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Staged Fontan Operation Via Bidirectional Glenn Operation (양방향성 GLENN 수술을 통한 단계적 FONTAN 수술의 임상분석)

  • 한재진;김웅한
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1062-1068
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    • 1997
  • From August 1989 to January 1996, a total of 105 cases of bidirectional Glean operations have been done as the interim stage for the patien s with some risk of univentricular correction at Sejong General Hospital. From December 1992, we started the conversion to Fontal operations for them, and 42 cases underwent Fontal-stage operation till February 1996. Their diagnoses were univentricular heart in 19(right ventricular type : 14), tricuspid atresia 11, double outlet of right ventricle 9, and others in 3 cases. The median age of bidirectional Glerln-stage operation was 12.5 months(range 2 months to 8 years) and Fontan-stage operation was at 59.6 months of median age(range 1 year 5 months to ,9 year 7 months). The mean waiting interval between the two operations was 33.88 $\pm$ 17.85 months with a range of 10 months to 6 years 3 months. During the waiting periods, 18 patients developed significant systemic-pulmonary collaterals andfor systemic verso-veno collateral channels. There were 5 hospital deaths after operations due to low cardiac output in 4 and sepsis in one. Most of the Fontal-stage operations were done by the late al tunneling with Core-Tex tube graft patch and fenestrated with the size of 2.5 ~6 mm. All the patients were followed-up(7 months to 4 years 2 months, mean 21.97$\pm$10.82 months) and there were 5 late deaths(postoperatively 6 months to 2 years) due to thromboembolism in 1, after heart transplantation 1, plastic bronchitis 1, protein loosing enteropathy 1, and pneumonia in 1. Dividing the patients by the waiting interval of 2 years, the early correction to Fontal group (N=16) showed the better results(hospital mortality 1116, late mortality 1116, significant collateral development 2/16) compared to the other group(N=26) (4/26, 4/26, 16/26). In conclusion, after the bidirectional Glean-stage operation successfully got rid of the previous risk factors, we recommand to do the Fontan-stage operation no later than 2 years of interval.

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Comparison of Growth Characteristics and Compounds of Ginseng Cultivated by Paddy and Upland Cultivation (논 . 밭재배에 따른 인삼의 생육 및 성분 특성 비교)

  • Lee, Sung-Woo;Kang, Seung-Won;Kim, Do-Yong;Seong, Nak-Sul;Park, Hee-Woon
    • Korean Journal of Medicinal Crop Science
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    • v.12 no.1
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    • pp.10-16
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    • 2004
  • This study was carried out to investigate the difference of growth characteristics and the content of root chemical components in four years old ginseng by paddy and upland cultivation at farmers' field in Korea. Proportions of silt, clay, liquid phase and porosity were higher in paddy soil than upland soil. The range of liquid phase was $17.5{\sim}19.5%$ in paddy and $7.0{\sim}12.8%$ in upland during growth period. EC and the other contents of OM, $NO_3^-,\;K_2O$, and Mg in paddy soil were higher than those of upland soil, while the contents of $P_2O_5$ and Ca were less than those of upland soil. The levels of chemical components of tested soil exceeded recommended range in EC, $NO_3^-$ and Ca of paddy soil, and in $P_2O_5$ and Ca of upland soil. Stem length, fresh root weight and total dry weight per plant in paddy were greater than those of upland. Root weight in paddy-ginseng showed a great increase on September, while it was not increased in upland because of early defoliation. Net assimilation rate and crop growth rate by paddy and upland cultivation showed distinct differences on May and September, and those of paddy-ginseng were higher than those of upland-ginseng. Yield and ratio of red-colored root showed no significant difference by paddy and upland cultivation, while significant differences were observed in diameter and length of primary root, contents of crude saponin and 50% ethanol extracts of primary root, and water content of root. Hardness of primary root showed no significant difference by paddy and upland cultivation until August, but it showed distinct difference on September, at which the hardness in upland cultivation was drastically decreased.

