• Title/Summary/Keyword: 기간분석

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Clinical Analysis of Influenza in Children and Rapid Antigen Detection Test on First Half of the Year 2004 in Busan (2004 상반기 부산 지역에서 유행한 인플루엔자의 임상 역학적 분석 및 인플루엔자 진단에 있어서의 신속 항원 검사법)

  • Choi, So Young;Lee, Na Young;Kim, Sung Mi;Kim, Gil Heun;Jung, Jin Hwa;Choi, Im Jung;Cho, Kyung Soon
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.158-169
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    • 2004
  • Purpose : Although influenza is one of the most important cause of acute respiratory tract infections in children, virus isolation is not popular and there are only a few clinical studies on influenza and diagnostic methods. We evaluated the epidemiological and clinical features of influenza in children and rapid antigen detection test(QuickVue influenza test) on fist half of the year 2004 in Busan. Methods : From January 2004 to June 2004, throat swab and nasal secretion were obtained and cultured for the isolation of influenza virus and tested by rapid antigen detection test(QuickVue influenza test) in children with suspected influenza infections. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Influenza viruses were isolated in 79(17.2%) out of 621 patients examined. Influenza virus was isolated mainly from March to April 2004. The ratio of male and female with influenza virus infection was 1.2 : 1 with median age of 4 years 6month. The most common clinical diagnosis of influenza virus infection was bronchitis. There was no difference between influenza A and B infection in clinical diagnosis and symptoms. All patients recovered without severe complication. The sensitivity obtained for rapid antigen detection test (QuickVue influenza test) was 93.6% and the specificity was 80.2%, the positive predictive value 40.8%, the negative predictive value 98.8%. Conclusion : With rapid antigen detection test, it is possible early detection of influenza in children. reduction in use of antimicrobial agent and early use of antiviral agent.

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A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System (의료전달체계 실시 전후의 3차 진료기관 외래환자 이용양상 비교)

  • Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.88-100
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    • 1992
  • This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

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Radiation Therapy Alone for Early Stage Non-small Cell Carcinoma of the Lung (초기 비소세포폐암의 방사선 단독치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.323-327
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    • 2002
  • Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.

Comparison of the Result of Radiation Alone and Radiation with Daily Low Dose Cisplatin in Management of Locally Advanced Cervical Cancer (국소적으로 진행된 자궁경부암에서 방사선 단독치료와 방사선 및 저용량 Cisplatin 항암화학요법 병용치료의 비교)

  • Kim Hun Jung;Kim Woo Chul;Lee Mee Jo;Kim Chul Su;Song Eun Seop;Loh John J K.
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.200-207
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    • 2004
  • Purpose: An analysis was to compare the results of radiation alone with those of radiation with dally low dose cisplatin as a radiation sensitizer in locally advanced cervical cancer. Materials and Methods: A retrospective analysis of 59 patients diagnosed with locally advanced uterine cervix cancer between December 1996 and March 2001 was peformed. Thirty one patients received radiation alone and 28 patients received dally low dose cisplatin, as a radiation sensitizer, and radiation therapy. The median follow-up period was 34 months, ranging from 2.5 to 73 months. The radiation therapy consisted of 4500 cGy external beam irradiation to the whole pelvis (midline block after 3060 cGy), a 900$\~$l,000 cGy boost to the involved parametrium and high dose-rate intracavitary brachytherapy (a total dose of 3,000$\~$3,500 cGy/500 cGy per fraction to point A, twice per week). In the chemoradiation group, 10 mg of daily intravenous cisplatin was given daily from the 1st day of radiation therapy to the 20th day of radiation therapy. According to the FIGO classification, the patients were subdivided into 51 (86.4$\%$) and 8 (13.6$\%$) stages IIB and stage IIIB, respectively. Results: The overall 5 year survival rate was 65.65$\%$ and according to treatment modality were 56.75$\%$ and 73.42$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.180). The 5 year disease-free survival rates were 49.39$\%$ and 63.34$\%$ in the radiation alone and chemoradiatoin groups, respectively (p=0.053), The 5 year locoregional control rates were 52.34$\%$ and 73.58$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.013). The 5 year distant disease-free survival rates were 59.29$\%$ and 81.46$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.477), Treatment related hematologic toxicity were prominent in the chemoradiation group. Leukopenia $\geq$grade) occurred in 3.2$\%$and 28.5$\%$ of the radiation alone and chemoradiation groups, respectively (p=0.02). There were no statistical differences in the incidences of vesical, rectal and small bowel complications between two groups. Conclusion: Radiation therapy with low dose cisplatin did not improve the rates of survival and response rates, but did improve the rate of disease free survival and locoregional control rates In locally advanced cervical cancer. The incidence of bone marrow suppression was higher in the chemoradiation group.

