• Journal of Chest Surgery
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• v.30 no.4
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• pp.383-389
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• 1997

From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1237-1241
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• 1997

Tracheal stenosis is a difficult disease entity to manage. Laser ablation is one effective treatment for treacheal stenosis and can be utilized if tracheal reconstructive surgery is impossible. Potassium titanyl phosphate laser, transmitted via flexible quartz fiber, can be precisely manipulated through flexible bronchoscope under local anesthesia. We treated 7 patients with trach al and broncheal lesion under local anesthesia with KTP laser from January 1995 to July 1996. The patients included three males and four females. The age of patients ranged from 22 to 66 years with a mean of 43.7 years The etiology of tracheal stenosis in patients was stenosis after tracheostomy(3 cases), prolong inturbation in cases of sepsis(1 cases), and the recurrence of lung cancer within endobronchial lesion(2 cases). In the cases of tracheal stenosis treated with laser ablation, there were 2 cases of recurrence of stenosis at the anastomosis site after the operation, 3 cases of stenosis at tracheostomy site, and 2 cases of local recurrence of lung cancer. The site of the tracheal stenosis was the balloon site of the tracheostomy tube(3-4cm inferior to the tracheostomy site, 2-3cm superior to the carina) and the anastomosis site that were narrowed to less than 5mm(4 cases). For the stenosis lesion in the endobronchial area, there were 2 patients with a lesion at the anterior wa l, 1 patient with a lesion at the posterior wall, 2 patients with circumferential stenosis. Laser ablation time was 25.4 $\pm$5.9min and used energy was 1768 $\pm$365J. We have used KTP laser via (lexible bronchoscope without major complications. Adjuvant radiation therapy may prevent fibroblast proliferation which leads to restenosis. In three patients of restenosis after laser ablation, adjuvant irradiation started within 4 hours after laser ablation, and the radiation doses were 1500cGy given in five fraction. In patients with adjuvant radiation therapy, stenosis has not recurred

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.175-181
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• 1989

Visual assessment of regional wall motion abnormality (RWMA) by gated blood pol scan (GBPS) serves as an useful parameter in the diagnosis, functional evaluation, and follow up in various clinical settings, but are still subject to some inherent limitations. On important problem may be the interobserver as well as intraobsever variation that may well be present due to the subjective nature of the interpretations. This study was carried out to determine the reliability and reproducibility of visual assessments made in GBPSs, and to observe the degree to which the results would be influenced by observer variation. Fifty two patients with coronary heart disease had resting GBPS and contrast ventriculography within 4 days appall. Contrast ventriculography-showed normal wall motion in 6 patients and the remaining 46 had RWMA in one or more segments. The anterior and left anterolateral views of all 52 GBPSs were analyzed by three independent observers, who selected from 5 scales, their level of confidence that there was RWMA in that segment. Reciever operating characteristic (ROC) curves for each analysis was plotted and the area under the curve $(\theta)$ was used as a parameter representing each observer's performance in his interpretations. The findings of contrast ventriculographies were used as the standard for RWMA. The apical and inferoapical segments showed the best correlation with contrast ventriculography ($\theta=0.90-0.94$, 0.81-0.94, respectively), and the inferior wall showed the poorest correlation $(\theta=0.70-0.74)$. The interpretations of the inferior, septal, apical, and posteroinferior, segments showed no difference between the observers, but there was significantly better performance in assessment by observer A compared to that by B or C for the anterolateral segments ($\theta=0.87$, 0.78, 0.76, respectively. p<0.01 for A vs B, p<0.05 for A vs C), as well as when all segments were considered altogether ($\theta=0.88$, 0.83, 0.82, respectively. both p<0.05). This was also true for the infero-apical segment between A and C ($\theta=0.09$, 0.81, p<0.05). The intraobserver variation, however, did not appear significant, with only the inferior segment for observer B showing any significant difference when observer A and B repeated the analysis 10 days latter. There was no difference in assessing dyskinesia, with all observers showing a high performance ($\theta=0.98$, 0.87, 0.97, respectively). The visual assessment of left ventricular ejection fraction by all three observers correlated well with the calculated value from a semiautomated method (Spearman's r = 0.91, 0.83, 0.83. p<0.01, p<0.05, p < 0.05). The assessment of LV and RV size also correlated well between the three observers (Kendall's w = 0.80, 0.51, p<0.01 for both left and right ventricles). The above findings suggest that RWMA visually assessed by GBPS correlates well with that done by contrast ventriculography. And although the observer's experience or skill may influence the results in certain segments, visual analysis of GBPS may serve as a reliable and reproducible means for evaluating ventricular function.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.41-48
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• 2008