A Analysis of Trophic Structure in Lake Namyang Using the Ecopath Modelling (Ecopath 모델을 이용한 남양호의 영양구조 분석)

  • Jang, Sung-Hyun;Zhang, Chang-Ik;Na, Jong-Hun;Kim, Se-Wha;An, Kwang-Guk;Lee, Jung-Joon;Lee, Jung-Ho
    • Korean Journal of Ecology and Environment
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    • v.41 no.2
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    • pp.144-154
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    • 2008
  • The purpose of this study was to describe quantitatively trophic structures and to analyze energy flows in the Lake Namyang using the Ecopath with ecosim (Walter et al., 1997). The sampling and analyses were carried out at 6 sampling sites of the Lake Namyang during May and November in 2007. A total of 10 groups were considered in this study (detritus, macrophytes, phytoplankton, zooplankton, zoobenthos, Cyprinus carpio, Carassius cuvieri, Carassius auratus, Pseudobagrus fulvidraco and other fishes) to assess the trophic relationship, energy flows and interactions between them. As a result, it was concluded that Lake Namyang was consisted of primary producers (Detritus, Macrophytes, Phytoplankton), primary consumers (Zooplankton, Zoobenthos, Cyprinus carpio, Carassius cuvieri, Carassius auratus, Other fishes) and secondary consumer (Pseudobagrus fulvidraco). The total system throughput was estimated at $14.1\;kg\;m^{-1}\;year^{-1}$ including a consumption of 39%, exports of 21%, respiratory flows of 12% and flows into detritus of 28%. MTI analyses indicate that Pseudobagrus fulvidraco have positive impact on Cyprinus carpio, Carassius cuvieri and Carassius auratus. On the other hand, other fishes have negative impact on Cyprinus carpio, Carassius cuvieri and Carassius auratus. All the functional groups except detritus had a negative impact on themselves and this may show within-group competition for the same resources.

Effect of Supportive Nursing Intervention on Hopelessness, Self-Esteem, Self-Concept of Operative Patient with Head and Neck Cancer (전인적 지지간호중재가 두경부암 수술환자의 절망감, 자아존중감 및 자아개념에 미치는 효과)

  • Seok, Jung-Hee;Kang, Eun-Sil;Choi, Hwa-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.189-199
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    • 2004
  • Purpose: Despite the small incidence, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking. It may provoke hopelessness, change self-esteem and self-concept after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. Methods: This study was a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research designed to determine how supportive nursing intervention effects on hopelessness, self-esteem and self-concept of head and neck cancer patients. Subjects of the study included 40 adult inpatients of K University hospital in Pusan who were diagnosed as having head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher by means of reference, literal review and expert's advice. The measurement tool of hopelessness was translated by Won was the device of hopelessness self-evaluation from Beck, the tool for self-esteem measurement was developed by Rosenberg and translated by Kim, and the device of self-concept used by Lee et al, modified by Lee were used respectively. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using $x^2-test$ and t-test. 3 hypotheses were tested using t-test. Results: The results of the study can be summarized as follows. 1. The third hypothesis that the experimental group receiving supportive nursing intervention showed a little hopelessness than the control group not receiving supportive nursing intervention was supported (t=4.550, P=.000). 2. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-esteem than the control group not receiving supportive nursing intervention was supported (t=-6.40, p=.000). 3. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-concept than the control group not receiving supportive nursing intervention was supported (t=-6.065, P=.000). Conclusion: Supportive nursing intervention was effective nursing intervention strategy for reducing hopelessness and increasing self-esteem and self-concept of head and neck cancer patients. Then the quality of life of head and neck cancer patients can be enhanced by providing supportive nursing intervention in nursing practice.

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Study on the Distributional Characteristics and Classification of Quaternary Monogenetic Volcanoes in Jeju Island, Korea (제주도에 분포하는 제4기 단성화산체의 형태적 분류 및 분포 특성 연구)

