• Journal of Chest Surgery
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• v.36 no.10
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• pp.741-747
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• 2003

Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

• Proceedings of the Korea Water Resources Association Conference
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• 2006.05a
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• pp.1385-1390
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• 2006

외국에서 ASM 모델의 BNR 적용 연구결과를 국내 하수에 적용하기에는 하수농도, 온도, 슬러지농도 등이 국내와는 달라 적용상 무리가 있다. 본 연구에서 BNR 시뮬레이션을 위한 입력 자료로 활용되는 인자들은 IAWPRC task group에서 제안하는 값들을 사용하되 국내 하수성상에서 필요로 하는 인자들은 직접 실험을 통하여 부분적으로 구해냄으로써 모델 시뮬레이션의 신뢰도를 높이고자 하였다. F/M비의 변화량과 1/SRT과의 관계로부터, 종속영양미생물 생산계수 $Y_H$값을 구한결과, 0.40mg VSS/mg COD였다. 이것을 ASM No.2d에 적용하기 위하여 mg cell COD formed/mg COD oxidized 단위로 환산한 결과 0.58을 나타냈다. H 하수처리장의 1차 침전지 하수를 이용하여 호기성상태에서 OUR Test를 통한 미생물에 의한 유기물 섭취시 산소섭취율 변화를 측정하였다. 호기성상태와 무산소상태에서 구한 쉽게 분해되는 용존성유기물(Ss)값을 비교해보면 각각 35.5mg/L와 39.9mg/L로 약간의 차이는 있으나 유사한 값을 보여주고 있다. 시뮬레이션을 위한 동력학적 계수 중 무산소 상태에서 종속영양미생물의 ${\mu}_{max,H}$는 $3.56d^{-1}$로 나타났고, 호기성상태에서는 구하면 ${\mu}_{max,H}$는 $4.2d^{-1}$로 산출되었다. 종속영양미생물의 사멸계수 $b_H$를 구하기 위한 실험에서 초기 OUR의 10%이내가 될 때까지 걸린 시간은 7일정도가 걸렸으며, 사멸률 $b_H$는 $0.043hr^{-1}$로 나타났다. 독립영양미생물의 최대비성장률 ${\mu}_{max,A}$는 최대암모니아 섭취률을 이용하여 구한 결과 $0.65d^{-1}$로 나타났다.EX>$60%{\sim}87%$가 수심 10m 이내에 분포하였고, 녹조강과 남조강이 우점하는 하절기에는 5m 이내에 주로 분포하였다. 취수탑 지점의 수심이 연중 $25{\sim}35m$를 유지하는 H호의 경우 간헐식 폭기장치를 가동하는 기간은 물론 그 외 기간에도 취수구의 심도를 표층 10m 이하로 유지 할 경우 전체 조류 유입량을 60% 이상 저감할 수 있을 것으로 조사되었다.심볼 및 색채 디자인 등의 작업이 수반되어야 하며, 이들을 고려한 인터넷용 GIS기본도를 신규 제작한다. 상습침수지구와 관련된 각종 GIS데이타와 각 기관이 보유하고 있는 공공정보 가운데 공간정보와 연계되어야 하는 자료를 인터넷 GIS를 이용하여 효율적으로 관리하기 위해서는 단계별 구축전략이 필요하다. 따라서 본 논문에서는 인터넷 GIS를 이용하여 상습침수구역관련 정보를 검색, 처리 및 분석할 수 있는 상습침수 구역 종합정보화 시스템을 구축토록 하였다.N, 항목에서 보 상류가 높게 나타났으나, 철거되지 않은 검전보나 안양대교보에 비해 그 차이가 크지 않은 것으로 나타났다.의 기상변화가 자발성 기흉 발생에 영향을 미친다고 추론할 수 있었다. 향후 본 연구에서 추론된 기상변화와 기흉 발생과의 인과관계를 확인하고 좀 더 구체화하기 위한 연구가 필요할 것이다.게 이루어질 수 있을 것으로 기대된다.는 초과수익률이 상승하지만, 이후로는 감소하므로, 반전거래전략을 활용하는 경우 주식투자기간은 24개월이하의 중단기가 적합함을 발견하였다. 이상의 행태적 측면과 투자성과측면의 실증결과를 통하여 한국주식시장에 있어서 시장수익률을 평균적으로 초과할 수 있는 거래전략은 존재하므로 이러한 전략을 개발 및 활용할 수 있으며, 특히, 한국주식시장에 적합한 거래전략은 반전거래전략이고, 이 전략의 유용성은 투자자가 설정한 투자기간보다 더욱 긴 분석기간의 주식가격정보에 의하여 최대한 발휘될 수 있음을 확인하였다.(M1), 무역적자의 폭, 산업의 생산