Treatment Result of Ovarian Dysgerminoma (난소 미분화배세포종에 대한 방사선치료 결과)

  • Shin Seong Soo;Park Suk Won;Shin Kyung Hwan;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.379-385
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    • 1997
  • Purpose : Ovarian dysgerminoma is a highly radiosensitive malignant tumor occurring in young age group. The conventional treatment was total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiotherapy. We retrospectively analyzed the treatment results of Patients who had received radiotherapy in the era before chemotherapy was widely used. Material and Method : Twenty two patients with ovarian dysgerminoma were treated at the Department of Therapeutic Radiology, Seoul National University Hospital between August, 1980 and May, 1991. Four patients were excluded from this study, because three patients received incomplete treatment and one received combined chemotherapy. Sixteen patients received postoperative radiotherapy and two patients had radical radiotherapy as tumor was unresectable. Median follow-up period was 99 months (range, 51-178) Median age was 22 years (range, 11-42). Among the postoperatively treated patients, three Patients were in stage IA, eight in stage IC, two in stage II, and three in stage III. One patient had Turner's syndrome. Radiotherapy was performed with high energy photon (telecobalt unit or linear accelerator, either 6MV or 10MV), The radiation dose to the whole abdomen was 1950-2100cGy (median, 2000) and 1050-2520cGy was added to the whole pelvis, the total dose to the whole pelvis was 3000-4500cGy (median, 3500). Prophylactic Paraaortic area irradiation was done in six Patients (dose range, 900-1500cGy). One patient who had positive Paraaortic node, received radiation dose of 1620cGy, followed by additional 900cGy to the gross mass with shrinking field. Total dose to the paraaortic node was 4470cGy. Six patients, including one who had paraaortic node metastasis, received Prophylactic irradiation to mediastinum and supraclavicular area (2520cGy). Of the two patients with unresectable tumors who received radical radiotherapy, one was in stage III and the other was in stage IV with left supraclavicular lymph node metastasis. The stage III patient received radiation to the whole abdomen (2000cGy), followed by boost to whole pelvis (2070cGy) and paraaortic area (2450cGy). Stage IV patient received radiation to the whole abdomen (2000cGy), followed by radiation to the whole pelvis and paraaortic area (2400cGy), mediastinum (2520cGy) , and left supraclavicular area (3550cGy) .Results : The 5 year local control rate was $100\%$ in patients who received postoperative adiuvant radiotherapy after total abdominal hysterectomy and bilateral salpingo-oophorectomy. Only one patient in stage III who did not receive prophylactic irradiation to mediastinum developed mediastinal metastasis. but was salvaged by chemotherapy. So. the 5 year overall survival rate uras also $100\%$. Two patients who received radiation only, are alive without disease at 112 and 155 months. Conclusion : Postoperntive adjuvant radiotherapy as well as radical radiotherapy in unresectable ovarian dysgerminoma was very effective. aut chemotherapy is also an effective treatment modality We now recomrneifd chemotherapy for Patients who need to save their ovarian functien and reserve radiotherapv fov chemo-resistant tumor or recurrence alter che motherapy.

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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.

Economic Sanction and DPRK Trade - Estimating the Impact of Japan's Sanction in the 2000s - (대북 경제제재와 북한무역 - 2000년대 일본 대북제재의 영향력 추정 -)

