• Title/Summary/Keyword: 감소의 순환

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Characteristics of Sea Exchange in Gwangyang Bay and Jinju Bay considering Freshwater from Rivers (하천유출수를 고려한 광양만과 진주만의 해수교환 특성)

  • Hong, Doung;Kim, Jongkyu;Kwak, Inn-Sil
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.2
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    • pp.201-211
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    • 2022
  • At the center of the Noryang waterway, the Gwangyang bay area (including the Yeosu Strait) is located at the west, and the Jinju bay area (including Gangjin bay and Sacheon bay) is located at the east. Freshwater from several rivers is flowing into the study area. In particula,r the event of flood, great quantities freshwater flow from Seomjingang (Seomjin river) into the Gwangyang bay area and from Gahwacheon (discharge from Namgang Dam) into the Jinju bay. The Gwangyang and Jinju bay are connected to the Noryang waterway. In addition, freshwater from Seomjingang and Gahwacheon also affect through the Noryang waterway. In this study, we elucidated the characteristics of the tidal exchange rate and residence time for dry season and flood season on 50 frequency, considering freshwater from 51 rivers, including Seomjingang and Gahwacheon, using a particle tracking method. We conducted additional experiments to determine the effect of freshwater from Seomjingang and Gahwacheon during flooding. In both the dry season and flood season, the result showed that the particles released from the Gwangyang bay moved to the Jinju bay through the Noryang waterway. However, comparatively small amount of particles moved from the Jinju bay to the Gwangyang bay. Each experimental case, the sea exchange rate was 44.40~67.21% in the Gwangyang bay and 50.37~73.10% in the Jinju bay, and the average residence time was 7.07~15.36days in the Gwangyang bay and 6.45~12.75days in the Jinju bay. Consequently the sea exchange rate increased and the residence time decreased during flooding. A calculation of cross-section water flux over 30 days for 7 internal and 5 external areas, indicated that the main essential flow direction of the water flux was the river outflow water from Seomjingang flow through the Yeosu strait to the outer sea and from Gahwacheon flow through Sacheon bay, Jinju bay and the Daebang waterway to the outer sea.

Predicting the Effects of Agriculture Non-point Sources Best Management Practices (BMPs) on the Stream Water Quality using HSPF (HSPF를 이용한 농업비점오염원 최적관리방안에 따른 수질개선효과 예측)

  • Kyoung-Seok Lee;Dong Hoon Lee;Youngmi Ahn;Joo-Hyon Kang
    • Journal of Wetlands Research
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    • v.25 no.2
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    • pp.99-110
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    • 2023
  • Non-point source (NP) pollutants in an agricultural landuse are discharged from a large area compared to those in other land uses, and thus effective source control measures are needed. To develop appropriate control measures, it is necessary to quantify discharge load of each source and evaluate the degree of water quality improvement by implementing different options of the control measures. This study used Hydrological Simulation Program-FORTRAN (HSPF) to quantify pollutant discharge loads from different sources and effects of different control measures on water quality improvements, thereby supporting decision making in developing appropirate pollutant control strategies. The study area is the Gyeseong river watershed in Changnyeong county, Gyeongsangnam-do, with agricultural areas occupying the largest proportion (26.13%) of the total area except for the forest area. The main pollutant sources include chemical and liquid fertilizers for agricultural activities, and manure produced from small scale livestock facilities and applied to agriculture lands or stacked near the facilities. Source loads of chemical fertilizers, liquid fertilizers and livestock manure of small scale livestock facilities, and point sources such as municipal wastewater treatment plants (WWTPs), community WWTPs, private sewage treament plants were considered in the HSPF model setup. Especially, NITR and PHOS modules were used to simulate detailed fate and transport processes including vegitation uptake, nutrient deposition, adsorption/desorption, and loss by deep percolation. The HSPF model was calibrated and validated based on the observed data from 2015 to 2020 at the outlet of the watershed. The calibrated model showed reasonably good performance in simulating the flow and water quality. Five Pollutants control scenarios were established from three sectors: agriculture pollution management (drainge outlet control, and replacement of controlled release fertilizers), livestock pollution management (liquid fertilizer reduction, and 'manure management of small scale livestock facilities) and private STP management. Each pollutant control measure was further divided into short-term, mid-term, and long-term scenarios based on the potential achievement period. The simulation results showed that the most effective control measure is the replacement of controlled release fertilizers followed by the drainge outlet control and the manure management of small scale livestock facilities. Furthermore, the simulation showed that application of all the control measures in the entire watershed can decrease the annual TN and TP loads at the outlet by 40.6% and 41.1%, respectively, and the annual average concentrations of TN and TP at the outlet by 35.1% and 29.2%, respectively. This study supports decision makers in priotizing different pollutant control measures based on their predicted performance on the water quality improvements in an agriculturally dominated watershed.