  • Lee, Jeong-Hyun;Yun, Sung-Hyo
    • The Journal of the Petrological Society of Korea
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    • v.21 no.4
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    • pp.385-396
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    • 2012
  • Jeju island is the biggest volcanic island in Korea and there are over 455 Quaternary monogenetic volcanoes, of which approximately 373 volcanoes(82.0%) are cinder cones. Other volcanic forms in the island include sharp-pointed lava cone without crater(9 volcanoes; 2.0%), shield volcanoes(27 volcanoes; 5.9%), tuff rings(17 volcanoes; 3.7%), tuff cones(3 volcanoes; 0.7%), a maar(1 volcano; 0.2%) and lava domes(25 volcanoes; 5.5%). The monogenetic volcanoes include 15 small nested cinder cones(aloreum). The monogenetic volcanoes are more abundant in the eastern part of the island than in the western part. If the main cause of the weathering such as precipitation affected the shape of the monogenetic volcanoes, more monogenetic volcanoes(BC, CC, DC, etc.) are supposed to be present in the southern part that have more precipitation than in the northern part. But the distribution of the monogenetic volcanoes shows no difference between the southern and the northern parts. So we suggest that the difference of the climatic conditions did not affect the distribution or the shape of cinder cones. Tuff rings, tuff cones and a maar are distributed beneath the island or in the low-altitude areas along the shore although cinder cones are distributed in the interior of the island. This means that the volcanic activity which formed the monogenetic volcanoes resulted from either phreatomagmatic eruption or magmatic (hawaiian or strombolian) eruptions depending on the reaction with water (underground water or shallow waters). The distribution of the monogenetic volcanoes according to the altitude shows that 253(55.6%) volcanoes occur in low-lying coastal areas at an altitude below 300 m, 110(24.2%) in a middle mountainous area at an altitude between 300~600 m and 92(20.2%) in a high mountainous area at an altitude above 600 m. So more than half of monogenetic volcanoes are distributed in low-lying coastal areas.

Mutational Analysis of MECP2 Gene in 34 Rett Syndrome (Rett 증후군 34례의 MECP2 유전자 변이에 관한 연구)

  • Park, Sang Jo;Hwang, Tae Gyu;Son, Byeong Hee;Kim, Chul Min
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1263-1272
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    • 2002
  • Purpose : Rett syndrome(RTT) is an X-linked dominant neurodevelopmental disorder affecting 1 per 10,000-15,000 female births worldwide. It was initially described by Andreas Rett in 1966. RTT involves developmental regression characterized stereotypic hand movements, tremors, gait apraxia, seizures, deceleration of head growth after the age of 6-18 months. The disease-causing gene was identified as MECP2 on chromosome Xq28. We carried out mutational analysis of MECP2 genes in RTT patients. Methods : Whole blood(5 cc) of 34 sporadic RTT patients was collected in EDTA-anticoagulated tubes. Genomic DNA was extracted from peripheral blood using the E.Z.N.A. blood DNA kit. Four exons of the MECP2 gene were amplified by PCR in 34 Korean with RTT. We carried out PCR divided the exon three into two parts and the exon four into five parts. Primer sequences designed by Amir et al. in 1999 were almost used(AF030876). Sequencing primers used were the same as PCR. DNA sequencing reactions were performed using an ABI 377 DNA sequencer and ABI PRISM dye terminator cycle sequencing reaction kit(Perkin-elmer). The results were compared with the normal DNA sequence(X99686). To confirm the change of sequence on novel mutations, RFLP analysis was performed. Results : The MECP2 mutations were detected in 23(67.6%) of the 34 patients. The mutations consisted of 12 different types including nine missense and three nonsense mutations. Of these, three (L100V, G161E and T311M) mutations were newly identified. Most of the mutations discovered are located within MBD(39.1%) and TRD(39.1%). In this study, three(T158M, R270X, R306C) mutations were identified high frequency. Conclusion : MECP2 gene was also an important cause of Korean RTT patients. MECP2 gene study is an important tool for diagnosis of Korean RTT patients.

Effects of Glycogen Supercompensation in Fast and Slow Muscles on Maximal Running Time of Endurance-trained Rats (단련한 흰쥐의 속근 및 지근에 Glycogen 과저장이 운동 지구력에 미치는 영향)

