• Korean Journal of Soil Science and Fertilizer
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• v.29 no.2
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• pp.158-164
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• 1996

This survey was conducted to investigate the distribution of heavy metal contents in medicinal plants and soils. Plant and soil samples were collected at 254 sites(Angelica gigas : 81, Astragalus membranceus : 38, Platycodn glandiflorum : 36, Paeonia albilora : 34, Codonopsis lanoceolata : 32, Ligusticum chuanxiong : 17, Bupleurum falcatum : 16, respectively) over the country, Soil texture, pH values and heavy metal content of soils and medicinal plants were evaluated as major factors. Soil texture classification showed that sandy loam, loam, loamy sand and silt loam were 46.1%, 26.0%, 19.3% and 8.6% of the total, respectively. The contents of O.M, Ex.Ca. Ex.Mg and EC value were higher in loamy(sandy loam, loam and silt loam)soils than in sandy(loamy sand)soils, but available $P_2O_5$ contents of loamy sand soils were higher than those of sandy loam, loam, and silt loam. The contents of Cd, Cu, Pb, Zn and Ni in soil were high in loamy soils, while Cr content was high in loamy silt soils. The contents of Cu and Cr in Angelica gigas were high in loamy soils, and those of Pb in Astragalus membranceus, Paeonia albiflora and Codonopsis lanoceolata were high in sandy loam soils. Correlation coefficients between heavy metal contents in medicinal plants and their soils with soil texture were positively correlated in sandy loam and loam at Cu, loam at Zn, sandy loam, loam and loamy sand at Cr, respectively. Correlation coefficients between pH value of the soils and contents of Cd, Zn and Ni in medicinal plants were negatively correlated, but those of Cd, Pb, Zn and Ni in soils were positively correlated.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.961-969
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• 2003

The purpose of this study was to evaluate the fate of left atrioventricular valve regurgitation(LAVVR) following repair of complete atrioventricular septal defects (AVSDs). Material and Method: Between July 1984 and March 2002, repair of complete AV defects were performed in 77 patients. Mean age at surgery was 30.23$\pm$69.11 months (range 1 to 456). Echocardiograms of all survivors after isolated AVSDs correction were reviewed. LAVVR were evaluated with color doppler echocardiography in 64 survival periodically. On each study, LAVVR severity was graded on a 1 to 4 scale, based upon the size of the regurgitated jet. Result: Mild deterioration of LAVV function was fairly common. LAVVR severity increased by >1 grade in 19 patients (30.2%) during the course of the study. However, the deterioration in LAVVR function occurred primarily between 12 and 24 months postoperatively. After the initial 24 postoperative months, LAVVR worsened on only 8 occasions and in each instance worsened by only 1 grade. Deterioration more than 3+ LAVVR occurred in only 3 patients. And deterioration to 4+ LAVVR was not observed after the initial 24 postoperative months but one. Survival curve analysis predicted a 88.2% of ten-year freedom rate from development of 4+ LAVVR after initial operation of complete AVSDs. Conclusion: Postoperative LAVVR remains fairly stable following AVSDs repair, Serious deterioration is rare after 24 postoperative months, especially after the initial 48 postoperative months. But serial follow-up study with echocariogram was need till 24 postoperative months after repair of complete AVSDs.

• Journal of Chest Surgery
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• v.38 no.4 s.249
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• pp.291-300
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• 2005

