• Title/Summary/Keyword: replacement materials

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The Cox-Maze Procedure for Atrial Fibrillation Concomitant with Mitral Valve Disease (승모판막질환에 동반된 심방세동에서 Cox-Maze 술식)

  • Kim, Ki-Bong;Cho, Kwang-Ree;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.939-944
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    • 1998
  • Background: The sugical results of the Cox-Maze procedure (CMP) for lone atrial fibrillation(AF) have proven to be exellent. However, those for AF associated with mitral valve(MV) disease have been reported to be a little inferior. Materials and methods: To assess the efficacy and safety of the CMP as a combined procedure with MV operation, we studied retrospectively our experiences. Between April 1994 and October 1997, we experienced 70 (23 males, 47 females) cases of CMP concomitantly with MV operation. Results: The etiologies of MV disease were rheumatic in 67 and degenerative in 3 cases. The mean duration of AF before sugery was 66$\pm$70 months. Fifteen patients had the past medical history of thromboembolic complications, and left atrial thrombi were identified at operation in 24 patients. Twelve cases were reoperations. Aortic cross clamp (ACC) time was mean 151$\pm$44 minutes, and cardiopulmonary bypass (CPB) time was mean 246$\pm$65 minutes. Concomitant procedures were mitral valve replacement (MVR) in 19, MVR and aortic valve replacement (AVR) in 14, MVR and tricupid annuloplasty (TAP) in 8, MVR with AV repair in 3, MV repair in 11, MVR and coronary artery bypass grafting (CABG) in 2, MVR and AVR and CABG in 1, redo-MVR in 10, redo-MVR and redo-AVR in 2 patients. The rate of hospital mortality was 1.4%(1/70). Perioperative recurrence of AF was seen in 44(62.9%), and atrial tachyarrhythmias in 10(14.3%), low cardiac output syndrome in 4(5.7%), postoperative bleeding that required mediastinal exploration in 4(5.7%) patients. Other complications were acute renal failure in 2, aggravation of preoperative hemiplegia in 1, and transient delirium in 1 patient. We followed up all the survivors for 16.4 months(3-44months) on an average. Sinus rhythm has been restored in 65(94.2%) patients. AF has been controlled by operation alone in 73.9% and operation plus medication in 20.3%. Two patients needed permanent pacemaker implantation; one with sick sinus syndrome, and the other with tachycardia- bradycardia syndrome. Only two patients remained in AF. We followed up our patients with transthoracic echocardiography to assess the atrial contractilities and other cardiac functions. Right atrial contractility could be demonstrated in 92% and left atrial contractility in 53%.We compared our non-redo cases with redo cases. Although the duration of AF was significantly longer in redo cases, there was no differences in ACC time, CPB time, postoperative bleeding amount and sinus conversion rate. Conclusions: In conclusion, the CMP concomitant with MV operation demonstrated a high sinus conversion rate under the acceptable operative risk even in case of reoperation.

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An Iterative, Interactive and Unified Seismic Velocity Analysis (반복적 대화식 통합 탄성파 속도분석)

