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An Analysis of Swimming Injuries and Their Rehabilitation (근육 골격계의 질환 및 재활분석(수영선수를 중심으로))

  • Kim, Kwi-Baek;Ji, Jin-Gu;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.32 no.4
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    • pp.325-330
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    • 2022
  • While swimming is a very popular competitive sports activity, swimming injuries are unique due to the repetitive nature of the swimming stroke and demanding training programs that can result in upper limb overuse. Therefore, the primary objective of this review was to analyze swimmers' injury areas, injury types by stroke type, and swimming rehabilitation, as well as to discuss safety management for improving swimming performance. In this study, the injuries incurred in swimming events were discussed in the order of upper limb injuries (neck, shoulder, arm, and wrist), lower limb injuries (knee and ankle), and waist injuries. An analysis by stroke type found that shoulder injuries occurred most often with freestyle, backstroke, and butterfly strokes, followed by rotator cuff injury, impingement syndrome, and SLAP (superior labral tear from anterior to posterior) lesions. Knee injuries were associated with the breaststroke, whereas spinal cord injuries occurred with the breaststroke and butterfly stroke. Finally, back injuries were associated with the butterfly stroke. During the freestyle stroke, the shoulder undergoes repetitive overhead movement; hence, shoulder and musculoskeletal pain are the most common and well-documented complaints of swimmers. For safety management, coaches and instructors must ensure that athletes do sufficient warm-up and cool-down exercises to avoid injuries. In case of an injury, they should be familiar with first aid measures so that secondary damage can be prevented with its quick application. In addition, coaches and instructors need to be trained in injury prevention and treatment so that they can provide appropriate rehabilitation treatment for athletes. Although swimming-related injuries cannot be completely eliminated, to reduce them to a minimum, leaders need the knowledge to apply scientific and systematic training principles and methods individualized for each athlete.

The Effect of Science Class Using Smart Devices on the Perceptions and Scientific Attitude of Middle School Gifted Students (스마트 기기를 활용한 과학 수업이 중학교 영재 학생의 인식 및 과학적 태도에 미치는 영향)

  • Kim, Eun-Ji;Kim, Hyun-Kyung
    • Journal of the Korean Chemical Society
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    • v.66 no.4
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    • pp.323-332
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    • 2022
  • The purpose of this study is to investigate the effects of science classes using smart devices that combine augmented reality (AR) and virtual reality (VR) on the scientific attitude of middle school gifted students. In addition, it is intended to find out the perception of science classes using these smart devices. In addition to actual experiments, a science class program that allows students to experience science experiments virtually using AR and VR was applied to 15 middle school gifted students. Before and after the application of the program, the questionnaire is to investigate the interest in scientific classes, the attitude toward science exploration, and the professional interest in science, and the recognition of classes that combine AR and VR. In addition, through in-depth interviews, the perceptions of gifted students was accurately investigated. As a result of this study, the content of science classes and instructors showed high class satisfaction, but the smart devices and applications used during the science classes showed lower class satisfaction than others. As a result of comparing and analyzing the pre-post of gifted students, interest in science class, attitude toward science inquiry, and professional interest in science increased significantly among the sub-areas of the scientific attitude test. As a result of analyzing free responses and indepth interviews, gifted students responded with the advantage that classes using smart devices that combine AR and VR can be tested quickly and safely for a short time compared to actual experiments. On the other hand, they responded with low completeness of the application and dizziness when operating virtual reality. Based on this, implications for the development of applications and instructional programs using advanced technologies that can experience realistically limited scientific experiments such as experimental preparation, class time, and risk factors were obtained.

Mass Proliferation of Hibiscus hamabo Adventitious Root in an Air-lift Bioreactor, and the Antioxidant and Whitening Activity of the Extract (생물반응기를 이용한 황근 부정근의 대량증식과 추출물의 항산화 및 미백 활성 평가)