One-stage repair of aortic arch anomalies and intracardiac defects through median sternotomy has been recently adopted by many institutions since it is known to be safer than the staged repair. The early and midterm results of the one-stage repair of aortic arch anomalies and intracardiac defects were retrospectively evaluated. Material and Method: 45 patients who underwent one-stage repair of aortic arch anomalies and intracardiac defects performed by one surgeon from January 1996 to July 2003 were included in this retrospective study. The median age of repair was 16 days (range, 3 days$\~$23.7 months) and the mean weight was $3.62\;\pm\;1.30 kg$. Thirty one $(68.9\%)$ had coarctation and 14 $(31.1\%)$ had interrupted aortic arch. Associated intracardiac anomalies were VSD in 31 patients (VSD group), TGA or Taussig-Bing anomaly in 10 (TGA group), and others in 4 (ASD in 1, aortopulmonary window 1, truncus arteriosus 1, aortic and mitral stenoses 1, miscellaneous group). The arch obstruction was repaired with end-to-side anastomosis in 23 patients and end-to-end anastomosis in 22. Result: Overall postoperative hospital mortality was $22.2\%\;(10/45);\;16.1\%$ (5/31) in VSD group, $40\%$ (4/10) in TGA group, and$25\%$ (1/4) in miscellaneous group. There was no mortality in VSD group since 1998, and the mortality in TGA group has remarkably reduced since technical modification for coronary transfer was adopted $(75\%\;vs\;16.7\%)$. There was no postoperative seizure or other neurological complications. Postoperative aortic restenosis occurred in 5 patients $(5/35,\;14.3\%)$. Two patients underwent balloon aortoplasty with successful results. There was no reoperation. There was one late death caused by pneumonia 5 months after the operation. Two-year actuarial survival rate including operative death was $72.9\%$. Conclusion: The operative mortality of one-stage repair has been reduced with time and aortic restenosis rate was also acceptable. We concluded that this procedure is a reproducible procedure for aortic arch anomalies associated with intracardiac defects.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.635-642
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• 2006

Purpose : The purpose of this study is to determine whether the new pulmonary valve reconstruction technique prevents short-term postoperative pulmonary regurgitation and improves early and mid-term clinical outcome. Methods : We reviewed postoperative echocardiographic variables and chest X-ray films from 31 patients who had undergone valve reconstruction(pulmonary valve reconstruction group : PVR) for the repair of TOF between April 2000 and August 2004. We compared the clinical data of these patients with those from 47 patients who had right ventricular outflow tract reconstruction with a monocusp valve(monocusp ventricular outflow patch group : MVOP) and 22 patients who had a transannular patch repair without a monocusp valve(transannular patch group : TAP). Results : In the PVR group, 25 patients(81 percent) had trivial or mild pulmonary regurgitation in their early post operative echocardiogram. Only 12 patients(26 percent) in the MVOP group had mild pulmonary regurgitation; and no patient in the TAP group had it. Pulmonary valve function was good in 96 percent of the PVR group, 36 percent of the MVOP group, and none in the TAP group in early post-operative echocardiogram. Follow-up echocardiogram(1, 2, 3, 4 years later) of the MVOP and TAP groups showed moderate pulmonary regurgitation and severely decreased valve function in almost all cases. However, in the PVR group 54 percent(16/28), 50 percent(14/28), 37 percent(9/24), and 31 percent(5/16) of the patients had trivial or mild pulmonary regurgitation 1, 2, 3 and 4 years after operation, respectively. The valve function remained good in 80 percent(24/30), 64 percent(18/28), 57 percent(12/21), and 31 percent(5/16) of the patients 1, 2, 3 and 4 years after operation respectively. Conclusion : Pulmonary valve reconstruction is effective in reducing pulmonary regurgitation and right ventricular dilatation in the repair of TOF, even though regurgitation increases with time. Further study is needed to determine long-term results.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.24-31
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• 1996