• Journal of Chest Surgery
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• v.40 no.12
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• pp.825-830
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• 2007

Background: Minimally invasive cardiac surgery appears to offer certain advantages such as earlier postoperative recovery and a greater cosmetic effect than that achieved through conventional sternotomy. However, this approach has not yet been widely adopted in Korea to replace complex open heart surgery such as mitral valve reconstruction. This study compared the results of robot assisted minimally invasive mitral valve repair with those results of conventional sternotomy. Material and Method: From December 1993 to December 2005, 520 consecutive patients underwent mitral valve reconstruction for mitral regurgitation in our institution. These patients were subdivided according to those whose surgery used the conventional sternotomy approach (Group S, n=432) and those who underwent minimally invasive right anterior thoracotomy (Group M, n=88); we then compared the clinical results of both groups. When we performed minimally invasive right thoracotomy, we used a robot (AESOP 3000) and made an incision less than 5 cm. Result: Our study patients in both groups were similar for their age, gender and preoperative ejection fraction. There were two hospital mortalities in group S. but there was no mortality in the group M patients. Significant reductions in the ICU stay and the postoperative hospital stay were observed in the group M patients compared with the group S patients. However, both the bypass time and the aortic cross-clamp time were significantly longer in the group M patients. In spite of the confined incision in the group M patients, there were no limitations on the mitral valve repair techniques. There was a similar frequency of postoperative significant residual mitral regurgitation in both groups. Conclusion: In this study, the minimally invasive mitral valve repair showed comparable early results with the conventional sternotomy patients. We will now need long-term follow-up of these patients who underwent minimally invasive mitral valve repair, but we anticipate that based on the results of this study, we will begin to routinely perform minimally invasive cardiac surgery as out primary approach for mitral valve reconstruction.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.181-190
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• 2005

The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

• The KIPS Transactions:PartD
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• v.14D no.1 s.111
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• pp.121-130
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• 2007

in a software development, the design or architecture prior to implementing the software is essential for the success. This paper presents a case that we successfully designed a software architecture of radiation monitoring system (RMS) for HANARO research reactor currently operating in KAERI by applying the quality attribute-driven design method which is modified from the attribute-driven design (ADD) introduced by Bass[1]. The quality attribute-driven design method consists of following procedures: eliciting functionality and quality requirements of system as architecture drivers, selecting tactics to satisfy the drivers, determining architectures based on the tactics, and implementing and validating the architectures. The availability, maintainability, and interchangeability were elicited as duality requirements, hot-standby dual servers and weak-coupled modulization were selected as tactics, and client-server structure and object-oriented data processing structure were determined at architectures for the RMS. The architecture was implemented using Adroit which is a commercial off-the-shelf software tool and was validated based on performing the function-oriented testing. We found that the design method in this paper is an efficient method for a project which has constraints such as low budget and short period of development time. The architecture will be reused for the development of other RMS in KAERI. Further works are necessary to quantitatively evaluate the architecture.

• Korea and Global Affairs
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• v.1 no.1
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• pp.71-96
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• 2017

This study speculates on responses to the nuclear threats of North Korea and mutual assistance and cooperation between South Korea, the U.S. and China for the unification of the Korean Peninsula. As for the North Koreas nuclear issue and unification of the Korean Peninsula, South Korea is the subject of national division, the U.S. is a responsible country in international issues and does not have diplomatic ties with North Korea. China is a traditional socialist nation and a supporter of North Korea. As North Korea's strategic weapons including nuclear weapons and ballistic missiles are international issues, to defend against Kim Jung-Eun's unexpected acts, the three countries should actively cooperate with each other and develop countermeasures. However, with respect to the road map of the North Koreas issue, there are subtle differences between the U.S. and China in recognition of and sanctions against North Korea as a resolution of the U..N. Security Council. The U.S. has continued a deterrence policy and sanctions against North Korea based on joint threats between South Korea and the U.S. while China has showed a negative position in the process of solving the North Korean nuclear issue because of the unstable security derived from the U.S. 's intervention in the Korean peninsula. North Korea should change its diplomatic policy in a more concrete way towards world peace although it has continued trade of strategic weapons with Middle Eastern countries to maintain its political system. For example, to restart the summit talks and open multilateral security channels. Although the issue of unification of the Korean peninsula should be resolved by South and North Korea themselves, it is strange that South and North Korea depend on the logic of powerful countries for the resolution of a national problem. As for North Koreas nuclear and the Unification issues, peaceful solutions presented by South Korea seem more persuasive than the solution presented by North Korea which did not secure any international support. However, South Korea, the U.S. and China need to develop uni-directional two-tract strategies for sanctions against North Korea and talks with North Korea for peace on the Korean peninsula, and should continue to support the economic independence of North Korea.

