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Clinical Experiences of Cardiac Surgery Using Minimal Incision (소절개선을 이용한 심장수술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.373-378
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    • 1999
  • Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

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Outcomes of Chronic Peritoneal Dialysis by Various Modalities in Korean Children - A Single Center Study (소아 환자에서 다양한 복막투석 방법간의 결과 비교-단일기관 연구)

  • Lee, Sung-Ha;Baek, Jae-Suk;Lee, Hyun-Kyung;Han, Kyoung-Hee;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.255-263
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    • 2007
  • Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

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Construction of a Genetic Linkage Map in Radish(Raphanus sativus L.) Using RAPD Markers (RAPD 마커를 이용한 무의 유전자지도 작성)

  • Ahn, Choon-Hee;Choi, Su-Ryun;Lim, Yong-Pyo;Chung, Hae-Joon;Yae, Byeong-Woo;Yoon, Wha-Mo
    • Journal of Plant Biotechnology
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    • v.29 no.3
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    • pp.151-159
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    • 2002
  • Genetic map and molecular marker have a great importance in improving and facilitating crop breeding program as well as in genome analysis and map-based cloning of genes representing desirable characters. This study aimed at developing RAPD markers and constructing a genetic linkage map using 82 BC$_1$F$_1$individuals originated from the cross between '835' and B$_2$in radish (Raphanus sativus L.). One of the parents for genetic linkage map construction, '835'(P$_1$) of egg type is susceptible to Fusarium wilt and have medium resistance to virus infection and the other parent, B$_2$(P$_2$) of round type, is susceptible to Fusarium wilt and virus, Screening of 394 RAPD primers in BC$_1$F$_1$) population resulted in selecting 128 polymorphic markers which displayed 1:1 segregation pattern. Two markers failed to display 1:1 segregation and showed the segregation ratio skewed to maternal genotype. Selected markers were categorized into 14 linkage group based on LOD score represented by MAPMAKER/EXP program. Five groups composed of single marker among them were excluded from the linkage map, and consequently, the remaining groups are well matched with the number of radish chromosome (n=9). The linkage map constructed with 128 markers covers 1,688.3 cM and the average distance between markers was 13.8 cM. For developing STS marker, we determined the partial nucleotide sequence of OPE10 marker at both ends and designed a oligonucleotide primer pair based on this sequence. STS PCR using the primer pair displayed a single, clear band of which segregation is perfectly matched with that of OPE10 marker. This implies that RAPD markers could readily convert into clear and reliable STS markers.

학교교육과정의 인구교육내용분석

  • 박덕규
    • Korea journal of population studies
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    • v.11 no.1
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    • pp.50-57
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    • 1988
  • This study focused on the anding of Inchon's identity The empirical method and ethnomethodological approaches were used to collect the data. Among members ofcitizen movement groups,government workers,and students who are living inInchon were selected as 613 samples using a purposive sampling method. MultipleClassification Analysis (MCA) and cross-tabulation methods were used in theanalysisThe study of identity in an area is important in terms of providing the solution ofthe problem in a region and social integration of the citizens. The scores of the indexabout Inchon's identity are quite low and more than half of the respondents to allthree groups showed the middle position of the scores from the identity index. By thecharacteristics of the respondents,female,unmarried single,30 years or more,lowerincome groups showed relatively higher identity index scores than other counter-parts . And professional,administrative,clerical workers'identity index scores werehigher than people who work at sales,service,and agricultural sectors. Respondentswith 2 years of college or more,with intentions to donate special monies for cultural, social welfare, environmental reform,persons who want to live in Inchon for along period of time equipped with a stronger identity index.For the character of Inchon's identity,there are no identity,making it fromnow on,capacity or broad-minded city,vanguard pioneer,displeased, Oiversity/multiplicity of the city,defense spirit from foreign invasion,entrancecity from the world in that order. Therefore,it is hard to say what exactly Inchon'simage is in a single word. However,Inchon can be characterized as a diverse citywith capacity to live together without any serious conflicts among citizens who come from Seoul,Kyunggi-Do,Chungchung-Do,Chunla-Do,Kyungsang-Do,and foreign countries including North Korea. These facts imply that Inchon should continue topursue this image as a diverse city with capacity as an identity pursuing towardsworld city and hub city of North East Asia.ty as an identity pursuing towardsworld city and hub city of North East Asia. East Asia.