  • Lee, Jong-Du;Hyun, Ho Bong;Hyeon, Hyejin;Jang, Eunbi;Ko, Min-Hee;Yoon, Weon-Jong;Ham, Young Min;Jung, Yong-Hwan;Choi, Hwon;O, Eu Gene;Oh, Daeju
    • Korean Journal of Plant Resources
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    • v.35 no.4
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    • pp.435-444
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    • 2022
  • Hibiscus hamabo Sieb. et Zucc. (yellow hibiscus) is a deciduous semi-shrub plant and mainly growing in Jeju Island. This is known the unique wild hibiscus genus and classified as an 2nd grade of endangered plant for Korean Red List. In previous studies, properties of germination, ecological, genetical and salt resistance have been reported. In this study, we investigated mass-proliferated adventitious root using bioreactor, antioxidant and whitening effects to conduct functional ingredients. Yellow hibiscus were collected from Gujwa, Jeju by prior permission and they were introduced by explant type and various medium composition after surface sterilization. As a result, seed response rates were evaluated at range of 51.17~51.83%, in terms of comprehensive efficiency of shoot and root formation. In the case of adventitious root propagation condition was confirmed in half strength Murashige and Skoog medium salts, 30 mg/L sucrose, and 2 mg/L indole-3-butyric acid for 8 weeks in 5,000 mL bioreactor. We also compared between relationship with biomass and secondary metabolites accumulation by total phenolics content, the flavonoid content, DPPH free radical scavenging activity and melanin content. The results indicated that adventitious root mass proliferation, antioxidant and whitening effect could develop value of the high-quality cosmeceutical ingredient and further metabolite studies.

A Study on the Adaptation Process of North Korean Immigrant Youth Discontinuing Formal Education (학업중단 북한이탈 청소년의 적응과정에 관한 질적연구)

  • Yang, Young Eun;Bae, Imho
    • Korean Journal of Social Welfare Studies
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    • v.41 no.4
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    • pp.189-224
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    • 2010
  • Nowadays Korean society has a fast growing population of North Korean immigrant youth. Especially, North Korean immigrant youth, who are discontinuing formal education, experience difficulties in social exclusion and adaptation. Therefore, the purpose of this study was to understand the experiences of adaptation and social support of North Korean immigrant youth discontinuing formal education, and to seek affirmative supporting plans and solutions for their adaptation. The methodology utilized for this study was a case study research. On the basis of the results and categorization, 'a network between overall categories and of early adaptation' was derived. The major findings of this study are summarized as follows. First, the participants of this study experienced major difficulties during 'economical adaptation', and their economical adaptation was strongly interrelated with their 'educational adaptation'. The discontinuing of their education resulting from their fleeing period caused 'academic differential and age disparity.' Thus they could not enroll in the formal education system, and their insufficient educational background resulted in low wages and overwork due to manual labor jobs. Second, participants recognized 'interpersonal relations' as the most essential factor in adaptation, and 'social support' from the interpersonal relations played an important role in adaptation to and comfort in Korean society. 'Interactions with South Koreans' was recognized as a significant resource for gaining informational and appraisal support, but was not activated satisfactorily. On the other hand, interaction with North Korean immigrants was avoided by the reason that 'there's nothing to learn', however emotional support from North Korean immigrants of close relationship played an important role in participants' adaptation, especially in all aspects of psychological adaptation. Third, participants experienced a lot of difficulties and stresses in their 'physical health and psychological adaptation'. Their chronic diseases worsened by remaining untreated, and female perceived symptoms were observed more often than in male. Meanwhile, excessive 'stresses' from the unfamiliar environment of South Korea negatively affected their psychological adaptation. However, they were satisfied with sense of liberty and security from living in a democratic society.

Development of a prototype simulator for dental education (치의학 교육을 위한 프로토타입 시뮬레이터의 개발)

  • Mi-El Kim;Jaehoon Sim;Aein Mon;Myung-Joo Kim;Young-Seok Park;Ho-Beom Kwon;Jaeheung Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.257-267
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    • 2023
  • Purpose. The purpose of the study was to fabricate a prototype robotic simulator for dental education, to test whether it could simulate mandibular movements, and to assess the possibility of the stimulator responding to stimuli during dental practice. Materials and methods. A virtual simulator model was developed based on segmentation of the hard tissues using cone-beam computed tomography (CBCT) data. The simulator frame was 3D printed using polylactic acid (PLA) material, and dentiforms and silicone face skin were also inserted. Servo actuators were used to control the movements of the simulator, and the simulator's response to dental stimuli was created by pressure and water level sensors. A water level test was performed to determine the specific threshold of the water level sensor. The mandibular movements and mandibular range of motion of the simulator were tested through computer simulation and the actual model. Results. The prototype robotic simulator consisted of an operational unit, an upper body with an electric device, a head with a temporomandibular joint (TMJ) and dentiforms. The TMJ of the simulator was capable of driving two degrees of freedom, implementing rotational and translational movements. In the water level test, the specific threshold of the water level sensor was 10.35 ml. The mandibular range of motion of the simulator was 50 mm in both computer simulation and the actual model. Conclusion. Although further advancements are still required to improve its efficiency and stability, the upper-body prototype simulator has the potential to be useful in dental practice education.

