• Journal of Chest Surgery
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• v.42 no.3
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• pp.305-310
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• 2009

Background: The Ross procedure is known as a good surgical option for a young age group with aortic valve problems, but few reports on the Ross procedure are available in the Korean literature. This study is a review of our midterm results of 10 year experience with the pediatric Ross operation in Asan Medical Center. Material and Method: From March 1997 to October 2008, eighteen patients who were aged less than 16 years underwent the Ross procedure. There were 11 males and 7 females. The patients median age was 8.5 years (range: $0.5\sim14.0$). The aortic valve pathophysiology was 6 patients with aortic insufficiency, 4 patients with aortic stenosis, 7 patients with mixed aortic stenoinsufficiencey and 1 patient with infective endocarditis. The valve morphology was bicuspid in 11 and tricuspid in 7. All the patients were operated on with the root replacement technique. All the pumonic valves were replaced with an allograft except for one pericardial monocusp valve. The mean follow up duration was 52.8 months (range: 5.8$\sim$138.2 months). We reviewed the echocardiographic data with focusing on the, auto-graft dysfunction and reoperation. Result: There was no hospital mortality and late mortality. According to the last echocardiographic data, 2 autografts showed aortic regurgitation grade 2, 4 autografts showed aortic regurgitation grade 1 and the others were less than trivial. Reoperation of the pulmonic position conduit was performed 4 times in three patients. The rate of freedom from reoperation at 5 years was 72.2%. On the serial follow up, the Z-values of the aortic annulus/aortic sinus were changed from $1.6{\pm}1.7/0.9{\pm}1.7$ at preoperation to $1.8{\pm}1.6$(p=0.64)/$2.2{\pm}0.9$ (p=0.01) at the last follow-up. There was no significant relation between the growth of the neoaortic root and neoaortic insufficiency. Conclusion: Our midterm results of the Ross procedure in pediatric patients showed good autograft function and growth potential. Vet reoperation due to allograft dysfunction was a major concern.

• Archives of design research
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• v.16 no.4
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• pp.385-394
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• 2003

An investigation by KRNIC (Korea Network Information Center) on the real state of usage of internet has shown that 96.9％ of children investigated had experiences of using internet. Especially the firstly ranked item that had been answered by children as a necessity of internet was 'Studying to solve tasks' rated by 83.9％. As seen from the research result, the need as a homework sonics is actually so dominant that it cannot be ignored when considering the profitability at the area of education contents, but any profound research has not been accomplished yet. Internet has been positioned as a more effective and fruitful learning tool, and also all activities done by users for exploring informations and choosing learning items under the on-line circumstances are based on the successive mutual reactions between users and computers. Up to now much of the web based learning circumstances has been introducing the User Interface using metaphor, and the same is found dominantly from the sites for children. But in spite of the availability of metaphor mentioned above the current status is much lack of profound researches about metaphor interface; and what is more, in the case of the site for elementary school students the gap of the ability recognizing metaphor is very large between lower classes and higher classes according to the degree of mental growth but that is used to be simply ignored, then a common concept is adapted to interface for all grades of classes and moreover for infant and kindergarten without any objections. Based on foregoing problems this research has put the main focus on the groping and presenting desirable directions on the prospect design of interface for children-oriented sites by analyzing the status of practical usage of metaphor interface in the field of the sites for children-oriented learning sites with concentration upon homework supporting domains.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.152-157
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• 1997

From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. worthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age(median : 43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients(6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients : repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1 Used valves were 51. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturlal survival rate was 85.3%. Postoperative complications were low cardiac utput in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79 $\pm$ 0.66 preoperatively to 1.25 $\pm$ 0.49 postoperatively(p < 0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57 $\pm$ 0.06 to 0.54 $\pm$ 0.05 (p < 0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.

• Korean Journal of Poultry Science
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• v.18 no.3
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• pp.151-159
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• 1991

As a part of investigation on causes of drop in egg production in domestic chicken breeding farm, bacteriological contamination on air, feed, drinking water and artificial insemination instruments of randomly selected three farms was surveyed. Total bacterial population in the air was very high in all of the chicken houses tested and was not significantly different among these farms . However, total bacterial counts in the air of the problem house having egg drop problem and colibacillosis was higher than normal house within the problem farm. Bacterial population in the assorted feed was low before or after administration on the normal farm while it was much more increased after administration than before administration on the problem farm. Bacterial population of the drinking water in the source of water supply was very low and has no differences among farms tested. Also, bacterial population in the normal farm was not significantly different between source of water supply and after administration. However, population of total bacteria and coliform bacteria after administration was increased. Bacterial population was much higher in the artificial insemination instrument of problem farm than normal farm. However, this bacterial population in the problem farm was decreased to those of normal farm after these instruments were sanitized.