  • Suh Sayng-Yong;Chung Bu-Heung;Jang Seong-Hyung
    • Geophysics and Geophysical Exploration
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    • v.2 no.1
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    • pp.26-32
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    • 1999
  • Among the various seismic data processing sequences, the velocity analysis is the most time consuming and man-hour intensive processing steps. For the production seismic data processing, a good velocity analysis tool as well as the high performance computer is required. The tool must give fast and accurate velocity analysis. There are two different approches in the velocity analysis, batch and interactive. In the batch processing, a velocity plot is made at every analysis point. Generally, the plot consisted of a semblance contour, super gather, and a stack pannel. The interpreter chooses the velocity function by analyzing the velocity plot. The technique is highly dependent on the interpreters skill and requires human efforts. As the high speed graphic workstations are becoming more popular, various interactive velocity analysis programs are developed. Although, the programs enabled faster picking of the velocity nodes using mouse, the main improvement of these programs is simply the replacement of the paper plot by the graphic screen. The velocity spectrum is highly sensitive to the presence of the noise, especially the coherent noise often found in the shallow region of the marine seismic data. For the accurate velocity analysis, these noise must be removed before the spectrum is computed. Also, the velocity analysis must be carried out by carefully choosing the location of the analysis point and accuarate computation of the spectrum. The analyzed velocity function must be verified by the mute and stack, and the sequence must be repeated most time. Therefore an iterative, interactive, and unified velocity analysis tool is highly required. An interactive velocity analysis program, xva(X-Window based Velocity Analysis) was invented. The program handles all processes required in the velocity analysis such as composing the super gather, computing the velocity spectrum, NMO correction, mute, and stack. Most of the parameter changes give the final stack via a few mouse clicks thereby enabling the iterative and interactive processing. A simple trace indexing scheme is introduced and a program to nike the index of the Geobit seismic disk file was invented. The index is used to reference the original input, i.e., CDP sort, directly A transformation techinique of the mute function between the T-X domain and NMOC domain is introduced and adopted to the program. The result of the transform is simliar to the remove-NMO technique in suppressing the shallow noise such as direct wave and refracted wave. However, it has two improvements, i.e., no interpolation error and very high speed computing time. By the introduction of the technique, the mute times can be easily designed from the NMOC domain and applied to the super gather in the T-X domain, thereby producing more accurate velocity spectrum interactively. The xva program consists of 28 files, 12,029 lines, 34,990 words and 304,073 characters. The program references Geobit utility libraries and can be installed under Geobit preinstalled environment. The program runs on X-Window/Motif environment. The program menu is designed according to the Motif style guide. A brief usage of the program has been discussed. The program allows fast and accurate seismic velocity analysis, which is necessary computing the AVO (Amplitude Versus Offset) based DHI (Direct Hydrocarn Indicator), and making the high quality seismic sections.