• Journal of Korean Society of Forest Science
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• v.103 no.2
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• pp.159-164
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• 2014

The objective of this study was to establish an open-field experimental warming treatment and precipitation manipulation system to simulate climate change impact for Pinus densiflora seedlings based on a climate change scenario in Korea. Two-year-old seedlings were planted in a nursery in April, 2013. The air temperature of warmed plots (W) was set to increase by $3.0^{\circ}C$ compared to control plots (C) using infrared lamps from May, 2013. The three precipitation manipulation consisted of precipitation decrease using transparent panel (-30%; $P^-$), precipitation increase using pump and drip-irrigation (+30%; $P^+$) and precipitation control (0%; $P^0$). Initially, the air temperature was $2.2^{\circ}C$ higher in warmed plots than in control plots and later air temperature was maintained close to the target temperature of $3.0^{\circ}C$. The average soil temperature was $3.1^{\circ}C$ higher in warmed plots than in control plots. Also the average soil moisture content after the precipitation manipulation increased by 13.9% in $P^+W$ and decreased by 10.0% in $P^-W$ compared to $P^0W$, and increased by 23.7% in $P^+C$ and decreased by 7.6% in $P^-C$ compared to $P^0C$. It was confirmed that the open-field experimental warming and precipitation manipulation system was properly designed and operating.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.225-232
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• 1994

Purpose : This study was to obtain the basic dosimetric data using the 10 MV X-ray for the total body irradiation. Materials and Methods : A linear accelerator photon beam is planned to be used as a radiation source for total body irradiation (TBI) in Chonnam University Hospital. The planned distance from the target to the midplane of a patient is 360cm and the maximum geometric field size is 144cm x 144cm. Polystyrene phantom sized $30{\times}30{\times}30.2cm^3$ and consisted of several sheets with various thickness, and a parallel plate ionization chamber were used to measure surface dose and percent depth dose (PDD) at 345cm SSD, and dose profiles. To evaluate whether a beam modifier is necessary for TBI, dosimetry in build up region was made first with no modifier and next with an 1cm thick acryl plate 20cm far from the polystyrene phantom surface. For a fixed sourec-chamber distance, output factors were measured for various depth. Results : As any beam modifier was not on the way of radiation of 10MV X-ray, the $d_{max}$ and surface dose was 1.8cm and $61\%$, respectively, for 345cm SSD. When an 1cm thick acryl plate was put 20cm far from polystyrene phantom for the SSD, the $d_{max}$ and surface dose were 0.8cm and $94\%$, respectively. With acryl as a beam spoiler, the PDD at 10cm depth was $78.4\%$ and exit dose was a little higher than expected dose at interface of exit surface. For two-opposing fields for a 30cm phantom thick phantom, the surface dose and maximum dose relative to mid-depth dose in our experiments were $102.5\%$ and $106.3\%$, respectively. The off-axis distance of that point of $95\%$ of beam axis dose were 70cm on principal axis and 80cm on diagonal axis. Conclusion: 1. To increase surface dose for TBI by 10MV X-ray at 360cm SAD, 1cm thick acrylic spoiler was sufficient when distance from phantom surface to spoiler was 20cm. 2. At 345cm SSD, 10MV X-ray beam of full field produced a satisfiable dose uniformity for TBI within $7\%$ in the phantom of 30cm thickness by two-opposing irradiation technique. 3. The uniform dose distribution region was 67cm on principal axis of the beam and 80cm on diagonal axis from beam axis. 4. The output factors at mid-point of various thickness revealed linear relation with depth, and it could be applicable to practical TBI.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.347-353
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• 2006

Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.966-972
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• 1997

Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.