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Effect of Sternal Closure Method on Sternal Dehiscence With or Without Infection (흉골 봉합 방법이 흉골 열개 및 감염에 미치는 영향)

  • 이삼윤;박권재;고광표;최종범
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.485-489
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    • 2001
  • Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

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Design of accelerated life test on temperature stress of piezoelectric sensor for monitoring high-level nuclear waste repository (고준위방사성폐기물 처분장 모니터링용 피에조센서의 온도 스트레스에 관한 가속수명시험 설계)

  • Hwang, Hyun-Joong;Park, Changhee;Hong, Chang-Ho;Kim, Jin-Seop;Cho, Gye-Chun
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.24 no.6
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    • pp.451-464
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    • 2022
  • The high-level nuclear waste repository is a deep geological disposal system exposed to complex environmental conditions such as high temperature, radiation, and ground-water due to handling spent nuclear fuel. Continuous exposure can lead to cracking and deterioration of the structure over time. On the other hand, the high-level nuclear waste repository requires an ultra-long life expectancy. Thus long-term structural health monitoring is essential. Various sensors such as an accelerometer, earth pressure gauge, and displacement meter can be used to monitor the health of a structure, and a piezoelectric sensor is generally used. Therefore, it is necessary to develop a highly durable sensor based on the durability assessment of the piezoelectric sensor. This study designed an accelerated life test for durability assessment and life prediction of the piezoelectric sensor. Based on the literature review, the number of accelerated stress levels for a single stress factor, and the number of samples for each level were selected. The failure mode and mechanism of the piezoelectric sensor that can occur in the environmental conditions of the high-level waste repository were analyzed. In addition, two methods were proposed to investigate the maximum harsh condition for the temperature stress factor. The reliable operating limit of the piezoelectric sensor was derived, and a reasonable accelerated stress level was set for the accelerated life test. The suggested methods contain economical and practical ideas and can be widely used in designing accelerated life tests of piezoelectric sensors.

Estimation of Domestic Greenhouse Gas Emission of Refrigeration and Air Conditioning Sector adapting 2006 IPCC GL Tier 2b Method (국내 냉동 및 냉방부문 온실가스 배출량 산정 - 2006 IPCC GL Tier 2b 적용 -)

  • Shin, Myung-Hwan;Lyu, Young-Sook;Seo, Kyoung-Ae;Lee, Sue-Been;Lim, Cheolsoo;Lee, Sukjo
    • Journal of Climate Change Research
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    • v.3 no.2
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    • pp.117-128
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    • 2012
  • The Government of South Korea has continued its effort to fixate virtuous circle of economic growth and climate change response to cope with international demands and pressure to commitment for greenhouse gas reduction effectively. Nationally, Korean Government has established "Enforcement of the Framework Act on Low carbon, Green Growth"(2010. 4. 13) to implement national mid-term GHG mitigation goal(30% reduction by 2020 compare to BAU), which established the foundation for phased GHG mitigation by setting up the sectoral and industrial goal, adopting GHG and Energy Target Management System. Also, follow-up measures are taken such as planning and control of mid-term and short-term mitigation target by detailed analysis of potential mitigation of sector and industry, building up the infrastructure for periodic and systematic analysis of target management. Likewise, it is required to establish more accurate, reliable and detailed sectoral GHG inventory for successfully establishment and implement the frame act. In comparison to the $CO_2$ emission, Especially fluorinated greenhouse gases (HFCs, PFCs, $SF_6$) are lacking research to build the greenhouse gas inventories to identify emissions sources and collection of the applicable collection activities data. In this study, with the refrigeration and air conditioning sector being used to fluorine refrigerant(HFCs) as the center, greenhouse gas emission estimation methodology for evaluating the feasibility of using this methodology look over and mobile air conditioning, fixed air conditioning, household refrigeration equipment, commercial refrigeration equipment for the greenhouse gas emissions were calculated. First look at in terms of methodology, refrigeration and air conditioning sector GHG emissions in developing country-specific emission factors and activity data of the industrial sector the construction of the DB is not enough, it's 2006 IPCC Guidelines Tier 2a (emission factor approach) rather than the Tier 2b (mass balance approach) deems appropriate, and each detail by process, sectoral activity data more accurate, if DB is built Tier 2a (emission factor approach) can be applied will also be judged. Refrigeration and air conditioning sector in 2009 due to the use of refrigerant greenhouse gas emissions ($CO_2eq.$) assessment results, portable air conditioner 1,974,646 ton to year, fixed-mount air conditioner 1,011,754 ton to year, household refrigeration unit 4,396 ton to year, commercial refrigeration equipment 1,263 ton to year was estimated to total 2,992,037 tons.