  • Yeoun, Dong-Soo;Hwang, Soo-Kwan;Kim, In-Sook;Ko, Seong-Kyeong;Nam, Taick-Sang;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.22 no.1
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    • pp.63-77
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    • 1988
  • This study was carried out to investigate relationships between maximal running time (MRT) and glycogen supercompensation in fast twitch white fibers (white vastus, WV), fast twitch red fibers (red vastus, RV) and slow twitch red fibers (soleus muscle, SM) of endurance-trained rats. Male rats of a Sprague-Dawley strain were divided into the trained groups and untrained groups. Untrained groups were acquired to run on the treadmill 10 minutes for 3 days and remained rest and maintained with mixed diet for 4 weeks. For last 10 days of resting period, the untrained rats were divided into 3 groups i.e. mixed diet (untrained control), high and low carbohydrate (CHO) diet groups. And each group was subdivided into 2 groups, one group was tested for the MRT and the other was sacrificed to measure the blood glucose, blood lactate, glycogen contents of liver and muscles. The experimental groups were trained on treadmill by a modified method of Constable et al. (1984) maintained with mixed diet for 4 weeks. After measurement of MRT of this group, they were also divided into high and low CHO groups and fed with these diet for 2 days and MRT of each group was measured again to see the effect of high or low CHO feeding on the MRT. Each group was maintained with the same diet for next 2 days during which some of the rats were sacrificed at given time intervals for the measurements of blood glucose and lactate, liver and the muscles glycogen. The results were summarized as follows; 1) In the untrained group, there were no significant differences between subgroups in MRT, glycogen conent of SM, RV and WV. But blood glucose concentration and glycogen content of liver of low CHO group were significantly lower than those of mixed diet group. 2) The MRT and glycogen content of SM, RV and WV of trained mixed diet group were significantly increased compared to those of untrained mixed diet group, but there was no significant difference in glycogen content of liver. 3) MRT of trained mixed, high CHO and low CHO groups were $137{\pm}9.8,\;176{\pm}9.8\;and\;129{\pm}7.3\;min$ respectively with the significant difference between them. 4) There were no differences in blood lactate concentrations between the trained high and low CHO groups immediately after maximal running and during recovery period. 5) Glycogen contents in RV and SM of trained high CHO group were significantly increased, and glycogen contents in RV, WV and liver of trained low CHO group were significantly decreased compared to those of trained mixed diet group. 6) Immediately after maximal running, the blood glucose concentrations of trained high CHO and low CHO groups were $73{\pm}4.0\;and\;67{\pm}6.9mg%$ respecitively. The blood glucose of the trained high CHO group was fully recovered within one hour by feeding. But blood glucose concentration of low CHO group was slowly recovered up to $114{\pm}4.1mg%$ after two hours of feeding and maintained. Those values were still significantly lower than that of trained mixed diet group. The synthetic rates of glycogen in liver and muscles during the recovery period followed the similar time course of the blood glucose recoveries in each group. These results suggest that an increase in MRT of trained high CHO group was attributed to the glycogen supercompensation in slow twitch muscle fibers. And a decrease in MRT of trained low CHO may be due to decreased glycogen contents of liver and muscles. The results also suggest that glycogen supercompensation was more evident in slow twitch red fibers of endurance-trained rats and blood glucose is one of the limiting factors of glycogen synthesis.

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Change in Potential Productivity of Rice around Lake Juam Due to Construction of Dam by SIMRIW (벼 생장모형 SIMRIW를 이용한 주암호 건설에 따른 주변지역의 벼 잠재생산성 변이 추정)

  • 임준택;윤진일;권병선
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.42 no.6
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    • pp.729-738
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    • 1997
  • To estimate the change in rice productivity around lake Juam due to construction of artificial lake, growth, yield components and yield of rice were measured at different locations around lake Juam for three years from 1994 to 1996. Automated weather stations(AWS) were installed nearby the experimental paddy fields, and daily maximum, average and minimum temperature, solar radiation, relative humidity, and precipitation were measured for the whole growing period of rice. Plant height, number of tillers, leaf area and shoot dry weight per hill were observed from 8 to 10 times in the interval of 7 days after transplanting. Yield and yield components of rice were observed at the harvest time. Simulation model of rice productivity used in the study was SIMRIW developed by Horie. The observed data of rice at 5 locations in 1994, 3 locations in 1995 and 4 locations in 1996 were inputted in the model to estimate the unknown parameters. Comparisons between observed and predicted values of shoot dry weights, leaf area indices, and rough rice yield were fairly well, so that SIMRIW appeared to predict relatively well the variations in productivity due to variations of climatic factors in the habitat. Climatic elements prior to as well as posterior to dam construction were generated at six locatons around lake Juam for thirty years by the method of Pickering et al. Climatic elements simulated in the study were daily maximum and minimum temperature, and amount of daily solar radiation. The change in rice productivity around lake Juam due to dam construction were estimated by inputting the generated climatic elements into SIMRIW. Average daily maximum temperature after dam construction appeared to be more or less lower than that before dam construction, while average daily minimum temperature became higher after dam construction. Average amount of daily solar radiation became lower with 0.9 MJ $d^{-1}$ after dam construction. As a result of simulation, the average productivity of habitats around lake Juam decreased about 5.6% by the construction of dam.

