• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.194-198
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• 2009

Purpose : Active perioperative intervention and improvement on surgical technique has decreased the mortality rate of total anomalous pulmonary venous connection (TAPVC); however, when complicated with pulmonary venous obstruction, operative mortality is still high. The purpose of this study was to investigate the clinical course of TAPVC. Methods : Twenty-seven patients who were diagnosed with TAPVC (without other complex heart anomalies) by echocardiogram at Kyungpook National University Hospital from January 1994 to February 2008 were included. Results : Mean age at diagnosis was $28.1{\pm}33.4$ days (1-126 days). Sites of drainage were supracardiac type (15), cardiac (6), infracardiac (5), and mixed (1). Seven patients had pulmonary venous obstruction: 5 with supracardiac type, 1 with cardiac, and 1 with infracardiac. Intraoperative trans-esophageal echocardiograms were performed in 14 patients (58.3%). The operative mortality was 16.7% (4 of 24) and overall hospital mortality (including deaths without operation) was 22.2% (6 of 27). There were 5 postoperative pulmonary venous obstructions. The sites of obstruction were anastomotic in 3 of 5 (60%) patients, and ostial pulmonary vein in the other 2 (40%) patients. Three patients who presented with anastomotic pulmonary venous obstruction underwent reoperation, but all the patients were found to have pulmonary venous anastomotic obstruction. The other 2 patients with ostial pulmonary vein obstruction who had no significant symptoms were diagnosed by routine echocardiographic examination during follow-up. Conclusion : In TAPVC patients, early diagnosis and aggressive surgical management will improve prognosis, and we must pay attention to early and late pulmonary vein restenosis through intraoperative trans-esophageal echocardiogram and peri- and post-operative echocardiographic follow-up examinations.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.199-204
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• 2009

Purpose : Seizure associated with fever may indicate the presence of underlying inherited metabolic diseases. The present study was performed to investigate the presence of underlying metabolic diseases in patients with complex febrile seizures, using analyses of urine organic acids. Method : We retrospectively analyzed and compared the results of urine organic acid analysis with routine laboratory findings in 278 patients referred for complex febrile seizure. Results : Of 278 patients, 132 had no abnormal laboratory findings, and 146 patients had at least one of the following abnormal laboratory findings: acidosis (n=58), hyperammonemia (n=55), hypoglycemia (n=21), ketosis (n=12). Twenty-six (19.7 %) of the 132 patients with no abnormal findings and 104 (71.2%) of the 146 patients with statistically significant abnormalities showed abnormalities on the organic acid analysis (P<0.05). Mitochondrial respiratory chain disorders (n=23) were the most common diseases found in the normal routine laboratory group, followed by PDH deficiency (n=2) and ketolytic defect (n=1). In the abnormal routine laboratory group, mitochondrial respiratory chain disorder (n=29) was the most common disease, followed by ketolytic defects (n=27), PDH deficiency (n=9), glutaric aciduria type II (n=9), 3-methylglutaconic aciduria type III (n=6), biotinidase deficiency (n=5), propionic acidemia (n=4), methylmalonic acidemia (n=2), 3-hydroxyisobutyric aciduria (n=2), orotic aciduria (n=2), fatty acid oxidation disorders (n=2), 2-methylbranched chain acyl CoA dehydrogenase deficiency (n=2), 3-methylglutaconic aciduria type I (n=1), maple syrup urine disease (n=1), isovaleric acidemia (n=1), HMG-CoA lyase deficiency (n=1), L-2-hydroxyglutaric aciduria (n=1), and pyruvate carboxylase deficiency (n=1). Conclusion : These findings suggest that urine organic acid analysis should be performed in all patients with complex febrile seizure and other risk factors for early detection of inherited metabolic diseases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.326-333
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• 2016