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APPLICATION OF FUZZY SET THEORY IN SAFEGUARDS

  • Fattah, A.;Nishiwaki, Y.
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1993.06a
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    • pp.1051-1054
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    • 1993
  • The International Atomic Energy Agency's Statute in Article III.A.5 allows it“to establish and administer safeguards designed to ensure that special fissionable and other materials, services, equipment, facilities and information made available by the Agency or at its request or under its supervision or control are not used in such a way as to further any military purpose; and to apply safeguards, at the request of the parties, to any bilateral or multilateral arrangement, or at the request of a State, to any of that State's activities in the field of atomic energy”. Safeguards are essentially a technical means of verifying the fulfilment of political obligations undertaken by States and given a legal force in international agreements relating to the peaceful uses of nuclear energy. The main political objectives are: to assure the international community that States are complying with their non-proliferation and other peaceful undertakings; and to deter (a) the diversion of afeguarded nuclear materials to the production of nuclear explosives or for military purposes and (b) the misuse of safeguarded facilities with the aim of producing unsafeguarded nuclear material. It is clear that no international safeguards system can physically prevent diversion. The IAEA safeguards system is basically a verification measure designed to provide assurance in those cases in which diversion has not occurred. Verification is accomplished by two basic means: material accountancy and containment and surveillance measures. Nuclear material accountancy is the fundamental IAEA safeguards mechanism, while containment and surveillance serve as important complementary measures. Material accountancy refers to a collection of measurements and other determinations which enable the State and the Agency to maintain a current picture of the location and movement of nuclear material into and out of material balance areas, i. e. areas where all material entering or leaving is measurab e. A containment measure is one that is designed by taking advantage of structural characteristics, such as containers, tanks or pipes, etc. To establish the physical integrity of an area or item by preventing the undetected movement of nuclear material or equipment. Such measures involve the application of tamper-indicating or surveillance devices. Surveillance refers to both human and instrumental observation aimed at indicating the movement of nuclear material. The verification process consists of three over-lapping elements: (a) Provision by the State of information such as - design information describing nuclear installations; - accounting reports listing nuclear material inventories, receipts and shipments; - documents amplifying and clarifying reports, as applicable; - notification of international transfers of nuclear material. (b) Collection by the IAEA of information through inspection activities such as - verification of design information - examination of records and repo ts - measurement of nuclear material - examination of containment and surveillance measures - follow-up activities in case of unusual findings. (c) Evaluation of the information provided by the State and of that collected by inspectors to determine the completeness, accuracy and validity of the information provided by the State and to resolve any anomalies and discrepancies. To design an effective verification system, one must identify possible ways and means by which nuclear material could be diverted from peaceful uses, including means to conceal such diversions. These theoretical ways and means, which have become known as diversion strategies, are used as one of the basic inputs for the development of safeguards procedures, equipment and instrumentation. For analysis of implementation strategy purposes, it is assumed that non-compliance cannot be excluded a priori and that consequently there is a low but non-zero probability that a diversion could be attempted in all safeguards ituations. An important element of diversion strategies is the identification of various possible diversion paths; the amount, type and location of nuclear material involved, the physical route and conversion of the material that may take place, rate of removal and concealment methods, as appropriate. With regard to the physical route and conversion of nuclear material the following main categories may be considered: - unreported removal of nuclear material from an installation or during transit - unreported introduction of nuclear material into an installation - unreported transfer of nuclear material from one material balance area to another - unreported production of nuclear material, e. g. enrichment of uranium or production of plutonium - undeclared uses of the material within the installation. With respect to the amount of nuclear material that might be diverted in a given time (the diversion rate), the continuum between the following two limiting cases is cons dered: - one significant quantity or more in a short time, often known as abrupt diversion; and - one significant quantity or more per year, for example, by accumulation of smaller amounts each time to add up to a significant quantity over a period of one year, often called protracted diversion. Concealment methods may include: - restriction of access of inspectors - falsification of records, reports and other material balance areas - replacement of nuclear material, e. g. use of dummy objects - falsification of measurements or of their evaluation - interference with IAEA installed equipment.As a result of diversion and its concealment or other actions, anomalies will occur. All reasonable diversion routes, scenarios/strategies and concealment methods have to be taken into account in designing safeguards implementation strategies so as to provide sufficient opportunities for the IAEA to observe such anomalies. The safeguards approach for each facility will make a different use of these procedures, equipment and instrumentation according to the various diversion strategies which could be applicable to that facility and according to the detection and inspection goals which are applied. Postulated pathways sets of scenarios comprise those elements of diversion strategies which might be carried out at a facility or across a State's fuel cycle with declared or undeclared activities. All such factors, however, contain a degree of fuzziness that need a human judgment to make the ultimate conclusion that all material is being used for peaceful purposes. Safeguards has been traditionally based on verification of declared material and facilities using material accountancy as a fundamental measure. The strength of material accountancy is based on the fact that it allows to detect any diversion independent of the diversion route taken. Material accountancy detects a diversion after it actually happened and thus is powerless to physically prevent it and can only deter by the risk of early detection any contemplation by State authorities to carry out a diversion. Recently the IAEA has been faced with new challenges. To deal with these, various measures are being reconsidered to strengthen the safeguards system such as enhanced assessment of the completeness of the State's initial declaration of nuclear material and installations under its jurisdiction enhanced monitoring and analysis of open information and analysis of open information that may indicate inconsistencies with the State's safeguards obligations. Precise information vital for such enhanced assessments and analyses is normally not available or, if available, difficult and expensive collection of information would be necessary. Above all, realistic appraisal of truth needs sound human judgment.

