• Title/Summary/Keyword: safety indicators

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Early Clinical Experience in Valve Replacement Using On-X Prosthetic Heart Valve (On-X 기계판막을 이용한 판막치환술의 단기성적분석)

  • 김인섭;김우식;신용철;유환국;김병열;정성철
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.742-748
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    • 2004
  • The On-X valve was recently introduced. It was the aim of this study to assess the safety and feasibility from the data derived from 28 patients who underwent aortic and/or mitral valve replacement with this prosthesis in National Medical Center. Material and Method: From May 1999 and May 2003, a series of 28 consecutive patients who had been implanted with 32 On-X prosthesis were reviewed, The operative procedure comprised of 12 MVR, 10 AVR and 6 DVR. The study followed the guidelines of AATS/STS. Mean follow-up was 27 months (total 04 patient-years). Result: Early ($\leq$30 days) mortality was 7.44% (2/28) and no late mortality occurred in the study. Total actuarial freedom from mortality at 2 years was 92.86$\pm$4.87% for all cases, 100% for MVR, 90$\pm$9.49% for AVR, and 83.3$\pm$1.52% for DVR. Thromboembolic event occurred in 2 MVR patients and that was the only complication; therefore, the linearized incidence of valve related complications was 3.17%/ patient-years for all cases and 6.5%/patient-years for MVR and the actuarial freedom from valve related complications at 2 years was 84.85$\pm$10.75%. Preoperatively, 24 (85.71%) patients were in NYHA functional class III or IV but postoperatively, 25 (89,29%) patients were in NYHA functional class I or II. The levels of hemoglobin, hematocrit, serum LDH, reticulocyte rate and indirect bilirubin were all within normal range at postoperative 3 month. In mitral position, the peak gradient was 6.1$\pm$1.8 mmHg and the mean gradient was 3.0$\pm$0.6 mmHg and EOA were 2.54$\pm$0.56 $m^2$, 2.39$\pm$0.73 $m^2$, 2.34$\pm$0.55 $m^2$, 2.40$\pm$0.63 $m^2$ at 27 mm, 29 mm, 31 mm, 33 mm respectively. In aortic postion, the peak gradient was 21.1 $\pm$14.12 mmHg and the mean gradient was 12.3$\pm$6.52 mmHg. Conclusion: Since there was no significant difference in the postoperative mortality, valve related complications and echocardiographic hemodynamic data compared to standard bileaflet design and since there was an improvement in the NYHA functional class and normal values of hemolytic indicators, it can be assumed that On-X valve is safe and feasible. However, accumulation of cases and long-term follow-up of this patient group is needed to establish this result.

Long-term Monitoring Study of Soil Chemical Contents and Quality in Paddy Fields (논토양의 화학성과 질의 장기 변동)

  • Kim, M.S.;Kim, W.I.;Lee, J.S.;Lee, G.J.;Jo, G.L.;Ahn, M.S.;Choi, S.C.;Kim, H.J.;Kim, Y.S.;Choi, M.T.;Moon, Y.H.;Ahn, B.K.;Kim, H.W.;Seo, Y.J.;Lee, Y.H.;Hwang, J.J.;Kim, Y.H.;Ha, S.K.
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.6
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    • pp.930-936
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    • 2010
  • There is very important to investigate long-term trend of soil chemical properties and quality index for sustainable agriculture and production of agricultural safety products. Monitoring on soil chemical properties in paddy soils was conducted as one cycle with 4 years from 1999 to 2007. Paddy soil samples were taken from 4,007, 1,970, 2,070 sites in 1999, 2003 and 2007, respectively. With these data, soil quality index (SQI) was evaluated by method that Yoon et al suggested in 2004. Chemical properties of paddy soils were 5.8 for pH, 24 g $kg^{-1}$ for organic matter, 132 mg $kg^{-1}$ for available phosphate, 0.29 cmol_c\; kg-1 for exchangeable potassium, 4.7 $cmol_c\;kg^{-1}$ for exchangeable calcium, 1.3 $cmol_c\;kg^{-1}$ for exchangeable magnesium and 126 mg $kg^{-1}$ for available silicate in 2007. Long-term change was shown that pH has increased gradually whereas exchangeable potassium has decreased. However, reasonably large changes were found. Exchangeable calcium and available silicate level in 1999 was 4.0 $cmol_c\;kg^{-1}$, 86 mg $kg^{-1}$, but had risen to 4.7 $cmol_c\;kg^{-1}$, 126 mg $kg^{-1}$ in 2007, respectively. The change of paddy soils quality index was increased gradually and increasement of silicate quality index was higher than other quality indicators.

