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Analysis of Quantitative Indices in Tl-201 Myocardial Perfusion SPECT: Comparison of 4DM, QPS, and ECT Program (Tl-201 심근 관류 SPECT에서 4DM, QPS, ECT 프로그램의 정량적 지표 비교 분석)

  • Lee, Dong-Hun;Shim, Dong-Oh;Yoo, Hee-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.67-75
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    • 2009
  • Purpose: As to the analytical method of data, the various programs in which it is used for the quantitative rating of the Tl-201 myocardial perfusion SPECT are reported that there is a difference. Therefore, the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made against data of the same patient. Using quantitative index that able to represent myocardial perfusion defect level, we aimed to determine correlation among three myocardial perfusion analysis programs 4DM (4DMSPECT), QPS (Quantitative Perfusion SPECT), ECT (Emory Cardiac Toolbox) that be used generally in most departments of Nuclear Medicine. Materials and Methods: We analyzed the 145 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Mediacal Center from December 1th 2008 to February 14th 2008. We sorted as normal group and abnormal group. Normal group consist of 80 patients (Male/Female=38/42, age:$65.1{\pm}9.9$) who have low possibility of cardiovascular disease. And abnormal group consist of 65 patients (Male/Female=45/20, age:$63.0{\pm}8.7$) who were diagnosed cardiovascular disease with reversible perfusion defect or fixed perfusion defect through myocardial perfusion SPECT results. Using the 4DM, QPS, and ECT programs, the total defect extent (TDE) such as LAD, LCX, RCA and the summed stress score (SSS) have been analysed for their correlations and statistical comparison with the paried t-test for the quantitative indices analysed from each group. Results: The correlation of 4DM:QPS, QPS:ECT, ECT:4DM each group result from 145 patients is 0.84, 0.86, 0.82 at SSS, 0.87, 0.84, 0.87 at TDE, and both index showed good correlation. In paired t-test and Bland-Altman analysis results showed no statistically significant difference in the comparison of QPS:ECT at the mean SSS and TDE, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index. The correlation of 4DM:QPS, QPS:ECT, ECT:4DM program results from abnormal group (65 patients) is 0.72, 0.72, 0.70 at SSS and 0.77, 0.70, 0.77 at TDE and TDE and SSS has a good correlation. In abnormal group, paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.89) and TDE (p=0.23) comparison, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). In normal group (80 patients), paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.95) and TDE (p=0.73) comparison. And 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). Conclusions: The perfusion defect of the Tl-201 myocardial perfusion SPECT was analyzed in not only the patient in whom it has the cardiovascular disease but also the patient in whom the possibility of the cardiovascular disease is few. In the comparison of the all group research, the mean of the TDE and SSS, 4DM was lower than QPS and ECT progrms. Each program showed good correlation and the results showed statistically significant difference. However, in this way, it is determined to be compatible about the analysis value in which the large-scale side between the programs uses each program a difference in a clinical in the Bland-Altman analyzed result in spite of the good correlation and cannot use. but, this analyzed result will be able to be usefully used as the reference material for the clinical read and is expected.

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Community Residents' Knowledge, Attitude, and Needs for Hospice Care (일부 지역주민들의 호스피스에 대한 인지와 태도 및 간호요구 조사)