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UX Methodology Study by Data Analysis Focusing on deriving persona through customer segment classification (데이터 분석을 통한 UX 방법론 연구 고객 세그먼트 분류를 통한 페르소나 도출을 중심으로)

  • Lee, Seul-Yi;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.151-176
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    • 2021
  • As the information technology industry develops, various kinds of data are being created, and it is now essential to process them and use them in the industry. Analyzing and utilizing various digital data collected online and offline is a necessary process to provide an appropriate experience for customers in the industry. In order to create new businesses, products, and services, it is essential to use customer data collected in various ways to deeply understand potential customers' needs and analyze behavior patterns to capture hidden signals of desire. However, it is true that research using data analysis and UX methodology, which should be conducted in parallel for effective service development, is being conducted separately and that there is a lack of examples of use in the industry. In thiswork, we construct a single process by applying data analysis methods and UX methodologies. This study is important in that it is highly likely to be used because it applies methodologies that are actively used in practice. We conducted a survey on the topic to identify and cluster the associations between factors to establish customer classification and target customers. The research methods are as follows. First, we first conduct a factor, regression analysis to determine the association between factors in the happiness data survey. Groups are grouped according to the survey results and identify the relationship between 34 questions of psychological stability, family life, relational satisfaction, health, economic satisfaction, work satisfaction, daily life satisfaction, and residential environment satisfaction. Second, we classify clusters based on factors affecting happiness and extract the optimal number of clusters. Based on the results, we cross-analyzed the characteristics of each cluster. Third, forservice definition, analysis was conducted by correlating with keywords related to happiness. We leverage keyword analysis of the thumb trend to derive ideas based on the interest and associations of the keyword. We also collected approximately 11,000 news articles based on the top three keywords that are highly related to happiness, then derived issues between keywords through text mining analysis in SAS, and utilized them in defining services after ideas were conceived. Fourth, based on the characteristics identified through data analysis, we selected segmentation and targetingappropriate for service discovery. To this end, the characteristics of the factors were grouped and selected into four groups, and the profile was drawn up and the main target customers were selected. Fifth, based on the characteristics of the main target customers, interviewers were selected and the In-depthinterviews were conducted to discover the causes of happiness, causes of unhappiness, and needs for services. Sixth, we derive customer behavior patterns based on segment results and detailed interviews, and specify the objectives associated with the characteristics. Seventh, a typical persona using qualitative surveys and a persona using data were produced to analyze each characteristic and pros and cons by comparing the two personas. Existing market segmentation classifies customers based on purchasing factors, and UX methodology measures users' behavior variables to establish criteria and redefine users' classification. Utilizing these segment classification methods, applying the process of producinguser classification and persona in UX methodology will be able to utilize them as more accurate customer classification schemes. The significance of this study is summarized in two ways: First, the idea of using data to create a variety of services was linked to the UX methodology used to plan IT services by applying it in the hot topic era. Second, we further enhance user classification by applying segment analysis methods that are not currently used well in UX methodologies. To provide a consistent experience in creating a single service, from large to small, it is necessary to define customers with common goals. To this end, it is necessary to derive persona and persuade various stakeholders. Under these circumstances, designing a consistent experience from beginning to end, through fast and concrete user descriptions, would be a very effective way to produce a successful service.

Identification of Domesticated Silkworm Varieties Using a Whole Genome Single Nucleotide Polymorphisms-based Decision Tree (전장유전체 SNP 기반 decision tree를 이용한 누에 품종 판별)

  • Park, Jong Woo;Park, Jeong Sun;Jeong, Chan Young;Kwon, Hyeok Gyu;Kang, Sang Kuk;Kim, Seong-Wan;Kim, Nam-Suk;Kim, Kee Young;Kim, Iksoo
    • Journal of Life Science
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    • v.32 no.12
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    • pp.947-955
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    • 2022
  • Silkworms, which have recently shown promise as functional health foods, show functional differences between varieties; therefore, the need for variety identification is emerging. In this study, we analyzed the whole silkworm genome to identify 10 unique silkworm varieties (Baekhwang, Baekok, Daebaek, Daebak, Daehwang, Goldensilk, Hansaeng, Joohwang, Kumkang, and Kumok) using single nucleotide polymorphisms (SNP) present in the genome as biomarkers. In addition, nine SNPs were selected to discriminate between varieties by selecting SNPs specific to each variety. We subsequently created a decision tree capable of cross-verifying each variety and classifying the varieties through sequential analysis. Restriction fragment length polymorphism (RFLP) was used for SNP867 and SNP9183 to differentiate between the varieties of Daehwang and Goldensilk and between Kumkang and Daebak, respectively. A tetra-primer amplification refractory (T-ARMS) mutation was used to analyze the remaining SNPs. As a result, we could isolate the same group or select an individual variety using the nine unique SNPs from SNP780 to SNP9183. Furthermore, nucleotide sequence analysis for the region confirmed that the alleles were identical. In conclusion, our results show that combining SNP analysis of the whole silkworm genome with the decision tree is of high value as a discriminative marker for classifying silkworm varieties.

