• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.269-274
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• 2006

Background: Tetralogy of Fallot (TOF) with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAS) is complex lesion with marked heterogeneity of pulmonary blood supply and arborization anomalies. Patients with TOF with PA and MAPCAS have traditionally required multiple staged unifocalization of pulmonary blood supply before undergoing complete repair. In this report, we describe recent change of strategy and the results in our institution. Material and Method: We established surgical stratagies: early correction, central mediastinal approach, initial RV-PA conduit interposition, and aggressive intervention. Between July 1998 and August 2004, 23 patients were surgically treated at our institution. We divided them into 3 groups by initial operation method; group I: one stage total correction, group II: RV-PA conduit and unifocalization, group III: RV-PA conduit interposition only. Result: Mean ages at initial operation in each group were $13.9{\pm}16.0$ months (group 1), $10.4{\pm}15.6$ months (group II), and $7.9{\pm}7.7$ months (group III). True pulmonary arteries were not present in f patient and the pulmonary arteries were confluent in 22 patients. The balloon angioplasty was done in average 1.3 times (range: $1{\sim}6$). There were 4 early deaths relating initial operation, and 1 late death due to incracranial hemorrhage after definitive repair. The operative mortalities of initial procedures in each group were 25.0% (1/4: group I), 20.0% (2/10: group II), and 12.2% (1/9: group III). The causes of operative mortality were hypoxia (2), low cardiac output (1) and sudden cardiac arrest (1). Definitive repair rates in each group were 75% (3/4) in group I, 20% (2/10, fenestration: 2) in group II, and 55.0% (5/9, fenestration: 1) in group III. Conclusion: In patients of TOF with PA and MAPCAS, RV-PA connection as a initial procedure could be performed with relatively low risk, and high rate of definitive repair can be obtained in the help of balloon pulmonary angioplasty. One stage RV-PA connection and unifocalization appeared to be successful in selected patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.11
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• pp.416-424
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• 2017

This study was conducted to examine the awareness of workers in public institutions of automated external defibrillators, their usage intention and related educational experience in an effort to increase the efficiency of education and the rate of automated external defibrillator usage in emergency situations. The subjects in this study were 243 selected. male and female adults who worked in public institutions in Gangwon Province. A survey was conducted from June 13 to August 21, 2016. The statistical analysis was based on the frequency analysis and the $X^2$-test. There were significant differences among the public institution workers awareness of how to use an automated external defibrillator according to gender (${\chi}^2=6.32$, p<0.05) and academic credentials (${\chi}^2=5.91$, p<0.05). Additionally, there were significant differences in usage intention according to academic background (${\chi}^2=5.70$, p<0.05). The most common reason for having no intention to use an automated external defibrillator for patients with cardiac arrest was that the respondents did not know how to use it (31.5%). There were also significant differences in educational experience with automated external defibrillators according to age (${\chi}^2=6.15$, p<0.05), academic credentials (${\chi}^2=11.56$, p<0.01) and career (${\chi}^2=11.92$, p<0.01). The most common form of education that the workers received pertaining to automated external defibrillators was a combination of theoretical and practical education, which represented 55.9%. The findings of the study seem to suggest that workers in public institutions used by many people must receive compulsory standard education regarding automated external defibrillators and try to boost the revival rate of patients with cardiac arrest in real emergency situations.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.638-645
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• 2003

The purposes of this study were to evaluate the effect of myocardial protection with our cold blood cardioplegic solution and to observe the relationship between ultrastructural study and other evaluation methods and its effectiveness. Material and Method: We evaluated the changes of myocardial ultrastructure using semi-quantitative scoring system, CK-MB fraction, SGOT and LDH1/LDH2, and EKG in 18 patients undergoing valvular heart surgery and coronary artery bypass grafting (CABG). Right atrial auricular biopsies were taken before the cardiopulmonary bypass (CPB) and shortly after the end of CPB. Myocardium-related serum enzymes ＆ EKG were checked for 3 days of postoperative period and their postoperative peak enzyme value and observed new Q wave ＆ ST segment elevation in EKG were choosen. Result: There were 8 males and 10 females, and their mean age was 55.6$\pm$13. Eight patients underwent valvular heart surgery and ten coronary artery bypass grafting, The mean CPB time was 119$\pm$29 minutes and the mean aortic cross-clamp (ACC) time was 75.4$\pm$24 minutes. Before the start of CPB, the mean mitochondrial score was 4.28$\pm$0.53 and after the end of CPB, it significantly increased to 2.35$\pm$0.79. There was no evidence of perioperative myocardial infarction in terms of myocardiumrelated serum enzyme value and Q wave and ST change in EKG. There was no significant relationship between pre-CPB and post-CPB mitochondrial score and the mean time of CPB and ACC, and the mean value of postoperative peak CK-MB, SGOT and LDH1/LDH2, but there was relatively positive correlation of CPB time with peak LDH1/LDH2. Conclusion: Despite the apparent satisfactory results in myocardium-related serum enzymes ＆ EKG, with this study using the cold blood cardioplegic solution, there were many changes in myocardial ultrastructures, and more studies are needed to obtain further information.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.184-192
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• 2009