Between January 1992 and February 1995, 36 patients with mitral regurgitation were treated by a mitral repair There wert nineteen men and seventeen women whose mean age was 41.8 years, ranged from 10 to 71. Seventeenth patients had dystrophic change of mitral valve, twelve patients had rheumatic change of mitral valve, second patients had infective change of mitral valve and another fifth patients had functional change of mitral valve. Operation proced res were suture annuloplasty (35 cases), resection of leaflet (25 cases), chordal shortening(9 cases) and commisurotomy(1 cases). These procedures were combined in most patients. Two third of the patients were in New York Heart Association class III or IV and four fifth of the patients were in mitral regurgitation grade III or IV by doppler echocardiogram. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data and functional class. Intraoperative TEE had been used in all most patients after weaning of bypass. If there remained MR more than grade 2, the valve was re-repaired or replacement. There were no operative death. The late mortality was 5.5% and cause of death was congestive heart failure. Patients have been followed up from 3 to 40 months, mean 15. Second patients underwant reoperation due to recurred mitral regurgitation, 4 and 19 days after the operation. During reoperation, we found that the repair suture was disrupted in both patients. Th s expierence demonstrated that intraoperative TEE is accurate and predictable and excellent immediate and mid-term results have been achieved by mitral valve repair.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.366-375
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• 2006

Background: Hypomagnesemia is a common complication after cardiac surgery with cardiopulmonary bypass. The purpose of this study was to assess the clinical beneficial effect of administration of magnesium sulfate in cardiac surgery. Material and Method: Thirty five patients scheduled for elective cardiac surgery were randomly assigned to magnesium group (n=20) which received magnesium sulfate in priming solution (1 g) and cardioplegic solution (1 g) or control group (n=15) which did not receive it. Arterial blood samples were drawn for measuring $Mg^{++}$ and electrolytes contents, blood gas analysis, CBC, total protein, albumin, blood urea nitrogen (BUN), creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, tumor necrosis factor-${\alpha}$ $(TNF-{\alpha})$, interleukin-6 (IL-6), interleukin-10 (IL-10), creatine phosphokinase (CpK), creatine kinase-MB (CK-MB), lactate dehydrogenase(LDH), troponin-1 (TNI), prothrombin time (PT) and activated pratial thromboplastin time level (aPTT). Venous blood samples were drawn before and after the operation for measuring activated clotting time level (ACT). Result: $Mg^{++}$ levels in magensium group were higher than those of control group at intraoperative and post-operative periods (p<0.05). dysrhythmias were lower in magnesium group (8 cases out of 17 patients, 46.4%) than in control group (10 cases out of 10, 100%, p=0.050). Conclusion: These results showed that administration of low dose magnesium sulfate during cardiac surgery prevented hypomagnesemia and lowered incidence of dysrhythmia.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.313-321
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• 2004

Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (＞30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.364-374
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• 2010

Background: We assessed the early and mid-term results of the modified Norwood procedure for first-stage palliation of hypoplastic left heart syndrome (HLHS) and its variants to identify the risk factors for hospital mortality. Material and Method: Between March, 2003, and December, 2009, 23 patients (18 males and 5 females) with HLHS or variants underwent the modified Norwood procedure. The age at operation ranged from 3 to 60 days (mean, $11.7{\pm}13.2days$) and weight at operation ranged from 2.2 to 4.8 kg (mean, $3.17{\pm}0.52kg$). We used a modified technique that spared the anterior wall of the main pulmonary artery in 20 patients. The sources of pulmonary blood flow were RV-PA conduit in 15 patients (group I) and RMBTS in 8 (group II). Follow-up was completed in 19 patients (19/20, 95%) in our hospital (mean $26.0{\pm}22.8months$). Result: Early death occurred in 3 patients (3/23, 13%), of whom 2 had TAPVC. Fourteen patients underwent subsequent bidirectional cavopulmonary connection (BCPC, stage 2) and seven underwent the Fontan operation (stage 3). Three patients died between stages, 2 before stage 2 and one before stage 3. The estimated 1-year and 5-year survival rates were 78% and 69%, respectively. On multivariate regression analysis, aberrant right subclavian artery (RSCA) and associated total anomalous pulmonary venous connection (TAPVC) were risk factors for hospital mortality after stage 1 Norwood procedure. Conclusion: HLHS and its variants can be palliated by the modified Norwood procedure with low operative mortality. Total anomalous pulmonary venous connection adversely affects the survival after a stage 1 Norwood procedure, and interstage mortality rates need to be improved.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.375-380
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• 2010