Background: Accurate assessment of the preload and the fluid responsiveness is of great importance for optimizing cardiac output, especially in those patients with coronary artery occlusive disease (CAOD). In this study, we evaluated the relationship between the parameters of preload with the changes in the stroke volume index (SVI) after fluid loading in patients who were undergoing coronary artery bypass grafting (CABG). The purpose of this study was to find the predictors of fluid responsiveness in order to assess the feasibility of using. certain parameters of preload as a guide to fluid therapy. Material and Method: We studied 96 patients who were undergoing CABG. After induction of anesthesia, the hemodynamic parameters were measured before (T1) and 10 min after volume replacement (T2) by an infusion of 6% hydroxyethyl starch 130/0.4 (10 mL/kg) over 20 min. Result: The right ventricular end-diastolic volume index (RVEDVI), as well as the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), failed to demonstrate significant correlation with the changes in the SVI (%). Only the right ventricular ejection fraction (RVEF) measured at T1 showed significant correlation. with the changes of the SVI by linear regression (r=0.272, p=0.017). However, when the area under the curve of receiver operating characteristics (ROC) was evaluated, none of the parameters were over 0.7. The volume-induced increase in the SVI was 10% or greater in 31 patients (responders) and under 10% in 65 patients (non-responders). None of the parameters of preload measured at T1 showed a significant difference between the responders and non-responders, except for the RVEF. Conclusion: The conventional parameters measured with a volumetric pulmonary artery catheter failed to predict the response of SVI following fluid administration in patients suffering with CAOD.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.251-256
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• 2000

Purpose : To evaluate efficacy and complication of stereotactic radiosurgery using stereotactic body frame. Methods and Materials :From December 1997 to June 1999, 11 patients with primary and metastatic tumors were treated with stereotactic radiosurgery using stereotactic body frame(Precision TherapyTu). Three patients were treated with primary hepatoma and seven with metastatic tumor from liver, lung, breast, trachea and one with arteriovenous malformation on neck. We used vacuum pillow for immobilization and made skin marker on sternum and tibia area with chest marker and leg marker. Diaphragm control was used for reducing movement by respiration. CT-simulation and treatment planning were peformed. Set-up error was checked by CT-Simulator before each treatment. Dose were calculated on the 80$\~$90$\%$ isodose of isocenter dose and given consecutive 3 fractions for total dose of 30 Gy (10 Gy/fraction). Results :Median follow-up was 12 months. One patient (9$\%$) showed complete response and four Patients (36$\%$) showed partial response and others showed stable disease. Planning target volumes (PTV) ranged from 3 to 111 cc (mean 18.4 n). Set-up error was within 5 mm in all directions (X, Y, Z axis). There was no complication in all patients. Conclusion :In Primary and metastatic tumors, stereotactic body frame is very safe, accurate and effective treatment modality.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.8-14
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• 2012

Background: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. Methods: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second ($FEV_1$)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with $FEV_1$ - the index of the severity of airflow limitation. Results: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient ${\beta}$=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; ${\beta}$=-0.24; p<0.001), and airway wall thickness (mean wall area %; ${\beta}$=-0.19, p=0.001), as well as current smoking status (${\beta}$=-0.14; p=0.009) were independent contributors to $FEV_1$. Conclusion: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with COPD.

• Journal of Wetlands Research
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• v.21 no.4
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• pp.384-391
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• 2019

Nutrients in stormwater runoff have raised concerns regarding water quality degradation in the recent years. Low impact development (LID) technologies are types of nature-based solutions developed to address water quality problems and restore the predevelopment hydrology of a catchment area. Two LID facilities, infiltration trench (IT) and infiltration planter (IP), are known for their high removal rate of nutrients through sedimentation and vegetation. Long-term monitoring was conducted to assess the performance and cite the advantages and disadvantages of utilizing the facilities in nutrient removal. Since a strong ionic bond exists between phosphorus compounds and sediments, reduction of total phosphorus (TP) (more than 76%), in both facilities was associated to the removal of total suspended solids (TSS) (more than 84%). The efficiency of nitrogen in IP is 28% higher than IT. Effective nitrification occurred in IT and particulate forms of nitrogen were removed through sedimentation and media filters. Decrease in ammonium- nitrogen (NH₄-N) and nitrite-nitrogen (NO₂-N), and increase in nitrate-nitrogen (NO₃-N) fraction forms indicated that effective nitrification and denitrification occurred in IP. Hydrologic factors such as rainfall depth and rainfall intensity affected nutrient treatment capabilities of urban stormwater LID facilities The greatest monitored rainfall intensity of 11 mm/hr for IT yielded to 34% and 55% removal efficiencies for TN and TP, respectively, whereas, low rainfall intensities below 5 mm resulted to 100 % removal efficiency. The greatest monitored rainfall intensity for IP was 27 mm/hr, which still resulted to high removal efficiencies of 98% and 97% for TN and TP, respectively. Water quality assessment showed that both facilities were effective in reducing the amount of nutrients; however, IP was found to be more efficient than IT due to its additional provisions for plant uptake and larger storage volume.