Background: Although complications from transfusion are known to happen, transfusion is performed during most open heart surgeries. The aim of this study was to investigate the possibility of performing cardiac surgery without allogenic blood transfusion. Material and Method: Between January to August 2007, 44 consecutive patients who underwent open heart surgery with using various blood conservation methods were retrospectively enrolled. They were divided into group I (the onpump group, n=17) and group II (the offpump group, n=27). The blood conservation methods were intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. Antianemic agents were administered to all the patients postoperatively. We analyzed the possibility of bloodless operations, the causes of homologous transfusion, the serial change of the hematocrit and the postoperative chest tube drainage, and we compared the results between the two groups. If comparison between the two groups was not reasonable, then we compared two groups with the individual control groups I and II (49 patients) in 2006. Result: 40 (90.9%) of 44 patients were successfully operated on without transfusion and the success rate was 88.2% (15/17) for group I and 92.6% (25/27) for group II. There was no statistical difference between the two groups (p=NS). The causes of transfusion were 2 cases of postoperative bleedings, 1 case of intraoperative bleeding and 1 mistake of the indication for transfusion. There was no statistical difference of the total chest tube drainage (Group I: $417{\pm}359mL$, Group II: $451{\pm}237mL$) (p=NS), but the total chest tube drainages of the two groups were less than each of the control groups 1 and II (p<0.05). The lowest hematocrit level of Group I was $16.4{\pm}2%$, and this occurred just after infusion of cardioplegics and the hematocrits of both groups were recovered to the preoperative level at 2 months postoperatively. Conclusion: In this study, bloodless open heart surgery could be performed in 90.9% of the patients with intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. A combination of various blood conservation methods is the most important and bloodless cardiac surgery could be performed with meticulous bleeding control and strictly following the transfusion indications.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.179-189
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• 1993

It has recently become possible to record electrical activity originating from abnormally conducting myocardium from the body surface with high - gain amplification and averaging technique. These signals, which result from delayed ventricular activation(late potentials), have been recorded in patients with documented ventricular tachyarrythmia. Several electrode lead system for detecting ventricular late potential were introduced. Pyramidal electrode lead system(PLS) is useful. Also interpretation of SAECG in the young could be of value in detecting those at risk for episodic ventricular tachycardia, but suffer from a lack of data in normal young people. Selection of subjects : For this study, normal healthy young adult volunteers (age: mean 24 years) were recruited from the medical students at Yeungnam University Hospital, Internal Medicine. Twenty fourths male and seventeenths female subjects were selected. All subjects had normal resting ECGs as judged from both the standard 12 channel lead and echocardiography, and none had a history of cardiovascular disease. All subjects were considered to be in good general physical condition. Signal-averaged electrocardiography : In order to obtain low noise recordings with a small number of averaging cycles, all subject ware asked to relax completely in the supine position. Silver/silver chloride electrodes were attached after the skin was cleaned with alcohol, to constitute classic flank lead system(FLS) and pyramidal lead system(PLS). Signals were recorded and processed using a commercially available microprocessor-augmented ECG cart(Marquette Electronics, USA) suitable for portable bedside recording. There was no difference between normal values, determined by FLS and PLS at high pass filtering of 25 Hz and 80 Hz, but significant, difference was found in HFLAD and RMS-40 of 40 Hz(p<0.05). These results will provide a basis for interpretations of SAECG, determined by FLS and PLS in healthy young adults with normal QRS duration.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.456-463
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• 2009

