• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.209-214
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• 2007

Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.196-204
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• 2001

Background : Bronchial asthma is characterized by a reversible airway obstruction, airway hyperresponsiveness, and eosinophilic airway inflammation. The bronchodilator response(BDR) after short acting beta agonist inhalation and PC20 with methacholine inhalation are frequently used for diagnosing bronchial asthma. However, the relationship between the presence of a bronchodilator response and the degree of airway hyperresponsiveness is uncertain. Therefore, the availability of a eosinophil cationic protein (ECP) and a correlation ECP with a bronchodilator response and airway hyperresponsiveness was investigated. Method : A total 71 patients with a moderate to severe degree of bronchial asthma were enrolled and divided into two groups. 31 patients with a positive bronchodilator response and 38 patients with a negative bronchodilator response were evaluated. In both groups, the serum ECP, peripheral blood eosinophil counts, and total IgE level were measured and the methacholine bronchial provocation test was examined. Results : There were no differences observed in age, sex, atopy, and baseline spirometry in both groups. The peripheral eosinophil counts showed no difference in both groups, but the ECP level in group 1 (bronchodilator responder group) was higher than in group 2(non-bronchodilator responder group) ($22.4{\pm}20.7$ vs $14.2{\pm}10.4$, mean$\pm$SD). The PC20 in group 1 was significantly lower than in group 2 ($1.14{\pm}1.68$ vs $66{\pm}2.98$). There was a significant positive correlation between the BDR and ECP, and a negative correlation between the bronchial hyperresponsiveness and ECP. Conclusion : The bronchodilator response significantly correlated with the bronchial hyperresponsiveness and serum ECP in the moderate to severe asthma patients. Hence, the positive bronchodilator response is probably related with active bronchial inflammation and may be used as a valuable index in treatment, course and prognosis of bronchial asthma.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.459-466
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• 2003

Background : Asthma and eosinophilic bronchitis(EB) are eosinophilic inflammatory diseases of the airway. However, EB differs from asthma in that there is no variable airway obstruction or airway hyper-responsiveness. Pathologically, asthma is characterized by the accumulation of eosinophils and CD4+ T lymphocytes in the submucosa. A recent study showed that there was no significant difference between asthma and EB in terms of the submucosal eosinophil and T lymphocyte count. However, it is not known whether or not an infiltration of CD4+ and CD8+ T lymphocytes occurs in the airways of EB patients. The aim of this study was to identify the difference between the two conditions by measuring the submucosal CD4+ and CD8+ T lymphocyte count. Methods : Immunohistochemical analysis of bronchial-biopsy specimens was performed in 17 subjects with asthma and 24 subjects with EB. Results : The CD4+ T lymphocytes count in the asthma subjects and the EB subjects was similar (median, 58.6 vs 50.0 $cells/mm^2$, respectively; P=0.341). In contrast, the number of CD8+ T lymphocytes in the EB subjects was higher than that in the asthma subjects (median, 46.7 vs 11.8 $cells/mm^2$, respectively; P=0.003). Conclusion : The infiltration of submucosal CD8+ T lymphocytes may be associated with the pathophysiology of EB.

• Tuberculosis and Respiratory Diseases
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• v.58 no.1
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• pp.18-24
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• 2005

Background : Endobronchial tuberculosis often complicates bronchostenosis, which can cause dyspnea due to an airway obstruction, and can be misdiagnosed as bronchial asthma or lung cancer. This study investigated the possible correlation between the $interferon-{\gamma}$($IFN-{\gamma}$) and transforming growth $factor-{\beta}$($TGF-{\beta}$) levels in the serum and bronchial washing fluid and the treatment results in endobronchial tuberculosis patients. Methods : Sixteen patients, who were diagnosed as endobronchial tuberculosis using bronchoscopy, and 10 healthy control subjects were enrolled in this study. The $IFN-{\gamma}$ and $TGF-{\beta}$ levels were measured in the serum and bronchial washing fluid of 16 endobronchial tuberculosis patients before and after treatment using the ELISA method. The endobronchial tuberculosis patients were divided into those who showed bronchial fibrostenosis after treatment and those who did not. Results : The $IFN-{\gamma}$ and $TGF-{\beta}$ levels in the bronchial washing fluid in endobronchial tuberculosis patients were elevated comparing to the control (p<0.05). After treatment, 7 of the 16 endobronchial tuberculosis patients showed bronchial fibrostenosis and the other 9 cases healed without this sequela. In the patients with fibrostenosis after treatment, the initial serum $TGF-{\beta}$ level was lower than the patients without fibrostenosis after treatment (p<0.05). Moreover, the serum $TGF-{\beta}$ level after treatment further decreased comparing to the patients without fibrostenosis after treatment(p<0.05). Conclusion : Elevated $IFN-{\gamma}$ and $TGF-{\beta}$ levels in the bronchial washing fluid in endobronchial tuberculosis patients are believed to be related to the pathogenesis of endobronchial tuberculosis. The decreased initial serum $TGF-{\beta}$ level and the change in the serum $TGF-{\beta}$ level after treatment are believed to be involved in bronchial fibrostenosis during the course of the disease.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.812-819
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• 2003

Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.107-115
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• 1998

Background: Chronic eosinophilic pneumonia(CEP) presents with profound systemic symptoms, including fever, malaise, night sweats, weight loss, and anorexia together with localized pulmonary manifestations such as cough, wheeze, and sputum. It is an illness occurring predominantly in women. The chest radiogragh shows fluffy opacities that often have a characteristic peripheral configuration. The hallmark of CEP is the peripheral blood eosinophilia and a prompt response to oral corticosteroid therapy. We investigated characteristics of eleven patients of chronic eosinophilic pneumonia, reported in Korea. Method: There were eleven reports of CEP from 1980 to 1996, including three cases experienced in our hospital. The journals were analysed in respects of clinical history, laboratory, and radiographic findings. Results: 1) Male vs. female ratio is 3 : 8. The peak incidence occurred in forty and fifty decades. The atopic diseases were present in 6 cases. Asthma was the commonest manifestation 2) The presenting symptoms were as follows: cough, dyspnea, sputum, weight loss, fever, general weakness, night sweats, urticaria with the descending incidence. 3) Peripheral blood eosinophilia was present in all patients(mean ; 38.4%) and serum IgE level was elevated in nine patients(mean ; 880IU/ml). Conclusion: The diagnosis of chronic eosinophilic pneumonia is based on classic symptoms, including fever, night sweats, weight loss with a typical roentgenogram of peripheral pulmonary infiltrates and peripheral blood eosinophilia, and that is confimed by lung biopsy and/or bronchoalveolar lavage. Chronic eosinophilic pneumonia is responsive to corticosteroid promptly and recommended at least 6 months of therapy to prevent relapse.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.374-382
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• 1999

Background: The aim of this study was to investigate etiologic factor, treatment, prognosis of spontaneous pneumothorax (SP). Material and Methods: The medical records of 225 cases of SP experienced at Kyungpook University Hospital from Jan. 1996 to Dec. 1997 were retrospectively analyzed. Results: The patients were 128 primary SP and 97 secondary SP. The mean age was $30{\pm}15.5$ years in primary SP and $51{\pm}7.4$ years in secondary SP. The ratio of male to female was 8:1 in primary SP and 5.5:1 in secondary SP. Smoker was more common in seconday SP (71.1 %) than primary SP (34.4%). About 70% of patients with primary and secondary SP was underweighted. The previous history of SP was present in 28.9% and 25.8% of primary and secondary SP, respectively. The main underlying lung diseases in secondary SP were inactive tuberculosis (68%), active tuberculosis (12.4%) and COPD (11.3%). Tube thoracostomy was performed in 96.8% and 97.9% of primary and secondary SP, respectively. The duration of chest tube insertion was longer in seconday SP ($18.2{\pm}19.59$ days) than primary SP ($7.5{\pm}6.57$ days). The open thoracotomy were performed in 22.7% and 10.3% of primary and secondary SP, respectively. The most com- mon indication of open thoracotomy was recurrence in primary SP and persistent air leak in secondary SP. During following-up of $17{\pm}7.8$ months, the recurrence rate in patients with conservative treatment was 16.5% and 11.8% of primary and secondary SP, respectively. The recurrence was most common within 1 month after discharge. Conclusion: Greater attention and research about SP are necessary for more efficient patient care.