A Contemplation on Measures to Advance Logistics Centers (물류센터 선진화를 위한 발전 방안에 대한 소고)

  • Sun, Il-Suck;Lee, Won-Dong
    • Journal of Distribution Science
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    • v.9 no.1
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    • pp.17-27
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    • 2011
  • As the world becomes more globalized, business competition becomes fiercer, while consumers' needs for less expensive quality products are on the increase. Business operations make an effort to secure a competitive edge in costs and services, and the logistics industry, that is, the industry operating the storing and transporting of goods, once thought to be an expense, begins to be considered as the third cash cow, a source of new income. Logistics centers are central to storage, loading and unloading of deliveries, packaging operations, and dispensing goods' information. As hubs for various deliveries, they also serve as a core infrastructure to smoothly coordinate manufacturing and selling, using varied information and operation systems. Logistics centers are increasingly on the rise as centers of business supply activities, growing beyond their previous role of primarily storing goods. They are no longer just facilities; they have become logistics strongholds that encompass various features from demand forecast to the regulation of supply, manufacturing, and sales by realizing SCM, taking into account marketability and the operation of service and products. However, despite these changes in logistics operations, some centers have been unable to shed their past roles as warehouses. For the continuous development of logistics centers, various measures would be needed, including a revision of current supporting policies, formulating effective management plans, and establishing systematic standards for founding, managing, and controlling logistics centers. To this end, the research explored previous studies on the use and effectiveness of logistics centers. From a theoretical perspective, an evaluation of the overall introduction, purposes, and transitions in the use of logistics centers found issues to ponder and suggested measures to promote and further advance logistics centers. First, a fact-finding survey to establish demand forecast and standardization is needed. As logistics newspapers predicted that after 2012 supply would exceed demand, causing rents to fall, the business environment for logistics centers has faltered. However, since there is a shortage of fact-finding surveys regarding actual demand for domestic logistic centers, it is hard to predict what the future holds for this industry. Accordingly, the first priority should be to get to the essence of the current market situation by conducting accurate domestic and international fact-finding surveys. Based on those, management and evaluation indicators should be developed to build the foundation for the consistent advancement of logistics centers. Second, many policies for logistics centers should be revised or developed. Above all, a guideline for fair trade between a shipper and a commercial logistics center should be enacted. Since there are no standards for fair trade between them, rampant unfair trades according to market practices have brought chaos to market orders, and now the logistics industry is confronting its own difficulties. Therefore, unfair trade cases that currently plague logistics centers should be gathered by the industry and fair trade guidelines should be established and implemented. In addition, restrictive employment regulations for foreign workers should be eased, and logistics centers should be charged industry rates for the use of electricity. Third, various measures should be taken to improve the management environment. First, we need to find out how to activate value-added logistics. Because the traditional purpose of logistics centers was storage and loading/unloading of goods, their profitability had a limit, and the need arose to find a new angle to create a value added service. Logistic centers have been perceived as support for a company's storage, manufacturing, and sales needs, not as creators of profits. The center's role in the company's economics has been lowering costs. However, as the logistics' management environment spiraled, along with its storage purpose, developing a new feature of profit creation should be a desirable goal, and to achieve that, value added logistics should be promoted. Logistics centers can also be improved through cost estimation. In the meantime, they have achieved some strides in facility development but have still fallen behind in others, particularly in management functioning. Lax management has been rampant because the industry has not developed a concept of cost estimation. The centers have since made an effort toward unification, standardization, and informatization while realizing cost reductions by establishing systems for effective management, but it has been hard to produce profits. Thus, there is an urgent need to estimate costs by determining a basic cost range for each division of work at logistics centers. This undertaking can be the first step to improving the ineffective aspects of how they operate. Ongoing research and constant efforts have been made to improve the level of effectiveness in the manufacturing industry, but studies on resource management in logistics centers are hardly enough. Thus, a plan to calculate the optimal level of resources necessary to operate a logistics center should be developed and implemented in management behavior, for example, by standardizing the hours of operation. If logistics centers, shippers, related trade groups, academic figures, and other experts could launch a committee to work with the government and maintain an ongoing relationship, the constraint and cooperation among members would help lead to coherent development plans for logistics centers. If the government continues its efforts to provide financial support, nurture professional workers, and maintain safety management, we can anticipate the continuous advancement of logistics centers.

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