is changed now. There is no difference in functional aspects, so companies are trying to differentiate IT devices in terms of appearance design. Consumers also consider design as being a more important factor in the decision-making of smart phones. Smart phones have become a fashion items, revealing consumers' own characteristics and personality. As the design and appearance of the smartphone become important things, it is necessary to examine consumer values from the design and appearance of IT devices. Furthermore, it is crucial to clarify the mechanisms of consumers' design evaluation and develop the design evaluation model based on the mechanism. Since the influence of design gets continuously strong, various and many studies related to design were carried out. These studies can classify three main streams. The first stream focuses on the role of design from the perspective of marketing and communication. The second one is the studies to find out an effective and appealing design from the perspective of industrial design. The last one is to examine the consumer values created by a product design, which means consumers' perception or feeling when they look and feel it. These numerous studies somewhat have dealt with consumer values, but they do not include product attributes, or do not cover the whole process and mechanism from product attributes to consumer values. In this study, we try to develop the holistic design evaluation model based on consumer values based on three-step approach from product attributes, perceived attributes, to consumer values. Product attributes means the real and physical characteristics each smart phone has. They consist of bezel, length, width, thickness, weight and curvature. Perceived attributes are derived from consumers' perception on product attributes. We consider perceived size of device, perceived size of display, perceived thickness, perceived weight, perceived bezel (top - bottom / left - right side), perceived curvature of edge, perceived curvature of back side, gap of each part, perceived gloss and perceived screen ratio. They are factorized into six clusters named as 'Size,' 'Slimness,' 'No-Frame,' 'Roundness,' 'Screen Ratio,' and 'Looseness.' We conducted qualitative research to find out consumer values, which are categorized into two: look and feel values. We identified the values named as 'Silhouette,' 'Neatness,' 'Attractiveness,' 'Polishing,' 'Innovativeness,' 'Professionalism,' 'Intellectualness,' 'Individuality,' and 'Distinctiveness' in terms of look values. Also, we identifies 'Stability,' 'Comfortableness,' 'Grip,' 'Solidity,' 'Non-fragility,' and 'Smoothness' in terms of feel values. They are factorized into five key values: 'Sleek Value,' 'Professional Value,' 'Unique Value,' 'Comfortable Value,' and 'Solid Value.' Finally, we developed the holistic design evaluation model by analyzing each relationship from product attributes, perceived attributes, to consumer values. This study has several theoretical and practical contributions. First, we found consumer values in terms of design evaluation and implicit chain relationship from the objective and physical characteristics to the subjective and mental evaluation. That is, the model explains the mechanism of design evaluation in consumer minds. Second, we suggest a general design evaluation process from product attributes, perceived attributes to consumer values. It is an adaptable methodology not only smart phone but also other IT products. Practically, this model can support the decision-making when companies initiative new product development. It can help product designers focus on their capacities with limited resources. Moreover, if its model combined with machine learning collecting consumers' purchasing data, most preferred values, sales data, etc., it will be able to evolve intelligent design decision support system.

• Investigative Magnetic Resonance Imaging
• /
• v.18 no.1
• /
• pp.7-16
• /
• 2014

Purpose : To evaluate the prevalence and pattern of perfusion defect (PD) on first-pass stress perfusion MR imaging in relation with the degree of left ventricular hypertrophy (LVH) and late gadolinium-enhancement (LGE) in patients with apical hypertrophic cardiomyopathy (APH). Materials and Methods: Cardiac MR imaging with first-pass stress perfusion, cine, and LGE sequence was performed in 26 patients with APH from January 2008 to December 2012. We analyzed a total of 416 segments for LV wall thickness on end-diastolic phase of cine images, and evaluated the number of hypertrophied segment and number of consecutive hypertrophied segment (NCH). We assessed the presence or absence of PD and LGE from all patients. If there was PD, we subdivided the pattern into sporadic (sporadic-PD) or ring (ring-PD). Using univariate logistic method, we obtained the independent predictor for presence of overall PD and ring-PD. Results: PD on stress perfusion MRI was observed in 20 patients (76.9%), 12 of them (60%) showed ring-PD. Maximal LV wall thickness and number of hypertrophied segment were independent predictors for overall PD (all, p < 0.05). NCH with more than 3 segments was an additional independent factor for ring-PD. However, LGE was not statistically related with PD in patients with APH. Conclusion: About three quarters of the patients with APH showed PD, most of them represented as ring-PD. LVH degree or distribution was related with pattern of PD, however, LGE was not related with PD. Therefore, the clinical significance of PD in the patients with APH seems to be different from those with non-APH, and further comparison study between the two groups should be carried out.