Background: Primary cardiac tumors are extremely rare. The most common type are benign myxomas, and these are almost completely curable with early surgery. Malignant tumors, however, such as sarcomas, are difficult to remove surgically, and their prognosis is known to be poor. In this study, data on patients who had undergone surgical treatment of cardiac tumor in the authors' hospital were collected and analyzed. Material and Method: The subjects included 28 patients who had undergone surgical treatment of cardiac tumor from August 1993 to December 2008. Their medical records were reviewed and retrospectively analyzed. Result: The patients were aged from 20 to 76 years (mean age: $54.2{\pm}15.6$), and 11 were male (39%) and 17 female (61%). Fifteen of them (54%) underwent emergency surgery to improve heart failure symptoms. The most common preoperative symptom was dyspnea (15 cases, 54%). Preoperative echocardiography was performed on all the patients. The average size of the tumor as measured during the operation was $7.0{\pm}6.9cm$ (the average length of the long axis was 2∼40 cm), and the sites of tumor attachment were the interatrial septum (18 cases, 64%), the left atrium (9 cases, 32%), the mitral valve annulus (2 cases, 7%), and the left ventricle (2 cases, 7%). The operation was performed with an incision through both atria in all the patients, and a complete excision was made in 25 cases (89%). According to the biopsy results, there were 4 cases of sarcoma (14%), 1 case of lipoma (4%), and 23 cases of myxoma (82%). The three cases in which the tumors were not completely excised were sarcomas. No operative deaths occurred after the operations. Outpatient follow-up was possible for 24 cases (86%), with a mean follow-up period of $46.8{\pm}42.7$ months. Late death occurred in 3 of the 24 patients; each of these patients had sarcomas. Of these patients, the first had undergone two repeat surgeries, the second had metastatic sites removed, and the last had only chemotherapy. The average recurrence time was $12.7{\pm}10.8$ months, and the average metastasis time was $20.5{\pm}16.8$ months. Conclusion: Most cardiac tumors are benign myxomas. In principle, they should be surgically treated because they can create risks such as embolism, and can be radically treated when surgically removed. In most cases, however, malignant sarcomas are already considerably advanced with severe infiltration into the neighboring tissues at the time of diagnosis. The surgical removal of malignant sarcomas is known to be difficult because of the advanced stage and degree of infiltration. We suggest that excision of the removable portion of the tumor sites to alleviate symptoms such as heart failure can improve quality of life.

• Proceedings of the Korean Environmental Sciences Society Conference
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• 2007.05a
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• pp.308-311
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• 2007