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Structural Analysis of Concrete-filled FRP Tube Dowel Bar for Jointed Concrete Pavements (콘크리트 포장에서 FRP 튜브 다웰바의 역학적 특성 분석)

  • Park, Jun-Young;Lee, Jae-Hoon;Sohn, Dueck-Su
    • International Journal of Highway Engineering
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    • v.13 no.3
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    • pp.21-30
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    • 2011
  • As well known, dowel bars are used to transfer traffic load acting on one edge to another edge of concrete slab in concrete pavement system. The dowel bars widely used in South Korea are round shape steel bar and they shows satisfactory performance under bending stress which is developed by repetitive traffic loading and environment loading. However, they are not invulnerable to erosion that may be caused by moisture from masonry joint or bottom of the pavement system. Especially, the erosion could rapidly progress with saline to prevent frost of snow in winter time. The problem under this circumstance is that the erosion not only drops strength of the steel dower bar but also comes with volume expansion of the steel dowel bar which can reduce load transferring efficiency of the steel dowel bar. To avoid this erosion problem in reasonable expenses, dowers bars with various materials are being developed. Fiber reinforced plastic(FRP) dower that is presented in this paper is suggested as an alternative of the steel dowel bar and it shows competitive resistance against erosion and tensile stress. The FRP dowel bar is developed in tube shape and is filled with high strength no shrinkage. Several slab thickness designs with the FRP dowel bars are performed by evaluating bearing stress between the dowel bar and concrete slab. To calculated the bearing stresses, theoretical formulation and finite element method(FEM) are utilized with material properties measured from laboratory tests. The results show that both FRP tube dowel bars with diameters of 32mm and 40mm satisfy bearing stress requirement for dowel bars. Also, with consideration that lean concrete is typical material to support concrete slab in South Korea, which means low load transfer efficiency and, therefore, low bearing stress, the FRP tube dowel bar can be used as a replacement of round shape steel bar.

The effect of silk fibroin and rhBMP-2 on bone regeneration in rat calvarial defect model (백서 두개골결손모델에서 실크단백과 골형성단백 이식체가 골재생에 미치는 영향)

  • Nam, Jeong-Hun;Noh, Kyung-Lok;Pang, Eun-O;Yu, Woo-Geun;Kang, Eung-Sun;Kweon, Hae-Yong;Kim, Seong-Gon;Park, Young-Ju
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.5
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    • pp.366-374
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    • 2010
  • Introduction: This study evaluated the capability of silk fibroin (SF) and recombinant human bone morphogenetic protein-2 loaded SF (SF-BMP) as a bone defect replacement matrix when grafted in a calvarial bone defect of rats in vivo. Materials and Methods: A total 70 calvarial critical size defects (5.0 mm in diameter) made on 35 adult female Sprague-Dawley rats were used in this study. The defects were transplanted with (1) rhBMP-2 loaded silk fibroin graft (SF-BMP: 0.8+$10\;{\mu}g$), (2) Silk fibroin (SF: $10\;{\mu}g$), and (3) no graft material (Raw). The samples were evaluated with soft x-rays, alkaline phosphatase activity, calcium/phosphate quantification, histological and histomorphometric analysis at postoperative 4 and 8 weeks. Results: The SF-BMP group ($48.86{\pm}14.92%$) had a significantly higher mean percentage bone area than the SF group ($24.96{\pm}11.01%$) at postoperative 4 weeks.(P<0.05) In addition, the SF-BMP group ($40.01{\pm}12.43%$) had a higher % bone area at postoperative 8 weeks than the SF group ($33.26{\pm}5.15%$). The mean ratio of gray scale levels to the host bone showed that the SF-BMP group ($0.67{\pm}0.08$) had a higher mean ratio level than the SF group ($0.61{\pm}0.09$) at postoperative 8 weeks. These differences were not statistically significant.(P=0.168 and P=0.243, respectively) The ratio of the calcium and phosphate contents of the SF-BMP ($0.93{\pm}0.22$) group was lower than that of the SF ($1.90{\pm}1.42$) group at postoperative 4 weeks. However, the SF-BMP group ($0.75{\pm}0.31$) had a higher Ca/$PO_4$ ratio than the SF ($0.68{\pm}0.04$) at postoperative 8 weeks. These differences were not statistically significant.(P=0.126 and P=0.627, respectively) For the bone-specific alkaline phosphatase (ALP) activity, which is recognized as a reliable indicator of the osteoblast function, the SF-BMP ($23.71{\pm}8.60\;U/L$) groups had a significantly higher value than the SF group ($12.65{\pm}6.47\;U/L$) at postoperative 4 weeks.(P<0.05) At postoperative 8 weeks, the SF-BMP ($21.65{\pm}10.02\;U/L$) group had a lower bone-specific ALP activity than the SF group ($16.72{\pm}7.35\;U/L$). This difference was not statistically significant.(P=0.263) For the histological evaluation, the SF-BMP group revealed less inflammation, lower foreign body reactions and higher bone healing than the SF group at postoperative 4 and 8 weeks. The SF group revealed more foreign body reactions at postoperative 4 weeks. However, this immunogenic reaction decreased and the remnant of grafted material was observed at postoperative 8 weeks. For histomorphometric analysis, the SF-BMP group had a significantly longer bone length to total length ratio than those of the SF group at postoperative 4 and 8 weeks.(P<0.05) Conclusion: The rhBMP-2 loaded silk fibroin graft revealed fewer immunoreactions and inflammation as well as more new bone formation than the pure silk fibroin graft. Therefore, silk fibroin may be a candidate scaffold for tissue engineered bone regeneration.

