• 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.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.629-633
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• 1998

Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

• Proceedings of the Korean Society of Embryo Transfer Conference
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• 2002.11a
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• pp.87-87
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• 2002

초음파기기를 이용한 난포란의 채란 기술은 유전적으로 우수한 수정란의 다량확보가 가능함으로써 가축개량에 널리 응용할 수 있다. 그러나 초음파유도 난포란의 채란은 무엇보다도 회수율과 회수한 난포란의 질적 등급의 개선이 이루어져야 할 것이다. 본 연구는 등지방층두께, 일당증체량, 근내지방도 및 배최장근 단면적에 연관된 DNA marker가 검정된 한우로부터 FSH(FOLLTROPIN-V, Vetrepharm, Canada)를 투여하여 FSH 투여전.후의 포의 발달율과 등급별 회수율을 조사하였다. 공시동물의 발정주기에 관계없이 매주 무처리와 채란 12시간 전에 FSH를 각각 l00mg 과 200mg을 근육 주사하여 난포란의 채취를 유토하였다. 난소내 난포란의 채란은 SONOACE-600형 (Medison CO., 한국) 초음파기기를 사용하여 모니터 상에 검게 나타나는 난포를 17-gauge needle (Cook, Australia) 로써 70mmHg로 유지된 regulated vacuum pump를 이용하여 모두 채란하였으며, 소난포는 손가락 촉지를 이용하여 채란하였다. 난포의 크기는(large : $\geq$6mm, medium : 2-6mm, small $\leq$2mm) 무처리구에서 small(56.6%), medium(33.0%), large follicles(10.4%) 순으로 나타났으며, 전체 난포수는 106(8.2$\pm$3.6개) 였다. FSH 200mg 투여구에서는 medium(47.5%), small(32.5%), large follicles(20.0%) 순으로 나타났으며, 전체난포수는 40(10.0$\pm$2.2개) 였다. FSH l00mg 투여구에서는 medium(45.6%), small(43.5%), large follicles (10.9%) 순으로 나타났으며, 전체 난포는 92(7.7$\pm$2.5개) 였다. FSH 투여전 초음파 image 상으로 관찰한 난포수와 FSH 투여 후 초음파기기와 손가락 촉지를 이용하여 난포의 발달 및 난포란의 채란율은 200mg 투여 구에서는 투여 전에 4.3$\pm$0.6개였으나 투여 후에는 9.3$\pm$2.1개로 증가하였으며, 채란율은 75.0% 였다. l00mg 투여구에서도 투여 전후에 각각 5.3$\pm$1.2개 및 8.2$\pm$2.3개였으며, 채란율은 81.6%였다. 난포란의 채란율은 무처리구에서 88.7%(7.2$\pm$3.9개)로 나타났으며, 회수한 난포란의 등급은 각각 0.0%(GI), 5.3%(GII), 28.T%(GIII), 66.0%(GIV)로 나타났다. FSH 200mg 투여구의 채란율은 87.5%(8.8$\pm$2.6개)로 나타났으며, 등급별회수율은 GI(2.8%), GII(8.6%), GIII(34.3%), GIV(54.3%)으로 나타났다. 뿐만 아니라 FSH 100mg 투여구에서도 회수율은 89.1%(6.8$\pm$5.2개)였으며, 등급별 회수율은 각각 GI(8.5%), GII(13.4%), GIII(43.9%), GIV(34.2%)로 나타났다.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.730-735
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• 2002

Diaphragm is innervated by phrenic nerve and lower intercostal nerves. For patients with avulsion injury of brachial plexus, an in situ graft of phrenic nerve is frequently used to neurotize a branch of the brachial plexus. We studied short-term and mid-term changes of diaphragmatic level and movement in patients with dissection of phrenic nerve for neurotization. Material and Method : Thirteen patients with division of either-side phrenic nerve for neurotization of musculocutaneous nerve were included in this study. With endoscopic surgical procedure, the intrathoracic phrenic nerve was entirely dissected and divided just above the diaphragm. The dissected phrenic nerve was taken out through thoracic inlet and neck wound and then anastomosed to the musculocutaneous nerve through a subcutaneous tunnel. With chest films and fluoroscopy, levels and movements of diaphragm were measured before and after operation. Result : There was no specific technical difficulty or even minor postoperative complications following endoscopic division of phrenic nerve. After division of phrenic nerve, diaphragm was soon elevated about 1.7 intercostal spaces compared with the preoperative level, but it did not show paradoxical motion in fluoroscopy. More than 1.5 months later, diaphragm returned downward close to the preoperative level (average level difference was 0.9 intercostal spaces; p＝NS). Movement of diaphragm was not significantly decreased compared with the preoperative one. Conclusion : After division of phrenic nerve, the affected diaphragm did not show a significant decrease in movement, and the elevated diaphragm returned downward with time. However, the decreased lung volumes in the last spirometry suggest the decreased inspiratory force following partial paralysis of diaphragm.