• Journal of Korean Home Economics Education Association
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• v.19 no.4
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• pp.233-245
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• 2007

The purpose of this study is to investigate the appropriate way of essay writing education which helps the learners perceive and express a stream of knowledge through Home Economics education curriculum by themselves. While one-way type, which teachers just give instructions to students and students just learn from them, has dominated the education, new education focuses on interactive and reciprocal way in thinking and researching together. This new stream requires appropriate and various education method as well as the new concept of education curriculum. This study applies the curriculum of the German practical philosophy that recently has been a debated topic in Home Economics education. The purpose of the curriculum pursuits improving students' practical and critical thinking competence and essay writing is the center of it. In the curriculum learners write essays by asking and answering the questions through seven areas which students can experience based on three angles such as individual, social, and idealogical viewpoints. In this process learners don't remain in the individual angles and are able to be trained as intellectuals who can lead the social and cultural change as well as the individual growth by getting an insight into the idealogical angles. The Germany curriculum what is mentioned in advance presents one possibility that essay education can be introduced in Home Economics education that has accessed the education process by the practical inference based on the practical philosophy. That is, Home Economics education shares the context with essay education whose purpose is the intellect enlightenment because the former is the curriculum to make students build the abilities to access in many-sided angles not just one point, to deal with problems wisely, and to deduce the solutions. Therefore, students are expected to participate in the class dynamically by being satisfied intellectually abreast of practical essay education that helps learners read the stream of knowledge through Home Economics education. In this manner the category of Home Economics education will enlarge by making efforts to diversify the education methodology not staying only one method.

• Tuberculosis and Respiratory Diseases
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• v.58 no.4
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• pp.367-374
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• 2005

Background : The fact that only 10-20% of chronic cigarette smokers develop chronic obstructive pulmonary disease (COPD) reflects the presence of genetic factors associated with the susceptibility to COPD. Recently, it was reported that the surfactant protein A increases the secretion of matrix metalloprotease 9, which degrades extracellular matrices of the lung, through a Toll-like receptor 2 (TLR2). In this context, possible role of TLR2 in the pathogenesis of COPD was postulated, and a functional dinucleotide repeat polymorphism in intron II of TLR2 was evaluated for any association with COPD. Method : Male patients with COPD and male smokers with a normal pulmonary function were enrolled in this study. The number of Guanine-Thymine repeats in intron II of the TLR2 gene were counted. Because the distributions of the repeats were trimodal, the alleles were classified into three subclasses, 12-16 repeats: short (S) alleles; 17-22 repeats: medium length (M) alleles; and 23-27 repeats: long (L) alleles. Result : 125 male patients with COPD and 144 age- and gender-matched blood donors with a normal lung function were enrolled. There were no differences in the distribution of each allele subclass (S, M and L) between the COPD and control group (p=0.75). The frequencies of the genotypes with and without each allele subclass in the COPD and control group were similar. Conclusion : A microsatellite polymorphism in intron II of TLR2 gene was not associated with the development of COPD in Koreans.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.22 no.3
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• pp.88-102
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• 2017

Long-term changes in bathymetry and grain size of surface sediments were investigated for understanding depositional sedimentary environments in the channelized Yeongsan River Estuary, Korea. The results revealed that an average depth of the estuary had decreased up to 2.1 m from 1982 to 2006, while it had increased to 0.3 m from 2006 to 2012. The rapid decrease of the water depth from 1982 to 2006 was due to the vast deposition of mud caused by the change of water course and flow velocity after the estuary was dammed. Meanwhile the increase of the water depth from 2006 to 2012 may be associated with multiple erosional processes, including a dredging at the southern part of the estuary and other erosions from the dike sluice expansion work. Considering the water-depth change and tidal-level variation in the study area, an depositional rate in the estuary is estimated to be 8~9 cm/yr for the last 2 decades (1982~2006). The sediments of Yeongsan River Estuary are largely composed of silt-clay mixtures: overall, silt is distributed mainly in the shallow area of the estuary edge, while clay is confined to the deep area of the estuary center. Mean grain size of the sediments is 6.0 Ø on average in 1997, 7.8 Ø on average in 2005 and 7.7 Ø on average in 2012, respectively, suggesting that the sediments became finer due to the increase of silt and clay contents in 1997~2005. Furthermore, several lines of evidences, including the comparison between the amounts of the sediment influx discharged from the Yeongsan River and the sediments in the estuary, and the changes in distribution pattern of silt and clay contents implying that they moved from offshore to estuary dike, indicate that the mud sediments are originated mainly from the offshore, not from the river.