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Improved Cerebral Blood Flow and Cerebrovascular Reserve after Carotid Endarterectomy in Patients with Carotid Stenosis and Contralateral Carotid Occlusion: Acetazolamide Stress Brain SPECT Study (반대측 내경동맥 폐쇄를 동반한 경동맥 협착에서 경동맥 내막절제술 후 뇌혈류 및 뇌혈관 예비능의 증가: 아세타졸아마이드 부하 뇌혈류 SPECT 연구)

  • Kim, Jae-Seung;Moon, Dae-Hyuk;Kim, Geun-Eun;Kim, Jong-S.;Kweon, Sun-Uck;Cho, Yong-Pil;Ryu, Jin-Sook;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.352-361
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    • 1999
  • Purpose: Carotid endarterectomy nay benefit patients with bilateral carotid stenosis by improving cerebro-vascular hemodynamics of ipsilateral as well as contralateral cerebral hemispheres. We investigated cerebro-vascular hemodynamics after carotid endarterectomy in patients with contralateral carotid occlusion by acetazolamide stress brain SPECT. Materials and Methods: Subjects were 14 symptomatic patients (all men, mean age 66 yrs) with carotid stenosis (>50%) with contralateral carotid occlusion. Acetazolamide stress Tc-99m ECD brain SPECTs were performed within 2 weeks before and after carotid endarterectomy using one day protocol. Cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were assessed visually. In 12 patients, correlation between the patency of proximal anterior cerebral or anterior communicating arteries (A1/A-comm) and the improvement of CBF or CVR after endarterectomy was assessed. Results: Preoperative SPECT showed reduced CBF in 2 ipsilateral and 10 contralateral hemispheres. CVR was reduced in 4 ipsilateral and 9 contralateral hemispheres. Of 12 hemispheres with reduced CBF, 2 hemispheres (16.7%) showed improvement of CBF after endarterectomy. However, reduced CVR was improved in all 4 ipsilateral and 7 of 9 (78%) of contralateral hemispheres after endarterectomy. Three of4 with stenotic Al/A-comm and 4 of 8 with patent A1/A-comm had reduced contralateral CVR. Reduced contralateral CVR improved in all 3 patients with stenotic A1/A-comm and 3 of 4 with patent A1/A-comm. Conclusion: Acetazolamide stress brain SPECT demonstrated improvement of compromised cerebrovascular reserve in not only ipsilateral but also contralateral hemispheres of patients with contralateral carotid occlusion after carotid endarterectomy, and may, therefore, be useful for evaluating cerebral blood flow and cerebrovascular reserve after carotid endarterectomy.

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The Effect of the Addition of Carbohydrate Sources on the Concentration of Odorous Compounds for Recycling of Pig Slurry to Grassland (발효탄수화물 첨가 비육돈사료가 초지환원용 슬러리의 악취물질 농도에 미치는 영향)

  • Cho, Sung Back;Hwang, Ok Hwa;Park, Kyu Hyeun;Choi, Dong Yun;Yang, Seung Bong;Kim, Do Hwan;Park, Sung Kwon
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.33 no.4
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    • pp.257-262
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    • 2013
  • This study investigates the effect of fermentable carbohydrate on the concentration of odorous compounds in pig slurry. Four types of pig diet were studied: control, peanut hull (crude fiber 29.87, NDF 44.02%), golden fiber (crude fiber 48.77, NDF 65.88%), and almond hull (crude fiber 44.30, NDF 64.44%). Pigs (average BW 37.0 kg) were fed diets that met the Korean Feeding Standard (2012) and their excreta samples were collected from the slurry pits. Levels of volatile organic compounds (phenols and indoles) and volatile fatty acids were analyzed by gas chromatography. Phenol level was the lowest (p<0.05) in golden fiber (33.26 ppm) group and the highest in control (97.29 ppm). The concentration of indoles in the peanut hull (1.27 ppm), almond hull (1.20 ppm), and golden fiber (1.02 ppm) groups was lower (p < 0.05) than that of control (1.79 ppm). Levels of short chain fatty acid (SCFA) were lower (p < 0.05) in golden fiber (1,319 ppm) and almond hull (1,433 ppm) groups than in control (1,893 ppm). Concentration of branched chain fatty acid (BCFA) in the golden fiber group (74 ppm) was lower (p < 0.05) than that of control (98 ppm). Taken together, the concentration levels of phenols, indoles, and VFAs decreased on addition of peanut hull, golden fiber or almond hull to the diet, suggesting that fermentable carbohydrate may contribute to reducing odorous compounds in pig slurry.