This case study identified the effects of joint mobilization on knee pain, isokinetic strength, muscle tone, and muscle stiffness in an elite volleyball player with a knee injury. The subject had experienced cartilage defects of the left knee joint and underwent surgery to correct the condition. The patient complained of continuous pain in the left knee joint in daily life in addition to pain during exercise. The study was conducted from August 5 to 12, 2015 and joint mobilization was applied to the left knee joint for 15 minutes once a day for 8 days. Knee pain was measured using a visual analogue scale, and the concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic muscular strength measurement device. The muscle tone and stiffness of the rectus femoris muscle, vastus medialis, and vastus lateralis on the injured side were measured using a myotonometer. All the measurements were conducted before and after the intervention. Joint mobilization was effective in reducing knee pain on the injured side, increasing the concentric peak torque of the quadriceps and hamstring muscles on both sides, and increasing the muscle stiffness of the quadriceps muscle on the injured side. Concentric peak torque of the quadriceps muscle on the injured side increased a great deal as the number of joint mobilizations was increased, largely diminishing the difference in concentric peak torque between the normal side and injured side. On the other hand, joint mobilization was ineffective in improving the hamstring to quadriceps strength ratio on the injured side. While this study suggests that joint mobilization can be an effective intervention to improve the knee pain, isokinetic strength, and muscle stiffness of elite volleyball players, it should be performed alongside training for an appropriate strength ratio.

• Korean Security Journal
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• no.7
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• pp.95-124
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• 2004

It can be said that 'the September 11th Terrorist Attacks' in 2001 were not only the indiscriminate attacks on innocent people but also the whole - political, economical and military - attacks on human life. Also, 'the September 11th Terrorist Attacks' can be regarded as the significant events in the history of world, which were on the peak of the super-terrorism or new-terrorism that had emerged from the 1980s. However, if one would have analysed the developments of terrorism from the 1970s, they could have been foreknown without difficulty. The finding from this study can be summarized as the followings, First, in spite that the USA responsive system against terrorism had been assessed as perfect before 'the September 11th Terrorist Attacks', the fragilities were found in the aspects of the response on the new-terrorism or super-terrorism. The previous responsive system before 'the September 11th Terrorist Attacks' had the following defects as the followings: (1) it was impossible to establish the integrated strategy, because the organizations related to the response against terrorism had not integrated; (2) there were some weakness to collect and diffuse the informations related to terrorism; (3) the security system for the domestic airline service in USA and the responsive system of air defense against terrors on aircraft were very fragile. For these reasons, USA government established the 'Department of Homeland Security' of which the President is the head so that the many organizations related to terrorism were integrated into a single management system. And, it legislated a new act to protect security from terrors, which legalized of the wiretapping in spite of the risk of encroachment upon personal rights, increased the jail terms upon terrorists, froze the bank related to terrorist organization, and could censor e-mails. Second, it seem that Korean responsive system against terrors more fragile than that of USA. One of the reasons is that people have some perception that Korea is a safe zone from terrors, because there were little attacks from international terrorists in Korea. This can be found from the fact that the legal arrangement against terrorism is only the President's instruction No. 47. Under this responsive system against terrorism dependent on only the President's instruction, it is expected that there would be a poor response against terrors due to the lack of unified and integrated responsive agency as like the case of USA before 'the September 11th Terrorist Attacks'. And, where there is no legal countermeasure, it is impossible to expect the binding force on the outside of administrative agencies and the performances to prevent and hinder the terrorist actions can not but be limited. That is to say, the current responsive system can not counteract effectively against the new-terrorism and super-terrorism. Third, although there were some changes in Korean government's policies against terrorism. there still are problems. One of the most important problems is that the new responsive system against terrorism in Korea, different from that of USA, is not a permanent agency but a meeting body that is organized by a commission. This commission is controled by the Prime Minister and the substantial tasks are under the National Intelligence Service. Under this configuration, there can be the lack of strong leadership and control. Additionally, because there is no statute to response against terrorism, it is impossible to prevent and counteract effectively against terrorism. The above summarized suggests that, because the contemporary super-terrorism or new-terrorism makes numerous casualties of unspecified persons and enormous nationwide damages, the thorough prevention against terrorism is the most important challenge, and that the full range of legal and institutional arrangements for the ex post counteraction should be established. In order to do so, it is necessary for the government to make legal and institutional arrangements such as the permanent agency for protection from terrorism in which the related departments cooperates with together and the development of efficient anti-terror programs, and to show its willingness and ability that it can counteract upon any type of domestic and foreign terrorism so that obtain the active supports and confidence from citizens.