• Survey Research
• /
• v.10 no.1
• /
• pp.1-32
• /
• 2009

This study examines the changes of income, everyday life and living condition of consumer in the aftermath of financial crisis. In this period financial crisis was the crucial factor behind various social problems such as the dissolution of families and individuals. This research explores the range and degree of impact on individuals and social groups after the financial crisis. We explore the social mobility in terns of maintaining middle class and falling into the lower class measured by middle class identification. The 60% of the middle class before the financial crisis maintained the middle class position and the rest of people left out of middle class and fell into lower class. The 60% of those who has been maintained and has just became the members of middle class were college - educated people. The great part of people whose income and assets has increased after financial crisis belongs to college - educated group. Many of those whose income have decreased belong to the high school educated group and blow, the older than 50 years old, self - employed without employee and unpaid family employee. Those whose income and assets decreased and those who experienced downward mobility have undergone changes in everyday life and living conditions as a consumer. Many of them experienced the unemployment, nonpayment or credit - delinquency, dissolution of family, worsening health condition, depression, feeling the impulse to commit suicide simultaneously. The poor consumer disposition, reduction of living expenses, sound consumer culture have expanded to people since economic crisis. The middle class reported that the cost of private education often goes beyond the family ability to pay. The lower class has suffered from the cost of living. In a meanwhile luxury goods preference, consumer consciousness for status symbol have continuously increased among all the classes since 1997. Thus fluctuations of one's income and social mobility during past 10 years were some of the major determinants which brought about the various damaging life events, changes of living conditions and everyday lives as a consumer.

• Journal of Chest Surgery
• /
• v.36 no.1
• /
• pp.15-20
• /
• 2003

Myasthenia gravis is a rare autoimmune disease involving acetylcholine receptor and its autoantibody on neuromuscular junction. The methods of treatment are medical treatment and surgical thymectomy. In this paper we analyzed the result of thymectomy and the factors affecting the postoperative symptom improvement. Material and method : This study obtained medical records of 37 patients who received the thymectomy for myasthenia gravis from March 1986 to December 1998. Result Out of 37 cases, 21 cases(57%) showed improvement, of which 8 cases (50%) in the group of thymoma(n=16), and 13 cases (62%) in the group of thymic hyperplasia(n=21) showed the improvement of symptoms. Postoperative complications were respiratory insufficiency due to aggravation of symptoms after operation, including tracheal intubation for ventilator support in 9 cases, pneumonia in 3 cases, pneumothorax in 2 cases and left vocal cord palsy in 1 case. There was one postoperative mortality. The relation between postoperative improvement and sex(P=0.3222), age(P=0.7642), thymic pathologic variants,(P=0.4335) and classification of thymoma(P=0.20) showed no statistically significant correlation. However, the lower grade of preoperative symptoms can predict the lower grade of postoperative symptoms significantly(P=0.0032). Follow up study to 36 postoperative survivors was performed in October 2002 based on the out-patient records and call with patients. Out of 36 cases, 33 cases(91.7%) could be investigated and 3 cases could not. Mean follow up period was 83.2 months. Out of 33 cases, 25 cases(75.8%) showed symptomatic improvement, of which 8 cases(53.3%) in the group of thymoma(n=15) and 17 cases(94.4%) in the group of thymic hyperplasia(n=18) showed the improvement of$\boxUl$ symptoms. Conclusion : In myasthenia gravis, thymectomy showed the good improvement, and more important factor affecting the improvement of symptoms was the grdae of preoperative symptoms. Also midterm and long term follow up results showed good symptomatic improvement.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.1
• /
• pp.21-29
• /
• 2004

