• Journal of Chest Surgery
• /
• v.24 no.7
• /
• pp.674-684
• /
• 1991

The surgical treatment of tetralogy of Fallot [TOF] was initiated by Blalock and Taussig in 1945 with the establishment of the subclavian artery to pulmonary artery anastomosis. In an imaginative and daring effort, in 1954, Lillehei and collaborators [1955] using controlled cross-circulation, carried out the first intracardiac repair of TOF by closing the ventricular septal defect [VSD] and relieving the pulmonary stenosis under direct vision. Nowadays, total correction is the ideal operation for treatment of TOF and is accomplished with extracorporeal circulation. And the results of surgery for TOF have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentation, TOF continues to offer challenges to cardiologist and cardiac surgeons. Thirty two cases of TOF have undergone total corrective surgery using extracorporeal circulation in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, Inje University, from Oct. 1985 to Feb. 1990. Clinical considerations were applied to these cases and the results were obtained as follows. 1. The heart lung machine used for extracorporeal circulation was SarnsO 7000, 5-head roller pump, and the number and type of oxygenators were 10 of bubble type and 22 of membrane type. The mean bypass time was 148.9 minutes and the mean aortic cross clamp time was 123.8 minutes. The GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 2. 20 cases were male and 12 were female, the mean age was 8 years old and the mean body weight was 25Kg. 3. The preoperative symptoms were cyanosis [29 cases], squatting [27 cases] and etc. The mean values of preoperative Hb., Hct., and SaO2 were 16.5 gm /dl, 50.3%, and 78.5%. 4. Combined anomalies were noticed in 16 cases [50%]. Among them 10 cases were PFO and 6 cases were ASD. 5. The degree of aorta overriding were 25% in 5 cases, 25 ~ 50% in 22 cases and above 50% in 5 cases. The dPA/Ao [ratio of diameter of pulmonary artery trunk to ascending aorta] were below 25% in 5 cases, 25 ~ 50% in 10 cases, 50 ~ 70% in 6 cases and above 75% in 11 cases. 6. The types of RVOT [right ventricular outflow tract] stenosis were valvular and infundibular in 14 cases [43.6%], diffuse hypoplastic type in 12 cases [37.5%], infundibular in 5 cases, and valvular and supravalvular in 1 case. 7. One stage radical corrective surgery was applied to the all cases. In widening of the RVOT, 3 types of patches were used: MVOP [monocusp ventricular outflow patch, Polystan BioprosthesesO] in 3 cases, knitted Dacron vessel patches in 2 cases, and double layer with bovine pericardium and woven Dacron prosthesis in 26 cases. 8. Postoperative complications were occurred in 15 cases. Among them, low output syndrome were occurred in 10 cases [31.3%] and 2 of them were expired postoperatively.

• Journal of English Language & Literature
• /
• v.56 no.2
• /
• pp.383-408
• /
• 2010

This paper intends to suggest the positive, ecological vision of sustainability in Karen Hesse's Out of the Dust that Billie Jo Kelby recovers herself through her readjustment of interior consciousness and outer environment in her tragic situations caused by the Dust Bowl. In spite of her desires for happiness and affluence of home, she loses her mother and brother, and her musical talent as a pianist, and lies in self-abandonment. But she finally raises up herself with her courage and patience, reconciliating with the nature and ameliorating the community by taking care of the devastated landscapes. Hence it is appropriate to approach the loss-recovery process of nature and consciousness with ecological solutions, The Dust Bowl breaks down human mind and body, and eventually leads to the situations of despairs and death. Hesse proposes the primary solution that humans should reconstruct their interior consciousness and participate in recovering the nature because humans are inevitably linked with nature. In this novel, the nature takes a dynamic and active role as a catalyst, reconciling the self with other humans and settling with the conflicting situations in history and culture. This verse novel as an active, self-ordering, and corrective process gives the more intense ecological message. As Hesse defines the setting of Dirty Thirties as a channel of energy, she creates the utmost effects of ecological process that human and environment are part of a total situation, representing the transactional formulation, each conditioned by conditioning to the other. Therefore Billie Jo takes her part as an interpreter and actualizes herself, understanding the nature with metaphor and symbol. Eventually Billie Jo realizes that she should rebuild her environment not out of the dust but in the dust, accepting the reality of Dust Bowl.