Background: Although the reports on re-operative coronary revascularization (redo-CABG) have increased, there are only limited reports on redo-CABG using arterial grafts. The aim of this study was to analyze the safety and feasibility of using various arterial grafts for redo-CABG. Material and Method: A consecutive series of patients who underwent 33 redo-CABGs from March 2001 to July 2008 were retrospectively reviewed. We performed conventional CABG in 17 patients, on-pump beating CABG in 7, off-pump CABG in 7 and minimally invasive direct coronary artery bypass in 2. The grafted that were used included 34 internal thoracic arteries (ITA), 14 radial arteries, 14 right gastroepiploic arteries and others. Arterial composite grafts were constructed in 26 patients. Of these, a previously patent in-situ left ITA was re-used as the in-flow of a composite graft in 10 patients. Result: No hospital deaths or major wound problems occurred. The post-operative complications included 2 myocardial infarctions (6%), 1 intra-aortic balloon pump insertion (3%), 5 cases of atrial fibrillation (15.1 %) and 3 neurologic complications (9.1%). The meanfollow-up duration was 31.1$\pm$22.7 months and the 3 year survival rate was 86.4%. There were 4 late deaths (2 cardiac deaths) and no recurrent angina during the follow-up period. Conclusion: Redo-CABG with using various arterial grafts is currently a safe, feasible procedure, but further investigation and long term follow-up are needed.

• Korean Journal of Environment and Ecology
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• v.21 no.3
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• pp.213-222
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• 2007

The goal of the study is to provide basic information that can be used to come up with environmental interpretation methods that are appropriate to the conditions of urban parks. For this matter, research was conducted to find out whether the environmental interpretation that was provided to the visitors of the World Cup Park Visitor Center encouraged them to become interested in the environment and to understand how such environmental interest was related to the level of satisfaction that the visitors were experiencing from their visits to the park. At the same time, the research was designed to find out whether the park's visitors were affected differently in terms of their environmental interests and their experience depending on the two different types of environmental interpretations; Interpreter's Interpretation and Self-guiding Interpretation. Experimental result showed no statistically meaningful correlation between environmental interpretation and environmental knowledge, though the experimental group subjected to environmental interpretation was found to have higher environmental knowledge than that of the control group, which was not subjected to environmental interpretation. As for the correlation between environmental knowledge, which was acquired through environmental interpretation, and environmental interest, the group, which showed big changes in terms of the volume of environmental knowledge, was found to have higher environmental interest than that of the group, which recorded a low level of changes in the volume of environmental knowledge. Also, the difference in their level of environmental interest was big enough to be acknowledged statistically. Also environmental interest, which was created thanks to environmental interpretation, was found to affect the level of satisfaction visitors feel when visiting the park. Even though the study was intended to find out how environmental interpretation affects park visitors by means of analysis that can be proved based on facts, it was difficult to control some of the variables due to the circumstances under which the experiments were conducted. Despite this, the study can be considered meaningful in the fact that the researches and experiments were conducted at a park that is actually visited by people. It is also believed that as one of the first studies done on the World Cup Park, it could serve as a basis upon which future studies could be carried out.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.28 no.3
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• pp.1-13
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• 2010

This research is the semantic study on the nature cognition and lyricism of pavilion builders as reflected in the pavilion tablets in the Damyang poetry culture area built during 16th century. The names of pavilions, pavilion writings and "poetry with given theme" were studied by actual site visits. The view on the nature and aesthetic awareness of the pavilion builders at the time were explored together with surrounding landscapes. Following conclusions were drawn. 1. Pavilion names borrowed phrases from the famous historical events left by the sages. Or, they took the compliment on the beautiful nature surrounding orthe academic achievement of pavilion owners as the theme, then elaborated them with thinking based on Sung Confucianism. 2. The writings of pavilion literature were the idealistic view on the nature. They think the nature and human as "object and ego are one, object and ego communicate each other, object and ego become one". 3. The nature in the 16th century was the "principle of birth-death-grow-wither" for the intellectuals. They thought that the nature is the ultimate place to return for the realization of life with self-respect. 4. The introduction of fairy land among literary activities in the pavilion was the symbolic means healing the frustrated ego. It was confirmed that they temporarily entrusted their depressed feelings by borrowing the fairy land, far from the reality. The pavilion was the space to escape from the reality and soothe the anger and discord in the reality. 5. The pavilion literature in the Damyang poetry culture area during 16th century sang their pleasure of enjoying the beautiful scenery in the rural area using their social status. The literary works also contained their agony due to the frustration of difficulty in the realization of ideal. When the intellectuals, who already mastered literature, history and philosophy, came down to rural area, built pavilions at the location with beautiful scenery, and spent time while composing poetry, it was an escape from the burden that they should take the social responsibility as the model intellectuals of the society. The pavilions in Damyang poetry-culture area during 16th century were the idealized conceptual world and the space of awareness reflecting the philosophy and thinking of the time.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.18 no.4
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• pp.206-213
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• 2013