• Proceedings of the Materials Research Society of Korea Conference
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• 2011.05a
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• pp.14-14
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• 2011

W (tungsten)-alloys will be the most promising plasma facing armor materials in highly loaded plasma interactive components of the next step fusion reactors due to its high melting point, high sputtering resistance and low deuterium/tritium retention. The bonding technology of tungsten to Cu alloy was one of the key issues. In this paper, W/CuCrZr diffusion bonding has been performed successfully by inserting pure metal interlay. The joint microstructure, interfacial elements migration and phase composition were analyzed by SEM, EDS, XRD, and the joint shear strength and micro-hardness were investigated. The mock-ups were fabricated successfully with diffusion bonding and the cladding technology respectively, and the high heat flux test and thermal fatigue test were carried out under actively cooling condition. When Ni foil was used for the bonding of tungsten to CuCrZr, two reaction layers, Ni4W and Ni(W) layer, appeared between the tungsten and Ni interlayer with the optimized condition. Even though Ni4W is hard and brittle, and the strength of the joint was oppositely increased (217 MPa) due primarily to extremely small thicknesses (2~3 ${\mu}m$). When Ti foil was selected as the interlayer, the Ti foil diffused quickly with Cu and was transformed into liquid phase at $1,000^{\circ}C$. Almost all of the liquid was extruded out of the interface zone under bonding pressure, and an extremely thin residual layer (1~2 ${\mu}m$) of the liquid phase was retained between the tungsten and CuCrZr, which shear strength exceeded 160 MPa. When Ni/Ti/Ni multiple interlayers were used for bonding of tungsten to CuCrZr, a large number of intermetallic compound ($Ni_4W/NiTi_2/NiTi/Ni_3T$) were formed for the interdiffusion among W, Ni and Ti. Therefore, the shear strength of the joint was low and just about 85 MPa. The residual stresses in the clad samples with flat, arc, rectangle and trapezoid interface were estimated by Finite Element Analysis. The simulation results show that the flat clad sample was subjected maximum residual stress at the edge of the interface, which could be cracked at the edge and propagated along the interface. As for the rectangle and trapezoid interface, the residual stresses of the interface were lower than that of the flat interface, and the interface of the arc clad sample have lowest residual stress and all of the residual stress with arc interface were divided into different grooved zones, so the probabilities of cracking and propagation were lower than other interfaces. The residual stresses of the mock-ups under high heat flux of 10 $MW/m^2$ were estimated by Finite Element Analysis. The tungsten of the flat interfaces was subjected to tensile stresses (positive $S_x$), and the CuCrZr was subjected to compressive stresses (negative $S_x$). If the interface have a little microcrack, the tungsten of joint was more liable to propagate than the CuCrZr due to the brittle of the tungsten. However, when the flat interface was substituted by arc interfaces, the periodical residual stresses in the joining region were either released or formed a stress field prohibiting the growth or nucleation of the interfacial cracks. Thermal fatigue tests were performed on the mock-ups of flat and arc interface under the heat flux of 10 $MW/m^2$ with the cooling water velocity of 10 m/s. After thermal cycle experiments, a large number of microcracks appeared at the tungsten substrate due to large radial tensile stress on the flat mock-up. The defects would largely affect the heat transfer capability and the structure reliability of the mock-up. As for the arc mock-up, even though some microcracks were found at the interface of the regions, all microcracks with arc interface were divided into different arc-grooved zones, so the propagation of microcracks is difficult.

• Nuclear Engineering and Technology
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• v.4 no.3
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• pp.214-222
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• 1972

In the optic,11 grade LiF crystal, the electron traps corresponding to the thermoluminescence(abbreviated to TL) glow peak develop as irradiation dose is increased. Originally the electron trap of the crystal has two levels but as the dose reaches to the order of 10$^4$rontgen, it attains five levels as observed in the TL glow curves. The five trap depths are determined from the glow peak temperatures for two different heating rates, $\theta$=6.6$^{\circ}C$/sec and 3.4$^{\circ}C$/sec. The electron trap depths have the following values E$_1$=0.79 eV, E$_2$=0.93 eV, E$_3$=1.02 eV, E$_4$=1.35 eV, E$_{5}$=1.69eV. The special feature of thermoluminescence of optical grade LiF is that the traps, except E$_1$and E$_2$corresponding to 12$0^{\circ}C$ glow peak and 15$0^{\circ}C$ glow peak for $\theta$=6.6$^{\circ}C$/sec, have severe thermal instability, namely E$_3$, E$_4$and E$_{5}$ levels disappear during bleaching process. These defects in the optical grade LiF crystal seem annealed out during the course of TL measurement. The fresh or long time unused LiF(Mg) crystal shows only two glow peaks at 17$0^{\circ}C$ and 23$0^{\circ}C$ for $\theta$=6.6$^{\circ}C$/sec, but upon sensitization with r-ray irradiation, it converts to the six glow peak state. The four electron traps, E$_1$, E$_2$, E$_3$, and E$_{6}$ created by r-ray irradiation and corresponding to the glow peaks at T=10$0^{\circ}C$ 13$0^{\circ}C$, 15$0^{\circ}C$ and 29$0^{\circ}C$ are stable and not easily annealed out thermally, The sensitization essentially required to LiF(Mg) dosimeter is to give the crystal the stable six levels in the electron trap. In optical grade LiF, the plot between logarithm of total TL output versus logarithm of r-ray dose gives more supra-linear feature than that of LiF(Mg). However, if one takes the height of 12$0^{\circ}C$ glow peak(S=6.6$^{\circ}C$/sec), instead of the total TL output, the curve becomes close to that of LiF(Mg).

