• Journal of Chest Surgery
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• v.41 no.4
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• pp.423-429
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• 2008

Background: The interest in robotic cardiac surgery has recently grown but there has not been much clinical research reported on this. The aim of this study is to examine our initial experience, since August 2007, with robotic cardiac surgery using the da $Vince^{TM}$ surgical system and to evaluate the feasibility and safety of it. Material and Method: Between August and December 2007, a total of 20 patients underwent robotic cardiac surgery using the da Vinci surgical system. For mitral valve repair (n=11), tricuspid valve repair (n=1), and ASD repair (n=1), cannulation, antegrade cardioplegia and transthoracic aortic cross-clamping were conducted for the right femoral vessels and the right internal jugular vein. For minimally invasive direct CABG (MIDCAB) (n=7), the internal thoracic artery (ITA) was harvested with the da Vinci surgical system. Result: The mean age of the patients was 50.1 (range: $26{\sim}78$) years. Three concomitant Maze procedures and one tricuspid annuloplasty were combined with mitral valve repair. The mean cardiopulmonary bypass time was $208.0{\pm}61.3$ minutes and the aortic cross clamp time was $158.8{\pm}40.6$ minutes. No patients showed more than mild mitral regurgitation after repair and the median hospital stay was 4 days. The robotic-harvested ITA was used for either left ITA (n=6) or bilateral ITA (n=1). The mean harvest time was $43.2{\pm}12.0$ minutes. The harvested ITA showed good flow and it was anastomosed under direct vision after left anterolateral thoracotomy. The patency of all the grafts was 100% (18/18) in MIDCAB. Conclusion: Robotic cardiac surgery using the da Vinci surgical system was variously adapted to areas such as mitral and tricuspid valve repair, ASD repair and ITA harvest for MIDCAB. The early results of the robotic cardiac surgery showed its safety and feasibility. With this primary report, we anticipate that clinical applications and further studies on robotic cardiac surgery using the da Vinci surgical system will be actively conducted in Korea.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.229-241
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• 2003

Background:Autogenous vein is the preferred vascular graft for patients who require coronary artery bypass surgery or peripheral arterial bypass surgery. When an autogenous vein is not available, an allograft saphenous vein can be used as an alternative conduit. Although arterial homograft has been under investigation since the beginning of this century, the viability of endothelial cells and the optimum mode of storage for the venous and arterial allografts is controversial. In addition, with the recently gained knowledge of vascular endothelial functions, such as the production of nitric oxide or thrombomodulin, the viability and antigenicity of endothelial cells are being studied again. The purpose of this study was to evaluate the viability of endothelial cells in the preserved human saphenous veins. Material and Method: The veins were stored in a $4^{\circ}C$ RPMI (Roswell Park Memorial Institute) 1640 solution including 10% fetal calf serum, for one, three, five, seven or fourteen days. After the completion of the storage period, the veins were divided into two groups: Group I: studied immediately at $4^{\circ}C$ (cold) storage (I-1, I-3, I-5, I-7, I-14), and Group II: studied after storage at $-196^{\circ}C$ liquid nitrogen tank (cryopreservation) in an RPMI 1640 solution containing 10% DMSO for two weeks (II-1, II-3, II-5, II-7, II-14). Light microscopy and scanning electron microscopy (SEM), frypan blue exclusion testing, and thrombomodulin immunohistochemistry were performed. Result: In a morphometric study using SEM, there was statistically significant increase in Gundry Score in Groups I-7, I-14, II-5, II-7, and II-14 and showed cellular destruction (p<0.05). In the thrombomodulin immunohistochemistry study, there was reactivity in Groups I-1, I-3, and I-5, but the cryopreserved group revealed decreased reactivity (p<0.05). The trypan blue exclusion testing also showed superior viability in cold storage Group I. Conclusion: Venous allografts preserved in a $4^{\circ}C$ RPMI 1640 solution showed well preserved endothelial cellular integrity and thrombomodulin expression at up to seven days of preservation. Although cryopreservation of venous allografts stored in 10% DMSO -RPMI 1640 solution maintained the endothelial cellular structure on SEM, immunohistochemistry from the thrombomodulin and trypan blue exclusion testing showed decreased viability, It remains to be seen whether the decreased thrombomodulin reactivity could be restored, and what the nature to the relationship is between thrombomodulin and long-term patency of allografts.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.359-365
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• 2006

Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

• KDI Journal of Economic Policy
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• v.35 no.4
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• pp.31-61
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• 2013

The purpose of this study is to calculate the economic value of transport demand forecasting risks in the road PPP project. Under the assumption that volatility of the road PPP project value occurs only in regard with uncertainty of traffic volume forecasting, this study calculates the economic value of the traffic forecasting risks in the case of the road PPP project. To that end, forecasted traffic volume is assumed to be a stochastic variable and to follow the Geometric Brownian motion as time passes. In particular, this study attempts to differentiate itself from existing studies that simply use an arbitrary assumption by presenting the application of different traffic volume growth volatility and the rates before and after the ramp-up period. Analysis of the case projects reveals that the risk premium related to traffic volume forecast of the project turns out as 7.39~8.30%, without considering option value-such as minimum revenue guarantee-while the project value volatility caused by transport demand forecasting risks is 17.11%. As the discount rate grows higher, the project value volatility tends to decrease and volatility in project value is always suggested to be larger than that in transport volume influenced by leverage effect due to fixed expenditure. The market value of transport demand forecasting risk-calculated using the project value volatility and risk premium-is analyzed to be between 0.42~0.50, implying that a 1% increase or decrease in the transport amount volatility would lead to a 0.42~0.50% increase or decrease in risk premium of the project.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.10
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• pp.181-186
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• 2020