Correlation between Carotid Intima-media Thickness and Risk Factors for Atherosclerosis (경동맥 내중막 두께에 따른 죽상경화반의 위험요인과의 상관관계)

  • An, Hyun;Lee, Hyo Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.339-348
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    • 2019
  • The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.

Development of a Retrieval Algorithm for Adjustment of Satellite-viewed Cloudiness (위성관측운량 보정을 위한 알고리즘의 개발)

  • Son, Jiyoung;Lee, Yoon-Kyoung;Choi, Yong-Sang;Ok, Jung;Kim, Hye-Sil
    • Korean Journal of Remote Sensing
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    • v.35 no.3
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    • pp.415-431
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    • 2019
  • The satellite-viewed cloudiness, a ratio of cloudy pixels to total pixels ($C_{sat,\;prev}$), inevitably differs from the "ground-viewed" cloudiness ($C_{grd}$) due to different viewpoints. Here we develop an algorithm to retrieve the satellite-viewed, but adjusted cloudiness to $C_{grd} (C_{sat,\;adj})$. The key process of the algorithm is to convert the cloudiness projected on the plane surface into the cloudiness on the celestial hemisphere from the observer. For this conversion, the supplementary satellite retrievals such as cloud detection and cloud top pressure are used as they provide locations of cloudy pixels and cloud base height information, respectively. The algorithm is tested for Himawari-8 level 1B data. The $C_{sat,\;adj}$ and $C_{sat,\;prev}$ are retrieved and validated with $C_{grd}$ of SYNOP station over Korea (22 stations) and China (724 stations) during only daytime for the first seven days of every month from July 2016 to June 2017. As results, the mean error of $C_{sat,\;adj}$ (0.61) is less that than that of $C_{sat,\;prev}$ (1.01). The percent of detection for 'Cloudy' scenario of $C_{sat,\;adj}$ (73%) is higher than that of $C_{sat,\;prev}$ (60%) The percent of correction, the accuracy, of $C_{sat,\;adj}$ is 61%, while that of $C_{sat,\;prev}$ is 55% for all seasons. For the December-January-February period when cloudy pixels are readily overestimated, the proportion of correction of $C_{sat,\;adj$ is 60%, while that of $C_{sat,\;prev}$ is 56%. Therefore, we conclude that the present algorithm can effectively get the satellite cloudiness near to the ground-viewed cloudiness.

Effects of Telephone Hotline Counseling Program on Stroke Care (뇌졸중 환자에 적용한 핫라인 전화상담 프로그램의 효과)

  • Baik Kyun Kim;Dong-Wan Kang;Do Yeon Kim;Jung Hyun Park;Ji-Seok Woo;Young-Hee Kim;Hyun-Sook Kim;Min-Joo Moon;Jeong-Yoon Lee;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Hakyeu Ahn;Bosco Seong Kyu Yang;Jun Yup Kim;Jihoon Kang;Moon-Ku Han;Hee-Joon Bae;Beom Joon Kim
    • Health Policy and Management
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    • v.33 no.2
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    • pp.185-193
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    • 2023
  • Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

The Effect of Small-Scale Chemistry (SSC) Lab Program with Respect to High School Students' Extroversions and Introversions (고등학생의 내.외향성에 따른 SSC(Small-Scale Chemistry) 실험 수업의 효과)

  • Yoo, Mi-Hyun;Kim, Mi-Young;Hong, Hun-Gi
    • Journal of The Korean Association For Science Education
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    • v.29 no.2
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    • pp.179-192
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    • 2009
  • The purpose of this study was to examine the effects of Small-Scale Chemistry (below SSC) Lab Program with respect to students' extroversions and introversions. For this study, an SSC Lab Program was developed on the basis of analyzing the chemistry part of the high school science textbook in the 7th curriculum. The experimental group received SSC experiment lessons, and the comparison group received traditional experiment lessons based on textbook for 5 class periods. Afterwards, students were grouped into extrovert and introvert according to their personality test scores, the differences between the two groups were investigated using 2-way ANCOVA. Prior to the instructions, three test regarding the scientific attitude and academic self-efficacy were administered. After the instructions, the scientific attitude, academic self-efficacy, and students' perceptions on SSC Lab Program were examined. The scores in mid-term and end-of-term science exams were used as pre-test and post-test science achievement scores, respectively. Two-way ANCOVA results revealed that there were effects in the score of the academic achievement score, but there was no interactive effect between extroversion/introversion and treatment. In addition, a significant interactive effect was found in the scientific attitude, but there was no significant main effect. It was interpreted that extrovert students had many opportunities in SSC experiment classes and were able to experiment with initiative, but introverts would feel the responsibility and the pressure owing to the small group experiment. There were no main and interactive effects in the score of the academic self-efficacy test. Survey of students' perceptions on SSC Lab Program revealed that both over 90% extrovert and introvert students showed very positive perceptions in 'three-membered small group composition,' 'understanding,' and 'convenience' items. It was found to be a very different perception between extrovert and introvert students in 'comparing result with other students' item.