Biomass and distribution of Antarctic Krill, Euphausia superba, in the Northern part of the South Shetland Islands, Antarctic Ocean (남극 남쉐틀란드 군도 북부 해역의 크릴 분포 및 자원량)

  • KANG Donhyug;HWANG Doojin;KIM Suam
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.6
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    • pp.737-747
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    • 1999
  • To estimate biomass and distribution of the Antarctic krill (Euphausia superba), hydroacoustic survey was conducted on board of R/V Yuzhmorgeologiya, which was chartered by Korea Antarctic Research Program (KARP) group from 18 to 21 December 1998, in the northern part of the South Shetland Islands, Antarctic Ocean, The scientific echo sounder (towing body type) used was EK- 500 (SIMRAD, Norway) with echo integrator (BI-500) at 38 kHz frequency and recorded mean backscattering cross-section coefficient (SA) per 1 $mile^2$ of sea surface. Also, Bongo net sampling was carried out to determine the size of krill and CTD (Conductivity, Temperature and Depth) casting to understand physical structure. Water column was divided into 5 layers (22$\~$65 m, 65$\~$115 m, l15$\~$65 m, 165$\~$215 m and 215$\~$315 m) to know vertical distribution of krill biomass. The standard length of krill collected was between 30 mm and 51 mm, and adult krill had single mode (41 mm). Maximum horizontal length of krill patch was about 35 nautical mile and vertical thickness was about 275 m. High density of krill was appeared in frontal area between Circumpolar Deep Water (>$1^{\circ}C$) and very low temperature water mass (< $-0.5^{\circ}C$) that originate from Weddell Sea. According to the results calculated using target strength equation, krill density was totally higher in continental slope and open water areas than in coastal area. In the study area, krill seems to distribute in depth; density was low at first layer ($\={\rho}=17.0\;g/m^2$) and higher at fourth layer ($\={\rho}=40.19\;g/m^2$). The estimated krill biomass at total survey area and water column was about 2.77 million metric ion ($\={\rho}=151.0\;g/m^2$) and coefficient of valiance ( CV, $\%$) was 19.92. The proportions and biomass of krill biomass at each layer were as follows; layer 1 ($11.3\%$, 0.31 million metric ton, CV=16.24), layer 2 ($13.3\%$, 0.37 million metric ton, CV=34.91), layer 3 ($23.7\%$, 0.66 million metric ton, CV=41.5), layer 4 ($26.6\%$, 0.74 million metric ton, CV=27.84) and layer 5 ($25\%$, 0.69 million metric ton, CV= 26.83).

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The Clinical Application and Results of Palliative Damus-Kaye-Stansel Procedure (고식적 Damus-Kaye-Stansel 술식의 임상적 적용 및 결과)

  • Lim, Hong-Gook;Kim, Soo-Jin;Kim, Woong-Han;Hwang, Seong-Wook;Lee, Cheul;Shinn, Sung-Ho;Yie, Kil-Soo;Lee, Jae-Woong;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.1-11
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    • 2008
  • Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

Investigating Dynamic Mutation Process of Issues Using Unstructured Text Analysis (부도예측을 위한 KNN 앙상블 모형의 동시 최적화)