  • Ro, You-Ja;Han, Sung-Suk;Ahn, Sung-Hee;Yong, Jin-Sun
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.23-35
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    • 1999
  • Purpose : The hospice movement began about 30 years ago in Korea. However, basic studies have seldom been conducted about the general public's knowledge concerning hospice care and their needs for it. The purpose of this study was to investigate the general public's knowledge of and attitude toward hospice, and their needs for hospice care, and to analyze the needs for hospice care in relation to their knowledge and attitude in residents from a specific community. Methods : The survey was conducted with 924 people randomly selected from a district in Seoul. The data were collected through a self-reporting questionnaire constructed by the authors. With 30 items given in the questionnaire, the level of hospice needs showed Cronbach's alpha .89 in a pilot study and .92 in this study and the items were classified into four areas by a factor analysis. The data collected were analyzed by means of t-test and ANOVA. Results : 1) The average age of the respondents was 38. The majority of the respondents were well-educated. 2) Regarding awareness of hospice care, 54%(501 people) indicated they have heard of hospice. About 74% thought that people should be able to prepare for death in advance. About 83% wanted to be informed when they have life threatening illnesses such as terminal cancer. Also, about 63% responded that patients with terminal diseases should be provided with physical, spiritual, and psychological care for minimizing pain and peaceful death. Regarding the attitude toward hospice care, 74% responded that they would use hospice care if needed. The number of the respondents who preferred home visitation by the hospice team to care for the terminally ill ranked first with 34%. Concerning needs for hospice care : 1) By needs area, physical need showed highest mean(M=4.37), followed by social need(M=3.96), emotional need(M=3.87), and the spiritual need(M=3.79). The overall need level showed the mean value of 4.00 which reflects a considerable need for hospice care. 2) By demographic characteristics, people age over 50, the married, and the unemployed indicated higher level of needs for hospice care. Women showed higher level of needs than did men, and Catholics demonstrated higher level of needs than believers of other religion(P<0.0001). 3) As for the knowledge of and attitude toward hospice rare, the level of hospice care needs was significantly higher in the following groups: those who have heard of hospice, those who are aware of death preparation, those who want information on terminal diseases, those who want to use every method to sustain life, and those who are aware of hospice needs(P<0.001). Conclusion : It is assumed that the findings of this study on the knowledge, attitude, and needs for hospice care in the public can contribute to planning a successful hospice care program. Furthermore, the findings of this study will serve as useful data for the promotion of home hospice care to improve the quality of life of community residents, and contribute to the development of hospice care as a whole.

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Research on the Methods and Proper Provisions for Rotational Irrigation (윤환관개방법과 적정시설 연구)

  • 유한열
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.13 no.1
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    • pp.2191-2205
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    • 1971
  • In this research, Nong-rim No. 6 was adopted as a test variety of rice. Rice seedlings were transplanted on June 14, 1970. Roots were settled into soil on June 20 and a total number of days irrigated of $21cm{\times}21cm$ and an area of $9.9m^2$ for a test plot were accepted, planting 70 stumps of rice in a test plot. The soil in test plots are classified by soil test as oam, and its chemical contents are as shown in Table 3. Irrigation water was secured by pumping from the Sudun stream that originates at the Suho reservoir. Accordingly, the qualities of irrigation. water are considered to be the same as those of water stored in the Suho reservoir. There were 54 days of intermittent rainfalls in total during the whole 110-day period of irrigation. As a result, it is likely that the growth of rice plants was influenced by rainfall at a comparatively great degree. In order to measure the amounts of water consumption, infiltrometers, measuring devices for the decreases of water depths and lycimeters were provided. As a result of measurements, an average daily rate of infiltration was observed to be 14mm/day. It is expected from this research that the effect of increased yield will be secured by supplying optimum amounts of water for irrigation on proper times, and that the amounts of water consumption for irrigation can be saved by applying suitable irrigation methods. The test results obtained are summarized as follows: 1. Yields produced in the test plots of continuous irrigation are lower than those in the test plots of rotational irrigation, i.e., yields produced at the test plots irrigatied once in a period of 8 days are higher by 27% in average than those produced at test plots of continuous irrigation. 2. The amounts of irrigation water for test plots, which have a clay layer of 9cm in thickness and vynil diaphragm without holes, are saved by about 52% in comparison with ordinary test plots. 3. Ears are sprouted 5 days earlier at continuous irrigation plots as compared with other test plots. 4. It seems that there are growing stages of rice plants such as those of forming and sprouting of ears, in which the amounts of irrigation water are consumed more in comparison with the other stages. Therefore, it may be possible to increase of decrease the amount of irrigation water, according to the growing stage of rice plant, so as to save irrigation water.