• Journal of Music and Human Behavior
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• v.1 no.1
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• pp.11-32
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• 2004

According to Edwin Gordon(1987, 1997, 2003), music aptitude is a product of interaction of innate potential and early environmental experiences. He referred to music aptitude of children up to nine years of age as developmental music aptitude which fluctuates due to musical environment. Music aptitude stabilizes at age nine, and the music aptitude after age nine is called "stabilized music aptitude". This research is to examine Gorden's hypothesis that the younger a child receives music education, the higher music aptitude. Also, this research is to experiment the effect of Audiation activities developed in Audie Music Curriculum on music aptitude. The researcher and another Audie teacher as a co-teacher guided children together for 30 minutes once a week. The pedagogy guidelines for informal guidance in music learning theory were kept throughout the classes. Also, Audie's teaching method which had been developed for Korean Kindergarten educational environment was also applied. Five-year-old subjects in Experimental group 1 experienced the Audie Music Curriculum of one year; five-year-old subjects in Experimental group 2 experienced it for two years. Primary Measures of Music Audiation was administered three times during their last year of Kindergarten. Subjects in the Control groups, one examined at the beginning and the other at the end of their last year in Kindergarten, received no Audie instruction. There was no significant difference in tonal aptitude, but there was significant difference in rhythmic aptitude(p< .05) among the experiemental groups. Because both Experimental groups showed statistical significance (p< .001) in the music aptitude increase during their academic years, the significant differences of the year-end music aptitude between control group and experimental groups were the expected result.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.75-80
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• 2015

Purpose: Ventilator-associated pneumonia (VAP) is a serious threat in critically ill pediatric patients. Data regarding Stenotrophomonas maltophilia VAP in pediatric population is limited. We evaluated the clinical data of S. maltophilia associated VAP in critically ill pediatric patients. Methods: A retrospective chart review was performed in pediatric patients 18 years old or younger who developed S. maltophilia associated VAP at Samsung Medical Center, Seoul Korea from January 2008 to December 2012. Results: A total of 31 patients were identified S. maltophilia associated VAP. Median age was 8 months (range, 0.5 month to 16.6 years) and 13 patients were male (40.6%). Underlying illnesses were cardiologic diseases (n=11, 34.4%), hematologic oncologic malignancies (n=7, 25%), neurologic diseases (n=4, 12.5%), pulmonary diseases (n=3, 9.4%), and others (n=4, 12.5%). The median duration of ventilator use before S. maltophilia VAP diagnosis was 14 days (range, 4-256 days). Overall mortality at 30 days was 12.5% (4/32). Conclusions: S. maltophilia should be also considered as a possible pathogen for VAP in critically ill pediatric patients. Empiric antibiotic choice should include agents that are active against S. maltophilia in patients who are deteriorating on broad spectrum beta-lactam antimicrobial agents.

• Journal of Preventive Medicine and Public Health
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• v.32 no.2
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• pp.177-182
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• 1999

Objectives: To reexamine the association between air pollution and daily mortality in Seoul, Korea using a method of meta-analysis with the data filed for 1991 through 1995. Methods: A separate Poisson regression analysis on each district within the metropolitan area of Seoul was conducted to regress daily death counts on levels of each ambient air pollutant, such as total suspended particulates (TSP), sulfur dioxide $(SO_2)$, and ozone $(O_3)$, controlling for variability in the weather condition. We calculated a weighted mean as a meta-analysis summary of the estimates and its standard error. Results: We found that the p value from each pollutant model to test the homogeneity assumption was small (p<0.01) because of the large disparity among district-specific estimates. Therefore, all results reported here were estimated from the random effect model. Using the weighted mean that we calculated, the mortality at a $100{\mu}g/m^3$ increment in a 3-day moving average of TSP levels was 1.034 (95% Cl 1.009-1.059). The mortality was estimated to increase 6% (95% Cl 3-10%) and 3% (95% Cl 0-6%) with each 50 ppb increase for 9-day moving average of SO2 and 1-hr maximum O3, respectively. Conclusions: Like most of air pollution epidemiologic studies, this meta-analysis cannot avoid fleeing from measurement misclassification since no personal measurement was taken. However, we can expect that a measurement bias be reduced in a district-specific estimate since a monitoring station is hefter representative cf air quality of the matched district. The similar results to those from the previous studios indicated existence of health effect of air pollution at current levels in many industrialized countries, including Korea.

• Horticultural Science & Technology
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• v.30 no.6
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• pp.694-699
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• 2012