The Purpose and background of this study (노인질환에 대한 한양방동시종합검진 결과에 대한 보고)

  • Gwon, Gyeong-Suk;Lee, Tae-Hwan;Song, Jeong-Mo;Kim, In-Seop;Yun, Ho-Yeong;Im, Jun-Gyu
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.9-27
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    • 1994
  • This study is to analyze of senile disease status and the social problem according to increased old ages, and then to find distributions of old man's diseases and health status efficiency of oriental-occidental contemporary health examination. And it is the first oriental-occidental contemporary health examination of old man performed by JeonJu Woosuk University Oriental Medicine Hospital and Woosuk-Clinic in nation. Methods The objects in this research are 641's old man of KimJe Gun's over 60's years performed medical examination at JeonJu Woosuk University Oriental- Mmedicine-Hospital and Woosuk-Clinic by oriental-occidental medical contemporary exam., from 1994, 24th June till 1994. 13th July. The 1st occident medical examination methods were consisted of chest x-ray check. blood and urine exam., measurement of blood pressure, visual power and audiometry. The Oriental medical examination methods were consisted of four diagnostics (望,聞,問,切), present illness. chief complaint, past history, families history, social history by question and SA Sang constitution test index. The results and conclusions The results and conclusions are the next: 1. In order of distribution. the athletic disease (75.8%),the digestive disease(43.4%), the circulatory disease(41.5%), the respiratory disease(22.3%), EENT disease(8.1%), the endocrinopathy(5.6%), and the genito-urinary disease(5.3%) are the results of the object about 641's old man, by the oriental-occidental medicine's contemporay exam. 2. Distribution of disease distiction are lumbago. gastritis and peptic ulcer. knee joint pain. heart disease. hypertension. chronic bronchitis. asthma. anemia. DM. Tbc. visual disturbance. CVA. etc in order. 3. Disease distribution according to age is almost high incident in 60-75years. Disease incidence is decreased except E.E.N.T disease in over 76years. 4. The relationships of disease and family history are: the 25.0% of CVA pts. has family history and the 11.6% of hypertension pts has family history. so they showed high relative family history. In addition the 5.6% of TBC pts. and the 2.6% of DM pts. have family history. 5. The relationships of disease and drinking are: Drinking proportion is the 36.4% in respiratory disease pts. the 34.7% in hypertension pts. the 33.3% in heart disease pts.. the 28.4% in digestive disease pts.. but because of no surveying drinking amount we can't know the absolut relationships of disease and drinking. 6. The relationships of Disease and smoking are: Smoking proportion is the 44.1% in respiratory disease pts.. the 38.0% in Heart disease pts.. the 29.8% in Hypertension pts.. but because of no surveying of smoking amount. we can't know the absolut relationships of disease and smoking. 7. Distribution of Sasang constitution is : Tae-eum-in 44.8%. So-yang-in 30.7%. So-eum-in 24.6%. Tae-yang-in 0.0%. And disease distribution of Sasang constitution distinction is ; Tae-eum-in has high incidence of circulation disease(50.0%) and respiratory disease(23.1%).So-yang-in has high incidence of athletics disease(77.7%) and EENT disease(12.2%), So-eum-in has high incidence of digestive disease(65.8%). 8. Distribution of abnormal result in occidental medical examination and oriental-occidental contemporal exam result is considerably different. This is the reason of needing oriental medicine exam, for characteristics of Senile. I think that the oriental-occidental contemporary examination in old man is much more effecient than only occident medical examination. This oriental-occidental contemporary examination has many defects because it is the first practice. To participate in the public health program efficiently. I think that we must improve lots of problems and present the model of the oriental-occidental contemporary examination and the project of oriental medicine's for public health.

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Weaning Following a 60 Minutes Spontaneous Breathing Trial (1시간 자가호흡관찰에 의한 기계적 호흡치료로부터의 이탈)

  • Park, Keon-Uk;Won, Kyoung-Sook;Koh, Young-Min;Baik, Jae-Jung;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.361-369
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    • 1995
  • Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.