• Journal of Korean Ophthalmic Optics Society
• /
• v.17 no.3
• /
• pp.265-272
• /
• 2012

Purpose: To compare the results on myopia correction with reverse geometry lenses, effects of wearing reverse geometry lenses were evaluated for the children with low-level and high-level myopia. Methods: The research investigated the corrective effects of having worn reverse geometry lenses for one week, one month, three months and six months on a total of thirty-six persons (sixty-two eyes) between the ages of seven and fifteen, divided into three groups by the degree of their myopia; nineteen eyes(Group One) with myopia of -2.00 D and under, twenty-eight eyes(Group Two) with myopia between -2.25 D and -4 D, and fifteen eyes(Group Three) with myopia of -4.25 D and above; as shown by changes in uncorrected vision and the degree of refraction in the corneal topography, and tested for statistical similarity among the pursued results. Results: After wearing reverse geometry lenses, Group One showed an improvement in vision of 0.5, from 0.45 to 0.95, after one week, and improvements to 0.91 after one month and 1.02 after three months but, after six months, the group's vision regressed to 0.95. Group Two showed an improvement in vision of 0.43, from 0.34 to 0.77, after one week of wearing and to 0.91 after one month, to 0.97 after three months and this was statistically maintained through the remainder of six months. Group Three showed an improvement in vision of 0.55, from 0.15 to 0.7, after wearing for one week, to 0.87 after one month and to 0.91 after three months but saw a regression to 0.86 after six months. The average Sim K (simulated keratometry reading) value for Group One started from $42.84{\pm}1.17D$ and decreased to $41.48{\pm}0.98D$ after one week of wearing and continued declining through three months before increasing during the remainder of six months. Group Two began from $42.91{\pm}1.57D$ and recorded $41.78{\pm}1.58 D$ after one week, continuing the decline through three months before increasing during the remainder of six months. Group Three began at $42.64{\pm}1.64D$ and showed its Sim K value decrease to $40.77{\pm}1.20D$ after one week of wearing, increase after one month and decrease after three months and continue the decline through the remainder of six months. Conclusions: From the results of this study, wearing reverse geometry lenses had myopia-correcting effects after one week of wearing. Although there were variations in the time for such effect to take place but myopia-correcting effects were evident in all test groups.

• Journal of Korean Ophthalmic Optics Society
• /
• v.9 no.1
• /
• pp.93-104
• /
• 2004

In order to have a comfortable vision without any asthenopia in work place, it is very necessary to make a complete binocular correction in addition to the perfect correction of refractive deficits. For this, At first, the exact understanding of the required corrective value of the existing angular ametropia(associated phoria) is needed. The fact likely seems fact that a correction of refractive deficits could not to be reached with single optotype, the corrections of angular ametropia(associated phoria) with single optotype is impossible. The reason is that a most ametropia(associated phoria) is accompanied with the fixation disparity. To make a perfect measurement of ametropia(associated phoria), at least, 3 kinds of optotype is essential. This fact could be explained by stating the fusional stimulus in the binocular refraction tests on each eye. If these types of three tests have not practical practice. The most of many cases may result in undercorrection.