To examine the EC model in a culture medium, basic culture medium of Rush (2005) and EC model of Robinson and Strokes (1959) were applied analyzing the equivalence ion total amount, the EC variable of cation and anion. Following the experiential translation by Steiner (1980), 130 optimized domestic and foreign culture media for crop growth were utilized, and estimated EC model was also demonstrated. Results from basic culture medium of Rush (2005) suggests an estimated EC by equivalence ion total amount and high reliable regressive model with 0.96 y = 1.33x - 0.23 of 0.96 as value $R^2$. It was found out that the change in concentration of positive ion and anion did not differ significantly with the increase and decrease of EC, however, there occurred a slight variable range. The change brings about a bigger anion influence than the previously reported positive ion, seemingly like those based on nitride ion and sulfur ion. The above EC estimated models confirmed that with optimized 130 domestic and foreign culture media for crop growth, the value derived will be as follows: $R^2$ = 0.98 with y = 1.23x - 0.02. In addition, the contour analysis of positive ion and anion for EC, with popularly known concentration range of EC $1.5-2.5dS{\cdot}m^{-1}$ reveals an equivalent of more than $11meq{\cdot}L^{-1}$ for positive ion and $15meq{\cdot}L^{-1}$ for anion. On the other hand, the left bottom, low concentration $1.5dS{\cdot}m^{-1}$ and the right above, high concentration $2.5dS{\cdot}m^{-1}$, for both positive ion and anion existed differently in a proper culture medium concentration. This study adapted variables of both positive ion and anion of EC simultaneously, unlike in the previous culture medium by ion ratio in mutual ratio of Steiner (1980), and offers an EC model that can estimate levels or positive ion and anion in proper concentration, EC $1.5-2.5dS{\cdot}m^{-1}$, with distributed features of ions.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.913-919
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• 2006

Background: Vasodilatory shock has been implicated in life-threatening complications after open heart surgery, where the systemic inflammatory reaction is attributed to the cardiopulmonary bypass(CPB). The secretion of arginine vasopressin(AVP) has been found to be defective in a variety of vasodilatory shock states and administration of AVP markedly improves vasomotor tone and blood pressure. So we reviewed our experience of AVP therapy in patients with vasodilatory shock following heart surgery using CPB. Material and Method: From January 2004 to July 2006, we reviewed the records of patients who received AVP therapy for vasodilatory shock following heart surgery using CPB. Vasodilatory shock was defined as a mean arterial pressure lower(MAP) than 70 mmHg, a cardiac index greater than 2.5 $L/min/m^2$, peripheral vascular resistance lower than 800 $dyn/s/cm^5$, and vasopressor requirements. The hemodynamic responses of patients who received AVP therapy for vasodilatory shock after cardiac surgery were analyzed retrospectively. Result: One hundred ninety nine open cardiac surgery patients were consecutively included in this study. Twenty two patients(11.1%) met criteria for vasodilatory shock. Despite the administration of high dose catecholamine vasopressor, all patients were hypotensive with a mean arterial pressure less than 70 mmHg. AVP therapy increased MAP from $53.3{\pm}7.4\;to\;82.0{\pm}12.0$ mmHg at 1 hour (p<0.001) and decreased other vasopressor requirements from $25{\pm}7\;to\;18{\pm}6$ at 1 hour(p<0.001) and individually maintained it for 12 hours. Conclusion: Our date suggest that AVP may be a safe and an effective vasopressor in patients with vasodilatory shock. In patients exhibiting vasodilatory shock after heart surgery, replacement of AVP increases blood pressure and reduces catecholamine vasopressor requirements.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.765-769
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• 2007

Background: The curative treatment of choice for empyema is decortication of the pleura. The risks of this treatment however are increased for the patient with reduced pulmonary function, complicated calcification or septic shock. In the past, open window thoracostomy was a final stage treatment for chronic empyema. Relatively safe treatment of empyema could be achieved in difficult cases with a closure of the open window after open drainage and use of a myocutaneous flap (one stage or staged). Material and Method: A retrospective study of the cause, progression and final outcome of empyema patients who received open window thoracostomy was performed. 21 patients were followed from 1995 to 2004 in the department of Thoracic and Cardiovascular Surgery in the College of Medicine, Pusan National University. Result: The average age of the patients was $57.5{\pm}15.5$ years (range $25{\sim}78$ years), of whom 16 (76.2%) were men and five (23.8%) were women. Pulmonary function test results showed an average FEV1 of $1.58{\pm}0.49 L$. The type of empyema was tuberculous empyema in 13 cases (61.9%), aspergillosis in three cases (14.3%), parapneumonic empyema in three cases (14.3%) and post-resectional empyema in two cases (10%). Bronchopulmonary fistula was seen in 14 cases. Eight cases were complicated by severe calcification of the pleura. For the four cases of bronchopulmonary fistula, the patients' serratus anterior muscle was covered in their first operation. The average number of ribs resected was $4{\pm}1$. Closure of the open window thoracostomy was performed in 12 cases. The average time to closure after open drainage was $10.22{\pm}3.11$ months and the average defect of the empyemal cavity before the final operation was $330{\pm}110 cc$. Among the 12 cases, there were two cases of spontaneous closure. In two cases closure was only achieved by using the reserved skin fold during the first surgery. Of the remaining eight cases, in seven we used the myocutaneous flap (four cases of lattisimus dorsi muscle and three cases of pectoralis major muscle), and in one case we used soft tissue. As regards complications of the closure, tissue necrosis occurred in one case, which led to failed closure, and there was one case of abdominal hernia in the rectus abdominis muscle flap. One patient died within 30 days of the surgery and one patient died of metastatic cancer. Conclusion: A staged operation with a final closure using open window thoracostomy, which consists of open drainage, transposition of the muscle and a myocutaneous flap, can be a safe and effective option for the chronic empyema patient who is difficult to cure with traditional surgical methods.