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The Influence of the Preoperative Chronic Cyanosis on the Cardiac Troponin I in the Pediatric Cardiac Operation (지속적인 청색증에 노출된 선천성 심장병에서 수술 후 Cardiac Troponin I의 농도 변화)

  • Song, Jinyoung;Lee, Sungkyu;Lee, Jaeyoung;Kim, Soojin;Shim, Wooseup
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.498-504
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    • 2002
  • Purpose : The purpose of this study was to evaluate the perioperative myocardial damage in pediatric congenital heart disease with the cardiac specific protein of cardiac troponin I(cTpn-I). Methods : All 25 pediatric patients who were diagnosed with tetralogy of Fallot or double outlet right ventricle were classified as group A(acyanotic, $SaO_2$ >90%), group B(mildly cyanotic, $SaO_2$ >80-90%) and group C(moderately cyanotic, $SaO_2$ <80%). The control group D was consisted of 10 patients with ventricular septal defects who were operated in the same period. We measured preoperative hemoglobin, preoperative and postoperative(24 and 72 hour) arterial oxygen saturation, cTpn-I and creatine kinase(CK-MB). Results : Total 25 patients were subdivided into 6 of group A, 12 of group B and 7 of group C. The concentrations of preoperative cTpn-I were $0.23{\pm}0.12ng/mL$ in group A, $0.25{\pm}00.12 ng/mL$ in group B, $0.26{\pm}0.13ng/mL$ in group C. And the concentrations of cTpn-I in postoperative 24 hour were $10.04{\pm}5.28ng/mL$ in group A, $12.50{\pm}6.86ng/mL$ in group B, $12.55{\pm}9.90ng/mL$ in group C. Which revealed cTpn-I in group C was higher than that of the another less cyanotic groups. In addition, the concentration of cTpn-I of group C in postoperative 72 hour was higher than any other groups. The concentration of cTpn-I in postoperative 72 hour was statistically correlated with that in postoperative 24 hour and preoperative arterial oxygen saturation(P=0.001). Conclusion : Preoperative chronic cyanosis can influence on the postoperative concentration of cTpn-I in pediatric cardiac patients, which means impairment on the postoperative myocardial recovery.

Strategy for Store Management Using SOM Based on RFM (RFM 기반 SOM을 이용한 매장관리 전략 도출)

  • Jeong, Yoon Jeong;Choi, Il Young;Kim, Jae Kyeong;Choi, Ju Choel
    • Journal of Intelligence and Information Systems
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    • v.21 no.2
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    • pp.93-112
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    • 2015
  • Depending on the change in consumer's consumption pattern, existing retail shop has evolved in hypermarket or convenience store offering grocery and daily products mostly. Therefore, it is important to maintain the inventory levels and proper product configuration for effectively utilize the limited space in the retail store and increasing sales. Accordingly, this study proposed proper product configuration and inventory level strategy based on RFM(Recency, Frequency, Monetary) model and SOM(self-organizing map) for manage the retail shop effectively. RFM model is analytic model to analyze customer behaviors based on the past customer's buying activities. And it can differentiates important customers from large data by three variables. R represents recency, which refers to the last purchase of commodities. The latest consuming customer has bigger R. F represents frequency, which refers to the number of transactions in a particular period and M represents monetary, which refers to consumption money amount in a particular period. Thus, RFM method has been known to be a very effective model for customer segmentation. In this study, using a normalized value of the RFM variables, SOM cluster analysis was performed. SOM is regarded as one of the most distinguished artificial neural network models in the unsupervised learning tool space. It is a popular tool for clustering and visualization of high dimensional data in such a way that similar items are grouped spatially close to one another. In particular, it has been successfully applied in various technical fields for finding patterns. In our research, the procedure tries to find sales patterns by analyzing product sales records with Recency, Frequency and Monetary values. And to suggest a business strategy, we conduct the decision tree based on SOM results. To validate the proposed procedure in this study, we adopted the M-mart data collected between 2014.01.01~2014.12.31. Each product get the value of R, F, M, and they are clustered by 9 using SOM. And we also performed three tests using the weekday data, weekend data, whole data in order to analyze the sales pattern change. In order to propose the strategy of each cluster, we examine the criteria of product clustering. The clusters through the SOM can be explained by the characteristics of these clusters of decision trees. As a result, we can suggest the inventory management strategy of each 9 clusters through the suggested procedures of the study. The highest of all three value(R, F, M) cluster's products need to have high level of the inventory as well as to be disposed in a place where it can be increasing customer's path. In contrast, the lowest of all three value(R, F, M) cluster's products need to have low level of inventory as well as to be disposed in a place where visibility is low. The highest R value cluster's products is usually new releases products, and need to be placed on the front of the store. And, manager should decrease inventory levels gradually in the highest F value cluster's products purchased in the past. Because, we assume that cluster has lower R value and the M value than the average value of good. And it can be deduced that product are sold poorly in recent days and total sales also will be lower than the frequency. The procedure presented in this study is expected to contribute to raising the profitability of the retail store. The paper is organized as follows. The second chapter briefly reviews the literature related to this study. The third chapter suggests procedures for research proposals, and the fourth chapter applied suggested procedure using the actual product sales data. Finally, the fifth chapter described the conclusion of the study and further research.