  • Min, Sung-Hwan
    • Journal of Intelligence and Information Systems
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    • v.22 no.1
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    • pp.139-157
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    • 2016
  • Bankruptcy involves considerable costs, so it can have significant effects on a country's economy. Thus, bankruptcy prediction is an important issue. Over the past several decades, many researchers have addressed topics associated with bankruptcy prediction. Early research on bankruptcy prediction employed conventional statistical methods such as univariate analysis, discriminant analysis, multiple regression, and logistic regression. Later on, many studies began utilizing artificial intelligence techniques such as inductive learning, neural networks, and case-based reasoning. Currently, ensemble models are being utilized to enhance the accuracy of bankruptcy prediction. Ensemble classification involves combining multiple classifiers to obtain more accurate predictions than those obtained using individual models. Ensemble learning techniques are known to be very useful for improving the generalization ability of the classifier. Base classifiers in the ensemble must be as accurate and diverse as possible in order to enhance the generalization ability of an ensemble model. Commonly used methods for constructing ensemble classifiers include bagging, boosting, and random subspace. The random subspace method selects a random feature subset for each classifier from the original feature space to diversify the base classifiers of an ensemble. Each ensemble member is trained by a randomly chosen feature subspace from the original feature set, and predictions from each ensemble member are combined by an aggregation method. The k-nearest neighbors (KNN) classifier is robust with respect to variations in the dataset but is very sensitive to changes in the feature space. For this reason, KNN is a good classifier for the random subspace method. The KNN random subspace ensemble model has been shown to be very effective for improving an individual KNN model. The k parameter of KNN base classifiers and selected feature subsets for base classifiers play an important role in determining the performance of the KNN ensemble model. However, few studies have focused on optimizing the k parameter and feature subsets of base classifiers in the ensemble. This study proposed a new ensemble method that improves upon the performance KNN ensemble model by optimizing both k parameters and feature subsets of base classifiers. A genetic algorithm was used to optimize the KNN ensemble model and improve the prediction accuracy of the ensemble model. The proposed model was applied to a bankruptcy prediction problem by using a real dataset from Korean companies. The research data included 1800 externally non-audited firms that filed for bankruptcy (900 cases) or non-bankruptcy (900 cases). Initially, the dataset consisted of 134 financial ratios. Prior to the experiments, 75 financial ratios were selected based on an independent sample t-test of each financial ratio as an input variable and bankruptcy or non-bankruptcy as an output variable. Of these, 24 financial ratios were selected by using a logistic regression backward feature selection method. The complete dataset was separated into two parts: training and validation. The training dataset was further divided into two portions: one for the training model and the other to avoid overfitting. The prediction accuracy against this dataset was used to determine the fitness value in order to avoid overfitting. The validation dataset was used to evaluate the effectiveness of the final model. A 10-fold cross-validation was implemented to compare the performances of the proposed model and other models. To evaluate the effectiveness of the proposed model, the classification accuracy of the proposed model was compared with that of other models. The Q-statistic values and average classification accuracies of base classifiers were investigated. The experimental results showed that the proposed model outperformed other models, such as the single model and random subspace ensemble model.

SCANNING ELECTRON MICROSCOPIC STUDY ON THE EFFICACY OF ROOT CANAL WALL DEBRIDEMENT OF ROTARY NI-TI INSTRUMENTS WITH DIFFERENT CUTTING ANGLE (엔진 구동형 니켈-타이타늄 합금파일의 절삭각에 따른 근관성형 효과에 관한 전자현미경적 연구)

  • Jeon, In-Soo;Yoon, Tai-Cheol;Park, Seong-Ho;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.27 no.6
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    • pp.577-586
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    • 2002
  • The purpose of this in vitro study was to compare the effects of root canal cleanness following two Ni-Ti rotary instruments with different rake angle. Thirty-six sound, extracted human premolars with single root were randomly divided into three groups. The used rotary instruments were HEROShaper (Group 1, Micro-Mega, Besancon, France, n=12) and ProFile (Group 2, Maillefer, Ballaigues, Switzerland, n=12). Control group (n=12) was only extirpated with barbed broach (Mani, Matsutani Seisakusho Co., Japan) Group 1 & 2 teeth were prepared to a #40/.04 taper at the apex followed by 1 mm using crown-down technique. After canal preparation and frequent irrigation with 5.25% sodium hypochlorite, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. All root specimens were processed for SEM investigation and photographed. Separate evaluations by one endodontist were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. The penetration depth of smear layer into dentinal tubules was also estimated in the other halves. Following results were obtained: 1. Smear layer was observed on all the prepared walls with two experimental groups except control group. 2. Smear layer characteristics in two experimental groups; 1) HEROShaper group showed snowy, dusty appearance and were shown open dentinal tubuli on the prepared walls of almost specimens, and the thickness of smear layer covering onto dentinal surfaces was within 1-2 ${\mu}m$ in a few specimens. 2) ProFile group showed shiny, burnished appearance and complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli in all specimens. The penetration of smear layer into dentinal tubules was found in all specimens and the thickness was at 2-4 ${\mu}m$ in all specimens. These results demonstrated that a completely clean root canal could not be achieved regardless of positive or negative rake angle, which is in accordance with the majority of previous studies on root canal cleanliness In conclusion, through irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal wall in spite of Ni-Ti instrumentation.