Development of Composite Flours and Their Products Utilizing Domestic Raw Materials - II. Bread-making Test with Composite Flours - (국산원료(國産原料)를 활용(活用)한 복합분(複合粉) 및 제품개발(製品開發)에 관(關)한 연구(硏究) - 제 2 보 복합분(複合粉)을 이용(利用)한 제빵시험(試驗) -)

  • Kim, Hyong-Soo;Kim, Yong-Hui;Woo, Chang-Myung;Lee, Su-Rae
    • Korean Journal of Food Science and Technology
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    • v.5 no.1
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    • pp.16-24
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    • 1973
  • Breads were made from composite flours based on domestic resources and their quality was assessed to obtain the following results. 1) When barley bread was made according to the formula for standard wheat bread, its specific loaf volume (SLV) was quite low (1.3 at 100% addition of water) in comparison with 3.3 for wheat bread. Addition of 10% defatted soy flour increased its SLV to 1.7 (at 100% water). Among various flour-improving additives, the use of 1.5% GMS + 0.5% CSL gave best results (SLV: 2.0 at 100% water). Admixture of wheat flour with the composite flour based on barley was most effective. Replacement of barley flour with 25% wheat flour gave SLV of 2.8 (at 90% water) and that with 50% wheat flour gave SLV of 3.2 (at 90% water), comparable to standard wheat bread with respect to loaf volume, color and texture. 2) Sweet potato bread had the characteristics of turning black-brown on baking. Use of 20% defatted soy flour and GMS + CSL gave higher SLV (1.9 at 100% water). Addition of wheat flour at 25% or 50% level to the composite flour based on sweet potato flour gave SLV of 2.3 and 2.6, respectively, at 90% water and its color and texture were improved 3) Potato flour was different from sweet potato flour in baking, the effect of GMS + CSL being quite low. Bread from corn flour was different from barley flour bread and defatted rice bran was not suitable for bread-making. 4) Bread was made from following composite flours based on naked barley and sweet potato flours along with the use of proper additives: (a) naked barley flour + defatted soy flour + wheat flour (45 : 10 : 45) (b) naked barley flour + defatted soy flour + wheat flour (67 : 10 : 23) (c) naked barley flour + defatted soy flour (90 : 10) (d) sweet potato flour + defatted soy flour + wheat flour (40 : 20 : 40) (e) sweet potato flour + defatted soy flour (60 : 20 : 20) Sensory evaluation of above breads in comparison with standard wheat bread (So) gave the following decreasing order of scores, So>(a)>(b)>(c)>(e)>(d) and Duncan's multiple range test showed that bread (a) was not different from standard wheat bread significantly at 5% level, in overall evaluation including color, texture, taste and flavor.