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The Concentration of Economic Power in Korea (경제력집중(經濟力集中) : 기본시각(基本視角)과 정책방향(政策方向))

  • Lee, Kyu-uck
    • KDI Journal of Economic Policy
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    • v.12 no.1
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    • pp.31-68
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    • 1990
  • The concentration of economic power takes the form of one or a few firms controlling a substantial portion of the economic resources and means in a certain economic area. At the same time, to the extent that these firms are owned by a few individuals, resource allocation can be manipulated by them rather than by the impersonal market mechanism. This will impair allocative efficiency, run counter to a decentralized market system and hamper the equitable distribution of wealth. Viewed from the historical evolution of Western capitalism in general, the concentration of economic power is a paradox in that it is a product of the free market system itself. The economic principle of natural discrimination works so that a few big firms preempt scarce resources and market opportunities. Prominent historical examples include trusts in America, Konzern in Germany and Zaibatsu in Japan in the early twentieth century. In other words, the concentration of economic power is the outcome as well as the antithesis of free competition. As long as judgment of the economic system at large depends upon the value systems of individuals, therefore, the issue of how to evaluate the concentration of economic power will inevitably be tinged with ideology. We have witnessed several different approaches to this problem such as communism, fascism and revised capitalism, and the last one seems to be the only surviving alternative. The concentration of economic power in Korea can be summarily represented by the "jaebol," namely, the conglomerate business group, the majority of whose member firms are monopolistic or oligopolistic in their respective markets and are owned by particular individuals. The jaebol has many dimensions in its size, but to sketch its magnitude, the share of the jaebol in the manufacturing sector reached 37.3% in shipment and 17.6% in employment as of 1989. The concentration of economic power can be ascribed to a number of causes. In the early stages of economic development, when the market system is immature, entrepreneurship must fill the gap inherent in the market in addition to performing its customary managerial function. Entrepreneurship of this sort is a scarce resource and becomes even more valuable as the target rate of economic growth gets higher. Entrepreneurship can neither be readily obtained in the market nor exhausted despite repeated use. Because of these peculiarities, economic power is bound to be concentrated in the hands of a few entrepreneurs and their business groups. It goes without saying, however, that the issue of whether the full exercise of money-making entrepreneurship is compatible with social mores is a different matter entirely. The rapidity of the concentration of economic power can also be traced to the diversification of business groups. The transplantation of advanced technology oriented toward mass production tends to saturate the small domestic market quite early and allows a firm to expand into new markets by making use of excess capacity and of monopoly profits. One of the reasons why the jaebol issue has become so acute in Korea lies in the nature of the government-business relationship. The Korean government has set economic development as its foremost national goal and, since then, has intervened profoundly in the private sector. Since most strategic industries promoted by the government required a huge capacity in technology, capital and manpower, big firms were favored over smaller firms, and the benefits of industrial policy naturally accrued to large business groups. The concentration of economic power which occured along the way was, therefore, not necessarily a product of the market system. At the same time, the concentration of ownership in business groups has been left largely intact as they have customarily met capital requirements by means of debt. The real advantage enjoyed by large business groups lies in synergy due to multiplant and multiproduct production. Even these effects, however, cannot always be considered socially optimal, as they offer disadvantages to other independent firms-for example, by foreclosing their markets. Moreover their fictitious or artificial advantages only aggravate the popular perception that most business groups have accumulated their wealth at the expense of the general public and under the behest of the government. Since Korea stands now at the threshold of establishing a full-fledged market economy along with political democracy, the phenomenon called the concentration of economic power must be correctly understood and the roles of business groups must be accordingly redefined. In doing so, we would do better to take a closer look at Japan which has experienced a demise of family-controlled Zaibatsu and a success with business groups(Kigyoshudan) whose ownership is dispersed among many firms and ultimately among the general public. The Japanese case cannot be an ideal model, but at least it gives us a good point of departure in that the issue of ownership is at the heart of the matter. In setting the basic direction of public policy aimed at controlling the concentration of economic power, one must harmonize efficiency and equity. Firm size in itself is not a problem, if it is dictated by efficiency considerations and if the firm behaves competitively in the market. As long as entrepreneurship is required for continuous economic growth and there is a discrepancy in entrepreneurial capacity among individuals, a concentration of economic power is bound to take place to some degree. Hence, the most effective way of reducing the inefficiency of business groups may be to impose competitive pressure on their activities. Concurrently, unless the concentration of ownership in business groups is scaled down, the seed of social discontent will still remain. Nevertheless, the dispersion of ownership requires a number of preconditions and, consequently, we must make consistent, long-term efforts on many fronts. We can suggest a long list of policy measures specifically designed to control the concentration of economic power. Whatever the policy may be, however, its intended effects will not be fully realized unless business groups abide by the moral code expected of socially responsible entrepreneurs. This is especially true, since the root of the problem of the excessive concentration of economic power lies outside the issue of efficiency, in problems concerning distribution, equity, and social justice.

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