Glass eels (Anguilla japonica) are caught in the west coast of Korea on their migratory route from the breeding grounds in the Mariana Trench along the North Equatorial Current and the Kuroshio Current. To identify the food source of natural glass eels, we analyzed the stable C and N isotopes of glass eels caught in April 2012 and investigated possible food sources in the survey area. In particular, with respect to the stable C and N isotopes of particulate organic matter, we extended the surveying area to the northern parts of East China Sea as well as the west coast of Korea. The stable C and N isotope ratios of the glass eels caught in the west coast were found to be $-20.7{\pm}0.1$‰ and $5.0{\pm}0.2$‰, respectively. The stable C and N isotope ratios of the particulate organic matter in the west coast of Korea, in which the glass eels are assumed to eat the particulate organic matter as food source, were estimated to be $-24.0{\pm}0.3$‰ and $2.8{\pm}0.4$‰, respectively. Similar data were obtained from the northern part of the East China Sea, $-24.5{\pm}0.5$‰ and $0.8{\pm}0.3$‰. The stable isotope ratios showed values differing from the stepwise increasing rates up the food web in natural aquatic ecosystem, showing that particulate organic matter in the west coast of Korea and East China Sea was not served as the glass eels food source. This result suggested that the glass eels caught in the west coast might not assimilate nutrition from the marine environment during long migration.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.29 no.3
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• pp.40-51
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• 2011

The purpose of the study was to understand the symbol and locational meanings in building and relocating Gwangje-jeong(光霽亭) through the analysis and interpretation on the construction background, history, the location and its characteristics. Concerning physical environment, human activities, the symbol and meanings of the formal Gwangje-jeong site and the present location, the study was concluded about the site and its meaning of tradition as following. Gwangje, the name of the pavilion, represents the fidelity of Maedang(梅堂) Yangdon(楊墩) who refused as Seonbee(a man of virtue) to be tainted with the corrupt world, which was related with the situation at that time. It implies Maedang's feeling of realizing Noojeongjeyong(樓亭題詠) of Gwangje-jeong along with the high spirit of Gwangpoongjewol(光風霽月). According to the record about rebuilding Gwangje-jeong, Maedang was the very person who planted plum flowers at the pavilion and put up the tablet of its name, Gwangje. Even after his death, Gwangje-jeong was the symbol indicating Yangdon, given the triple high ground and the planting of plum flowers. Also, Sookho(宿虎) town at the entrance of Gwangje-jeong and Bokhoam(伏虎巖: a rock) at the right side of the pavilion signifies the location for praising Maedang Yangdon, and the Yangjipha's Oensi(五言詩: five words verse) engraved on the rock gives a good description about the place, Agyesa that worshiped Yangdon. As Agye-Sa(阿溪祠) where Yangdon was worshiped and praised had been abolished in the 5th year under the Kojong's reign(1868), the spirit praising Maedang had finally been used for the relocation of Gwangje-jeong. Despite the relocation of Gwangje-jeong, the old Gwangje-jeong site has remained at least for 359years at Hucheonli, and its surroundings have maintained the name 'Gwangje' as the front place name morpheme, for example, 'Gwangje-jeong,' 'Gwangje Town,' 'Gwangje Bridge' and 'Gwangje Creek,' for symbolizing the praising of Maedang. Gwangje-jeong, as the center place of solidarity among Namwon Yang's family clan, has been able to maintain its symbol and meanings in spite of relocation, mainly because of the fellowship among the descendants, family clan and alumni who respected virtuous achievements of ancestors and shared the agony of the time. In addition, the symbolism has been preserved since the spirit of Gwangpoonjewol of Yangdon and his high character were cherished along with the spirit of Bongseon(奉先) that inherited and kept virtuous achievements of ancestors.