황해의 25개 조사정점의 표층수에 대한 해양환경요인 및 식물플랑크톤 현존량의 월별 조사결과를 종합하여 주성분분석(PCA)을 실시한 결과 주성분 I에서는 변화를 26.6% 설명할 수 있으며, 이중 질산질소가 가장 많이 기여하였고, 이어서 용존무기질소, 규산규소, 수온, 용존산소, 암모니아질소 순으로 기여 하고 있었다. 주성분 II에서는 20.3%를 설명 할 수 있으며, 이중 용존산소가 가장 많이 기여하였고 그 외 엽록소 a, 수온, 염분, 규산규소, 식물플랑크톤 현존량 순으로 기여 하였다. 주성분 III에서는 15.1%를 설명 할 수 있으며, 이중 인산인이 가장 많이 기여하였고 그 외 염분, 아질산질소, 수온, 용존산소, 질산질소, 용존무기질소 순으로 기여하였다. PCA에 이용된 항목 중 부유물질은 제외한 모든 항목은 주성분 I, II, III에 5%이하 유의수준에서 의미 있는 상관성이 있었다. 주성분 I은 질산성질소, 용존무기질소, 규산규소, 인산인과는 긍정적인 상관성(p<0.0001)을 갖고, 수온, 암모니아질소와는 부정적인 상관성을 보였다(p<0.001). 주성분 II에서는 용존산소, 엽록소 a, 식물플랑크톤 현존량은 긍정적 상관성을 나타내었고, 수온, 염분, 규산규소와는 부정적인 상관성을 보였으며(p<0.0001), 주성분 III에서는 염분, 수온, 질산질소, 용존무기질소, 식물플랑크톤 현존량과는 긍정적인 상관성(P<0.0001)을 나타내었고 인산인, 아질산질소, 용존산소는 부정적인 상관성을 나타내었다 (p<0.01). 공간적인 분포특성은 조사정점에 따라 항목별 결과에 대한 분산이 커서 일정한 특성을 도출하기가 어려운 상태이나 대체로 PCA II축을 기준으로 상부인 $1/4{\sim}2/4$분면에 북부와 중부의 조사정점이 위치하고 음의 방향인 $3/4{\sim}4/4$분면에 중부와 남부의 조사정점이 위치하고 있어 북측의 307선과 308선 및 중부의 309선과 310선 그리고 남측의 311선과 312선으로 구분되어지는데 그 중에서 태안반도의 연안역인 307선의 03점은 계절에 변화가 가장 커서 분산의 폭이 심한 상태로서 다른 조사정점들과 구분되어진다. 전반적으로 북측해역에서는 용존산소, 엽록소 a, 식물플랑크톤 현존량이 남측해역에 비해 상대적으로 많은 반면, 남측해역은 수온과 염분 및 규산규소가 높은 상태이었다. 북쪽인 307선과 308선은 연안역과 외해에서 상대적으로 영양염류가 높았으며, 중부인 309선과 310선은 연안역과 준 외해역인 07점과 09점에서 영양염류가 높았었고, 남부 해역인 311선과 312선에서는 연안역에서 영양염류가 상대적으로 높은 경향을 나타내었다. 즉 황해 동부는 연안역에서는 조석간만의 차가 심하고, 새만금 및 시호호등과 같은 대규모의 간척 매립으로 육상의 오염원이 자정작용을 거치지 못하고 직접 연안으로 유입되고 있는 실정이다. 또한 10여 년 전부터 육지의 모래부족으로 다량의 바다 모래가 채취되어 왔고 그 량이 점차 증가추세이며, 중부외해역에서는 각종 폐기물 투기로 점차 영양염류의 부하량이 증가되고 있어 특히 질소계와 인의 영양염류 농도가 높아지고 있는 추세이다. 시간적 변동특성은 전반적으로 순환하는 형태를 유지하고 있다. 2005년 2월에는 질산질소, 용존무기질소, 규산규소, 인산인, 용존산소가 높았었으며 4월로 접어들면서 항목 간에 분산되는 경향을 보이면서 수온, 엽록소 a 및 식물플랑크톤이 증가 하면서 해역에 따라 좌우로 분산되는 경향을 나타내었고 6월에는 아질산질소를 제외한 영양염류가 감소하는 경향을 보였다. 8월에는 6월에 비해 수온이 높아지고 규산규소, 질산질소, 용존무기질소 등이 약간 증가추세이었으며 10월로 접어들면서 증가추세가 더 높아졌었고 12월에는 질산질소, 용존무기질소, 규산규소, 인산인, 용존산소가 높아졌었다. 2006년 4월에는 2005년 4월에 비해 수온, 엽록소 a, 식물플랑크톤의 현존량이 높아져서 전년 동시기와 약간 다른 양상을 보이고 있었다. 즉 동계인 2월을 시작으로 반 시계 또는 시계 방향으로 순환하는 형태를 유지하고 있으며, 4월은 2개년 비교해 보았을 때 해마다 해양환경에 따라 그 순환 정도 및 형태가 다를 것으로 추정된다.