  • Lee, Suk
    • KDI Journal of Economic Policy
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    • v.32 no.2
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    • pp.93-143
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    • 2010
  • This paper estimates the impact of Japan's economic sanction on DPRK trade in the 2000s. It conceptualizes the effects of sanction on DPRK trade, econometrically tests whether such effects exist in case of Japan's sanction using currently available DPRK trade statistics, and measures the size of the effects by correcting and reconfiguring the deficiencies of the currently available DPRK trade statistics. The main findings of the paper are as follows. First, Japan's sanction can have two different effects on DPRK trade: 'Sanction Country Effect' and "Third Country Effect.' The former means that the sanction diminishes DPRK trade with Japan while the latter refers to the effects on DPRK trade with other countries as well. The third country effect can arise not simply because the DPRK changes its trade routes to circumvent the sanction, but because the sanction forces the DPRK to readjust its major trade items and patterns. Second, currently no official DPRK trade statistics are available. Thus, the so-called mirror data referring to DPRK trading partners' statistics should be employed for the analysis of the sanction effects. However, all currently available mirror data suffer from three fundamental problems: 1) they may omit the real trade partners of the DPRK; 2) they may confuse ROK trade with DPRK trade; 3) they cannot distinguish non-commercial trade from commercial trade, whereas only the latter concerns Japan's sanction. Considering those problems, we have to adopt the following method in order to reach a reasonable conclusion about the sanction effect. That is, we should repeat the same analysis using all different mirror data currently available, which include KOTRA, IMF and UN Commodity Trade Statistics, and then discuss only the common results from them. Third, currently available mirror data make the following points. 1) DPRK trade is well explained by the gravity model. 2) Japan's sanction has not only the sanction country effect but also the third country effect on DPRK trade. 3) The third country effect occurs differently on DPRK export and import. In case of export, the mirror statistics reveal positive (+) third country effects on all of the major trade partners of the DPRK, including South Korea, China and Thailand. However, on DPRK import, such third country effects are not statistically significant even for South Korea and China. 4) This suggests that Japan's sanction has greater effects on DPRK import rather than its export. Fourth, as far as DPRK export is concerned, it is possible to resolve the abovementioned fundamental problems of mirror data and thus reconstruct more accurate statistics on DPRK trade. Those reconstructed statistics lead us to following conclusions. 1) Japan's economic sanction diminished DPRK's export to Japan from 2004 to 2006 by 103 million dollars on annual average (Sanction Country Effect). It comprises around 60 percent of DPRK's export to Japan in 2003. 2) However, for the same period, the DPRK diverted its exports to other countries to cope up with Japan's sanction, and as a result its export to other countries increased by 85 million dollars on annual average (Third Country Effect). 3) This means that more than 80 per cent of the sanction country effect was made up for by the third country effect. And the actual size of impact that Japan's sanction made on DPRK export in total was merely 30 million dollars on annual average. 4) The third country effect occurred mostly in inter-Korean trade. In fact, Japan's sanction increased DPRK export to the ROK by 72 million dollars on annual average. In contrast, there was no statistically significant increase in DPRK export to China caused by Japan's sanction. 5) It means that the DPRK confronted Japan's sanction and mitigated its impact primarily by using inter-Korean trade and thus the ROK. Fifth, two things should be noted concerning the fourth results above. 1) The results capture the third country effect caused only by trade transfer. Facing Japan's sanction, the DPRK could transfer its existing trade with Japan to other countries. Also it could change its main export items and increase the export of those new items to other countries as mentioned in the first result. However, the fourth results above reflect only the former, not the latter. 2) Although Japan's sanction did not make a huge impact on DPRK export, it might not be necessarily true for DPRK import. Indeed the currently available mirror statistics suggest that Japan's sanction has greater effects on DPRK import. Hence it would not be wise to argue that Japan's sanction did not have much impact on DPRK trade in general, simply using the fourth result above.

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Study on the Long-term Forecasting of Brown Planthopper Outbreaks (벼멸구 발생의 장기예찰을 위한 기초적 연구)

  • Paik Woon Hah;Paik Hyun Joon
    • Korean journal of applied entomology
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    • v.16 no.3 s.32
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    • pp.171-179
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    • 1977
  • Since the outbreak of the brown planthopper (Nilaparvata lugens) in 1915 caused tremendous losses in rice production, one of the more effective method of prevention of such a disaster could be the establishment of longterm forecasting system, In 1916 the author indicated there was a correlation between sunspot activities and brown planthopper and the white back planthopper outbreaks. However, the examples seem to be too small size to state a definite correlation. The purpose of the present study IS to revi~w the history of the brown planthopper outbreaks, and to establish a more effective forcasting system. The present forcasting methods are based on light trap catches of adults which already migrate into this country from mainland China. The regular cycle of 11.2 years of sunspot activity began in 1710, and was continued to present. To gather more records of brown planthopper, the author checked 'Joseon Wangjo Silrok' and analized the so-called 'Hwang' 'Hwang-chung' and 'Chung' which have multiple meanings, together with 'Samguk Sagi' 'Goryo Sa' and 'Munheon Bigo.' The results obtained by the about from review of these old literature citations revealed that ten species of insect and unknown species were involved: i. e., pine moth (Dendrolimus spectabilis), army worm (Mythimna separata), brown planthopper (Nilarvata lugens), white-back planthopper (Sogatella furcifera), migratory locust (Locutsa migratoria), rice stem borer (Chilo suppressalis,), mole cricket (Gryllotalpa africana), rice-plant weevil (Echinocnemus squameus), cut worm (Euxoa segetum), and mulberry pyralid Margaronia pyloalis) The suspected incidence of planthopper in old records expressed by 'Hwang' or 'Chung' revealed a total or 25 out of 37 in 'Samguk sagi,' 21 out of 49 in 'Goryo sa,' 9 of 73 in 'Wanjo-silrog,' and none of 8 in 'Munheon bigo' were planthoppers. Therefore, a total of 36 out of 167 records of insect incidence in the old literature can be possibly attributed to planthoppers. The brown planthopper and white-back planthopper migrate together to Korea every year from mainland China, However, the number of each species are differ by year. In 1975 outbreak the brown planthopper was dominant; and the white-back planthopper prevailed in 1946 and 1977 outbreaks, During the course of this study, the author was able to add a new record of outbreak of planthop per. In 1916 the white-back planthopper outbreak caused serious losses in Chungcheong-namdo and Jeonla-namdo, with losses estimated as high as 160 and 190 thousand seok (23.2 and 27.5 thousand M/T), in Naju and Secheon county, respectively. Since 1912, major outbreaks of brown planthopper or white-back planthopper have been recored 5 times. These occurrences coincide and well matched the period of minimum number of sunspots, With these authenticated records of planthoppers, the author believes there is a close correlation between brown planthopper and white-back planthopper outbreaks in Korea and sunspot activities. Therefore, in years of low number of sunspots, we should watch for and expect outbreaks of these. insects. At this time, it will be necessary to provide all possible prevention measures.