• Proceedings of the Korean Society of Embryo Transfer Conference
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• 2002.11a
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• pp.86-86
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• 2002

면양과 염소가 최근 수십년동안 세계여러 나라에서 번식생리의 연구를 위한 모델로 사용되어 왔는데, 체내수정란의 생산에 관한 영역도 유럽을 중심으로 활발하게 연구되어왔다. 수정란생산을 위한 발정동기화방법, 과배란처리 및 수정란회수방법 기술은 현재 상당히 많은 기술진척이 이루어진 상태이나, 우리나라 고유의 재래유전자원인 흑염소에는 이를 위한 기술이 미진한 실정이므로 본 실험에서는 흑염소의 체내수정란생산기술을 확립하여 재래가축 유전자원보존을 위한 기초기술을 마련하고자 한다. 축산기술연구소 남원지소에서 사육하고 있는 체중 20kg 이상의 건강한 흑염소를 이용하여 발정동기화를 위해 controlled intravaginal drug release(CIDR)를 질내에 14일 동안 삽입하고, 과배란처리는 FSH를 CIDR 삽입 12, 13, 14일째에 12시간 간격으로 점감법으로 총20mg을 투여하였으며, PGF$_2$a를 13일째 FSH와 함께 투여하였다. CIDR는 14일째의 아침에 제거하였다. 수컷과의 교미는 CIDR제거 24시간후에 GnRH를 투여와 동시에 실시하였으며, 채란은 교미후 3일째에 외과적인 방법으로 실시하였다. CIDR처리경과에 따른 progesterone농도는 CIDR 주입시 바로 수치가 상승하여 제거전까지 6~12ng/m1의 농도를 유지하였으며, 제거즉시 2ng/ml 이하로 떨어졌다. 채란시 평균 배란점은 16.5개, 미배란난포 9.8개였으며, 회수수정란은 6.0개를 나타내어 채란율은 36.4%를 나타내었다. 회수된 수정란의 발달단계는 4-cell 78.9%, 2-cell 5.3%, fragmentation 15.8%를 나타내었다. 이와 같은 체내수정란생산방법을 기반으로 하여 이후 수정란의 동결 및 수정란이식기법에 관한 연구를 수행한다면 우리나라의 재래가축인 흑염소의 유전자원 장기보존과 생산성향상에 기여할 것으로 사료된다.배양액에 30 embryos/50ul 소적으로하여 38.8$^{\circ}C$, 5% $CO_2$의 탄산가스 배양기에서 각각 7일간 배양을 실시하였다. 조사된 결과는 SAS/STAT를 이용하여 통계분석을 실시하였다. 체외수정 12시간 후에 난자 급속 염색법으로 염색을 실시한 결과, 모든 처리구에서 핵성숙률(76.4~95.2%), 정자침투율(51.1~66.9%), 웅성전핵형성률(95.2~100%), 다정자침입률(18.2~25.6%) 및 평균침입정자수(1.2~l.4개)에서 유의적인 차이가 인정되지 않았다. 체외배양 48시간 난할률을 조사한 결과, 처리구별 차이(53.9~67.9%)는 인정되지 않았으나, 배양 7일째 배반포형성률은 각각 14.5, 25.4, 17.3 및 12.4%로서 25uM의 $\beta$-ME처리구가 유의적(P<0.05)으로 높은 배발달률을 나타내었고, 총세포수에 있어서는 대조구와 처리구간 유의적인 차이가 인정되지 않았다. 따라서 돼지 난포란을 성숙배양할 때, 25uM $\beta$-ME를 첨가배양하는 것이 양질의 돼지체외수정란을 생산하는 하나의 방법으로 조사되었다.다.natural objects and was popular at the time of Yukjo Dynasty, and there are some documents of that period left both in Japan and Korea. "Hyojedo" in Korea is supposed to have been influenced by the letter design. Asite- is also considered to have been "Japanese Letter Jobcheso." Therefore, the purpose of this study is to look into the origin

