• Journal of Chest Surgery
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• v.31 no.4
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• pp.353-361
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• 1998

Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.421-427
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• 2005

Complete surgical resection is the most effective treatment for pT1/2N1 non-small cell lung cancer, however 5 year survival rate of these patients is about $40\%$ and the major cause of death is recurrent disease. We intended to clarify the risk factors of recurrence in completely resected pT1/2N1 non-small cell lung cancer. Material and Method: From Jan. f990 to Jul. 2003, total of 117 patients were operated for pT1/2N1 non-small cell lung cancer. The risk of recurrence according to patients characteristics, histopathologic findings, type of resection, pattern of lymph node metastasis, postoperative adjuvant treatment were evaluated retrospectively. Result: Mean age of patients was 59.3 years. There were 14 patients with T1N1 and 103 patients with T2N1 disease. Median follow-up time was 27.5 months and overall 5 year suwival rate was $41.3\%$. 5 year freedom-from recurrence rate was $54.1\%$. Recurrence was observed in $44 (37.6\%)$ patients and distant recurrence developed in 40 patients. 5 year survival rate of patients with recurence was $3.3\%$, which was significantly lower than patients without recurrence $(61.3\%,\;p=0.000).$ In multi-variate analysis of risk factors for freedom-from recurrence rate, multi-station N1 $(hazard\;ratio=1.997,\;p=0.047)$ was a poor prognostic factor. Conclusion: Multi-station N1 is the risk factor for recurrence in completely resected pT1/2N1 non-small cell lung cancer.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.806-812
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• 1999

Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1323-1328
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• 1996

The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.339-345
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• 1998

Arrhythmias are common after cardiac surgery and are multifactorial. Intravenous magnesium administration reduces the frequency of ventricular arrhythmias in patient with symptomatic heart failure or acute myocardial infarction. This study was designed to evaluate the role of magnesium in preventing PVCs(premature ventricular contractions) occurred frequently after coronary artery bypass graft(CABG). 50 consecutive patients were prospectively entered into a randomized trial to determine the efficacy of postoperative magnesium therapy on the incidence of cardiac arrhythmias after elective coronary artery bypass graft. The patients underwent coronary angiography, echocardiography, electrocardiography and clinical laboratory study preoperatively. Continuous electrocardiographic monitoring was done and magnesium level was checked 0, 3, 6, 12, 18, 24, 36, 48, 60 and 72 hours postoperatively. Study group of 25 patients were given 4g of magnesium continuously over the first 24 hours and then 2g/24hours from 25 to 72 hours. The clinical characteristics of both groups were similar(p<0.05). The preoperative mean serum magnesium concentration was similar in both study group, 1.59mg/dl and control group, 1.71mg/dl. The mean postoperative serum magnesium concentration in study group elevated significantly over postoperative 12hours through 36hours(p<0.05). The postoperative mean serum magnesium concentration in control group declined and remained significantly depressed over immediate postoperation through 72hours. The mean serum magnesium concentration was significantly greater in the study group compared with the control group over postoperative 3hours through 72hours(p<0.05). There was a significant decrease in the incidence of arrhythmias such as PVCs(p<0.01) which might jeopardize hemodynamics. There were no recognized adverse effects of magnesium Administration. In conclusion, prophylactic magnesium administration seems to lessen the incidence and severity of rrhythmias after coponary artery bypass graft.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.90-96
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• 2007

Background: Postoperative atrial fibrillation is the most frequently arrhythmic complication associated with coronary artery bypass graft surgery. This study was designed to investigate the incidence of atrial fibrillation in patients undergoing OPCAB and on-pump CABG and to identify the risk factors associated with its development. Material and Method: 247 consecutive patients were evaluated among 306 patients who underwent the coronary artery bypass graft surgery between January, 2002 and December, 2005. 178 patients underwent OPCAB (OPCAB group) and 69 patients underwent On-pump CABG (On-pump CABG group). The incidence and the risk factors of atrial fibrillation in two groups were determined. Result: There were no significant differences between two groups with respect to the preoperative demographic characteristics of the patients. The incidences of postoperative atrial fibrillation were 25 cases (14%) in OPCAB group and 15 cases (21%) in On-pump CABG group. Age over 65 years, net positive fluid imbalance for postoperative 3 days, and chest tube bleeding for postoperative 3 days were independent predictive factors in OPCAB group. Age over 65 years and net positive fluid imbalance for postoperative 3 days were independent predictive factors in On-pump CABG group. In multivariate analysis, age over 65 years was the only risk factor of postoperative atrial fibrillation in both groups. Conclusion: Atrial fibrillation is a common complication after procedures of myocardial revascularization. There wasn't a low incidence of postoperative atrial fibrillation in OPCAB, compared with On-pump CABG. Age over 65 years was associated with postoperative atrial fibrillation irrespective of the use of cardiopulmonary bypass.