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The Effects of Pergola Wisteria floribunda's LAI on Thermal Environment (그늘시렁 Wisteria floribunda의 엽면적지수가 온열환경에 미치는 영향)

  • Ryu, Nam-Hyong;Lee, Chun-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.6
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    • pp.115-125
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    • 2017
  • This study was to investigate the user's thermal environments under the pergola($L\;7,200{\times}W\;4,200{\times}H\;2,700mn$) covered with Wisteria floribunda(Willd.) DC. according to the variation of leaf area index(LAI). We carried out detailed measurements with two human-biometeorological stations on a popular square Jinju, Korea($N35^{\circ}10^{\prime}59.8^{{\prime}{\prime}}$, $E\;128^{\circ}05^{\prime}32.0^{{\prime}{\prime}}$, elevation: 38m). One of the stations stood under a pergola, while the other in the sun. The measurement spots were instrumented with microclimate monitoring stations to continuously measure air temperature and relative humidity, wind speed, shortwave and longwave radiation from the six cardinal directions at the height of 0.6m so as to calculate the Universal Thermal Climate Index(UTCI) from $9^{th}$ April to $27^{th}$ September 2017. The LAI was measured using the LAI-2200C Plant Canopy Analyzer. The analysis results of 18 day's 1 minute term human-biometeorological data absorbed by a man in sitting position from 10am to 4pm showed the following. During the whole observation period, daily average air temperatures under the pergola were respectively $0.7{\sim}2.3^{\circ}C$ lower compared with those in the sun, daily average wind speed and relative humidity under the pergola were respectively 0.17~0.38m/s and 0.4~3.1% higher compared with those in the sun. There was significant relationship in LAI, Julian day number and were expressed in the equation $y=-0.0004x^2+0.1719x-11.765(R^2=0.9897)$. The average $T_{mrt}$ under the pergola were $11.9{\sim}25.4^{\circ}C$ lower and maximum ${\Delta}T_{mrt}$ under the pergola were $24.1{\sim}30.2^{\circ}C$ when compared with those in the sun. There was significant relationship in LAI, reduction ratio(%) of daily average $T_{mrt}$ compared with those in the sun and was expressed in the equation $y=0.0678{\ln}(x)+0.3036(R^2=0.9454)$. The average UTCI under the pergola were $4.1{\sim}8.3^{\circ}C$ lower and maximum ${\Delta}UTCI$ under the pergola were $7.8{\sim}10.2^{\circ}C$ when compared with those in the sun. There was significant relationship in LAI, reduction ratio(%) of daily average UTCI compared with those in the sun and were expressed in the equation $y=0.0322{\ln}(x)+0.1538(R^2=0.8946)$. The shading by the pergola covered with vines was very effective for reducing daytime UTCI absorbed by a man in sitting position at summer largely through a reduction in mean radiant temperature from sun protection, lowering thermal stress from very strong(UTCI >$38^{\circ}C$) and strong(UTCI >$32^{\circ}C$) down to strong(UTCI >$32^{\circ}C$) and moderate(UTCI >$26^{\circ}C$). Therefore the pergola covered with vines used for shading outdoor spaces is essential to mitigate heat stress and can create better human thermal comfort especially in cities during summer. But the thermal environments under the pergola covered with vines during the heat wave supposed to user "very strong heat stress(UTCI>$38^{\circ}C$)". Therefore users must restrain themselves from outdoor activities during the heat waves.

Surgical Treatment for Isolated Aortic Endocarditis: a Comparison with Isolated Mitral Endocarditis (대동맥 판막만을 침범한 감염성 심내막염의 수술적 치료: 승모판막만을 침범한 경우와 비교 연구)

  • Hong, Seong-Beom;Park, Jeong-Min;Lee, Kyo-Seon;Ryu, Sang-Woo;Yun, Ju-Sik;CheKar, Jay-Key;Yun, Chi-Hyeong;Kim, Sang-Hyung;Ahn, Byoung-Hee
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.600-606
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    • 2007
  • Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.