• Journal of Korea Water Resources Association
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• v.40 no.11
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• pp.887-898
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• 2007

A physically based semi-distributed model, SWAT was applied to the Chungju Dam upstream watershed in order to investigate the spatial and temporal characteristics of watershed sediment yields. For this, general features of the SWAT and sediment simulation algorithm within the model were described briefly, and watershed sediment modeling system was constructed after calibration and validation of parameters related to the runoff and sediment. With this modeling system, temporal and spatial variation of soil loss and sediment yields according to watershed scales, land uses, and reaches was analyzed. Sediment yield rates with drainage areas resulted in $0.5{\sim}0.6ton/ha/yr$ excluding some upstream sub-watersheds and showed around 0.51 ton/ha/yr above the areas of $1,000km^2$. Annual average soil loss according to land use represented the higher values in upland areas, but relatively lower in paddy and forest areas which were similar to the previous results from other researchers. Among the upstream reaches, Pyeongchanggang and Jucheongang showed higher sediment yields which was thought to be caused by larger area and higher fraction of upland than other upstream sub-areas. Monthly sediment yields at the main outlet showed same trend with seasonal rainfall distribution, that is, approximately 62% of annual yield was generated during July to August and the amount was about 208 ton/yr. From the results, we could obtain the uniform value of sediment yield rate and could roughly evaluate the effect of soil loss with land uses, and also could analyze the temporal and spatial characteristics of sediment yields from each reach and monthly variation for the Chungju Dam upstream watershed.

• Journal of Soil and Groundwater Environment
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• v.11 no.3
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• pp.43-51
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• 2006

Generally abandoned mine soils have serious problems for introducing vegetation such as nutrient deficiency, poor physical properties, and phytotoxicity due to high levels of heavy metals. It is required to improve soil amenity for revegetation. One of its strategies is using organic materials such as compost manure and sludge. The pot experiments was conducted to evaluate the effects of pig manure and municipal sewage sludge on revegetation of mining area soil surface with Artemisia princeps and Zoysia japonica. Application rate of pig manure and municipal sewage sludge was $75{\sim}225$ Mg/ha and $150{\sim}450$ Mg/ha, respectively. The results showed that the application of manure and sludge increased organic matter about two-fold and total nitrogen contents about five-fold of mine soil and improved the growth of plants in all treatments compared to the control. The result of plant tissue analysis showed that both plants accumulate Cd, Cu and Zn in root tissue rather than shoot tissues. Increased sludge application reduced Zn accumulation in both plant tissue. Sequential extraction results indicated that addition of soil amendment induced increment of organically bound fractions of Cu and Zn. Organically bound fraction of Zn was significantly increased from 7.84% to 13.58% in Artemisia princeps planted soil and from 7.84% to 14.16% in Zoysia japonica planted soil, thereby bioavailability of heavy metals was reduced. The results suggested that application of organic materials to mine soil can reduce phytotoxicity of heavy metals and be helpful in introducing successful revegetation.

• Korean Journal of Remote Sensing
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• v.25 no.5
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• pp.423-434
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• 2009

The Arctic environment is sensitive to change of sea-ice distribution. The increase and decrease of sea ice work to an index of globe warming progress. In order to predict the progress of hereafter earth global warming, continuous monitoring regarding a change of the sea ice area in the Arctic should be performed. The remote sensing based on an artificial satellite is most effective on the North Pole. The sea ice observation using a passive microwave sensor has been continued from 1970's. The determination of sea ice extent and ice type is one of the great successes of the passive microwave imagers. In this paper, to investigate the seasonal and inter-annual variation of sea-ice distribution we used here the sea ice data from July 2002 to May 2009 around the Arctic within $60^{\circ}N$ for the AMSR-E 12.5km sea-ice concentration, a passive microwave sensor. From an early analysis of these data, the arctic sea-ice extent has been steadily decreasing at a rate of about 3.1%, accounting for about $2{\times}10^5\;km^2$, which was calculated for the sea-ice cover reaching its minimum extent at the end of each summer. It is also revealed that this trend corresponds to a decline in the multi-year ice that is affected mainly by summer sea surface and air temperature increases. The extent of younger and thinner (first-year) ice decreased to the 2007 minimum, but rapidly recovered in 2008 and 2009 due to the dramatic loss in 2007. Seasonal variations of the sea-ice extent show significant year-to-year variation in the seasons of January-March in the Barents and Labrador seas and August-October in the region from the East Siberian and Chukchi seas to the North Pole. The spatial distribution of multi-year ice (7-year old) indicates that the perennial ice fraction has rapidly shrunk recently out of the East Siberian, Laptev, and Kara seas to the high region of the Arctic within the last seven years and the Northeast Passage could become open year-round in near future.