This study examined the artificial fertilization efficiency of crossbred goats from a farmhouse using frozen semen. Electrostimulation was used to ejaculate and collect semen to assess the artificial fertilization efficiency of crossbred goats. The sperm concentration, vitality, and vitality after melting were investigated. The sperm volume was within 2.5~3 ml, and the concentration was 21~25 × 10⁸/ml for each male crossbred goat. The melted semen had high vitality (≥90%). An IDEXX Rapid Visual Pregnancy Test kit was used for an earlier diagnosis of the pregnancy and to determine the pregnancy rate of fertilization using frozen-thawed semen. The reproductive performance of the artificially fertilized crossbred goats had the highest delivery rate (68%) from Farm C and the lowest delivery rate (45%) from farm A. The delivery rate through artificial fertilization was equal to the fertilization rate according to early pregnancy diagnostic kits. The artificial insemination efficiency was 45~68%. These findings can be used as the basis for improvement and breeding goats in goat farms and livestock research institutes.

• Journal of Korean Society of Forest Science
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• v.100 no.3
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• pp.476-482
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• 2011

As part of studies on the reduction of forest trails degradation caused by high users density, this study was carried out to investigate soil physical properties of forest trails of Gyeongnam Domain in Mt. Jiri, Southeast Korea. Since the forest were opened for leisure trailing in 2008, the average soil erosion amounts per a square meter on the forest trails were $0.0015m^3$ from Inweol to Gumgeo, $0.0018m^3$ from Dongang to Suchol, and $0.0027m^3$ from Suchol to Chungam for 3 years. But, from Chungam to Agyang, the erosion was almost not occurred because it was recently opened. The soil hardness in 5 cm depth was significantly higher than in 10 cm depth. It indicates that intensive soil compaction by users has mainly affected in 5 cm soil depth until now on. In three forest trails compacted intensively, the porosity of 0-7.5 cm soil layer was down to 1.4-1.5 times compared to that in 2008. In additions, the bulk density was up to 1.6-3.1 times compared to the controls, which were not opened to users. As a result, the degradation caused by high users density would keep occurring on the three forest trails unless any counterplans are considered for the degradation reduction. At the moment, users distribution to other forest trails and long-term sabbatical years would be the most effective counterplans to keep from users gravitation on the three forest trails.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.289-297
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• 2006

Background: Surgery for Stanford type A aortic dissection shows a high operative mortality rate and frequent postoperative brain injury. This study was designed to find out the risk factors leading to operative mortality and brain injury after surgical repair in patients with type A aortic dissection. Material and Method: One hundred and eleven patients with type A aortic dissection who underwent surgical repair between February, 1995 and January 2005 were reviewed retrospectively. There were 99 acute dissections and 12 chronic dissections. Univariate and multivariate analysis were performed to identify risk factors of operative mortality and brain injury. Resuit: Hospital mortality occurred in 6 patients (5.4%). Permanent neurologic deficit occurred in 8 patients (7.2%) and transient neurologic deficit in 4 (3.6%). Overall 1, 5, 7 year survival rate was 94.4, 86.3, and 81.5%, respectively. Univariate analysis revealed 4 risk factors to be statistically significant as predictors of mortality: previous chronic type III dissection, emergency operation, intimal tear in aortic arch, and deep hypothemic circulatory arrest (DHCA) for more than 45 minutes. Multivariate analysis revealed previous chronic type III aortic dissection (odds ratio (OR) 52.2), and DHCA for more than 45 minutes (OR 12.0) as risk factors of operative mortality. Pathological obesity (OR 12.9) and total arch replacement (OR 8.5) were statistically significant risk factors of brain injury in multivariate analysis. Conclusion: The result of surgical repair for Stanford type A aortic dissection was good when we took into account the mortality rate, the incidence of neurologic injury, and the long-term survival rate. Surgery of type A aortic dissection in patients with a history of chronic type III dissection may increase the risk of operative mortality. Special care should be taken and efforts to reduce the hypothermic circulatory arrest time should alway: be kept in mind. Surgeons who are planning to operate on patients with pathological obesity, or total arch replacement should be seriously consider for there is a higher risk of brain injury.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.12 no.1
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• pp.98-108
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• 2013

The number of Hi-Pass lanes became 793 lanes at 316 expressway tollgates in 2011 due to the increase in the Hi-Pass use. In spite of the increase in the number of Hi-Pass lanes, there have been increased potential risks in tollgates where vehicles using a Hi-Pass lane must weave with other vehicles using a TCS lane. Therefore, there is a need for study on the safety in tollgates. To this end, this study aims at developing a methodology to evaluate the performance measures of diverse location countermeasures of Hi-Pass lanes in an efficient and systematic way. This study measured the mobility, safety and the convenience of installation and operation of Hi-Pass lanes using a microscopic traffic simulation tool, the surrogate safety assessment model and survey. In addition, this study aggregated the above three performance indexes using weight factors estimated using the AHP technique. For the test site, Dongsuwon interchange was selected. After building the microscopic traffic simulation model for the test site, the location countermeasures of Hi-Pass lanes applicable to the test site were compared with each other in terms of the mobility, safety and installing and operating convenience. As a result, there has been no apparent difference in mobility index based on delays. However, the countermeasures where Hi-Pass lanes are located in inside lanes generally showed better safety performance based on the number of conflicts. In addition, countermeasures with neighboring Hi-Pass lanes were favorable in terms of the safety and the convenience of installation and operation. The methodology proposed in this study was found to be useful to support decision makings by providing critical and quantitative information regarding the mobility, safety and the convenience of installation and operation.