Purpose: Much evidence suggests long-term cigarette smoking alters coronary vascular endothelial response. On this study, we applied nonnegative matrix factorization (NMF), an unsupervised learning algorithm, to CO-less $H_2^{15}O-PET$ to investigate coronary endothelial dysfunction caused by smoking noninvasively. Materials and methods: This study enrolled eighteen young male volunteers consisting of 9 smokers $(23.8{\pm}1.1\;yr;\;6.5{\pm}2.5$ pack-years) and 9 nonsmokers $(23.8{\pm}2.9 yr)$. They do not have any cardiovascular risk factor or disease history. Myocardial $H_2^{15}O-PET$ was performed at rest, during cold ($5^{\circ}C$) pressor stimulation and during adenosine infusion. Left ventricular blood pool and myocardium were segmented on dynamic PET data by NMF method. Myocardial blood flow (MBF) was calculated from input and tissue functions by a single compartmental model with correction of partial volume and spillover effects. Results: There were no significant difference in resting MBF between the two groups (Smokers: 1.43 0.41 ml/g/min and non-smokers: $1.37{\pm}0.41$ ml/g/min p=NS). during cold pressor stimulation, MBF in smokers was significantly lower than 4hat in non-smokers ($1.25{\pm}0.34$ ml/g/min vs $1.59{\pm}0.29$ ml/gmin; p=0.019). The difference in the ratio of cold pressor MBF to resting MBF between the two groups was also significant (p=0.024; $90{\pm}24%$ in smokers and $122{\pm}28%$ in non-smokers.). During adenosine infusion, however, hyperemic MBF did not differ significantly between smokers and non-smokers ($5.81{\pm}1.99$ ml/g/min vs $5.11{\pm}1.31$ ml/g/min ; p=NS). Conclusion: in smokers, MBF during cold pressor stimulation was significantly lower compared wi4h nonsmokers, reflecting smoking-Induced endothelial dysfunction. However, there was no significant difference in MBF during adenosine-induced hyperemia between the two groups.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.68-73
• /
• 2008

Background: The presence of infiltrated mediastinal lymph nodes is a crucial factor for the prognosis of lung cancer. The aim of our study is to investigate the pattern of metastatic non-small cell lung cancer that spreads to the mediastinal lymph nodes, in relation to the primary tumor site, in patients who underwent major lung resection with complete mediastinal lymph node dissection. Material and Method: We retrospectively. studies 293 consecutive patients [mean age $63.0{\pm}8.3$ years (range $37{\sim}88$) and 220 males (75.1%)] who underwent major lung resection due to non-small cell lung cancer from January 1998 to December 2005. The primary tumor and lymph node status was classified according to the international TNM staging system reported by Mountain. The histologic type of the tumors was determined according to the WHO classification. Fisher's exact test was used; otherwise the chi-square test of independence was employed. A p-value < 0.05 was considered significant. Result: Lobectomy was carried out in 180 patients, bilobectomy in 50, sleeve lobectomy in 10 and pnemonectomy in 53. The pathologic report revealed 124 adenocarcinomas, 138 squamous-cell tumors, 14 adenosquamous tumors, 1 carcinoid tumor, 8 large cell carcinomas, 1 carcinosarcoma, 2 mucoepidermoid carcinomas and 5 undifferentiated tumors. The TNM stage was IA in 51 patients, IB in 98, IIB in 41, IIIA in 71, IIIB in 61 and IV in 6. 25.9 % of the 79 patients had N2 tumor. Most common infiltrated mediastinal lymph node was level No.4 in the right upper lobe, level No. 4 and 5 in the left upper lobe and level No. 7 in the other lobes, but no statistically significant difference was observed. Thirty-six patients (12.3%) presented with skip metastasis to the mediastinum. Conclusion: Mediastinal lymph node dissection is necessary for accurately determining the pTNM stage. It seems that there is no definite way that non-small cell lung cancer spreads to the lymphatics, in relation to the location of the primary cancer. Further, skip metastasis to the mediastinal lymph nodes was present in 12.3% of our patients.