8년여의 세월호 사고원인 규명활동 결과의 정리와 분석 (1/2)

  • 조상래
    • Bulletin of the Society of Naval Architects of Korea
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    • v.61 no.1
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    • pp.16-29
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    • 2024
  • 2014년 4월 18일 오전 8시 48분경 전라남도 병풍도 인근 해역에서 세월호는 전복된 후 침몰하였다. 사고 당시 이 배에는 승객 443명과 선원 및 승무원 33명 모두 476명이 타고 있었고, 이 중 미수습자 5명을 포함하여304명이 생명을 잃었다. 그 동안 공식적인 사고원인 규명활동이 꾸준히 진행되어 이 사고의 원인을 규명하기 위한 조사가 네 차례 있었다. 하지만 아직까지 사고 원인이 무엇인지 명쾌하게 밝혀지지 않고 있다. 이 글에서는 먼저 그동안 있었던 네 차례의 공식적인 세월호 사고원인 규명활동을 정리하였다. 가장 먼저 사고원인 규명활동을 전개한 해양안전심판원 특별조사부는 2014년 사고 직후부터 그해 12월까지 활동하였다. 특별조사부 최종보고서에는 화물의 과적과 평형수 적재 부족으로 인한 선박복원성 기준 미달, 타각의 대각도 조타와 장시간 유지로 인한 부적절한 조타, 화물의 부실한 고박으로 인한 화물의 이동, 수밀문의 관리 부실로 인한 조기 침수와 비상대피장소(muster station)로의 승객대피 조치 미이행을 사고의 원인으로 들고 있다. 2015년 3월부터 2016년 6월까지 활동한 4·16세월호참사 특별조사위원회(특조위)는 '4·16 세월호 참사 특별 조사위원회 청산 백서'만을 간행하고 최종보고서를 제출하지 못한 채 활동을 종료하였다. 세월호 선체조사위원회(선조위)는 2017년 4월부터 2018년 8월까지 활동하였다. 선조위는 세월호 사고원인 규명을 위한 다른 기구에 비해 위원의 구성도 균형이 있었고, 직권사건 위주의 조사방법도 적절하였다. 또한 조타기와 조타 과실 여부, 급선회 항적 및 횡경사와 핀안정기의 물리적 손상에 관한 용역을 국내 여러 기관에 발주하였다. 뿐만 아니라 다양한 해양사고 원인규명 용역에 참여한 실적이 있는 영국의 기술용역회사인 Brookes Bell에 급선회와 빠른 침몰의 원인 조사를 요청하였다. 아울러 세계에서 가장 활발히 수조실험을 수행하고 있는 상업 연구소인 네덜란드의 MARIN에 수조시험과 시뮬레이션도 의뢰하였다. 하지만 아쉽게도 선조위는 서로 다른 사고 원인을 주장하는 두 권의 종합보고서를 간행하였다. 종합보고서로 '내인설' 종합보고서[6]는 타기 솔레노이드 밸브의 고착으로 시작된 급선회를 사고의 직접 원인으로 지목하고 있다. 하지만 '열린안' 종합보고서[7]에서는 수중체와의 충돌을 직접적인 사고 원인으로 밝히고 있다. 마지막으로 가습기살균제 사건과 4·16세월호 참사 특별조사위원회(사참위)가 2019년 3월부터 2022년 9월까지 활동하였다. 사참위는 위원으로 조선해양공학과 항해학 전문가가 포함되어 있지 않아 세월호의 사고원인 규명활동을 효과적으로 수행하기에는 적절하지 못하였다. 사참위는 주로 조타장치 고장에 따른 세월호 전타 선회현상 검증, 세월호 변형 손상부의 확인 및 원인 조사와 세월호 횡경사 원인과 침수과정 분석을 직권 과제로 추진하였다. 또한 네덜란드 MARIN에 자유항주시험을 추가로 의뢰하였으며, 핀란드의 NAPA group에도 복원성 계산과 침수해석을 의뢰하였다. 사참위는 선조위의 두 가지 사고원인에 대해 '내인설'의 솔레노이드 밸브 고착은 사고원인일 가능성이 매우 낮고, '열린안'의 수중체와의 충돌 시나리오는 근거가 부족함을 확인하였다. 이상에서 정리한 바와 같이 규명활동이 진행됨에 따라 사고원인이 수렴되어야 함에도 불구하고 아직까지 원인을 시원하게 밝히지 못하고 있다. 이 글에서는 사고원인 규명활동을 수행한 네 개 기구의 구성과 활동 내용을 비교하고, 사고조사 위원회의 바람직한 구성과 위원회의 운영 방법을 제시하고 있다. 또한 Brookes Bell 보고서에 수록된 출항 당시의 흘수에 근거한 배수량과 선미 램프의 폐쇄 전후의 횡경사각으로부터 도출한 GoM도 소개하고 있다. 아울러 출항 당시의 GoM값으로 추정한 사고 당시의 GoM값도 소개하고 있고, 수중체와의 충돌 시나리오를 후보 사고 시나리오에서 제외시켜야 할 이유도 열거하고 있다. 끝으로 해양사고 원인규명 활동이 보다 과학적으로 그리고 보다 합리적으로 이루어질 수 있기 위해 그리고 우리 사회의 안전문화 제고를 위한 몇 가지의 방안을 제시하고 있다. 또한 세월호 사고로 치른, 아직도 치르고 있는 희생을 딛고 해양안전문화가 한 걸음 더 나아가기 위해서는 세월호 사고의 원인을 반드시 규명해야 한다는 말씀으로 글을 마무리하고 있다.