• Journal of Sericultural and Entomological Science
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• v.45 no.1
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• pp.10-17
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• 2003

This study was carried out to analyze physicochemical characteristics of sericin cocoon from silkworm, Bombyx mori. The degumming loss increased with increasing treatment time up to 2 hr, and temperature up to 130$^{\circ}C$. At 130$^{\circ}C$, degumming loss of Nd-s jam and Nd$\^$H/ jam were 100% while that of Baegok jam was 24%. Nd-s jam and Baegok jam ha high glycine content of 29.1∼46.3 mol% where as Nd$\^$H/ jam had high serine content of 32.6 mol%. Thermal denaturation temperatures were found at 218$^{\circ}C$ for Nd-s jam, 216$^{\circ}C$ for Nd$\^$H/ jam, and 218$^{\circ}C$ for Baegok jam. Before degumming, crystallinities obtained by FT-IR analysis were 44.3, 43.7, and 59.9% for Nd-s jam, Nd$\^$H/ jam, and Baegok jam respectively. After degumming, crystallinity increased to 61.8% for Baegok jam. Before degumming, crystallinitics obtained from XRD were 35.9, 33.5, and 47.2%, for Nd-s jam, Nd$\^$H/ jam, and Baegok jam. After degumming, crystallinity increased to 49.8% for Baegok jam. The molecular weight of Nd$\^$H/ jam were 9,417 in 1 hr, 3,744 in 2 hr, 4,944 in hr, and 3,910 in 6 hr.

• Korean Journal of Soil Science and Fertilizer
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• v.39 no.5
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• pp.268-273
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• 2006

Soil loss induced by erosion has come to be a serious problem in Korea's sloped land since more than 70% of upland fields are located on the sloped land area. The purpose of this study was to investigate the phase of water flow in differently soil textured plot soil types by rainfall amount. Lysimeters with slope of 15%, 5 m in length, 2 m in width, and 1 m in depth were prepared and filled up with three different soil textures, such as sandy loam, loam, and clay loam, then relationships between seasonal rainfall and runoff, percolation were analyzed. Runoff and percolation rate were shown to increase linearly with increasing rainfall intensity in all the soil textures, but the starting threshold and increment rate in runoff and percolation occurrence were dependent differently upon soil textures. Percolation increment rate according to the increasing rainfall amount was 0.52, 0.36, and 0.57 for sandy loam, loam and clay loam soil respectively. The threshold rainfall amounts in which percolation occurs were 5.73 mm, 6.80 mm, and 12.86 mm for sandy loam, loam and clay loam respectively. Runoff increment rates were 0.42, 0.48 and 0.46 for sandy loam, loam and clay loam soil. The threshold rainfall amount in which runoff occurs was 10.50 mm in sandy loam, 7.76 mm in loam and 17.40 mm in clay loam. These different phases of water flow by soil texture could be used to suggest guidelines for the best management practice of the farming slope land.

• Korean Journal of Soil Science and Fertilizer
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• v.28 no.3
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• pp.270-277
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• 1995

The phosphate fractions and their relationships with other soil characteristics in greenhouse soils located on the southwest region in Korea were studied to demonstrate the possibility of the application of phosphate solubilizing microorganisms. The average contents of organic matter of 4.0% and exchangeable K, Ca, Mg of 1.16, 3.4, and $1.2cmol\;kg^{-1}$ respectively were higher than the aiming level for improvement of low fertile soil. Especially, available $P_2O_5$ of $1,193mg\;kg^{-1}$ was far more than the aiming level. The distribution of greenhouse soils classified by their total P contents was 46.1% for the range of $1,000{\sim}2,000mg\;kg^{-1}$, 29.6% for $2,000{\sim}3,000mg\;kg^{-1}$, and 12.9% for $3,000{\sim}4,000mg\;kg^{-1}$. And the soils containing more than $1,000mg\;kg^{-1}$, available $P_2O_5$ occupied 63.0% of the examined soils. The main forms of inorganic phosphates in greenhouse soils were Ca-P and Fe-P. The P fractions compared to total P were significantly correlated to soil pH, while available P was not so. Available phosphate was significantly correlated with the contents of organic matter and nitrogen, which are closely related to soil microbial activity, at the probability level of less than 1%.

• Korean Journal of Soil Science and Fertilizer
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• v.30 no.1
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• pp.56-61
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• 1997

A study was carried out to find out the basic information in physical properties for selection and manufacturing the good seedling media through the analysis of the physical properties, such as particle size, water retention and three phases of the major horticultural substrates. Easily available water(EAW), the water contents between 1kPa and 5kPa water potental, was highest in peatmoss with 39%, and perlite 34.0%, vermiculite 16.9%, but the values of osmunda and bark were lower than 4.8%. Water buffering capacity(WBC), the water content between 5kPa and 10kPa, was 6.1% in peatmoss and 2.3% in vermiculite but it was lower than 1.0% in other substrates. To adjust the suitable range of water potential at crossing point of water and air curves to 1.5~2.5kPa, more finer materials were needed in osmunda and bark, and more coarser materials must be added to peatmoss, perlite and vermiculite. Water potentials of substrates in saturated pot condition were equivalent to 2.2kPa in peatmoss and others were ranged in 1.0kPa to 4.3kPa of water potential in pressure chamber.