• Journal of Chest Surgery
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• v.43 no.4
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• pp.404-408
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• 2010

Background: Pleural symphysis is regarded as an important treatment option in reducing recurrence rates after surgical treatment of spontaneous pneumothorax. However, there is much debate over the best method for achieving pleural symphysis. We retrospectively compared apical pleurectomy (AP) with mechanical pleural abrasion (MPA). Material and Method: Between January 2000 and December 2007, 83 patients underwent video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax. In addition to wedge resection of bullae, MPA was performed in 21 patients (group A) and AP in 62 patients (group B). Result: There were no significant differences in age, gender and site of pneumothorax between the two groups. Operative time was $97{\pm}44$ minutes in group A and $77{\pm}18$ minutes in group B (p>0.05). The mean amount of pleural drainage through the chest tube on the first postoperative day was $156{\pm}87 cc$ in group A and $147{\pm}87 cc$ in group B (p>0.05). There was no mortality or significant morbidity in all patients with the exception of reoperation for bleeding in two patients in group B. In the postoperative course, there were no statistical differences between the two groups in the rate of residual air space, air leak and indwelling time of chest tube, and hospital stay. Mean follow up time was $31.7{\pm}25.3$ months, and the recurrence rate of pneumothorax was 9.5% (2/21) in group A and 6.5% (4/62) in group B, without statistical significance. Conclusion: AP was no more advantageous than MPA in terms of operative time, postoperative course and prevention of recurrent pneumothorax. Therefore, complete resection of bullae and existence of residual bullae are more important factors in reducing the incidence of recurrent pneumothorax than pleural symphysis.

• (The)Study of the Eastern Classic
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• no.62
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• pp.231-262
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• 2016

The Jongmyo Shrine(宗廟) of Zhou dynasty was a king's main building where a diversity of rituals were held, such as 'the assembly ceremony between a king and vassals in the morning', and was also called as Taechim(太寢) Nochim(路寢) Jeongchim(正寢) and others. Before Zhou dynasty, the expressions of Taesil(太室) and Sesil(世室) were used, and especially the term of Taesil(太室) is found in the records of the early period of West Zhou. In "Seogyeong(書經)", not only the term of Nochim(路寢) but also the letter of 'chim(寢)' itself is not found at all, but the letter of 'sil(室)' appeared several times in the chapters of "Haseo(夏書)" "Sangseo(商書)" "Juseo(周書)" except for that of "Wuseo(虞書)". "Jwajowusa(左祖右社)" meaning that 'the Jongmyo Shrine(宗廟) which keeps the late king's mortuary tablet is established in the left, and Sajikdan altar(社稷壇) which enshrines a god of land and grains is established in the right' was first mentioned in the part of 'Janginyeongguk(匠人營國 : a master craftsman builds different national infrastructures, for instance, a palace and roads)' in "Donggwangogonggi(冬官考工記)" of "Jurye(周禮)". In addition, so-called 'Jwamyowusa(左廟右社)', that is, "Sajik(社稷) enshrining the god of land and grains is built in the right('右'), and the Jongmyo Shrine(宗廟) in the left('左'). (右社稷 左宗廟)" was mentioned as one of different duties of a Sojongbaek(小宗伯) in charge of ancestral rites, which was recorded in "Chungwanjongbaek(春官宗伯)" of "Jurye(周禮)". And it seems that had affected the mention of "Jwajowusa(左祖右社)" in "Donggwangogonggi(冬官考工記)" appeared thereafter. Many manners scholars including Jeonghyun(鄭玄) since Han dynasty interpreted 'Jwa(左 : left)' and 'Wu(右 : right)' here as the arrangement relation of left and right of Jongmyo(宗廟) and Sajik(社稷), but when it is interpreted as "helping(右=佑 : to help) to sacrifice to a god of land and grains in Sajik(社稷), and helping(左=佐 : to help) memorial ceremonies in Jongmyo(宗廟)." it can correspond with a 'Jongbaek(宗伯)''s duties. 'Jeonmyohuchim(前廟後寢)' is the term that began from the expression that "what's in front is called as an jongmyo shrine(宗廟) and what's back as a bedroom.(前曰廟 後曰寢)" in Jeonghyun(鄭玄)'s annotation explaining the chapter of "Hagwansama(夏官司馬)" in "Jurye(周禮)" and "Wolryeong(月令)" in "Yegi(禮記)". Chaeong(蔡邕), a figure in the same age as Jeonghyun(鄭玄), used the expression that "a court is placed in the front, and a bedroom in the back(前有朝 後有寢)." In the paper, two hypotheses were discussed about the theory about Jeonmyohuchim(前廟後寢). In one hypothesis, it expressed two facilities within a wall; 'a court in the front to deal with governmental affairs, and a comfortable interior space in the back.' In another hypothesis, it refers to two independent and separate buildings of 'an jongmyo shrine(宗廟) building in the front as the area of governmental meetings, and the residential building in the back as the residence area with family'.