Evaluation of Anti-wrinkle Effect of Peanut Shell Extract and Stability of the Extract in Cosmetic Products (땅콩 겉껍질 추출물의 주름개선 효능 및 화장품 제형에서 추출물의 안정성 평가)

  • Narae Han;Jin Young Lee;Mihyang Kim;Eun Young Choi;Bong-Jeun An;Yu-Young Lee;Moon Seok Kang;Hyun-Joo Kim
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.49 no.3
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    • pp.203-212
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    • 2023
  • This study was conducted to investigate the possibility of peanut shell, a by-product of peanut, as a functional cosmetic ingredient. Peanut shell extract showed high antioxidant activity with IC50 values of 75.00, 46.33, and 472.83 ㎍/mL for DPPH and ABTS radical scavenging and SOD-like activity, respectively. Furthermore, peanut shell extract was efficiently decreased the MMP-1 and MMP-3 protein level in the UVB treated-HaCaT cell and maintained procollagen protein level similar to normal control. Similar to anti-wrinkle related protein expression assay, the IC50 value of elastase and collagnease inhibition in peanut shell extract was lower as 0.30 and 0.09 mg/mL, respectively, than that of the positive control. Additionally, eriodictyol and luteolin, which are isolated from peanut shell extract, showed 53.8 and 98.0% elastase inhibition rate, respectively, and 60.1 and 72.5% collagenase inhibition rate, respectively, at a concentration of 0.1 mg/mL. Thus, luteolin was assumed to be the effective ingredient for wrinkle inhibition in peanut shell extract. As a result of stability evaluation of lotion and cream formulations containing peanut shell extract, it was confirmed to be a stable formulation with no significant changes. Therefore, it is considered that peanut shell extract can be applied as a cosmetic ingredient for wrinkle inhibition.

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

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

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Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

Effects of Applying Livestock Manure on Productivity and Feed Value of Corn and Sorghum$\times$Sorghum Hybrid (가축분뇨시용이 옥수수와 수수$\times$수수교잡종의 생산성 및 사료가치에 미치는 영향)

  • Jo, Ik-Hwan
    • Korean Journal of Organic Agriculture
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    • v.16 no.1
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    • pp.115-125
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    • 2008
  • This study was conducted to determine adequate forage crop choice and optimal level of livestock manure, when different types and levels of the livestock manure were applied in corns or sorghum$\times$sorghum hybrids for the production of organic roughages by utilizing livestock manure. For the corn, yields of annual dry matter (DM) and total digestible nutrients (TDN) were highest in N+P+K-applied treatments, showing 17.3 and 11.7 ton/ha, respectively. Treatments applied 100% composted cattle manure (8.9 and 6.1 ton/ha) and 100% cattle slurry (9.4 and 7.5 ton/ ha) in contrast with chemical fertilizer-N had higher yields of DM and TDN than no fertilizer (4.8 and 2.7 ton/ha) and P+K-applied treatments (8.8 and 6.0 ton/ha). Particularly, treatments applied 150% composted cattle manure and 150% cattle slurry were markedly higher, which represented 11.4 and 7.6 ton/ha and 10.3 and 7.3 ton/ha, respectively. Crude protein (CP) contents for corns applied livestock manure ranged from 5.6 to 6.6%, which were significantly (p<0.05) higher than those of no fertilizer (3.9%) and P+K-applied treatments (5.5%). ADF (42.4%) and NDF (58.3%) contents for no fertilizer treatment were significantly (p<0.05) higher than those of other treatments. However, TDN contents were higher for livestock manure treatments than for no and/or chemical fertilizer treatments. In particular, TDN contents of treatments applied 150% composted cattle manure and 150% cattle slurry showed 72.3 and 70.8%, respectively and both treatments were significantly (p<0.05) higher than all of the other treatments. For the sorghum$\times$sorghum hybrid, yields of annual DM and TDN for 100% (12.4 and 7.4 ton/ha) and 150% (13.1 and 7.6 ton/ha) cattle slurry-applied treatments, and N+P+K-applied treatments (12.6 and 7.7 ton/ha) were significantly (p<0.05) higher than those of the others. In the others, 150% composted cattle manure (9.3 and 5.2 ton/ha) had higher annual DM and TDN yields than P+K-applied (8.4 and 4.8 ton/ha) and 100% composted cattle manure treatments (7.4 and 4.2 ton/ha), with no significant difference. Crude protein contents for sorghum$\times$sorghum hybrid applied P+K and cattle slurry were 8.8 and 8.6%, respectively. CP contents for both treatments were significantly higher than those of composted manure ($7.5{\sim}8.3%$) and no fertilizer (4.0%) treatments, but 100% livestock manure treatments had higher CP contents than 150%-applied treatments. ADF and NDF contents for N+P+K and cattle slurry-applied treatments were significantly (p<0.05) lower than the others. However, TDN contents were highest in N+P+K and cattle slurry-applied treatments, showing 61.2 and 58.3 to 59.4%, respectively. These results indicated that application of livestock manure instead of chemical fertilizer to the soil of forage crops might not only improve yields of DM and TDN, but also reduce environmental pollution by producing organic roughages through recycling of livestock manure.