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Protective Effect of Plantago asiatica L. Leaf Ethanolic Extract Against Ferric Nitrilotriacetate-Induced Prostate Oxidative Damage in Rats (랫드에서의 Fe-NTA 유발 산화스트레스에 대한 차전초 에탄올 추출물의 전립선보호 효과)

  • Hong, Seung-Taek;Hong, Chung-Oui;Nam, Mi-Hyun;Ma, Yuan-Yuan;Hong, Yun-Jin;Son, Da-Hee;Chun, Su-Hyun;Lee, Kwang-Won
    • Journal of Food Hygiene and Safety
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    • v.26 no.3
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    • pp.260-265
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    • 2011
  • Plantago asiatica L. (P. asiatica) has been used as one of the popular folk medicines in Asia for human health care practices. Various activities of P. asiatica have been reported, such as anti-oxidant, anti-glycation, anti-inflammatory and hepatoprotective activity. Therefore, the potential of P. asiatica to reduce oxidative stress has been studied in several ways for over 20 years, especially at liver and kidney. However no investigation has been reported revealing its protective effect on prostate. Method: Treatment of P. asiatica leaf ethanolic extract (PLE) (1 g/kg body weight (b.w.), 2 g/kg b.w., or 4 g/kg b.w.) were given separately to animals for pretreatment once per day for 7 days, and on the seventh day ferric nitrilotriacetate (Fe-NTA; 0.24 mmol Fe/kg b.w.), which is known as an oxidative stress-inducer at prostate, was administrated by i.p to negative control group. At the end of the study period, dissection was carried out for detecting the prostate protective effect of PLE. Result: Fe-NTA-treated animals produced reactive oxygen species (ROS) resulting in depletion of antioxidant biomaker, such as glutathione (GSH), glutathione reductase (GR), and glutathione s-transferase (GST) and increase of lipid peroxidation in prostate. However, PLE pretreatment resulted in an increase in the GSH, GST and GR levels concentration dependent manner and in an significant decrease in the levels of lipid peroxidation. Conclusion: Our data suggest that PLE may be effective in protecting oxidative stress-induced damage of prostate, and PLE may be an chemopreventive agent against Fe-NTA-mediated prostate oxidative damage.

Development of Conformal Radiotherapy with Respiratory Gate Device (호흡주기에 따른 방사선입체조형치료법의 개발)

  • Chu Sung Sil;Cho Kwang Hwan;Lee Chang Geol;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.41-52
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    • 2002
  • Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

The efficacy of continuous positive airway pressure (CPAP) for patient with left breast cancer (좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가)

  • Jung, Il Hun;Ha, Jin Sook;Chang, Won Suk;Jeon, Mi Jin;Kim, Sei Joon;Jung, Jin Wook;Park, Byul Nim;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.43-49
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    • 2019
  • Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

The Clinical Application and Results of Palliative Damus-Kaye-Stansel Procedure (고식적 Damus-Kaye-Stansel 술식의 임상적 적용 및 결과)

  • Lim, Hong-Gook;Kim, Soo-Jin;Kim, Woong-Han;Hwang, Seong-Wook;Lee, Cheul;Shinn, Sung-Ho;Yie, Kil-Soo;Lee, Jae-Woong;Lee, Chang-Ha
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.1-11
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    • 2008
  • Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.