Annual Analysis on Quality Attributes and Customer Satisfaction in School Foodservice (연차별 학교급식 품질 속성 및 전반적인 만족도 분석)

  • Yi, Bo-Sook;Yang, Il-Sun;Park, Moon-Kyung
    • Journal of Nutrition and Health
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    • v.42 no.8
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    • pp.770-783
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    • 2009
  • The school foodservice was quantitatively extended by policy of government all the while. There was carried out the survey of customer satisfaction about school foodservice by the ministry of education, science, and technology since 2006 years. Therefore, the purpose of this study was to grasp an improvement of the scores of school foodservice' quality attributes and satisfaction as compared with the preceding year by respondents and school type (elementary school, middle school, and high school). An annual survey was practiced to respondents (students, parents, and faculty) on september 2007 years and 2008 years in 16 cities and provinces. The statistics was analyzed to descriptive analysis and t-test for SPSS 12.0. The scores of school foodservice' quality attributes and overall customer satisfaction were almost increased to students, parents, and faculty and especially, big elevation in middle school. There was big increased the quality attributes such as 'providing information on foodservice', 'pleasant foodservice environment', 'kindness offered by employee' in elementary school, middle school, and high school to total respondents. An overall satisfaction in school foodservice was improved from 69.2 score to 71.9 score. On students, scores of overall satisfaction was increased from 72.9 to 74.0 as students of elementary school and from 61.5 to 65.8 as students of middle school (p < .001). Therefore, for improvement and development of school foodservice, there should be a necessary for an operator of school foodservice and an office of education to make an effort.

Evaluation of the Fruit Quality Indices during Maturation and Ripening and the Influence of Short-term Temperature Management on Shelf-life during Simulated Exportation in 'Changjo' Pears (Pyrus pyrifolia Nakai) (배 신품종 '창조'의 성숙 중 품질 요인 변화 및 수송온도 환경에 따른 반응성)