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Outbreak of Shigellosis Occurred in a Preschool and Two Elemetary Schools in Mapo-Gu, Seoul (서울시 마포구 관내 어린이집 및 초등학교에서 집단 발병한 세균성 이질)

  • Park, Tae Su;Lee, Ho Jun;Kim, Su Yeon;Lee, Dong Woo;Kim, Jae Yoon;Baik, Ji Na;Park, Yu Mi;Park, Mi Sun;Lee, Bok Kwon
    • Pediatric Infection and Vaccine
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    • v.13 no.1
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    • pp.71-77
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    • 2006
  • Purpose : Shigellosis is still an important cause of acute food-borne diarrheal diseases throughout the world. We investigated the transmission routes and clinical course through the outbreak of shigellosis in Mapo-Gu, Seoul. Methods : From October 7th to November 19th in 2005, Mapo-Gu public health center had referred 32 patients with confirmed or suspected shigellosis to the National Medical Center. We had investigated source of infection, epidemiology, laboratory findings, and clinical course of the cases occurred during this outbreak. Results : Among 32 patients, 24 patients had been confirmed with shigellosis, 8 patients had been diagnosed with suspected shigellosis. They ranged in age from 5 months to 12 years old and their mean age was 6.5 years. The clinical manifestations were as follows; diarrhea, fever, abdominal pain and asymptomatic condition. Symptoms had sustained for 3.7 days on the average. S. sonnei were cultured by rectal swab and founded to be resistant to ampicillin and TMP/SMX except to 3rd generation cephalosporin. After treatment with antibiotics such as cefixime and ceftriaxone or imipenem and conservative treatment with electrolyte and fluid replacement for 5~7 days, Stool cultures of the rectal swab grew no Shigella in these cases except 3 cases. Conclusion : An outbreak of shigellosis had occurred in a preschool and elementary school children. From the same results of antimicrobial susceptibility and pulsed-field gel electrophoresis patterns in this study, we suggest that the outbreak of shigellosis in this report had been originated from a single strain. According to all negative results about suspected food and water cultures, we couldn't find out source of infection. Through materials offerred by Mapo-Gu Public Health Center, we presumed the trasmission routes probably were person-to-person.

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Resolution Method of Hazard Factor for Life Safety in Rental Housing Complex (임대주택단지의 생활안전 위해요인 해소방안)

  • Sohn, Jeong-Rak;Cho, Gun-Hee;Kim, Jin-Won;Song, Sang-Hoon
    • Land and Housing Review
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    • v.8 no.1
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    • pp.1-11
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    • 2017
  • The government has been constructing and supplying public rental housing to ordinary people in order to stabilize housing since 1989. However, the public rental houses initially supplied to ordinary people are at high risk for safety accidents due to the deterioration of the facilities. Therefore, this study is aimed to propose a solution to solve the life safety hazards of the old rental housing complex as a follow-up study of Analysis of Accident Patterns and Hazard Factor for Life Safety in Rental Housing Complex. Types of life safety accidents that occur in public rental housing complexes are sliding, falling, crash, falling objects, breakage, fire accidents, traffic accidents and criminal accidents. The types of safety accidents that occur in rental housing complexes analyzed in this study are sliding, crashes, falling objects, and fire accidents. Although the incidence of safety accidents such as falling, breakage, traffic accidents and crime accidents in public rental housing complexes is low, these types are likely to cause safety accidents. The method of this study utilized interviews and seminar results, and it suggested ways to solve the life safety hazards in rental housing complexes. Interviews were conducted with residents and managers of rental housing complexes. Seminars were conducted twice with experts in construction, maintenance, asset management, housing welfare and safety. Through interviews and seminars, this study categorizes the life safety hazards that occur in rental housing complexes by types of accidents and suggests ways to resolve them as follows. (1) sliding ; use of flooring materials with high friction coefficient, installation of safety devices such as safety handles, implementation of maintenance, safety inspections and safety education, etc. (2) falling ; supplementation of safety facilities, Improvement of the design method of the falling parts, Safety education, etc. (3) crash ; increase the effective width of the elevator door, increase the effective width of the lamp, improve the lamp type (U type ${\rightarrow}$ I type), etc. (4) falling objects and breakage ; design of furniture considering the usability of residents, replacement of old facilities, enhancement of safety consciousness of residents, safety education, etc. (5) fire accidents ; installation of fire safety equipment, improvement by emergency evacuation, safety inspection and safety education, etc. (6) traffic accidents ; securing parking spaces, installing safety facilities, conducting safety education, etc. (7) criminal accidents; improvement of CCTV pixels, installation of street lights, removal of blind spots in the complex, securing of security, etc. The roles of suppliers, administrators and users of public rental housing proposed in this study are summarized as follows. Suppliers of rental housing should take into consideration the risk factors that may arise not only in the design and construction but also in the maintenance phase and should consider the possibility of easily repairing old facilities considering the life cycle of rental housing. Next, Administrators of rental housing should consider the safety of the users of the rental housing, conduct safety checks from time to time, and immediately remove any hazardous elements within the apartment complex. Finally, the users of the rental housing needs to form a sense of ownership of all the facilities in the rental housing complex, and efforts should be made not to cause safety accidents caused by the user's carelessness. The results of this study can provide the necessary information to enable residents of rental housing complexes to live a safe and comfortable residential life. It is also expected that this information will be used to reduce the incidence of safety accidents in rental housing complexes.