• Journal of Chest Surgery
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• v.37 no.4
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• pp.313-321
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• 2004

Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (＞30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.293-298
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• 2010

Purpose: The objective of the present study was to determine the capability of electrospun silk fibroin as a biomaterial template for bone formation when mixed with nano-hydoxyapatite in vivo. Materials and Methods: Ten New Zealand white rabbits were used for this study and bilateral round shaped defects were formed in the parietal bone (diameter: 8.0 mm). The electrospun silk fibroin was coated by nano-hydroxyapatite and grafted into the right parietal bone (experimental group). The left side (control group) did not receive a graft. The animals were sacrificed at 6 weeks and 12 weeks, humanly. The microcomputerized tomogram (${\mu}CT$) was taken for each specimen. Subsequently, they were undergone decalcification and stained for the histological analysis. Results: The average value of all measured variables was higher in the experimental group than in the control at 6 weeks after the operation. BMC in the experimental group at 6 weeks after operation was $48.94{\pm}19.25$ and that in the control was $26.17{\pm}16.40$ (P = 0.027). BMD in the experimental group at 6 weeks after operation was $324.59{\pm}165.24$ and that in the control was $173.03{\pm}120.30$ (P = 0.044). TMC in the experimental group at 6 weeks after operation was $19.50{\pm}6.00$ and that in the control was $10.52{\pm}6.20$ (P = 0.011). TMD in the experimental group at 6 weeks after operation was $508.88{\pm}297.57$ and that in the control was $273.54{\pm}175.91$ (P = 0.06). Gross image of both groups showed higher calcification area at 12 weeks than them in 6 weeks. The average value of ${\mu}CT$ analysis was higher at 12 weeks than that in 6 weeks in both groups. BMC in the experimental group at 12 weeks after operation was $51.21{\pm}8.81$ and that in the control was $33.47{\pm}11.13$ (P = 0.010). BMD in the experimental group at 12 weeks after operation was $323.39{\pm}21.54$ and that in the control was $197.75{\pm}76.23$ (P = 0.012). TMC in the experimental group at 12 weeks after operation was $21.44{\pm}5.30$ and that in the control was $13.31{\pm}4.17$ (P = 0.008). TMD in the experimental group at 12 weeks after operation was $524.47{\pm}19.37$ and that in the control was $299.60{\pm}136.20$ (P = 0.016). Conclusion: The rabbit calvarial defect could be successfully repaired by electrospun silk nano-fiber combined with nano-hydroxyapatite.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.24-31
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• 2008

Purpose: We purposed to analyze the incidence and the patterns of the injuries associated with anterior cruciate ligament(ACL) tears. Materials and Methods: We retrospectively reviewed 547 knees that had undergone ACL reconstructions and compared the associated injuries according to the time of injury(acute vs. chronic), the cause of injury(sports vs. non-sports) and the type of sports. Results: Medial collateral ligament(MCL) injury and bone contusion were more in acute injury group less than 3 months after trauma(p=0.001, 0.019) and the injuries of medial or lateral meniscus were more in chronic injury group more than 3 months after trauma(p=0.014, 0.029). The trochlea in acute injury group(p=0.027) and the medial femoral condyle in chronic injury group(p=0.011) had higher incidence of chondral injury. Grade I, II chondral injury was frequent in acute injury group(p=0.016) and grade III, IV chondral injury was frequent in chronic injury group(p=0.017). Lateral meniscus injury was frequent in sports injury group(P=0.035). Medial collateral ligament injury was frequent in ski(P=0.005), and chondral injury was in gymnastics(P=0.017). Conclusions: The incidences of medial and lateral meniscus tears and grade III, IV chondral defects were high in chronic injury group. According to the causes of the tears and the types of sports, some differences in the incidence and pattern of associated injuries were found.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.232-241
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• 1997

The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.