  • Lee, Ug-Yong;Choi, Jin-Ho;Ahn, Young-Jik;Chun, Jong-Pil
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.378-385
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    • 2017
  • In this study, we evaluated the changes of fruit quality indices during fruit development and ripening in Korean new pear cultivar 'Changjo', developed from a cross between 'Tama' and '81-1-27' ('Danbae' ${\times}$ 'Okusankichi') in 1995 and named in 2009, to determine appropriate harvest time and to enhance the market quality and broaden the cultivation area. The fruits of 'Changjo' pears harvested from 132 days after full bloom (DAFB) to 160 DAFB. Fruit growth and quality indices were monitored at 1 week interval by measuring fruit weight, length, diameter, firmness, and taste related quality indices. The calculated fruit fresh weight increased continuously with fruit development and reached to an average of 594g on Sep. 20 (160 DAFB). The ratio of length to diameter declines as fruit maturation progress, resulting in 0.898 for ripe fruit stage as a round oblate shape. Flesh firmness of 'Changjo' pears showed over 30N until 153 DAFB and then decreased abruptly with fruit ripening, reaching a final level of about 26.44N on 160 DAFB. Starch content of fruit sap was also decreased abruptly after 146 DAFB which decreased almost half of the fruits harvested at 139 DAFB. In parallel with the decrease of flesh firmness, ethanol insoluble solids (EIS) content decreased sharply with fruit ripens, only 50% of EIS was detected on the fruits harvested on 160 DAFB when compared to that of the fruits harvested on 139 DAFB (Aug. 30). The maximum value of soluble solids contents was observed in the fruits harvested on 153 DAFB, resulting in $14.2^{\circ}Brix$. The changes of skin color difference $a^*$ which means loss of green color occurred only after 139 DAFB, coincide with the decrease of SPAD value of the fruit skin. The sugars of the 80% ethanol soluble fraction consisted mainly of fructose, sorbitol, glucose and sucrose, also increased during maturation and ripening. Fructose and sucrose contents were larger than those of glucose and sorbitol in flesh tissues. These results were explained that stored starch is converted to soluble sugars during fruit maturation, mainly in fructose and sucrose increasing the sweetness of this cultivar. Total polyphenols were increased up to middle of fruit maturation (146 DAFB) and then decreased continuously until the end of fruit maturation. Consequently, our results suggested that the commercial harvest time of 'Changjo' pears should not be passed 153 DAFB and late harvest of this cultivar would not good for quality maintenance during shelf-life. As a result of the post-harvest low-temperature acclimation experiment during the short-term transportation period, fruits harvested at 146 DAFB tended to maintain higher firmness after 14 days of simulated marketing at $25^{\circ}C$ compared to fruits harvested at 153 DAFB regardless of temperature set. And, the slower the rate of decrease to the final transport temperature of $5^{\circ}C$, the higher the incidence of internal browning and ethylene production. Therefore, in order to suppress the physiological disorder and to maintain the fruit quality when exporting to Southeast Asia in the 'Chanjo' pears, it is desirable to lower the temperature of the fruits within a short time after harvest and to set the harvest time before 146 days after full bloom.

A Study on Preparation of 3'-$[^{18}F]$Fluoro-3'-deoxythymidine and Its Biodistribution in 9L Glioma Bearing Rats (3'-$[^{18}F]$Fluoro-3'-deoxythymidine의 합성과 9L glioma 세포를 이식한 래트에서의 체내동태에 관한 연구)