Comparison of Thallium-201, Tc-99m MIBI and I-131 Scan in the Follow-up Assessment after I-131 Ablative Therapy in Differentiated Thyroid Cancer (방사성 옥소 치료 후 분화된 갑상선암 추적관찰에서 Thallium-201 스캔, Tc-99m MIBI 스캔과 I-131 스캔 검사 결과의 비교)

  • Kwon, Jae-Sung;Lee, Sung-Keun;Kim, Doe-Min;Park, Sae-Jong;Jang, Kyong-Sun;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.493-501
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    • 1999
  • Purpose: We conducted a comparative study to evaluate the diagnostic values of T1-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. Materials and Methods: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or mote times of I-131 retreatments (33 cases). In all patients, T1-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the results were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. Results: Positive rates (PR) of Tc-99m MIBI, T1-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant T1-201 and I-131 scans were in the order of therapeutic 131 scan 71%, T1-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between T1-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). Conclusion: Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. T1-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these patients.

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Clinical Analysis to the Early Results of the CABG (관상동맥우회술의 조기 성적에 대한 임상적 고찰)

  • Kim, Dae-Sig;Yang, Jin-Young;Koo, Won-Mo;Moon, Seung-Chul;Lee, Gun;Lee, Hyeon-Jae;Lim, Chang-Young
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1043-1048
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    • 1998
  • Background: As coronary arterial disease is increasing, we evaluated the patients who underwent CABG(Coronary Artery Bypass Grafting) and thus report the early results and risk factors related to mortality and morbidity. Materials and methods: Between July 1996 and February 1998, 42 patients underwent CABG. We analyzed age, sex, preoperative ejection fraction, Canadian heart classification, prevalence factors of CAD(Coronary Artery Disease), angiographic findings, graft vessel numbers, IMA(Internal Mallary Artery) use, ECC* (extracorporeal circulation) time and morbidity. We also evaluated the mortality rate and the causes of death. Results: Complication was developed at 17cases. The average age of the complication group was 61±11.9 years and that of the noncomplication group was 51±10.5 years(p=0.004). ECC time was 198±42.5(min) in the complication group and 158±47.4(min) in the noncomplication group(p=0.008). The other factors had no correlation to the morbidity, statistically. The average follow up duration was 12.5 months and all the patients were alive except for the 2 expired cases. The mortality rate was 4.7%, among which one patient who underwent CABG with aortic valve replacement died due to multiorgan failure and the other died due to sepsis with pneumonia and wound infection. Conclusions: We conclude that the risk factors related to morbidity were age and ECC time, and that there were no correlations between other factors and morbidity.

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