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Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.598-604
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    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

The Effect of Ginkgo Biloba Extract on the Fractionsted Radiation Therapy in C3H Mouse Fibrosarcoma (Ginkgo Biloba Extract가 C3H 마우스 섬유육종의 분할 방사선치료에 미치는 영향)

  • Kim, Jong-Hoon;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.155-164
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    • 2002
  • Purpose : A ginkgo biloba extract (GBE) has been known as a hypoxic cell radiosensitizer. Its mechanisms of action are increase of the red blood cell deformability, decrease the blood viscosity, and decrease the hypoxic cell fraction in the tumor. The aims of this study were to estimate the effect of GBE on fractionated radiotherapy and to clarify the mechanism of action of the GBE by estimating the blood flow in tumor and normal muscle. Materials and Methods : Fibrosarcoma (FSall) growing in a C3H mouse leg muscle was used as the tumor model. When the tumor size reached 7 mm in diameter, the GBE was given intraperitoneally at 1 and 25 hours prior to irradiation. The tumor growth delay was measured according to the various doses of radiation (3, 6, 9, 12 Gy and 15 Gy) and to the fractionation (single and fractionated irradiation) with and without the GBE injection. The radiation dose to the tumor the response relationships and the enhancement ratio of the GBE were measured. In addition, the blood flow of a normal muscle and a tumor was compared by laser Doppler flowmetry according to the GBE treatment. Results : When the GBE was used with single fraction irradiation with doses ranging from 3 to 12 Gy, GBE increased the tumor growth delay significantly (p<0.05) and the enhancement ratio of the GBE was 1.16. In fractionated irradiation with 3 Gy per day, the relationships between the radiation dose (D) and the tumor growth delay (TGD) were TGD $(days)=0.26{\times}D$ (Gy)+0.13 in the radiation alone group, and the TGD $(days)=0.30{\times}D$ (Gy)+0.13 in the radiation with GBE group. As a result, the enhancement ratio was 1.19 ($95\%$ confidence interval; $1.13\~1.27$). Laser Doppler flowmetry was used to measure the blood flow. The mean blood flow was higher in the muscle (7.78 mL/100 g/min in tumor and the 10.15 mL/100 g/min in muscle, p=0.005) and the low blood flow fraction (less than 2 mL/100 g/min) was higher in the tumor $(0.5\%\;vs.\;5.2\%,\;p=0.005)$. The blood flow was not changed with the GBE in normal muscle, but was increased by $23.5\%$ ( p=0.0004) in the tumor. Conclusion : Based on these results, it can be concluded that the GBE enhanced the radiation effect significantly when used with fractionated radiotherapy as well as with single fraction irradiation. Furthermore, the GBE increased the blood flow of the tumor selectively.

Early Result of Surgical Management of the Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (관상동맥-폐동맥 이상 기시증에 대한 수술의 조기 결과)

  • Yoon Yoo Sang;Park Jeong Jun;Yun Tae Jin;Kim Young Hwue;Ko Jae Kon;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.18-27
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    • 2006
  • Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

Off-pump Coronary Artery Bypass Surgery Versus Drug Eluting Stent for Multi-vessel Coronary Artery Disease (다혈관 관상동맥질환에서의 심폐바이패스를 사용하지 않은 관상동맥우회술과 약물용출 스텐트시술)

  • Lee, Jae-Hang;Kim, Ki-Bong;Cho, Kwang-Ree;Park, Jin-Shik;Kang, Hyun-Jae;Koo, Bon-Kwon;Kim, Hyo-Soo;Sohn, Dae-Won;Oh, Byung-Hee;Park, Young-Bae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.202-209
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    • 2008
  • Background: The introduction of Drug Eluting Stents (DES) decreased the number of patients referred for coronary artery bypass grafting (CABG). The impact of DES on CABG (Step 1) was studied and compared with the 1-year outcome after CABG with DES (Step 2). Material and Method: Surgical results for patients who underwent off-pump CABG (OPCAB) before the introduction of DES(n=298) were compared with those who underwent OPCAB after the introduction of DES (n=288) (Step 1). Postoperative 30-day and 1-year results were also compared between the patients who underwent percutaneous coronary intervention (PCI) using DES (n=220) and those who underwent OPCAB (n=255) (Step 2). Result: Since the introduction of DES, the ratio of CABG versus PCI decreased. In the CABG group, the number of high risk patients such as elderly patients (age 62 vs. 64, p=0.023), those with chronic renal failure (4% vs. 9%, p=0.021), calcification of the ascending aorta (9% vs. 15%, p=0.043), or frequency of urgent or emergent operations (12% vs. 22%, p=0.002) increased. However, there were no differences in the cardiac death and graft patency rates between the two groups (step 1). During the one-year follow up period, the rate of target vessel revascularization (12.3% vs. 2.4%, p<0.001) and major adverse cardiac events (MACE: death, myocardial infarct, TVR) were higher in the DES than the CABG group (13.6% vs 4.3%) (stage 2). Conclusion: Introduction of DES decreased the number of patients referred for surgery, and increased the comorbidity in patients who underwent CABG. DES increased the rate of target vessel revascularization, and the occurrence of MACE during the 1-year follow-up. However, there was no difference in the incidence of myocardial infarction and cardiac death between the two groups.