• Journal of the Institute of Electronics Engineers of Korea SD
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• v.38 no.10
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• pp.712-720
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• 2001

Algorithms from the research of the layout migration were proposed in the paper. These are automatic recognition algorithm for the VLSI devices from it, graph based construction algorithm to maintain the constraints, dependencies, and design rule between the devices, and high speed compaction algorithm to reduce size of the VLSI area and reuse the design with compacted size for the new technology. Also, this paper describes that why proposed algorithms are essential for the era of the SoC (System on a Chip), design reuse, and IP DB, which are the big concerns in these days. In addition to introduce our algorithms, the benchmark showed that our performance is superior by 27 times faster than that of the commercial one, and has better efficiency by 3 times in disk usage.

• Korean Journal of Soil Science and Fertilizer
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• v.43 no.1
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• pp.8-15
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• 2010

The effect of soil salinity and soil-wetting by rise of water table on the growth of fruit trees was studied to obtain information for orchard establishment in the Saemangeum reclaimed tidal land. Survival ratio of trees was 85%for grape, 31%for fig, 15%for apple and pear, and near zero for peach and blueberry. Wet injury induced by water-logged or flooded condition, rather than salt injury(soil EC was lower than 3.0dS $m^{-1}$ during growing period) is thought to be more responsible for low survival ratio of fruit trees transplanted in Saemangeum area. During the summer raining season in the reclaimed areas, the soil salinity tends to be decreased by natural rainfall effect, and the rainfall acceptable capacity(RAC) of soils dramatically is reduced(10-24 mm) as rainfall is continued to occur. In spite of high hydraulic conductivity(121 cm $day^{-1}$) of soils across the area, low RAC of soils might be due to high soil saturation and elevated water table during summer raining season. Therefore, the installation of effective drainage system should be the primary factor determining successful establishment of orchard in the Saemangeum reclaimed tidal land.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.220-226
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• 2007

Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.164-171
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• 1997

Heart transplantation is now accepted as a definitive therapeutic modality in patients with terminal hear failure. The first successful heart transplantation in humans was done in 1967 and the first case in Korea was performed in november, 1992. Since the first case in 1992, more than 50 cases have been performed in Korea. A total of 20 patients underwent orthotopic heart transplantation since November, 1992 in Asan Medicla Center. The purpose of this study is to evaluate the early results and the follow-up course of 20 cases of heart transplantation done in Asan Medical Center. The average age of 20 patients was 39.9$\pm$11.8 years old(20~58). The mean follow-up duration was 14.4$\pm$11.2 months(1~41). All patients are alive till now. The blood type was identical in 14 and compatible in 6 patients. ihe original heart disease was dilated cardiomyopathy in 16, valvular heart disease in 2, ischemic cardiomyopathy in 1, and giant cell myocarditis in 1 patient. HLA cross matching for recipient and donor was done in 18 cases and the results were negative for T-cell and B-cell in 16 patients, pos tive for warm B-cell in 2 patients. Among 6 loci of A, B, and DR, one locus was matched in 8 cases, 2 loci in 5 cases, and 3 loci matched in 1 case. The number of acute allograft rejection averaged 2.8$\pm$0.5 (0~6) per case and the number of acute allograft rejection requiring treatment averaged 1.0$\pm$0.9 (1~3) per case. The time interval from operation to the first acute rejection requiring treatment was 35.5$\pm$20.4 days (5~60). Acute humoral rejection was suspected strongly in 1 case and was successfully treated. The left ventricular ejection fraction measured by echocardiography and/or MUGA scan was dramatically increased from 17.5$\pm$6.8 (9~32)% to 58.9$\pm$2.0 (55~62)% after heart transplantation. Temporary pacing was needed in 5 patients over 24 hours but normal sinus rhythm appeared within 7 days in all cases. One patient has been taken permanent pacemaker implantation due to complete AV block appearing 140 days after heart transplantaion. One patient had cyclosporine-associated n urotoxicity during the immediate postoperative period and was recovered after 27 hours. The heart transplantation of Asan Medical Center is on a developing stage but the early result is comparable to that of well established centers in other countries, even though the long-term follow-up result must be reevaluated. We can conclude that the heart transplantion is a promising therapeutic option in patients with terminal heart failure.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.276-284
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• 2000

Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.