  • Shim, Ah-Young;Moon, Byung-Seok;Lee, Tae-Sup;Lee, Kyo-Chul;An, Gwang-Il;Yang, Seung-Dae;Yu, Kook-Hyun;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo;Chun, Kwon-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.263-270
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    • 2006
  • Purpose: Several radioisotope-labeled thymidine derivatives such as $[^{11}C]$thymidine was developed to demonstrate cell proliferation in tumor. But it is difficult to track metabolism with $[^{11}C]$thymidine due to rapid in vivo degradation and its short physical half-life. 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) was reported to have the longer half life of fluorine-18 and the lack of metabolic degradation in vivo. Here, we described the synthesis of the 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) and compared with $([^{18}F]FET)\;and\;([^{18}F]FDG)$ in cultured 9L cell and obtained the biodistribution and PET image in 9L tumor hearing rats. Material and Methods: For the synthesis of $[^{18}F]$FLT, 3-N-tert-butoxycarbonyl-(5'-O-(4,4'-dimet hoxytriphenylmethyl)-2'-deoxy-3'-O-(4-nitrobenzenesulfonyl)-${\beta}$-D-threopentofuranosyl)thymine was used as a FLT precursor, on which the tert-butyloxycarbonyl group was introduced to protect N3-position and nitrobenzenesulfonyl group. Radiolabeling of nosyl substitued precursor with $^{18}F$ was performed in acetonitrile at $120^{\circ}C$ and deproteced with 0.5 N HCI. The cell uptake was measured in cultured 9L glioma cell. The biodistribution was evaluated in 9L tumor bearing rats after intravenous injection at 10 min, 30 min, 60 min and 120 min and obtained PET image 60 minutes after injection. Results: The radiochemical yield was about 20-30% and radiochemical purity was more than 95% after HPLC purification. Cellular uptake of $[^{18}F]$FLT was increased as time elapsed. At 120 min post-injection, the ratios of tumor/blood, tumor/muscle and tumor/brain were $1.61{\pm}0.34,\;1.70{\pm}0.30\;and\;9.33{\pm}2.22$, respectively. The 9L tumor was well visualized at 60 min post injection in PET image. Conclusion: The uptake of $[^{18}F]$FLT in tumor was higher than in normal brain and PET image of $[^{18}F]$FLT was acceptable. These results suggest the possibility of $[^{18}F]$FLT at an imaging agent for brain tumor.

Effects of Rice Hull Addition and Bin Wall Characteristics on Pig Slurry Composting Properties (왕겨 이용 방법과 옹벽이 돈분 퇴비화에 미치는 효과)

  • ;Craig, Ian P
    • Journal of Animal Environmental Science
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    • v.10 no.1
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    • pp.47-58
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    • 2004
  • This work was carried out to investigate the effects of rice hull continuously utilized and/or replenished on the composting properties and to obtain the fundamental data between an unsupported wall and a soil supported wall during the period of composting with pig slurry in winter season. There were no the temperature holding effects in soil supported wall. New compost facility design for the temperature holding effects from a soil supported wall was required. The results were as follows; 1. Composting 1㎥ of pig slurry caused to save on 0.31㎥ of bulking agent in the unsupported wall in comparison with a soil supported wall in the rice hull single addition, and 0.45㎥ in the rice hull gradual addition. 2. The pile in the rice hull single addition had a high temperature in 4 days of composting indicating $71^{\circ}C$ and had a tendency in repeating periodically between $40^{\circ}C$ and $65^{\circ}C$ till 43 days of composting. And also the temperature of the pile was maintained between $48^{\circ}C$ and $28^{\circ}C$ after 50 days of composting. The pile of a rice hull gradual addition had the lower point of the temperature high increasingly according to adding up rice hull during the 35 days of composting. 3. The pH recorded in the rice hull single addition was higher(8.35∼10.02) compared to the rice hull gradual addition(8.6∼9.8). The pile of a rice hull single addition had a tendency in abruptly decreasing pH of the unsupported wall during the period of between 0.363$\textrm m^3$ and 0.537$\textrm m^3$ as a unit of pig slurry per rice hull. EC depending upon the way in adding rice hull was changed between 1.10 mS/$\textrm {cm}^3$ and 1.87 mS/$\textrm {cm}^3$. 4. The organic matter in an unsupported wall of the hull single addition was maintained the level of 55% during the period between 0.119㎥ and 0.363㎥ as a unit of pig slurry per rice hull while in the soil supported wall between 48 and 70. Water soluble C:N ratio was maintained between 1 and 2 in the rice hull single addition, while between 1 and 3 in the rice hull gradual addition. 5. Fertilizer constituents were detected higher level in the unsupported wall than in the soil supported wall in all treatments. This was dependant upon the input of pig slurry.

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20 Years Surgical Experiences for Ebstein's Anomaly (엡스타인 기형의 20년 수술 치험)

  • Lee, Sak;Park, Han-Ki;Lee, Chang-Young;Chang, Byung-Chul;Park, Young-Hwan
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.280-287
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    • 2007
  • Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.