• Journal of Korean Society of Industrial and Systems Engineering
• /
• v.39 no.2
• /
• pp.119-128
• /
• 2016

Use of ICT in Government has ability to improve service delivery to its citizens, and yet many developing countries have lagged behind in the implementation of e-Government. Many e-Government initiatives also failed to achieve their objectives in developing countries. This paper therefore aims to identify critical failure or success factors in Kenya, using Heeks' Factor Model. A survey questionnaire was developed and data were collected and analyzed from officials and interested citizens. The analysis results enabled to highlight seven specific success and failure factors, and their constituent elements in Kenya. The Kenyan overall e-Government implementation score belongs to the Zone of Improvement (3.52 of total 5.0), which means partial success or failure. The enablers of e-Government projects are good strategy formulation, and internal and external drive, whereas main failures of e-Government are weak ICT infrastructure. The areas for improvement are project management, design, competencies and funding. Data analysis highlights both strengths and weaknesses for each factor or variable. In particular, Kenyan government excels at the drive for change by top to bottom government officers as well as external stakeholders, while the government officers who are using e-Government are satisfied with the availability of vision, strategy and plan of e-Government implementation. Both technologies and e-transactions laws were the worst of all the variables in e-Government implementation. Two areas should be improved using immediate corrective action. In-depth study reveals that government officers and citizens can't fully use their laptop and mobile devices due to the lack of both ICT network and its operating technology, and legal system associated with the transaction of business information. Finally, the study ends up with recommendations for policy makers to shape the future of e-Government system in both developing and developed countries.

• Journal of Korean Ophthalmic Optics Society
• /
• v.20 no.2
• /
• pp.187-193
• /
• 2015

Purpose: This study was aimed to investigate effects of increased breath alcohol concentration (BrAC) which is the standard measurement of alcohol consumption in sobriety test under current laws on visual acuity and values of objective refraction. Methods: For twenty three males in 20s (average age $21.17{\pm}2.19$ years, body mass index (BMI) $22.09{\pm}2.16$) were selected. Distance and near visual test was performed at BrAC of 0%, 0.05% and 0.08%, and objective refraction with open-field auto-refractometer was also performed at different BrAC. Results: As breath alcohol concentration is increased, distance visual acuity was decreased, which was statistically significant, but near visual acuity was not changed. Also, values of objective refraction tended to be increased towards minus as breath alcohol concentration is increased. Conclusions: As breath alcohol concentration is increased, corrected visual acuity is decreased and refractive power is towards minus, it is necessary that visual acuity test and refraction measurement should be conducted under sober condition.

• Journal of Korean Ophthalmic Optics Society
• /
• v.9 no.1
• /
• pp.19-27
• /
• 2004

The purpose of this study is to survey spectacle wearers's way of thinking through the questionaire and to investigate their wearing conditions through fitting conditions, the pantascopic angle, vertex distance, the coincidence of vertical and horizontal distance between optical center of the lens and pupillary distance of the eye in random selected 150 ametropic corrective wearers in the age of 17 to 19. The results are as follows : 1. The most popular causes of physical complaints in the ex-wearing spectacle are frame pressure(34.0%), slipping forward(30.0%) and most popular visual complaints are blur vision(30.0%) and asthenopia(20.0%). 2. The most common physical or visual complaints in the present wearing spectacle are slipping forward(30.0%), pressure (50.0%), color(10.0%). 3. Myopic glasses wearers accounted for 56.7% of the subjects, the others were compound myopic astigmatism. In 60% of the subjects' binocular diopter did not coincide. 4. In the pantascopic angle of the both eyes coincide in 66.7% of the subjects. The average of pantascopic angle is $10.07^{\circ}$. 5. In the vertex distance of the both eyes coincided in 65.3% of the subjects. the he average of vertex distance is 13.6 mm. 6. Among 150 eyes with monocular, the vertical distance between optical center of the lens and pupillary distance of the eye is within the RAL-RG 915 that is tolerance of ophthalmic dispensing in German Standards in 82 eyes (54.6%). 7. Among 150 eyes with monocular, the horizontal distance between optical center of the lens and pupillary distance of the eye is within the RAL-RG915 that is tolerance of ophthalmic dispensing in German Standards in 86 eyes(57.3 %).